Bromelain, found in pineapple extracts, is an anti-inflammatory enzyme. It helps reduce pain, has anti-cancer activity, and improves digestive health. In addition, it even helps with weight loss.
The science behind bromelain is fascinating. Read this post to learn more about bromelain benefits and side effects. We also include the dosage information below.
What is Bromelain?
Bromelain is a group of proteolytic enzymes (along with other compounds) extracted from the fruit or stem of pineapples (Ananas comosus). Proteolytic enzymes, or proteases, are protein-digesting enzymes that break down proteins into amino acids [1, 2].
Stem and fruit bromelain are prepared differently and contain varying amounts of these enzymes. Bromelain extracted from stems is more commonly used in studies because it has a higher protease content [1, 3].
It is important to note that eating pineapple does not produce the same health benefits as bromelain supplementation.
Enzymes and Components
The composition of bromelain depends on the method of purification and the source of the pineapple extract .
Fruit bromelain is prepared using cooled pineapple juice, which goes through ultra-filtration .
Stem bromelain is made when pineapple stems are centrifuged, filtered, lyophilized, and freeze-dried .
Bromelain is a mixture of different thiol endopeptidases, which are enzymes that break down proteins. It also contains other enzymes such as phosphatase, glucosidase, peroxidase, cellulase, escharase, and different protease inhibitors. Protease inhibitors stop the protease enzymes from breaking down proteins .
Bromelain’s anti-inflammatory action and inhibition of platelet aggregation are likely due to its protease (protein-digesting) activity. However, it inhibits tumor growth and helps heal burns by other means than digesting proteins .
Commercially available bromelain is evaluated according to its proteolytic activity and other effects on health, like its anti-inflammatory effects and tumor inhibition .
1.) Helps with Weight Loss
Bromelain helps with weight loss due to its effects on fat (adipose) tissue .
In rat cell cultures, stem bromelain administration inhibited the formation (differentiation) of fat cells. It does this by increasing genes (C/EBPα and PPARγ) that are needed for fat cell formation .
Additionally, TNF-α induces the breakdown of fats (lipolysis). All of these factors combined together help prevent and address obesity .
2.) Helps the Immune System
Bromelain supports healthy immune responses.
In mice cell cultures, bromelain both inhibited and enhanced T cell responses. Under normal conditions, bromelain enhanced the T cell response to help the immune system stay healthy. At the same time, it inhibited IL-2 production in mice. These conflicting effects are due to the different kinds of proteases in bromelain .
On the other hand, when T cells are inappropriately activated during autoimmune or infectious diseases, bromelain inhibits T cell activation. This helps to fight against immune diseases .
3.) Reduces Inflammation
Bromelain decreases the majority of pro-inflammatory mediators and is a powerful anti-inflammatory agent .
Cyclooxygenase-2 (COX-2) is a major contributor to inflammation. It helps with the synthesis of prostaglandin E2 (PGE-2), which is a pro-inflammatory fat (lipid). PGE-2 also suppresses the immune system and promotes tumor progression .
Bromelain reduces COX-2 and PGE-2 levels in mouse and human cell cultures .
When inflammation causes the overproduction of proinflammatory cytokines, bromelain reduces IL-1β, IL-6 and TNF-α secretion. For example, bromelain reduces IFN-γ and TNF-α production in inflammatory bowel disease (IBD) .
In mouse cell cultures, the proteases in bromelain inhibited ERK-2 transmission. This inhibition blocks cytokine production and helps prevent inflammation .
4.) Helps Stop Cancer Growth
Bromelain inhibits key pathways that are integral in supporting cancer growth. These include nuclear factor-kappa B (NF-κB), cyclooxygenase-2 (COX-2), mitogen-activated protein kinases (MAPKs), Akt, and prostaglandin E2 (PGE-2) pathways .
PGE-2 is a pro-inflammatory fat. PGE-2 suppresses the immune system and promotes tumor progression. Bromelain reduced PGE-2 levels in mouse and human cell cultures .
In mouse cell cultures, bromelain also inhibited ERK-2 transmission. This blocked the Ras and MAPK pathways, which helped stop inflammation and tumor growth .
The overproduction of NF-κB also promotes cancer progression. Bromelain treatment in both mice and mice tissues inhibited the MAPK and Akt/PKB pathways, thus inhibiting NF-κB. Meanwhile, bromelain also inhibited NF-κB by stopping the cell growth cycle in human cancer cells [9, 3].
Cancer and immune cells involved in cancer growth express the CD44 cell marker. Bromelain reduces CD44 cellular production on the surface of mouse and human tumor cells .
In another study, bromelain treatment on mouse skin tumors reduced tumor formation, tumor volume, and caused cancer cell death .
Treatment with bromelain reduced the ability of human brain tumor cells to migrate and invade other cells. Bromelain did not harm neighboring non-cancer cells .
Some tumor cells can surround themselves with platelets (tiny blood cells fragments) to prevent immune cells from recognizing them. Oral administration of bromelain reduces platelet count in humans. The ability to inhibit platelet activity can uncoat cancer cells and expose them to the immune system [12, 3].
5.) Helps Treat Arthritis
Bromelain’s anti-inflammatory activity helps treat rheumatoid arthritis, due to its ability to lower the production of TGF-β, a major contributor to inflammation in patients with the autoimmune disease .
A review of 10 studies found that bromelain administration had significantly positive effects in patients with knee osteoarthritis. It reduced tissue swelling, pain, and joint stiffness .
In a double-blind, randomized controlled trial (DB-RCT) of 103 patients, a combination of rutosid, trypsin, and bromelain helped safely treat knee osteoarthritis. The patients rated the combination as efficient at reducing pain as the painkiller drug Diclofenac. Additionally, it was safer and more tolerable than other arthritis medications .
While there is evidence for the potential of bromelain in treating different types of arthritis, further studies are needed. Scientists have yet to establish an optimum dosage and the efficacy of long-term use .
6.) Treats Allergy Symptoms
Bromelain’s anti-inflammatory activity helps treat allergies and sinus problems.
In a study (DB-RCT) of 50 acute sinusitis patients, the bromelain group had a greater improvement in their symptoms compared to the placebo group. The bromelain group had less nose inflammation and less difficulty breathing .
In another study, stem bromelain was efficient at treating 62 children with acute sinusitis. In comparison, 54 children treated with antibiotics or a combination therapy recovered slower than the bromelain group .
Bromelain also helped treat inflammation in a mouse model of allergic airway disease.
These results suggest that bromelain may be helpful in treating allergies, asthma and hypersensitivity disorders in humans .
7.) Reduces Pain and Swelling
Bromelain is effective in reducing pain in otherwise healthy patients. Besides treating arthritis, pineapple extract helps treat muscle soreness after exercise, mild pain, and pain after surgery.
Muscle pain and soreness are common in individuals after exercise. In a study (DB-RCT) of 20 healthy male participants, protease supplementation (containing bromelain and other enzymes) helped relieve muscle soreness after downhill running .
Moreover, in comparison to the placebo group, the protease group demonstrated better muscle recovery. Protease supplementation helped the participants’ muscles heal faster. This allowed for quicker restoration of function after intense exercise. These effects are likely due to the anti-inflammatory activity of bromelain and other protease enzymes .
However, in a study of 39 subjects, the administration of bromelain by itself had no effect on elbow pain and muscle dysfunction after exercise. This might be due to the low bromelain dosage, lack of proper control, and insufficient statistics .
In another study, one month of bromelain administration helped decrease pain and stiffness in 77 participants with mild knee pain. Both 200 mg and 400 mg doses of bromelain were efficient at improving physical function in the otherwise healthy subjects .
However, that study did not have a control group to compare results. There was also no blindness, meaning that the researchers could have been biased and affected the results .
Bromelain also helps reduce pain and swelling after dental surgery. In a randomized study (RT), bromelain was effective in reducing pain and swelling in 28 out of 40 oral surgery patients. Since there was no placebo group to compare to, the results of this study may not be conclusive .
8.) Improves Intestinal Health
Bromelain’s anti-inflammatory effects benefit the gut. It helps reduce the symptoms of various gut disorders.
In rabbit intestinal cell cultures, bromelain stopped the activity of various diarrhea-causing bacteria and toxins. Bromelain stops intestinal fluid secretion, which might make it useful as an anti-diarrhea drug .
In mice, bromelain administration inhibited spasms in the intestine. Additionally, these effects were stronger in mice with diabetes and inflammation than in healthy mice. Therefore, bromelain might be a good treatment for gut disorders .
In a mouse model of inflammatory bowel disease (IBD), bromelain administration helped decrease symptoms of the disease. It also decreased CD44 production in the mice, which helped reduce colon inflammation .
Cell cultures from the colon of IBD patients have high levels of pro-inflammatory cytokines. Bromelain administration into these cells inhibited cytokine production. This may translate into reduced inflammation in IBD patients .
Unfortunately, there are currently no clinical studies on the effect of bromelain on IBD in human subjects. However, there have been two case studies where bromelain administration helped improve colitis symptoms .
9.) Protects the Heart
Blood platelet aggregation occurs when blood cells clump together. This causes blood clots to form and increases the risk of heart disease. Bromelain administration stops blood platelet aggregation and prevents clot formation .
In one study, the incubation of different blood samples from 10 healthy volunteers with bromelain led to a significant decrease in platelet count. Even after scientists used drugs to induce platelet aggregation, the bromelain-treated blood samples had less blood platelet aggregation compared to the control samples .
Ischemia injuries can occur during heart attacks or stroke. In rats, bromelain administration protects the heart by limiting ischemia injuries. In rats, it was able to reduce heart cell death and improve recovery after a heart attack or stroke .
Bromelain reduces heart cell death and increases heart cell survival . (Technical: These effects may be due to the activation of the Akt-FOXO pathway. Bromelain activates Akt and phosphorylates it, which in turn phosphorylates FOXO3A).
10.) Helps Heal Skin
Pityriasis lichenoides chronica (PLC) is a skin disease with unknown causes. Eight PLC patients supplemented with bromelain for three months. Bromelain treatment was effective in treating all the patients, who all showed complete recovery .
Although two patients had a relapse in symptoms five to six months after suspension of therapy, a brief cycle of therapy stopped PLC symptoms again .
Since the causes of PLC are unknown, scientists are unsure of the mechanism behind bromelain’s ability to treat the disease. The protein-digesting, anti-inflammatory and antiviral effects attributed to the extract are possible explanations .
11.) Potentially Reduces the Risk of Alzheimer’s Disease
Beta-amyloid plaques are thought to be the main contributors to the onset of Alzheimer’s disease. A proteinase complex containing trypsin, alpha-chymotrypsin, and bromelain helps degrade beta-amyloid .
An analysis of human blood samples showed that oral administration of the proteinases reduced beta-amyloid levels in healthy subjects. The increase in beta-amyloid degradation may help reduce the risk of developing Alzheimer’s disease .
Drug and Supplement Interactions
Bromelain increases the uptake and absorption of heparin in rat intestines. Heparin is a blood thinner and can stop blood clots from forming. People taking heparin and bromelain at the same time should be careful because it may increase the risk of bleeding .
Bromelain thins the blood, so it should not be used concurrently with other blood-thinning medications such as Warfarin .
One should also be cautious about using it concurrently with another supplement that also thins the blood, such as fish oil.
Curcumin has a low rate of absorption. Hence, curcumin and bromelain are often formulated together to increase absorption and enhance the anti-inflammatory effects of each supplement .
Bromelain is also used to enhance the absorption of quercetin, a flavonoid with many health benefits .
Bromelain also increases the absorption of:
Caution and Side Effects
In order for the enzyme to be absorbed and to have anti-inflammatory effects, bromelain should be taken on an empty stomach away from meals. However, for some people, this may cause some stomach discomfort.
People who are allergic to pineapple should not take bromelain supplements. Bromelain may cause allergic reactions in some people .
Some common side effects include diarrhea, nausea, flatulence, headache, fatigue, and skin rash .
In human osteoarthritis studies, scientists used doses of bromelain in the range of 540 to 1890 mg/day. At lower doses, bromelain is safe and tolerable .
However, studies using higher doses have conflicting results. In one study, 1890 mg was well tolerated while another study using 945 mg reported more adverse effects .
Further long-term studies are needed to assess its safety.
- I have been chewing one Bromelain tablet after each meal for two weeks & the stomach pain is gone & no side effects.
- Seems to decrease congestion, stuffiness, and swelling in paranasal sinuses and/or nostrils.
- I take Bromelain twice a day, I’ve been able to cut back on other OTC pain pills by half. I’m very pleased .
- Bromelain has anti-inflammatory effects and keeps the arteries of clots and eats the fibrin that can build up in clots and scar tissue. IMO, a must for anyone over 50 .
- “My doctor told me to take a Bromelain 250mg. My doctor said that it would not only heal me faster but help with my pain by reducing swelling and inflammation at surgery site as well as internally. The results were miraculous, to say the least! I recovered 2x as fast with this surgery than any of my previous surgeries and the pain was far less severe.”
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