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Search Health Information    Bromelain

Bromelain

Uses

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

This supplement has been used in connection with the following health conditions:

Used for Why
3 Stars
Sinusitis
3,000 MCU three times per day
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Bromelain , an enzyme derived from pineapple, has been reported to relieve symptoms of acute sinusitis. In a double-blind trial, 87% of patients who took bromelain reported good to excellent results compared with 68% of those taking placebo.1 Other double-blind research has shown that bromelain reduces symptoms of sinusitis.2 , 3 Research with bromelain for sinusitis generally uses the enteric-coated form. Enteric-coating prevents the stomach juices from partially destroying the bromelain. Most commercially available bromelain products today are not enteric-coated, and it is not known how the potency of these different products compares.

Studies conducted in the past have used bromelain compounds with therapeutic strengths measured in units called Rorer units (RU). Potency of contemporary bromelain compounds are quantified in either MCUs (milk clotting units) or GDUs (gelatin dissolving units); one GDU equals 1.5 MCU. One gram of bromelain standardized to 2,000 MCU would be approximately equal to 1 gram with 1,200 GDU of activity, or 8 grams with 100,000 RU of activity. Physicians sometimes recommend 3,000 MCU taken three times per day for several days, followed up by 2,000 MCU per day.4 Much of the research conducted has used smaller amounts likely to be the equivalent (in modern units of activity) of approximately 500 MCU taken four times a day.

3 Stars
Sprains and Strains
4 to 8 tablets a day of bromelain
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Several preliminary trials have reported reduced pain and swelling, and/or faster healing in people with a variety of conditions using either bromelain,5 papain from papaya, 6 , 7 or a combination of trypsin and chymotrypsin.8 Double-blind trials have reported faster recovery from athletic injuries, including sprains and strains, and earlier return to activity using eight tablets daily of trypsin/chymotrypsin,9 , 10 , 11 , 12 four to eight tablets daily of papain,13 eight tablets of bromelain (single-blind only),14 or a combination of these enzymes.15 However, one double-blind trial using eight tablets per day of trypsin/chymotrypsin to treat sprained ankles found no significant effect on swelling, bruising , or overall function.16

Bromelain is measured in MCUs (milk clotting units) or GDUs (gelatin dissolving units). One GDU equals 1.5 MCU. Strong products contain at least 2,000 MCU (1,333 GDU) per gram (1,000 mg). A supplement containing 500 mg labeled “2,000 MCU per gram” would have 1,000 MCU of activity, because 500 mg is half a gram. Some doctors recommend 3,000 MCU taken three times per day for several days, followed by 2,000 MCU three times per day. Some of the research, however, uses smaller amounts, such as 2,000 MCU taken in divided amounts in the course of a day (500 MCU taken four times per day).

3 Stars
Wound Healing
3,000 MCU (2,000 GDU) three times per day for several days, followed by 2,000 MCU three times per day
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Supplementation with bromelain , an enzyme derived from pineapple stem, prior to and following a surgical procedure has been shown to reduce swelling, bruising, healing time, and pain.17 Bromelain supplementation has also been shown to accelerate the healing of soft-tissue injuries in male boxers.18 The amount of bromelain used in these studies was 40 mg four times per day, in the form of enteric-coated tablets. Enteric-coating prevents the stomach acid from partially destroying the bromelain. Most currently available bromelain products are not enteric-coated, and it is not known if such products would be as effective as enteric-coated bromelain.

2 Stars
Prostatitis
2,000 to 9,000 mcu per day
Learn More

Quercetin , a flavonoid with anti-inflammatory and antioxidant effects, has recently been reported to improve symptoms of NBP and PD. An uncontrolled study reported that 500 mg of quercetin twice daily for at least two weeks significantly improved symptoms in 59% of men with chronic prostatitis.19 These results were confirmed in a double-blind study, in which similar treatment with quercetin for one month improved symptoms in 67% of men with NBP or PD.20 Another uncontrolled study combined 1,000 mg per day of quercetin with the enzymes bromelain and papain , resulting in significant improvement of symptoms.21 Bromelain and papain promote absorption of quercetin and have anti-inflammatory effects as well.22

2 Stars
Tendinitis
2,000 to 9,000 mcu per day
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Bromelain , a proteolytic enzyme, is an anti-inflammatory agent and for this reason is helpful in healing minor injuries, particularly sprains and strains , muscle injuries, and the pain , swelling, and tenderness that accompany sports injuries.23 , 24 , 25

2 Stars
Urinary Tract Infection
400 mg daily
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The proteolytic enzymes , bromelain (from pineapple) and trypsin may enhance the effectiveness of antibiotics in people with a UTI. In a double-blind trial, people with UTIs received antibiotics plus either bromelain/trypsin in combination (400 mg per day for two days) or a placebo. One hundred percent of those who received the enzymes had a resolution of their infection , compared with only 46% of those given the placebo.26 This study used enteric-coated tablets. Enteric-coating prevents stomach acid from partially destroying the bromelain. Most commercially available bromelain products today are not enteric-coated, and it is not known if non-enteric coated preparations would be as effective.

1 Star
Angina
Refer to label instructions
Learn More

Bromelain has been reported in a preliminary study to relieve angina. In that study, 600 people with cancer were receiving bromelain (400 to 1,000 mg per day). Fourteen of those individuals had been suffering from angina. In all 14 cases, the angina disappeared within 4 to 90 days after starting bromelain.27 However, as there was no control group in the study, the possibility of a placebo effect cannot be ruled out. Bromelain is known to prevent excessive stickiness of blood platelets,28 which is believed to be one of the triggering factors for angina.

1 Star
Asthma
Refer to label instructions
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Bromelain reduces the thickness of mucus, which may be beneficial for those with asthma,29 though clinical actions in asthmatics remain unproven.

1 Star
Low Back Pain
4 to 8 tablets a day of proteolytic enzymes containing trypsin and chymotrypsin, and/or bromelain
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Proteolytic enzymes , including bromelain , papain, trypsin, and chymotrypsin, may be helpful in healing minor injuries because they have anti-inflammatory activity and are capable of being absorbed from the gastrointestinal tract.30 , 31 , 32 Several preliminary trials have reported reduced pain and swelling, and/or faster healing in people with a variety of conditions who use either bromelain33 , 34 , 35 or papain.36 , 37 , 38

1 Star
Rheumatoid Arthritis
Refer to label instructions
Learn More

Bromelain has significant anti-inflammatory activity. Many years ago in a preliminary trial, people with RA who were given bromelain supplements experienced a decrease in joint swelling and improvement in joint mobility.39 The amount of bromelain used in that trial was 20–40 mg, three or four times per day, in the form of enteric-coated tablets. The authors provided no information about the strength of activity in the bromelain supplements that were used. (Today, better quality bromelain supplements are listed in gelatin-dissolving units [GDU] or in milk-clotting units [MCU].) Enteric-coating protects bromelain from exposure to stomach acid. Most commercially available bromelain products today are not enteric-coated.

How It Works

How to Use It

Assessing the right amount of bromelain to take is complicated. Most bromelain research was conducted years ago, when amounts used were listed in units of activity that no longer exist. These old units do not precisely convert to new ones. Today, bromelain is measured in MCUs (milk clotting units) or GDUs (gelatin dissolving units). One GDU equals approximately 1.5 MCU. Strong products contain at least 2,000 MCU (1,200–1,333 GDU) per gram (1,000 mg). A supplement containing 500 mg labeled “2,000 MCU per gram” would have 1,000 MCU of activity. Some doctors recommend as much as 3,000 MCU taken three times per day for several days, followed by 2,000 MCU three times per day.40 Much of the research uses smaller amounts, more like the equivalent of approximately 500 MCU taken four times per day. However, most of the bromelain used in the studies was enteric-coated in order to prevent it from being destroyed by gastric juice. It is likely, therefore, that currently available bromelain preparations (which typically are not enteric-coated) are of lower potency than the bromelain used in most studies.

Where to Find It

Bromelain is found mostly in the stems of pineapples and is available as a dietary supplement.

Possible Deficiencies

Since bromelain is not essential, deficiencies of this plant-based enzyme do not exist.

Interactions

Interactions with Supplements, Foods, & Other Compounds

Because bromelain acts as a blood thinner and little is known about how bromelain interacts with blood-thinning drugs, people should avoid combining such drugs with bromelain in order to reduce the theoretical risk of excessive bleeding.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • Amoxicillin

    When taken with amoxicillin, bromelain was shown to increase absorption of amoxicillin in humans.41 When 80 mg of bromelain was taken together with amoxicillin and tetracycline , blood levels of both drugs increased, though how bromelain acts on drug metabolism remains unknown.42 An older report found bromelain also increased the actions of other antibiotics, including penicillin, chloramphenicol, and erythromycin , in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to these antibiotics did so after adding bromelain taken four times per day.43

    Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.

  • Erythromycin

    One report found bromelain improved the action of antibiotic drugs, including penicillin and erythromycin, in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to the antibiotics did so after adding bromelain four times per day.44 Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Penicillamine

    One report found bromelain improved the action of antibiotic drugs, including penicillin and erythromycin, in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to the antibiotics did so after adding bromelain four times per day.45 Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.

  • Penicillin V

    One report found bromelain improved the action of antibiotic drugs, including penicillin and erythromycin , in treating a variety of infections. In that trial, 22 out of 23 people who had previously not responded to the antibiotics did so after adding bromelain four times per day.46 Doctors will sometimes prescribe enough bromelain to equal 2,400 gelatin dissolving units (listed as GDU on labels) per day. This amount would equal approximately 3,600 MCU (milk clotting units), another common measure of bromelain activity.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required

  • Warfarin

    In theory, bromelain might enhance the action of anticoagulants. This theoretical concern has not been substantiated by human research, however.47

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

Bromelain is generally safe and free of side effects when taken in moderate amounts. However, one preliminary report indicates increased heart rate with the use of bromelain.48 In addition, some people are allergic to bromelain. One woman reportedly developed a hives and severe swelling after taking bromelain, even though she had tolerated bromelain on two other occasions previously.49

References

1. Ryan R. A double blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache 1967;7:13–7.

2. Taub SJ. The use of bromelains in sinusitis: a double-blind evaluation. EENT Monthly 1967;46(3):361–5.

3. Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. EENT Monthly 1967;46(10):1281–8.

4. Gaby AR. The story of bromelain! Nutr Healing 1995;May:3, 4, 11.

5. Cirelli MG. Five years experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clin Med 1967;74(6):55–9.

6. Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;6:647–52.

7. Sweeny FJ. Treatment of athletic injuries with an oral proteolytic enzyme. Med Times 1963:91:765.

8. Boyne PS, Medhurst H. Oral anti-inflammatory enzyme therapy in injuries in professional footballers. Practitioner 1967;198:543–6.

9. Deitrick RE. Oral proteolytic enzymes in the treatment of athletic injuries: A double-blind study. Pennsylvania Med J 1965;Oct:35–7.

10. Rathgeber WF. The use of proteolytic enzymes (Chymoral) in sporting injuries. S Afr Med J 1971;45:181–3.

11. Buck JE, Phillips N. Trial of Chymoral in professional footballers. Br J Clin Pract 1970;24:375–7.

12. Tsomides J, Goldberg RI. Controlled evaluation of oral chymotrypsin-trypsin treatment of injuries to the head and face. Clin Med 1969;76(11):40.

13. Holt HT. Carica papaya as ancillary therapy for athletic injuries. Curr Ther Res 1969;11:621–4.

14. Blonstein JL. Oral enzyme tablets in the treatment of boxing injuries. Practitioner 1967;198:547.

15. Baumüller M. Therapy of ankle joint distortions with hydrolytic enzymes—results from a double blind clinical trial. In Hermans GPH, Mosterd WL, eds. Sports, Medicine and Health. Amsterdam: Excerpta Medica, 1990, 1137.

16. Craig RP. The quantitative evaluation of the use of oral proteolytic enzymes in the treatment of sprained ankles. Injury 1975;6:313–6.

17. Tassman G, Zafran J, Zayon G. A double-blind crossover study of a plant proteolytic enzyme in oral surgery. J Dent Med 1965;20:51–4.

18. Blonstein J. Control of swelling in boxing injuries. Practitioner 1960;203:206.

19. Shoskes DA. Use of the bioflavonoid quercetin in patients with longstanding chronic prostatitis. JANA 1999;2:36–9.

20. Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology 1999; 54:960–3.

21. Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology 1999; 54:960–3.

22. Izaka K, Yamada M, Kawano T, Suyama T. Gastrointestinal absorption and anti-inflammatory effect of bromelain. Jpn J Pharmacol 1972;22:519–34.

23. Seligman B. Bromelain: an anti-inflammatory agent. Angiology 1962;13:508–10.

24. Cirelli MG. Treatment of inflammation and edema with bromelain. Delaware Med J 1962;34:159–67.

25. Masson M. Bromelain in the treatment of blunt injuries to the musculoskeletal system. A case observation study by an orthopedic surgeon in private practice. Fortschr Med 1995;113:303–6.

26. 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;19:147–53.

27. Nieper H. Effect of bromelain on coronary heart diseases and angina pectoris. J Int Acad Prev Med 1976;3(2):62–3.

28. Heinicke R, van der Wal L, Yokoyama M. Effect of bromelain (Ananase) on human platelet aggregation. Experientia 1972;28:844–5.

29. Schafer A, Adelman B. Plasma inhibition of platelet function and of arachidonic acid metabolism. J Clin Invest 1985;75:456–61.

30. Seligman B. Bromelain: An anti-inflammatory agent. Angiology 1962;13:508–10.

31. Castell JV, Friedrich G, Kuhn CS, et al. Intestinal absorption of undegraded proteins in men: presence of bromelain in plasma after oral intake. Am J Physiol 1997;273:G139–46.

32. Miller JM. Absorption of orally introduced proteolytic enzymes. Clin Med 1968;75:35–42 [review].

33. Masson M. Bromelain in the treatment of blunt injuries to the musculoskeletal system. A case observation study by an orthopedic surgeon in private practice. Fortschr Med 1995;113(19):303–6.

34. Miller JN, Ginsberg M, McElfatrick GC, et al. The administration of bromelain orally in the treatment of inflammation and edema. Exp Med Surg 1964;22:293–9.

35. Cirelli MG. Five years experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clin Med 1967;74:55–9.

36. Vallis C, Lund M. Effect of treatment with Carica papaya on resolution of edema and ecchymosis following rhinoplasty. Curr Ther Res 1969;11:356–9.

37. Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;6:647–52.

38. Sweeny FJ. Treatment of athletic injuries with an oral proteolytic enzyme. Med Times 1963:91:765.

39. Cohen A, Goldman J. Bromelain therapy in rheumatoid arthritis. Pennsylvania Med J 1964;67:27–30.

40. Gaby AR. The story of bromelain. Nutr Healing May 1995:3, 4, 11.

41. Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exp Clin Res 1978;4:39–44.

42. Luerti M, Vignali M. Influence of bromelain on penetration of antibiotics in uterus, salpinx and ovary. Drugs Exp Clin Res 1978;4:45–8.

43. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143–60.

44. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143–60.

45. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143–60.

46. Neubauer RA. A plant protease for potentiation of and possible replacement of antibiotics. Exp Med Surg 1961;19:143–60.

47. Harris JE. Interaction of dietary factors with oral anticoagulants: Review and applications. J Am Diet Assoc 1995;95:580–4.

48. Gutfreund AE, Taussig SJ, Morris AK. Effect of oral bromelain on blood pressure and heart rate of hypertensive patients. Hawaii Med J 1978;37:143–6.

49. Nettis E, Napoli G, Ferrannini A, Tursi A. IgE-mediated allergy to bromelain. Allergy 2001;56:257–8.

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