Bromelain supplement benefit and side effects, which conditions is this enzyme product useful for?
Pineapple extract information
October 7 2016
by Ray Sahelian, M.D.

Bromelain is an enzyme found in all parts of the pineapple plant but the highest concentration is found in the stem. Bromelain is a combination of several protein-digesting enzymes along with peroxidase, acid phosphatase, protease inhibitors, and calcium. Bromelain is most often used to help digestion and help reduce inflammation. It may also have anti-viral and immune influencing properties.

Bromelain side effects, safety, toxicity, extended use, allergy
Bromelain supplements do not seem to have any obvious side effects. The use of a bromelain supplement at 800 mg a day was used on a group of patients for a period of 12 weeks without any significant side effects reported.

I was wondering what if any information / opinions you have on the safety / effectiveness of bromelain mainly for digestive purposes. I have read it is supposedly helpful also for the heart, but that it should be taken along with vitamin E.
   Thus far it appears to a be a safe natural product.

Long term use
I am taking a bromelain supplement for chronic inflammation, and would like to to take it long term, but am unfamiliar with it's profile. I've seen some websites say you should take it no longer than 10 days.
   The use of a bromelain supplement at 800 mg was used on a group of patients for a period of 12 weeks without any significant side effects. As with any supplement, we suggest taking breaks from use unless the supplement is necessary in the treatment of a condition and your doctor does not advise taking breaks.

I have been on bromelain 3000 mg a day and quercetin 1500 mg a day. I have started itching after a month. Is this an allergy to bromelain or quercetin?
   It is not possible for us to tell whether your itching is an allergy to these nutraceuticals, or some other ingredient in the capsule or something else that it causing the problem in your diet or environmental exposure. If the itching goes away and returns after using the supplement, then it is more likely that the bromelain, quercetin or some ingredient in the formula is causing the allergy.

Bromelain, derived from the pineapple plant, is one of a group of proteolytic enzymes (enzymes capable of digesting protein). It is widely believed that most orally ingested enzymes are destroyed by the digestive juices prior to being absorbed. However, there is evidence that some amounts can be absorbed intact. Proteolytic enzymes other than bromelain are often used with people who suffer from malabsorption. It may contribute to the digestion of protein, and may therefore be used as a digestive aid.
   The medicinal qualities of pineapple are attributed to bromelain, a 95%-mixture of proteases. These medicinal qualities include anti-inflammatory, anti-thrombotic, fibrinolytic and anti-cancer functions.

Anti inflammatory
I read about bromelain that it has healing and antiinflammatory properties. Can I give it for better wound healing after orthopedic surgery ?
   We are not familiar with its use after surgery. It does appear to have anti-inflammatory and antiviral activity.

Anti cancer agent?
Bromelain acts systemically, affecting multiple cellular and molecular targets. The anti-cancer activity of bromelain consists in the direct impact on cancer cells and their micro-environment, as well as in the modulation of immune, inflammatory and haemostatic systems.

Blood thinning
Are bromelain and quercetin blood thinners?
    They may have a slight blood thinning effect but I have not seen conclusive studies yet. If they do thin the blood, it is likely to be minimal. I can't be fully certain, this is my best guess.

So, after all the research on bromelain supplements, would you say it's worth a try for bursitis of the hips, assuming there are no extenuating circumstances?
   There's very little research regarding the use of bromelain supplements in joint disorders, therefore no statements can be made with confidence.

Dental surgery
J Oral Maxillofac Surg. 2014. Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: a randomized, double-blind, placebo-controlled clinical trial.Majid OW1, Al-Mashhadani BA2.Author information. The purpose of the present study was to compare the effect of oral bromelain (4 × 250 mg) versus oral diclofenac sodium (4 × 25 mg) on pain, swelling, trismus, and quality of life after surgical removal of impacted lower third molars.

Muscle pain and ache
Preliminary comparison of bromelain and Ibuprofen for delayed onset muscle soreness management.
Clin J Sport Med. 2002.
The purpose of this study was to determine whether a common bromelain regimen or common ibuprofen regimen are effective in resolving pain and muscle dysfunction associated with delayed onset muscle soreness of the elbow flexors. Forty subjects who had not participated in an upper body resistance-training program 3 months prior to the study, suffered pain or injury in the nondominant arm, or experienced an adverse response to nonsteroidal anti-inflammatory drugs or pineapple (bromelain source) were recruited. Subjects were assigned to one of four treatment groups (bromelain 300 mg three times a day, ibuprofen 400 mg t.i.d., placebo t.i.d., and control) and began treatment immediately following the exercise protocol. No differences among treatments were observed for any of the dependent variables at any time. ROM deficits and pain peaked between 48 and 72 hours. Peak torque deficiencies were observed between 24 and 72 hours. Ingestion of bromelain and ibuprofen had no effect on elbow flexor pain, loss of ROM, or loss of concentric peak torque as a result of an eccentric exercise regimen.

Osteoarthritis and arthritis
Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study.
QJM. 2006. Department of Primary Care, University of Southampton, Southampton, Southampton, UK.
Previous studies suggest that bromelain, a pineapple extract, may be a safer alternative or adjunctive treatment for knee osteoarthrits than current conventional treatment. Subjects with a confirmed diagnosis of moderate to severe knee osteoarthritis were randomized to 12 weeks of bromelain 800 mg a day or placebo, with a 4-week follow-up. Knee (pain, stiffness and function) and quality-of-life symptoms were reported monthly in the WOMAC and SF36 questionnaires, respectively. No statistically significant differences were observed between groups for the primary outcome. Both treatment groups showed clinically relevant improvement in the WOMAC disability subscale only. Adverse events were generally mild in nature. This study suggests that bromelain is not efficacious as an adjunctive treatment of moderate to severe osteoarthritis.

Skin disease
Role of bromelain in the treatment of patients with pityriasis lichenoides chronica.
J Dermatolog Treat. 2007. Department of Clinical Medicine and Immunological Sciences - Section of Dermatology, University of Siena, Italy.
Pityriasis lichenoides is a rash of unknown cause. The rash can range from a relatively mild chronic form to a more severe acute eruption. This skin condition affects adolescents and young adults, usually before the age of 30.
Eight patients (3 males and 5 females) with pityriasis lichenoides chronica were treated for three months with oral bromelain (40 mg 3 times a day for 1 month, 40 mg twice a day for 1 month and 40 mg/day for 1 month). All patients showed complete clinical recovery after treatment. After one year of follow up, two patients experienced relapse 6 months after suspension of therapy but responded to another brief cycle of therapy. No side effects were encountered during therapy.

Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain -POS in children with acute sinusitis in Germany. In Vivo. 2005.
The therapeutic efficiency and safety of the proteolytic enzyme bromelaine obtained from pineapple (Bromelain -POS, Ursapharm GmbH, Saarbrucken, Germany) was evaluated in children under the age of 11 years diagnosed with acute sinusitis. Data from 116 patients in Germany were analysed in a study. Patient cohorts were either treated with Bromelain -POS, in combination with Bromelain -POS and standard therapies, or with standard therapies. The primary parameter measuring effectiveness of the different treatment groups was the duration of symptoms. The shortest mean period of symptoms was observed in patients treated with Bromelain -POS alone (6.6 days), followed by the standard therapy (7.95 days) and those treated with a combination of Bromelain-POS and the standard therapy (9 days). Patients of the Bromelain -POS monotherapy group showed a statistically significant faster recovery from symptoms compared to the other treatment groups. One 10-year-old male patient, with a known pineapple allergy, showed a self-limiting mild allergic reaction. No other unwanted side-effects were reported. This trial documents that the proteolytic pineapple enzyme Bromelain -POS is widely used in the treatment of young children diagnosed with acute sinusitis in Germany and that the use of proteolytic enzymes can benefit such patients.

I take bromelain and quercetin for my sinus condition, and they have helped the condition for years.

Measuring the potency
What is the difference between Bromelain 45 Mg (225 I.U) and 5,000 M.C.U (Milk Clot Units Per Mg)?
    MCU stands for milk clotting units and refers to the proteolytic enzyme potency. Vitamins and minerals are measured in a variety of ways including milligrams (mg), micrograms (mcg), or International Units (IU). A measure of the potency of bromelain, which is an enzyme, is how quickly it can dissolve a protein, in this case milk protein, is expressed as milk clotting units (mcu). Bromelain is also measured as GDU, gelatin dissolving units. This is a good question, I am not sure how these different measures compare.

Interactions with dietary supplements
I am considering purchasing serrapeptase enzyme and combining it with bromelain. Are you aware of any adverse effects of combining the two?
   We are not aware of any contraindications combining serrapeptase enzyme and bromelain supplements, but we have not seen any studies combining the two and it is possible that one person may find it compatible why another person could get untoward side effects.

I came across bromelain in an email claiming it to be a wonder drug. So I did some looking into it and it does sound pretty amazing. It comes from pineapples, is drinking the juice or eating ready made pineapple chunks do just as well as taking the supplement.
   Taking a bromelain supplement is different than eating pineapple or drinking pineapple juice since the fruit has many other compounds. There are countless beneficial substances in the foods and herbs we consume, and bromelain is one of these, not necessarily a wonder drug.

Testimonial, lung health
I have taken a supplement of quercetin and bromelain for about two years for lung health. It has been very good for me. The daily dose of bromelain is a half of a gram, with seemingly no ill effect. A few weeks ago I fell and hurt myself. I had supplemental bromelain and was probably taking no more than two grams for a few days, and again I saw no problems like stomach upset or the like. I later cut myself and the bleeding was minimal.

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Supplement Facts buy bromelain capsules or tablets
Serving Size: 1 Capsule
  Amount per Serving % Daily Value
Bromelain (2,000 G.D.U.* per gram) 500 mg
†Daily Value not established.
*G.D.U. (Gelatin Digesting Units) is a standard measure of activity for bromelain.

Bromelain is a pineapple digestive enzyme (breaks down proteins) with a wide pH range, which can function within the acidic environment of the stomach.
Supplement Facts: Bromelain (2,000 G.D.U.* per gram) 500 mg
* Gelatin Digesting Units
Other products sold online
Now Foods, Quercetin with Bromelain, 240 Veg Capsules

Suggested Use and dosage: 1or 2 bromelain tablets daily or as suggested by your health care provider. If you have a delicate, easily irritated stomach, take with meals.
GDU is a standard measure of activity.