Bromelain is not actually a single substance, but rather a collection of protein-digesting enzymes (also called
What Is Bromelain Used for Today?
Bromelain (often in combination with other proteolytic enzymes
Other proposed uses of bromelain include chronic venous insufficiency (closely related to
Bromelain is definitely useful as a digestive enzyme. Unlike most digestive enzymes, bromelain is active both in the acid environment of the stomach and the alkaline environment of the small intestine.
Bromelain may also increase the absorption of various drugs, particularly antibiotics such as amoxicillin and tetracycline. This could offer both risks and benefits.
Bromelain is widely available in groceries as a meat tenderizer.
What Is the Scientific Evidence for Bromelain?
While most large enzymes are broken down in the digestive tract, those found in bromelain appear to be absorbed whole to a certain extent. 11-13
Injury and Surgery
The evidence for bromelain as a treatment for injuries and surgeries is mixed.
In a double-blind controlled trial, 95 patients undergoing treatment for cataracts were given 40 mg of bromelain or placebo (along with other treatments) 4 times daily for 2 days prior to surgery and 5 days post-operatively.
A somewhat informal controlled study of 146 boxers suggested that bromelain helps bruises to heal more quickly.
People who engage in intense exercise to which they are not accustomed may experience a set of symptoms called delayed onset muscle soreness (DOMS), consisting of pain, reduced flexibility, and weakness of the muscles involved. Bromelain has been proposed for this condition, but a small double-blind, placebo-controlled study failed to find it effective.
In a double-blind trial, 48 patients with moderately severe to severe
Benefits were also seen in two other studies enrolling a total of more than 100 individuals with sinusitis.
Recommended dosages of bromelain vary with the form used. Due to the wide variation, we suggest following label instructions.
Bromelain appears to be essentially nontoxic, and it seldom causes side effects other than occasional mild gastrointestinal distress or allergic reactions. 41
However, because bromelain "thins" the blood to some extent, it shouldn't be combined with drugs such as
According to one small
Safety in young children, pregnant or nursing women, or those with liver or kidney disease has not been established.
10. Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn. 1972;19:147-153.
17. Pirotta F, De Giuli-Morghen C. Bromelain—a deeper pharmacological study. Note I. Antiinflammatory and serum fibrinolytic activity after oral administration in the rat. Drugs Exp Clin Res . 1978;4:1-20.
23. Metzig C, Grabowska E, Eckert K, et al. Bromelain proteases reduce human platelet aggregation in vitro, adhesion to bovine endothelial cells and thrombus formation in rat vessels in vivo. In Vivo. 1999;13:7-12.
30. Barrett AJ, Starkey PM. The interaction of alpha 2-macroglobulin with proteinases. Characteristics and specificity of the reaction, and a hypothesis concerning its molecular mechanism. Biochem J. 1973;133:709-724.
35. Gylling U, Rintala A, Taipale S, et al. The effect of a proteolytic enzyme combinate (bromelain) on the postoperative oedema by oral application. A clinical and experimental study. Acta Chir Scand. 1966;131:193-196.
43. Brakebusch M, Wintergerst U, Petropoulou T, et al. Bromelain is an accelerator of phagocytosis, respiratory burst and killing of Candida albicans by human granulocytes and monocytes. Eur J Med Res. 2001;6:193-200.
45. Seltzer AP. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain): a controlled study of 53 rhinoplasty cases. Eye Ear Nose Throat Mon. 1962;41:813-817.
Last reviewed April 2009 by EBSCO CAM Review Board
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