Bromelain is made from enzymes found in pineapple juice and plant stems (1). Bromelain has historically been used as a folk remedy for burns and wounds. It has a large degree of uses. For instance, it aids digestion when taken orally it. It is both a natural pain reliever and a natural anti-inflammatory (2). It is believed to be as effective as NSAIDs/non steroidal anti-inflammatory medication (5). It slows swelling, blood clotting, and the growth of tumors, and is a natural blood thinner.
How bromelain works:
Bromelain assists with digestion and disorders of the digestive tract. It is an enzyme which digests protein, vitamins, and minerals. So, by improving the breakdown and absorption of nutrients, bromelain it improves health. It can also assist with healing problems in the bowels, like Crohn’s disease, constipation, and indigestion.
Irritable bowel disease/IBD can help to treat inflammatory bowel disease. An animal study showed that bromelain can help suppress IBD associated inflammation. Here bromelain was shown to reduce the severity and incidence of spontaneous (not lab induced) colitis. Bromelain also lowered significantly the severity of inflammation in the colon in these animals, according to histology reports. It is believed that these results were due to bromelains anti-inflammatory effects (21). In a study involving taking biopsied tissues from people with irritable bowel diseases (inflammatory bowel disease or IBD, Crohn’s disease or CD), and from people who were healthy. The tissues were then treated with bromelain in Petri dishes. The treated tissues experienced a reduction in the secretion of pro-inflammatory disease-causing factors. The concluding of the study was that bromelain may be a new or novel therapy for irritable bowel disease (22).
Diarrhea and intestinal issues are improved by bromelain. Bromelain can counter the effects of E. coli (Escherichia coli) and Vibrio cholera, and reduce diarrhea. It does this in two ways, firstly by reducing the ability of the bacteria to stick to cell receptor sites on the walls of the intestines; and secondly, by disrupting the cell signals that lead to the secretion of too much liquid by the intestines, which can cause symptoms of diarrhea (23).
Bromelain can improve allergies. It does this by moderating the immune response, and by blocking the activity of cells (called DC44 antigen-presenting cells). Bromelain also improves the functioning of (modulates) cells that link the part of the immune system that changes in reaction to challenges, called the adaptive immune response, with the part of the immune system that remains static or unchanged, called the innate immune response (called CD 11c dendritic cells). so, bromelain helps both the initiate immune response and the adapt the immune system in better addressing threats. In this way it can improve or slow allergic reactions/responses like nasal congestion, itchy eyes, rashes, and runny nose.
Sinusitis involves chronic inflammation of the sinuses. A small study of 12 people who had sinus surgery showed that those treated with bromelain for three months had better post surgery tests (rhinoscopy results), a great improvement in their symptoms, and reported an improved quality of life. Some research shows that bromelain can help reduce sinusitis related nasal mucus and coughing, and hay fever related swelling and inflammation (19).
Asthma can be improved with bromelain. Bromelain reduces inflammation of the airway, reduces swelling in the bronchi and bronchioles, and lowers mucus production (3). This last helps decrease any obstruction of airways. In an animal study bromelain was shown to have significant anti-inflammatory activity in the subjects’ respiratory passages. These animals also had lower numbers of pro-inflammatory enzymes etc. in their blood streams (eosinophil, leukocyte, and cellular infiltrate counts, as well as BAS CD8+ T and CD4+ cells, and interleukins IL-4, IL-12, IL-17, and IFN-a). At the same time no damage was done to healthy cells (3).
Urinary tract infections: when mixed with antibiotics bromelain boosted their effect on UTIs (4).
Osteoarthritis: bromelain helps treat osteoarthritis because it is anti-inflammatory in nature, and arthritis is a disease of inflammation (5). Arthritis is often related to age. It both chronic and progressive (worsening) in nature. It gradually reduces movement as bone related pain increases. It causes the loss of joint mobility and can impact life quality. Bromelain assist with osteoarthritis in three ways. It is analgesic (pain relieving). It helps to protect joint cartilage from damage, so slows the progression of arthritis. It can diminish inflammation related swelling and damage to joints. So, bromelain can be a good alternative to pain medication, which can have side effects (liver and kidney damage). Research has shown bromelain to be as effective as drugs used to treat arthritis related pain. Called NSAID or non-steroidal anti-inflammatory drugs. At higher doses (945 mg per day) bromelain has been shown, in human trials, to have a similar impact to prescription anti-inflammatory diclofenac. And, an even higher dose, 1890 gm per day was shown to have a greater impact than this medication on joint swelling (6). Some preliminary research suggests that bromelain can also reduce pain related to rheumatoid arthritis, but it is preliminary at this stage (19).
Heart/stroke: Bromelain slows or inhibits the build up of blood platelets, called platelet aggregation. This can cause clotting or thrombosis. It has the ability to prevent blood clot from growing and becoming problematic, called a fibrinolytic ability (6).
Skin: Bromelain stimulates wound healing. Its anti-inflammatory ability is one reason it is used to heal wounds (7). It also helps to clean skin wounds and remove dead, infected, thickened or callused skin. This is called debridement of skin. The enzymes from pineapple are of a class needed for proper cell division, so they are important for tissues health (8). When used topically (on skin) bromelain-based cream, with 35% bromelain, has been shown to eliminated debris from burns and to speed up wound healing (9). Bromelain, in clinical trials, has been effective in treating the skin condition pityriasis lichenoides chronica. This condition involves lesions that can be long-lasting. The cause of this disease is unknow. Treating it is problematic and results are inconsistent. A small study involving giving bromelain orally (by mouth) to eight people (three males/five females) resulted in all eight subjects going into remission. The study involved giving the subjects 40 mg of bromelain three times per day for one month. Followed by giving 40 mg two times per day for one month. And, giving the subjects 40 mg once per day for the final month. Two subjects had a relapse after five or six months, but this went away after they took bromalin for another three months, and on the same dosage schedule. This result was believed to be due to bromelain’s anti-inflammatory, anti-viral, and immunomodulatory effects (10).
Bromelain assists with keeping skin looking young (14). It can help to renew cells, whiten skin, and reduce the appearance of cellulite. Bromelain’s anti-inflammatory properties means that it can reduce the inflammation associated with red, irritated skin. Bromelain’s ability to reduce swelling also means that it can reduce age related eye puffiness. Bromelain is an exfoliant. It can break down proteins holding dead skin cells together. But, as bromelain doesn’t penetrate as deeply, it is less of an irritant.
you can make a face mask from pineapple by blending it until it is creamy. Then spread it over your face and neck, avoiding eyes. Leave the mask on for five minutes and then wash your face etc. with cool water.
you can also break open a bromelain capsule and mix the powder into your night cream once and a while. it will feel tight and dry, but your skin will glow when this is washed off.
Hair: health and length may be improved with bromelain. Bromelain is believed to improve protein absorption by the body (20). Hair is made from protein, so if the body is breaking it down and absorbing it in greater amounts, it will improve all bodily systems, including hair.
Varicose veins: may be managed better when taking bromelain. This condition involves the walls of veins becoming lax/relaxed, and the veins becoming larger and bulging. Bromelain can reduce the damage done to the veins and sustain the elasticity in them.
Cancer: Bromelain is being considered as an adjunct or add on therapy for cancer (11). for instance, it disrupts the growth of malignant/cancerous cells (12). Animal research and human research (breast cancer) demonstrated bromelain’s ability to slow or even stop tumors. This effect was dose dependent, with the animals absorbing 40% of the bromelain they consumed through their intestinal tract. These animals also experienced a reduction in both swelling (antiedematous) and inflammation. Bromelain has also been shown to inhibit experimentally induced tumors in animals, predominantly dose dependently, and exhibit antiedematous and anti-inflammatory activity (13). Bromelain has the ability to modulate the way the immune system interacts with tumor causing properties, called immune-cytotoxicity. Here substances called monocytes act to fight tumor cells, and they stimulate enzymes that help kill tumor cells called cytokines (11).
Dental health: Bromelain, when taken by mouth, can reduce swelling/edema, as well as pain and bruising in dental treatments. It also stimulates healing and reduces healing time after dental work. It is best to take Bromelain both before and after treatment (15;16).
Bone: Bromelain is known to help accelerate healing of bone fractures. When it was mixed into a proteolytic enzyme formula (rutin and trypsin) and given to people healing from fractures of the long bone these patients healed faster. They also reported less pain and needing less pain medication (17).
Bromelain can improve antibiotics ability to work (18), it may also benefit those suffering from bronchitis and angina (19).
Interactions and precautions: consult a health care provider before taking.
Don’t take bromelain if you are taking any of the following (19):
Antibiotics, the amount of which is absorbed may be increased by bromelain.
Blood thinning medications like antiplatelet and anticoagulant medications (Warfarin/Coumadin, Clopidogrel/Plavix, or aspirin). Bromelain can reduce blood’s clotting ability, so it can increase bleeding.
Sedatives: bromelain magnify the effect of the following: Alcohol, Anti-depressants (tricyclics like amitriptyline/Elavil), anti-seizure medications (Dilantin/phenytoin and Depakote/valproic acid). barbiturates, benzodiazepines (Xanax/alprazolam or Valium/diazepam), herbs (catnip, kava, valerian), and insomnia medications (Rozerem/ramelteon and Lunesta).
Bromelain side effects: are usually mild like loose bowel movements or abdominal distress. Rare reactions (usually in those with established allergies) include skin rashes, itching and hives, as well as breathing problems and swelling in the throat and face; diarrhea, nausea, and vomiting; and in younger women, increased menstrual flow. Keep in mind that bromelain can thin the blood and so increase the risk of bleeding during surgery. It is advised that if taking bromelain, it be stopped at least two weeks prior to surgery (19).
Bromelain should be avoided if you have one or more of the following: a bleeding disorder or high blood pressure; a kidney or liver disease; are pregnancy; or have an allergy to the following: carrots, celery, fennel, Latex, papain, pineapple, pollen (grass and cypress), or wheat (19).
Dosage: bromelains effect is dose dependent, and different conditions and different people may need different doses. It has been shown to be affective starting at 160 mg per day, with the therapeutic action toping out at 2000 mg per day. The last should be divided throughout the day. Bromelain should be taken on an empty stomach, so either before a meal or between meals.
Allergies: 500 mg twice a day Arthritis/joint pain: 500-1000 mg twice a day
Cancer: 1000 mg twice per day
Digestion: 250 mg, twice a day
Injuries: 500 mg, four times a day Surgery/wound recovery: 1000 mg twice per day.
1 MacKay, D., & Miller, A.L., (2003). Nutritional support for wound healing. Altern Med Rev.,8(4):359-77. PMID: 14653765.
2 Graf, J., (2000). Herbal anti-inflammatory agents for skin disease. Skin Therapy Lett.,5(4):3-5. PMID: 10785407.
3 Secor, E.R., Jr., Shah, S.J., Guernsey, L.A., Schramm, C.M., & Thrall, RS., (2012). Bromelain limits airway inflammation in an ovalbumin-induced murine model of established asthma. Altern Ther Health Med.,18(5):9-17. PMID: 22894886.
4 Mori, S., Ojima, Y., Hirose, T., Sasaki, T., & Hashimoto, Y., (1972). The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstetrica et Gynaecologica Japonica., 19(3):147–153.
5 Brien, S., Lewith, G., Walker, A., Hicks, S. M., & Middleton, D. (2004). Bromelain as a Treatment for Osteoarthritis: a Review of Clinical Studies. Evidence-based Complementary and Alternative Medicine: eCAM, 1(3), 251–257. DOI: https://doi.org/10.1093/ecam/neh035.
6 Taussig, S.J, & Batkin, S., (1988). Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J. Ethnopharmacol., 22(2):191-203. DOI: 10.1016/0378-8741(88)90127-4. PMID: 3287010.
7 MacKay, D., & Miller, A.L., (2003). Nutritional support for wound healing. Altern Med Rev.,8(4):359-77. PMID: 14653765.
8 Mótyán, J. A., Tóth, F., & Tőzsér, J. (2013). Research applications of proteolytic enzymes in molecular biology. Biomolecules, 3(4), 923–942. https://doi.org/10.3390/biom3040923.
9 Altern. Med. Rev. 1998; 3:302–5.
10 Massimiliano, R., Pietro, R., Paolo, S., Sara P., & Michele, F., (2007). Role of bromelain in the treatment of patients with pityriasis lichenoides chronica. J Dermatolog. Treat.,18(4):219-22. DOI: 10.1080/09546630701299147. PMID: 17671882.
11 Maurer, H.R., (2001). Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci.,58(9):1234-45. DOI: 10.1007/PL00000936. PMID: 11577981). It disrupts the growth of malignant/cancerous cells.
12 Taussig, S.J, & Batkin, S., (1988). Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J. Ethnopharmacol., 22(2):191-203. DOI: 10.1016/0378-8741(88)90127-4. PMID: 3287010.
13 Grabowska, E., Eckert, K., Fichtne,r I., Schulze-Forster, K., Maurer, H., (1990). Bromelain proteases suppress growth invasion and lung metastasis of B16F10 mouse melanoma cells. Planta Med., 56: 249-53.
14 Lourenço, C.B., Ataide, J.A., Cefali, L., Novaes, L.C., Moriel, P., Silveira, E., Tambourgi, E.B., & Mazzola, P.G., (2016). Evaluation of the enzymatic activity and stability of commercial bromelain incorporated in topical formulations. Int J Cosmet Sci.,38(5):535-40. DOI: 10.1111/ics.12308. Epub 2016 Mar 16. PMID: 26833020.
15 Tassman, G.C., Zafran, Z.N., & Zayon, G.M., (1965). A double-blind crossover study of a plant proteolytic enzyme in oral surgery. J. Dent. Med., 20:51–4.
16 Tassman, G.C., Zafran, Z.N., & Zayon, G.M., (1964). Evaluation of a plant proteolytic enzyme for the control of inflammation and pain. J. Dent. Med.,19:73–7.
17 Kamenícek, V., Holán, P., Franĕk, P., (2001). Systémová enzymoterapie v lécbĕ a profylaxi poúrazových a pooperacních otoků [Systemic enzyme therapy in the treatment and prevention of post-traumatic and postoperative swelling]. Acta Chir Orthop Traumatol Cech.,68(1):45-9. Czech. PMID: 11706714.
18 Bromelain. (1998). Altern Med Rev.,3(4):302-5. PMID: 9734239.
19 Mount Sinai Hospital, Bromelain, Ananas comosus; Bromelainum. Accessed at: https://www.mountsinai.org/health-library/supplement/bromelain.
20 Castell, J.V., Friedrich, G., Kuhn, C.S., & Poppe, G.E., (1997). Intestinal absorption of undegraded proteins in men: presence of bromelain in plasma after oral intake. Am J Physiol., 273(1 Pt 1): G139-46. DOI: 10.1152/ajpgi.1997.273.1. G139. PMID: 9252520
21 Hale, L.P., Greer, P.K., Trinh, C.T., & Gottfried, M.R., (2005). Treatment with oral bromelain decreases colonic inflammation in the IL-10-deficient murine model of inflammatory bowel disease. Clinical Immunology, 116(2): 135-142. DOI: https://doi.org/10.1016/j.clim.2005.04.011.
22 Onken, J.E., Greer, P.K., Calingaert, B., & Hale, L.P., (2008). Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro. Clinical Immunology, 126(3):345-352. DOI: https://doi.org/10.1016/j.clim.2007.11.002.
23 Pavan, R., Jain, S., Shraddha, & Kumar, A. (2012). Properties and therapeutic application of bromelain: a review. Biotechnology Research International, 2012, 976203. DOI: https://doi.org/10.1155/2012/976203.
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