Bromelain is a proteolytic enzyme found in the pineapple plant. It belongs to the group of enzymes known to the aid digestion of foods, the proteinous foods. The bromelain can be seen in the juice as well as the stem of pineapple. It is widely known for its health benefits in the treatment of chronic inflammatory conditions, such as osteoarthritis, sinusitis, and inflammation of the colon.
It is also useful for the treatment of allergic conditions, and the prevention of cancer and chronic heart diseases (2). it is widely known in central and south America. Bromelain can be used alone or in combination with quercetin. Bromelain and quercetin also aid in the balance of the natural inflammatory response in the body.
Bromelain is useful both in traditional and orthodox medicine to aid digestion and in the management of inflammatory conditions. It was discovered far back in the late 1800 but its medical use didn’t start till the year 1957. the scientists have since then been working on the therapeutic uses of bromelain, especially as a supplement (3).
Sources Of Bromelain
Bromelain can be seen in fruits such as pineapple, and other yellow fruits. It can be seen after manufacturing in the form of tablets or capsules. It is also available as cream or powder.
Most times, bromelain and quercetin can be packaged together as a single supplement as a capsule or as tablets to be used for an anti-inflammatory purpose. Bromelain can also be packaged alongside linoleic acid which is required for weight loss (1). Interestingly, even though bromelain is gotten from pineapple fruit and juice, eating pineapple does not guarantee the required quantity needed by the body (4).
The Health Benefits Of Bromelain
Bromelain supplements are used by people as a remedy for several health conditions. The following are some of the health benefits of bromelain:
- – Inflammation
The proteolytic enzyme bromelain from the gotten pineapple plant, particularly the stem has proven to be useful in the treatment of several medical conditions, one of which is inflammatory diseases. It is useful in the treatment of post-surgical inflammations, dental surgeries, and treatment of chronic inflammation of the sinuses and the nose.
Bromelain is also useful in the treatment of other inflammations like joint inflammation, osteoarthritis, rheumatoid arthritis, and skin diseases such as psoriasis and rosacea. Studies revealed that when bromelain is combined with quercetin, it produces a greater anti-inflammatory action for both acute state and chronic state inflammatory diseases.
Bromelain and quercetin are not uncommon and even though bromelain in food and quercetin in food is good, both are sold as a supplement alongside other enzymes such as amylase, and papain or with vitamin C to aid their action (3).
- – Osteoarthritis
Studies revealed that the anti-pain and anti-swelling properties of bromelain make it one of the best supplements required for the treatment of osteoarthritis to ease the pain and edema frequently experienced by patients. Particularly, the patient with arthritis affecting their knee joints or shoulders will benefit more from bromelain supplements. Research conducted revealed that patients treated with 400mg of bromelain daily improved than those given placebo as treatment (4).
- – Sinusitis
Particularly, bromelain is useful in relieving the symptoms of sinusitis and similar conditions affecting the respiratory system. In a study conducted in 2016, it was discovered that bromelain is useful in relieving the symptoms of sinusitis which helps to relieve difficulty with breathing in the patients as well as reducing the inflammation.
Another 2006 survey reported that when bromelain is used as adjuvants with other drugs in the treatment of inflammation, it has better health benefits compared to when only medications are used without the supplement (1).
- – Bowel Inflammatory Diseases
Bromelain has proven to also be useful in the treatment of inflammatory conditions of the bowel. In a 2008 study, they found out that bromelain when used for patients with ulcerative colitis, it helps to suppress the inflammatory symptoms in the patients and it also revealed that the pro-inflammatory chemicals like cytokines and chemokines were reduced in patients taking bromelain (2).
- – Food Digestion
Bromelain helps to aid digestion although studies are yet to discover the mechanism of action behind this. It also helps to relieve abdominal cramps associated with food indigestion. It is also known to reduce some of the actions bacteria have on the bowel that irritates resulting in diarrhea or dysentery such as Vibro cholera (1).
- – Heart Diseases
A study reveals that bromelain is useful in the management of cardiovascular pathologies such as heart failure, stroke, arterial diseases, hypertension, dyslipidemia, and lots more. Bromelain helps to prevent the formation of clots in the vessels thereby preventing the occurrences of heart events that can lead to death such as stroke (4).
- – Asthma
Bromelain has shown its importance in the management of airway inflammation in asthmatic patients. This was discovered in a study carried out on animals that bromelain helps to reduce the severity o symptoms as well as reduce the frequency of the symptoms. Also, it is safe to say that it may also be of benefit to patients with other atopy conditions (4).
- – Cancer
Research has shown that bromelain has some components which are anti-neoplastic and hence can help to prevent and treat the cancerous cells in cancer patients. Unfortunately, this has not been confirmed in humans as they are still in the preliminary phase.
In 2012, research conducted showed that bromelain is important in the treatment of breast cancer, and this is because of its ability to induce programmed cell death in the cancerous cells, otherwise called apoptosis.
In research conducted in 2007, bromelain was used in the treatment of animals with certain cancers, like sarcoma and leukemia. The result revealed that bromelain increased the quality of life of the animals. Hence, the conclusion is that bromelain supplements will be good adjuvants in cancer therapies (2).
- – Weight Loss
Producers of bromelain supplement explained that it is useful in those desiring weight reduction as it contains enzymes that help to increase the rate at which the body digests fat. However, there has not been enough study to support this claim (1).
- – Wound Healing
Bromelain has been known for his positive impact on wound healing, especially burns. The topical form of bromelain when applied to the surface of burn wounds, it helps to eliminate the gangrenous skin parts, that is, the dead parts. But there has been no evidence to prove if it helps in the treatment of wounds aside from the function above (2).
- – Knee Pain
The studies conducted on the effects of bromelain on knee pain have been unstable. In a study conducted in 2006 and published in the ‘monthly journal of the association of physicians, there was no seen positive effect of bromelain on knee pain other than acting as a placebo for patients with knee pain, edema, and stiffness. The study was carried out on 47 patients with osteoarthritis of the knee joint.
Conversely, in another study conducted in 2006 and published in the Journal of Arthritis Research and Therapy, it was discovered that in some of the patients, bromelain was very useful in the treatment of their knee pain and it was as effective as diclofenac in the patients. Only a few of the subjects, two out of seven, found bromelain as a mere placebo. Also, another study conducted showed that bromelain can ease knee pain in individuals without osteoarthritis (2).
- – Surgical Pain
For post-surgical pain, oral bromelain has been known to help in relieving pain and swelling in patients. However, it acts differently with different people and in different tissue in the same individual. In a study conducted on 40 patients, 70 percent of the patients had reduced pain and swelling compared to those given a placebo. 750 to 100mg per day is the recommended dose and should be taken before eating in divided doses per day (2).
Bromelain And Quercetin Combination
There has been research confirming that the combination of the proteolytic enzyme bromelain with quercetin produces the best anti-inflammatory result. Thus, bromelain and quercetin when combined can help to relieve and manage inflammation in both the acute and chronic states.
The majority of brands producing bromelain supplements do not provide enough dosage required to serve the anti-inflammatory purpose or they miss the idea of bromelain and quercetin combination, hence the reason why most formulations don’t serve the anti-inflammatory purpose. Bromelain and quercetin can also be combined with other enzymes and antioxidants to improve their functions.
Bromelain and quercetin combined in a supplement help to reduce the dosage and number of times required to use the supplement (3). The dosing for quercetin ranges from 500 to 2500mg per day in divided doses. The recommended dose will depend on the condition for which it is being used. The combination can be taken three days before the surgery and should continue till a week after the surgery. If used in case of traumatic injury, it can be used for up to ten days. Bromelain and quercetin supplements are the best in aiding fast recovery (3).
Side Effects Of Bromelain
Just like every other supplement, it is important to know the medical history of a patient before prescribing bromelain supplements for such. It can result in mild risk in some patients, especially in cases of overdose. Such effects are:
- – Nausea
- – Vomiting
- – Diarrhea
- – Others are menorrhagia, that is, the heavy menstrual flow which can be due to thinning of blood, especially when used with anticoagulants such as aspirin, and warfarin. Hence, the need to avoid or stop the use of anticoagulants when on bromelain.
Bromelain with quercetin side effects includes all stated above too (4). in some persons, bromelain with quercetin side effects can trigger allergic reactions, especially in those with personal or family history of atopy. Such reactions include skin rashes, difficulty with breathing, itchy skin, and eyes. These supplements should be avoided in persons with an allergy to bromelain (2).
Bromelin interact with the following drugs when used together:
- – Anticoagulants
Bromelain normally will cause a decrease in the blood clotting time, so a patient on blood thinners, that is, anticoagulants should be advised to stop the anticoagulants before using bromelain supplements. When used together, this can cause excessive bleeding and an increase in blood flow in women. Some examples of blood thinners are aspirin, warfarin, and clopidogrel.
- – Antibiotics
Bromelain when used together with certain antibiotics, it increases the rate of absorption of such drugs, thereby increasing the predisposition to the side effects of such drugs. Examples of such drugs are tetracycline and amoxicillin (4).
- – Sedatives
A combination of bromelain and sedatives makes the effect of sedative drugs stronger. Examples of such are:
- Benzodiazepines: examples are diazepam and alprazolam. When used together it increases the duration of action.
- Anticonvulsants: when bromelain is combined with sodium valproate or phenytoin, it increases the duration of action as well as side effects.
- Antidepressants: bromelain increases the action of tricyclic antidepressants such as amitriptyline.
- Herbal concoctions with alcohol base (4).
Allergy to bromelain is a major contraindication to the use of bromelain supplements. Other allergies include allergies to pineapple as bromelain is an enzyme seen in pineapple, and allergies to carrot, rye, and wheat. Patients with allergy to cypress pollens should also avoid the use of bromelain.
Bromelain is also contraindicated in pregnancy and patients with peptic ulcer disease. There has been no research to ascertain if bromelain and quercetin are safe in pregnancy. Other gastrointestinal diseases should be well evaluated before placing a patient on bromelain.
It is contraindicated in patients with bleeding disorders and patients on anticoagulant medications or anti-platelet drugs. Patients on supplements such as ginkgo Biloba should also avoid taking bromelain (2).
Bromelain is obtained from pineapple fruit or the stem. It is also a mixture of enzymes known to have health benefits. This includes inflammation treatment, wound healing, treatment of asthma, and a lot more when used as a supplement or as a treatment adjuvant as in cancer therapy. However, lot of works is currently ongoing to ascertain the effectiveness of the bromelain supplements.
- 1. https://www.medicalnewstoday.com/articles/323783#summary
- 2. https://www.verywellhealth.com/bromelain-what-should-you-know-about-it-88318
- 3. https://vitamedica.com/wellness-blog/bromelain-and-quercetin-natural-anti-inflammatory-supplements/
- 4. https://www.healthline.com/health/bromelain#interactions