Bromelain benefits and side effects

Bromelain is a protein digestive enzyme found in pineapples that help people with reducing pain and inflammation.

It also helps with treating osteoarthritis and cardiovascular conditions, as well chronic inflammation and autoimmune diseases, diarrhea, post-surgery pain and inflammation and wound debridement (the removal of damaged tissue from a wound to aid in healing). It also holds the potential to be an effective cancer fighter (1).

Because of the anti-inflammation properties, it is found in many joint supplements.

Benefits

Pineapple has long been used as a medicinal plant in several native cultures, and several in vitro and in vivo clinical studies have shown that bromelain has a place in modern medicine to successfully treat several medical conditions.

While bromelain is found in the fruit and juice of the pineapple, its concentration is highest in the stem. Researchers have discovered that bromelain contains compounds and proteinases that provide anti-clotting, anti-edema and anti-inflammatory effects (2).

Bromelain may reduce pain and inflammation of osteoarthritis. At the conclusion of a six-week study in which 103 patients with osteoarthritis of the knee were given either diclofenac, an anti-inflammatory NSAID drug, or a combination treatment of bromelain, rutin (a bioflavonoid found in some fruits and vegetables) and trypsin (a digestive enzyme), the results showed that both treatments provided the same significant reduction in pain and inflammation (3).

It is believed that bromelain has a direct impact on pain mediators, thus bringing relief to arthritis pain sufferers. Researchers are hopeful that supplements of bromelain may prove to be a safer alternative to NSAIDs with fewer side effects.

Bromelain has a positive effect on cardiovascular health and circulation. An article published in 2012 in the Biotechnology Research International journal reported that bromelain plays a positive role in several areas of cardiovascular health and supplements may reduce certain risk factors that contribute to the development of coronary heart disease, stroke, elevated blood pressure and peripheral artery disease.

In addition to preventing or minimizing the severity of angina (chest pain or discomfort) and transient ischemic attack, this pineapple enzyme is helpful in the prevention and treatment of inflammation and blood clots in the veins (thrombophlebitis) and may be able to break down cholesterol plaques (4).

Bromelain has shown to be effective in the treatment of chronic inflammation. When used with other medications to treat acute nasal and sinus inflammation, bromelain has been shown to be helpful in relieving uncomfortable symptoms.

There is also evidence that oral therapy with bromelain provides pain and anti-inflammatory relief in those diagnosed with rheumatoid arthritis (5, 6).

When taken before surgery, it can mitigate post-surgery pain and inflammation and is often used for the treatment of sports-related inflammation and injuries. (7).

Bromelain aids in the healing of second-degree and third-degree burns. Bromelain contains escharase, a debriding agent that helps to remove damaged and dead tissue caused by severe burns and helps to facilitate skin wound healing.

Researchers have found that debridement using a preparation of topical bromelain is favored over surgical debridement as a way to prevent painful surgical incision, repeated anesthesia and significant bleeding (8).

Bromelain helps treat diarrhea. Animal studies show that bromelain has the ability to fight diarrhea caused by Vibrio cholera and E. coli, two types of bacteria responsible for intestinal infections (9).

Bromelain may play a role in fighting cancer. Some lab studies show bromelain’s potential to help fight cancer.

The results of a recent experiment in which chemically-induced skin papillomas in mice were treated with bromelain, demonstrated a reduction in tumor volume, reduced tumor formation and signs of cell death. Early studies show it can also inhibit metastatic growth (10).

Side Effects

Bromelain is generally safe to use and studies show that it is well absorbed in the body when taken orally and has no major side effects, even after prolonged use (11). Mild side effects may include stomach and intestinal discomfort and diarrhea (12). Allergic reactions may occur in individuals who have an allergy to pineapples or are allergic to latex, wheat, celery, papain, carrot, fennel, cypress pollen or grass pollen. (13).

According to the Heart Institute in Florida, due to its anti-clotting ability, it should not be taken with drugs that thin the blood such as warfarin (Coumadin), Plavix, aspirin and ibuprofen without a doctor’s supervision. Doing so could raise the risk of bruising and dangerous bleeding. Abnormally heavy or prolonged menstrual bleeding may also occur.

Bromelain may interact with certain antibiotics, such as amoxicillin, by increasing the amount absorbed by the body.

There is an increased risk of bleeding during and after surgery while taking bromelain.

Use in young children, pregnant or nursing women, or those with liver or kidney disease has not been established.

Dosage

While bromelain is naturally found in pineapples, eating the fruit is not enough to have a medicinal effect. That is when supplements come into play. Bromelain is sold in tablet or capsule form, and it may be used alone or in combination with other ingredients (14).  A topical cream is available, but is used for burn treatment under the care of a medical professional. Dosing depends on the condition being treated, the health of the user and individual factors such as underlying health conditions. As with any supplement, consult with your physician before taking it and for guidance on the proper dosage. The following are general guidelines:

For osteoarthritis: a combination product, called Phlogenzym, which contains rutin, trypsin and bromelain, is taken three times a day.  (15).

For swelling, the recommended dosage ranges from 80 mg to 320 mg of extract taken two to three times a day (16).

Recap

Bromelain is a protein-digesting enzyme found in the stem and juice of pineapples.

Bromelain has been shown to provide many therapeutic benefits, especially when it comes to treating inflammation, mitigating post-surgery pain and swelling and healing second- and third-degree burns.

It also shows promise in the treatment of cardiovascular health, certain cancers, diarrhea and blood clots. It is generally well absorbed in the body and there have been no reports of major side effects even after prolonged use. Minor side effects include stomach and intestinal discomfort and allergic reaction.

Research and further clinical studies are ongoing and many in the medical community are excited for its potential to fight many medical conditions.

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