What Is Bromelain, and Why Do People Take It?

An enzyme in pineapple that may not be for everyone

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Bromelain is a mixture of enzymes found naturally in the juice and stems of the pineapple plant (Ananas comosus). It's generally considered safe but is not recommended for certain groups, such as people who are pregnant or have liver or kidney disorders.

Available in dietary supplement form, bromelain is considered a proteolytic enzyme, a class of enzymes that aid in the breakdown of protein. Bromelain supplements are marketed for a variety of health conditions, especially those associated with chronic inflammation, such as:

Bromelain has also been looked at for postsurgical use for third-molar (wisdom tooth) removal and topically for removing dead skin from burns. However, there is not enough evidence to support the use of bromelain for most conditions.

This article will review the uses of bromelain and what to look for if bromelain is recommended for you.

bromelain pineapple
 Verywell / Gary Ferster

Dietary supplements are not regulated the way drugs are in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. When possible, choose a supplement tested by a trusted third party, such as USP (U.S. Pharmacopeia), ConsumerLab, or NSF.

However, even if supplements are third-party tested, that doesn't mean they are necessarily safe for all or effective in general. Therefore, it is important to talk to your healthcare provider about any supplements you plan to take and check in about potential interactions with other supplements or medications.

Supplement Facts

  • Active ingredient(s): Bromelain
  • Alternate name(s): Ananas comosus, pineapple enzyme, pineapple extract
  • Suggested dose: No standard dose; discuss with a healthcare provider
  • Safety considerations: Avoid when pregnant or breastfeeding, or when also taking blood-thinning medications

Uses of Bromelain

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.

Research regarding the benefits of bromelain is limited. Here's a look at several findings from the available research on the potential uses of bromelain.

Sinusitis

A few studies have documented some benefits of bromelain supplementation for sinusitis:

  • A review of 10 randomized control trials reported that, when used with standard medications, bromelain may help relieve sinus inflammation.
  • Another review of studies reported that bromelain may improve symptoms associated with sinusitis such as difficulty breathing and nasal inflammation.
  • The most recent systematic review of alternative therapies for sinusitis concluded that bromelain showed some promise but that studies are still needed to compare bromelain to standard therapy.

Still, the research is limited overall and is not enough to recommend bromelain's use for sinusitis.

Pain Relief

Laboratory studies show that bromelain reduces the levels of some substances that cause inflammation from arthritis, but results from clinical trials are mixed.

Knee Pain

So far, studies testing bromelain's effects on knee pain have yielded mixed results.

In one small study, for example, bromelain supplements appeared to be no more effective than a placebo in alleviating symptoms such as pain and stiffness in people with knee osteoarthritis.

However, other research suggests that daily oral supplementation of bromelain works well for reducing knee pain and stiffness from osteoarthritis.

Surgical Pain

Research has looked at whether oral bromelain is effective in reducing pain, swelling, and healing time following oral surgery. However, its effectiveness has been found to vary from person to person and in different tissues in the body.

Four different systematic reviews (detailed reviews of articles focusing on answering a single question) evaluated bromelain for use after third-molar surgeries. The studies indicated that bromelain appeared to offer moderate pain relief after surgery. However, the results on whether it controlled swelling were mixed.

Wound Healing

The topical use of bromelain has been investigated for its effects on burn wounds. Surgical excision remains the standard of care for burn wound debridement (removal of burned tissue), but there is some evidence that topical bromelain may reduce the amount of excision needed.

It should be noted that this treatment is done under medical supervision and only for burn wounds that require hospitalization. This does not apply to oral supplementation of bromelain.

Eye Floaters

A group of researchers is studying an oral bromelain supplement and its effectiveness for treating eye floaters. In one study, participants with floaters were given varying daily dosages of a supplement containing the enzymes bromelain, papain, and ficin. After three months, 12 of the 40 participants taking the highest supplement dose reported having floaters, while 38 of the 40 participants who were given a placebo (vitamin C) reported having floaters.

Additional research is needed to understand the mechanism by which these enzymes can affect eye floaters, but the researchers believe it may be caused by the enzymes' ability to break down collagen found in the vitreous fluid of the eye.

Digestive Issues

Enzymes are needed for some digestive problems, including diseases that involve the pancreas. People with cystic fibrosis (CF) or exocrine pancreatic insufficiency (EPI) may rely on enzyme replacement for digestion. However, they require multiple types of enzymes, not just proteolytic enzymes like bromelain. Additionally, these enzymes are prescribed and monitored carefully by your healthcare provider.

There are no clinical trials in humans evaluating the effects of bromelain alone in bowel disease. If you have digestive problems, be sure to discuss them with a gastroenterologist or your healthcare provider.

Cancer

There is not enough evidence to support the use of bromelain supplementation for cancer. A 2021 systematic review analyzed 15 studies and found no clear benefit from proteolytic enzymes as an adjuvant (add-on) treatment for cancer.

Muscle Soreness

There is insufficient research to support using bromelain for muscle soreness. Research has been conflicting.

An older, preliminary study evaluated the use of bromelain, ibuprofen, or placebo for delayed onset muscle soreness of the elbow flexors after an intense exercise regimen. No differences were noted between treatment groups, and neither bromelain nor ibuprofen (the main ingredient in Advil and Motrin) had a positive effect on pain or reduced range of motion following an exercise regimen.

A newer study from 2016, however, found that a group of cyclists who took bromelain had less muscle fatigue after days of cycling than a group that took a placebo.

What Are the Side Effects of Bromelain?

Side effects commonly associated with bromelain include diarrhea and upset stomach.

In certain people, bromelain may trigger allergic reactions and asthma symptoms, such as breathing problems, tightness in the throat, hives, rash, and itchy skin. You should avoid bromelain supplementation if you are sensitive or allergic to pineapples. You may also be susceptible to an allergic reaction if you have an allergy to:

  • Carrots
  • Celery
  • Fennel
  • Rye
  • Papaya
  • Birch
  • Cypress pollen
  • Certain grasses
  • Latex

If you experience any of these symptoms, stop taking bromelain.

Precautions

Bromelain supplements are not recommended for use for people who are:

  • Sensitive or allergic to pineapples
  • Pregnant or breastfeeding
  • Have peptic ulcers or other digestive problems
  • Undergoing surgery, as it may increase the risk of bleeding
  • Taking blood thinners, such as Jantoven (warfarin), Lovenox (heparin), or aspirin, or supplements like ginkgo biloba
  • Diagnosed with liver or kidney disorders

Dosage: How Much Bromelain Should I Take?

Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.

Eating large amounts of pineapple will not give the same effect as taking a bromelain supplement. Bromelain is primarily found in the stem of the pineapple, which is not normally eaten.

When used as a digestive aid, bromelain is typically taken with meals. When used for inflammatory conditions, it's often taken between meals on an empty stomach to maximize absorption.

There is no standardized dose of bromelain. Doses are discussed in milligrams or enzyme activity units, known as milk clotting units (MCU) or gelatin dissolving units (GDU). Before starting bromelain, ask your healthcare provider or pharmacist about the right dosage for you. Make sure to read the product label for instructions on its use.

It should also be noted that avoiding or delaying standard care and self-treating a chronic condition with bromelain supplements may have serious consequences. Talk to your healthcare provider if you are considering using bromelain for any condition.

What Happens if I Take Too Much Bromelain?

Based on animal studies, bromelain is thought to have low toxicity. However, taking more bromelain than recommended may increase the likelihood of experiencing side effects, such as:

  • Nausea
  • Vomiting
  • Diarrhea
  • Indigestion
  • Rapid heartbeat
  • Uterine bleeding
  • Heavy menstruation

To prevent toxicity, follow your healthcare provider's advice on how to take bromelain safely.

Interactions

Since bromelain may slow blood clotting, using it in combination with prescribed blood thinners could increase the risk of bleeding and bruising. These can include:

  • Jantoven (warfarin)
  • Plavix (clopidogrel)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil (ibuprofen) and Naprosyn (naproxen)
  • Aspirin

Similarly, use caution with supplements that also have a bleeding risk, such as garlic and ginkgo biloba.

Bromelain may also increase the absorption of certain antibiotics, such as tetracycline and amoxicillin, which can increase their side effects.

Bromelain may also increase the strength of sedatives, such as barbiturates, antiseizure medications (Dilantin), insomnia medication (Ambien and Lunesta), and benzodiazepines (Xanax and Valium).

Before starting bromelain, tell your healthcare provider about any medicines you are taking or plan to take, including prescription and over-the-counter (OTC) drugs, vitamins, and herbal supplements.

It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss any potential interactions with foods, other supplements, and medications.

How to Store Bromelain

Store Bromelain supplements in a cool and dry place. Supplements and medications should always be kept out of reach of children.

How to Find Quality Forms of Bromelain

Bromelain supplements are sold as powders, creams, tablets, or capsules, either alone or in combination with other ingredients. Bromelain may also be found as a single ingredient or in combined products marketed for digestive health that provide multiple types of enzymes.

Since bromelain is an enzyme, the label should list the amount of enzyme activity in units, as well as its quantity in mass.

When choosing a supplement, look for products that have been certified by third-party authorities like ConsumerLab, USP, or NSF International. These certifying bodies ensure that supplements are pure and contain just the ingredients listed on the product label.

Summary

Bromelain is an enzyme found naturally in the juice and stems of pineapples that plays a role in protein breakdown. As a supplement, some research shows that it may help reduce pain and inflammation in some conditions. However, there is not enough high-quality evidence to recommend it for these uses.

Taken alone, it is not likely to help with digestive problems. Although marketed for several other health conditions, there is not enough evidence to support these claims.

Before starting to take any new supplements, talk to your healthcare provider to be sure the supplement is appropriate and safe for you to take.

21 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading

By Jennifer Lefton, MS, RD/N, CNSC, FAND
Jennifer Lefton, MS, RD/N-AP, CNSC, FAND is a Registered Dietitian/Nutritionist and writer with over 20 years of experience in clinical nutrition. Her experience ranges from counseling cardiac rehabilitation clients to managing the nutrition needs of complex surgical patients.

Originally written by Cathy Wong