Serrapeptase: Post Minor Surgery Safety Guide

Written by Dr. Jewel Alfoure, ND

Serrapeptase, or what is commonly know as the miracle enzyme is quite a versatile proteolytic enzyme synthesized by the non-pathogenic enterobacteria Serratia mercens. It was first discovered as the enzyme that silkworms use to breakdown their scar-tissue-like cocoon. Though currently synthesized by cell cultures, Serrapeptase is still associated with silkworms in the minds of many1.

The "miracle" in Serrapeptase comes from its directly targeted proteolytic (breaking down) effect. As a proteolytic enzyme, it only targets scar tissue, dead tissue, dying tissue and inflammatory markers. Such functionality adds to the safety profile of the enzyme as it means that healthy tissues are not targeted by the breaking down function of the enzyme2.

As most illnesses have some form of inflammatory nature to them, research has demonstrated the effectiveness of Serrapeptase for many pain-related complaints including, but not limited to, rheumatoid arthritis, back pain, post surgical swelling, vascular engorgement conditions as well as atherosclerosis1. Though highly versatile and of considerable safety profile, Serrapeptase use with surgical interventions is advised to take place under medical supervision. The following are common considerations to talk to your naturopath about prior to initiating post-surgical Serrapeptase use:

  1. When should I start to take Serrapeptase?

  2. What should I expect from taking Serrapeptase?

  3. How much Serrapeptase should I take?

  4. When will I stop Serrapeptase?

  5. What conditions should I expect Serrapeptase to work for?

  6. When should I be cautious about when using Serrapeptase?

  7. Is it possible for a child to use Serrapeptase post-surgically?

The answers to those questions are highly variable as the starting physiology of the individual determines those answers, however, to empower you though the conversation with your healthcare provider, consider the following general tips:

For Surgical Interventions, When Should I Start Serrapeptase?

Serrapeptase is a fibrinogenolytic enzyme. This means that is breaks down something called fibrinogen, the precursor to fibrin. Fibrin is the mesh that holds down blood clots1. While there is a lot of negative talk about blood clotting, the coagulation cascade is actually an incredible physiological life-saver. Healthy coagulation is needed for optimal body function. Thus, prior to surgery, it is always advised to discontinue serrapeptase 2 weeks before surgery. If you have established the safety of serrapeptase for your  post surgical recovery, be sure to give your body at least 3 days after the surgery to form an adequate clotting response and then introduce serrapeptase into the system.

What should I expect from Serrapeptase?

Expect that Serrapeptase, if used correctly, will probably not feel like much as it enters the gastrointestinal tract. When the enzyme is taken on an empty stomach, it makes its way down the intestines and starts releasing in bursts as the layers of a delayed released capsule disintegrate. Upon being released, the enzyme crosses the gastrointestinal walls and disperses through the body. As the enzyme is really large it will take some time before it can reach deep tissues3. Upon finding a substrate (active site that it can latch on to) it will make a connection to catalyze (make faster)the break down of a bond1. Thus, it should expedite the natural process of healing by facilitating the breakdown of inflammatory molecules and helping with the process of remodeling scar tissue from its rough copies to its better copies. It will continue working until the body reaches the final desired condition4. Most research shows that Serrapeptase, post surgically should help with:

  • Decreasing swelling

  • Faster healing

  • Less inflammation

  • Less clotting

  • Less scarring

How much Serrapeptase should I use?

The amount of Serrapeptase that the body will utilize is directly proportional to the substrate (active sites) the body will provide the enzyme to latch on to. Any enzyme that has not found an inflammatory compound, fibrinogen molecule, or dead piece of tissue to latch on to, will remain in the blood stream until it naturally disintegrates1. Having no function for the enzyme, leaves it function-less until it disintegrates. Always ask your medical practitioner how much Serrapeptase you should use3. The generally recommended safe dose is a single 120 000SU capsule. Higher doses only produce an effect under the condition that the body can utilize them for breakdown1.

When should I stop Serrapeptase?

Serrapeptase will continue to play a role, post-surgery, as long as the body is building and remodeling scar tissue. It is thus advised, with the consultation of a medical practitioner, to continue to use Serrapeptase until complete healing has taken place and the scar of the surgery has taken its final shape5. The answer to that question of "how long?" is usually directly related to the size of the surgery and the magnitude of scarring/ inflammation that took place. It is always advised to discontinue the use of Serrapeptase in the case that a medical practitioner warns you of a major infection1,5,6. Any anti-inflammatory may mask important infection symptoms. Always consult a healthcare practitioner when using Serrapeptase after any surgical complications6.

Ask Your Naturopath About Serrapeptase If You Have (7)

Pain Issues

  • Back pain

  • Arthritis pain

  • Arthritic inflammation

  • Fibromyalgia

  • Carpel Tunnel

  • Tissue adhesions

  • Bursitis

Swelling Issues

  • Acute injury

  • Joint injury

  • Insect bite (fast acting)

  • Jaw swelling

  • Post-surgical swelling

  • Cystic acne swelling

Women's Issues

  • Fibrocystic breast changes

  • Breast cysts

  • Ovarian cysts

  • Vaginal cysts

  • Breast engorgement

  • Uterine fibroids

  • Endometriosis

Vascular issues

  • Migraine headaches

  • Atherosclerosis

  • Thrombophlebitis

  • Varicose veins

  • Hemorrhoids


  • Irritable Bowel Disease

  • Ulcerative colitis

  • Crohn's Disease

When Should I Be Cautious about Serrapeptase?

Be cautious about Serrapeptase when you are told that you have extreme inflammation. In the case of severe inflammation it is best to consult a healthcare practitioner and take the lowest dose possible of Serrapeptase so not to mobilize inflammatory markers too fast for the body to clear them.

Pro Tip: Taking Serrapeptase at the first site of an insect bite may reduce swelling potential and help break down the venom. Always continue for at least 7 days past the last sight of swelling!

Pro Tip: If you have an acne cyst that has been on your face for more than a week, try taking Serrapeptase for 7 days instead of picking at the cyst. This way, you can satisfy yourself by knowing that you may be dissolving the cyst internally!

Pro Tip: Taking Serrapeptase during ovulation (~Day 14 of the female cycle), for the limited period of 1 week may breakdown inflammatory markers enough to positively impact the upcoming period (lower pain and less clotting).

How do I know that the Serrapeptase is working?

Serrapeptase is a fast working enzyme, and it usually ends up working even faster if there is higher inflammation in the body, but the best quantitative way to find out if Serrapeptase is working is to ask for a CRP, ESR and Fibrinogen level blood work! Those markers should be taken prior to the surgery, post surgically and after two weeks of Serrapeptase use1.

Is it safe for children to take Serrapeptase post-surgically?

Serrapeptase supplements are not labeled for use for children, thus no one is advised to use them for children without the supervision of a qualified medical practitioner. Studies show that a dose of 5-30 mg of Serrapeptase (depending on weight and age) has been demonstrated to be safe and effective at reducing post-surgical swelling and pain for children. Some companies such as Enerex offer a 60,000 SU Serrapeptase product which is equivalent to a 30mg dose8.

What makes a high quality Serrapeptase supplement?

  • Undisturbed whole cell culture use

  • Delayed release capsule

  • No phthalates

  • Third party testing for potency and purity

Serrapeptase is Commonly Recommended with:

Post Smoke Exposure/ Quitting smoking - NAC 1000 + Serrapeptase

Inflammatory Arthritic Conditions - Enerex Free Flex + Serrapeptase

Blood Vessel Clearance - Ginkgo Biloba + Serrapeptase

Erectile Dysfunction due to Athrosclerosis - Satisfaction + Serrapeptase

Chronic UTIs (Biofilms) - Enerex UTI X + Serrapeptase


  1. Read, M. F., Leaders, V. S., VIP, U. T., & Lifestyle, D. F. Serrapeptase-A Natural Anti-Inflammatory.

  2. Ethiraj, S., & Gopinath, S. (2017). Production, purification, characterization, immobilization, and application of Serrapeptase: a review. Frontiers in biology12(5), 333-348.

  3. Yang, L., Yan, S., Zhang, Y., Hu, X., Guo, Q., Yuan, Y., & Zhang, J. (2018). Novel enzyme formulations for improved pharmacokinetic properties and anti-inflammatory efficacies. International journal of pharmaceutics537(1-2), 268-277.

  4. Shah, S. A., & Nerurkar, R. P. (2013). Evaluation of prescribing trends and rationality of use of oral proteolytic enzymes. Indian journal of pharmacology45(3), 309.

  5. Al-Khateeb, T. H., & Nusair, Y. (2008). Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. International journal of oral and maxillofacial surgery37(3), 264-268.

  6. Rajaram, P., Bhattacharjee, A., & Ticku, S. (2016). Serratiopeptidase–A cause for spread of infection. Journal of clinical and diagnostic research: JCDR10(8), ZD31.

  7. Bhagat, S., Agarwal, M., & Roy, V. (2013). Serratiopeptidase: a systematic review of the existing evidence. International Journal of Surgery11(3), 209-217.

  8. Willital, G. H., & Maragakis, M. (1989). Wound healing in posttraumatic and postoperative oedematous tissue: results of treatment with serrapeptase. Acta therapeutica15(4), 395-409.