Bromelain: Benefits, Dosage, Contraindications
Other name(s)
Bromelin, Pineapple
Scientific name(s)
Ananas comosus
Family or group:
Enzymes
Indications
Rating methodology
EFSA approval.
Wound Healing ✪✪✪✪✪
Clinical research shows that gels formulated with proteolytic enzymes derived from bromelain help debride burns (chemical and electrical) when applied under an occlusive dressing for 4 hours, in children and adults.
Posologie
A Retrospective Review of an Off-label Bromelain-based Selective Enzymatic Debridement (Nexobrid) in the Treatment of Deep, Partial, and Full Thickness Burns and Hard to Heal Wounds
Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report
Edema ✪✪✪✪✪
Many studies indicate bromelain's effectiveness in reducing postsurgical inflammation. A double-blind study of patients who underwent oral surgery revealed that bromelain was significantly superior to placebo for reducing edema. Additionally, the duration of pain decreased to 5.1 days in the bromelain group compared to 8.1 days for the placebo group.
Posologie
Efficacy of proteolytic enzyme bromelain on health outcomes after third molar surgery. Systematic review and meta-analysis of randomized clinical trials
Bromelain
Effect of Oral Administration of Bromelain on Postoperative Discomfort After Third Molar Surgery
Properties and Therapeutic Application of Bromelain: A Review
Clinical trial with bromelain in third molar exodontia
Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period
Is bromelain effective in controlling the inflammatory parameters of pain, edema, and trismus after lower third molar surgery? A systematic review and meta-analysis
Perioperative Bromelain Therapy after Wisdom Teeth Extraction - A Randomized, Placebo-Controlled, Double-Blinded, Three-Armed, Cross-Over Dose-Finding Study
Digestive issues ✪✪✪✪✪
Bromelain aids digestion. Indeed, it has the property of breaking down proteins. Recommended dosages vary according to patients' symptoms, ranging between 200 mg and 2,000 mg per day, preferably divided into 4 doses. Bromelain can substitute for some proteolytic enzymes like trypsin and pepsin when they are secreted in insufficient quantities or in case of decreased pancreatic activity.
Posologie
Proteolytic activity and immunogenicity of oral bromelain within the gastrointestinal tract of mice
Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update
Benefit of dietary integrators for treating functional dyspepsia: a prospective pilot study
Comparative Trial of Nutrizym in Chronic Pancreatic Insufficiency
Bacterial infections ✪✪✪✪✪
Animal studies have shown that bromelain is effective against several E. coli strains. Other clinical studies show that bromelain can increase serum levels of several antibiotics (including tetracycline, amoxicillin, and penicillin) in various body fluids (including blood, cerebrospinal fluid, mucus, sputum, and urine) and at the tissue level.
Posologie
Bromelain protects piglets from diarrhoea caused by oral challenge with K88 positive enterotoxigenic Escherichia coli
The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method
Potential role of bromelain in clinical and therapeutic applications
Bromelain prevents secretion caused by Vibrio cholerae and Escherichia coli enterotoxins in rabbit ileum in vitro
Efficacy of enteric-coated protease in preventing attachment of enterotoxigenic Escherichia coli and diarrheal disease in the RITARD model
Osteoarthritis ✪✪✪✪✪
A combination of bromelain, trypsin, and rutin was compared to diclofenac in 103 patients suffering from knee osteoarthritis. After six weeks, both treatments resulted in a significant and similar reduction in pain and inflammation. Bromelain 180 mg was used in combination with trypsin 144 mg and rutin 200 mg three times a day for 6 to 12 weeks. Another study used a specific combined supplement containing 600 mg of devil's claw, 400 mg of turmeric, and 300 mg of bromelain, taken 2 to 3 times a day for 2 to 8 weeks, which may reduce pain and improve function in knee osteoarthritis. Another trial showed that taking 800 mg of bromelain daily for 12 weeks as an adjunct treatment for moderate to severe knee osteoarthritis is not more effective than placebo in improving symptom scores. Other preliminary clinical research shows that taking 500 mg of bromelain daily for 4 weeks in the treatment of mild to moderate osteoarthritis is less effective than diclofenac 100 mg per day in improving quality of life, joint pain, and joint function. It is unclear at this stage if bromelain alone is effective in managing osteoarthritis.
Posologie
Synergies
Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee--a double-blind prospective randomized study
A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain
Efficiency of proteolytic enzymes in treating lumbar spine osteoarthritis (low back pain) patients and its effects on liver and kidney enzymes
Tendinitis ✪✪✪✪✪
A clinical study conducted on patients suffering from Achilles tendon insertion tendinopathy shows that oral intake of two sachets of a specific supplement containing a total of 100 mg of bromelain, 1000 mg of L-arginine alpha-ketoglutarate, 1100 mg of methylsulfonylmethane (MSM), 600 mg of hydrolyzed type I collagen, 120 mg of vitamin C, and 25 mg of Vinitrox for 60 days improves function and pain compared to placebo.
Posologie
Synergies
Angina ✪✪✪✪✪
Research indicates that bromelain prevents or minimizes the severity of angina. After stopping bromelain, angina attacks reappear after a variable period of time. A reduction in the incidence of coronary infarction after administration of potassium and magnesium orotate along with 120-400 mg of bromelain per day has been reported.
Posologie
Synergies
Effect of bromelain (Ananase) on human platelet aggregation
Bromelain induces cardioprotection against ischemia-reperfusion injury through Akt/FOXO pathway in rat myocardium
Bromelain ameliorates hepatic microcirculation after warm ischemia
A REVIEW ON POTENTIAL PROPERTIES AND THERAPEUTIC APPLICATIONS OF BROMELAIN
Bromelain proteases reduce human platelet aggregation in vitro, adhesion to bovine endothelial cells and thrombus formation in rat vessels in vivo
[CLINICAL EXPERIENCES ON THE ACTION OF BROMELIN IN PERIPHERAL VENOUS DISEASES AND IN CHRONIC BRONCHITIC STATES]
Fibrinolytic and antithrombotic action of bromelain may eliminate thrombosis in heart patients
Beneficial Properties of Bromelain
Venous thrombosis ✪✪✪✪✪
In a study involving 73 patients with acute thrombophlebitis, it was shown that bromelain combined with analgesics reduced inflammation symptoms, including pain, swelling, tenderness, skin temperature, and incapacity.
Posologie
Effect of bromelain (Ananase) on human platelet aggregation
Bromelain induces cardioprotection against ischemia-reperfusion injury through Akt/FOXO pathway in rat myocardium
Bromelain ameliorates hepatic microcirculation after warm ischemia
A REVIEW ON POTENTIAL PROPERTIES AND THERAPEUTIC APPLICATIONS OF BROMELAIN
Bromelain proteases reduce human platelet aggregation in vitro, adhesion to bovine endothelial cells and thrombus formation in rat vessels in vivo
[CLINICAL EXPERIENCES ON THE ACTION OF BROMELIN IN PERIPHERAL VENOUS DISEASES AND IN CHRONIC BRONCHITIC STATES]
Fibrinolytic and antithrombotic action of bromelain may eliminate thrombosis in heart patients
Beneficial Properties of Bromelain
Properties
Anti-inflammatory
Bromelain exerts an anti-inflammatory effect by altering leukocyte activation and inhibiting the synthesis of prostaglandins and bradykinins. However, it is still unclear whether this substance can reach sufficient concentrations to achieve this anti-inflammatory activity outside of the gastrointestinal tract. Indeed, plasma contains proteinase inhibitors that can inactivate bromelain. Moreover, clinical research shows that in healthy young adults, oral bromelain does not affect the chemokines and interleukin cytokines (IL) -2, IL-5, IL-6, IL-8, IL-13, and MCP-1, but rather increases interferon-gamma compared to placebo. The increase in interferon gamma may play a role in the anti-inflammatory effects of bromelain. Furthermore, as a proteolytic enzyme, bromelain removes necrotic tissues and separates them from healthy tissues. Today, it is included in the preparation of medicinal creams and dressings to accelerate the healing of inflammations and the healing of skin wounds.
Usages associés
Antiplatelet/Anticoagulant
In vivo and in vitro research shows that bromelain is a powerful inhibitor of platelet aggregation. This effect may be due to an increase in plasmin. Plasmin is a proteolytic enzyme produced by the body whose role is to dissolve fibrin, a protein involved in the formation of blood clots.
Usages associés
Digestive Effect
Bromelain supplementation can facilitate the digestion of proteins. Bromelain is involved in the process of protein breakdown (proteolysis) like other proteolytic enzymes, such as trypsin and chymotrypsin produced by the pancreas. Indeed, it breaks the peptide bonds of proteins to decompose them into smaller pieces. Studies dedicated to bromelain and its action on digestion are still few. However, initial results obtained are encouraging. A study published in 2008 concludes that "plant-derived enzymes, such as pineapple-derived bromelain, are effective digestive aids for protein breakdown". Therefore, bromelain could compensate for pancreatic insufficiency.
Usages associés
Immunomodulator
In a study on mice, bromelain simultaneously enhanced and inhibited certain aspects of T cell responses. In a human study, bromelain supplementation increased the cytotoxicity of monocytes in people with reduced activity. It also stimulated the secretion of interleukin 1-beta by monocytes and reduced CD44 expression. Bromelain appears to act as a signaling molecule, capable of influencing various cell signaling cascades, many of which are important for cell survival.
Wound Healing
The removal of damaged or dead tissue (wound debridement) exposes healthy tissue, promotes healing, and provides a clear base for skin grafting. Debridement can be performed surgically, chemically, or using enzymes, such as bromelain, which operate without destroying the underlying healthy tissues. Bromelain's ability to aid in wound debridement is based on its ability to hydrolyze proteins into oligopeptides and amino acids.
Usages associés
Anticancer
Studies show that bromelain acts as an immunomodulator by inducing the production of cytokines (such as interleukin-1β, IL-6, and IL-8, as well as tumor necrosis factor-γ), and increasing the immunocytotoxicity of monocytes against tumor cells. Animal studies also suggest anti-metastatic properties with an inhibition of tumor cell growth. An in vitro study on glioma cells (primary brain tumor) showed that bromelain significantly and reversibly reduced the adhesion, migration, and invasion of glioma cells.
Anti-aging
As we age, various degenerative diseases appear, especially after the age of 50. The aging process is accompanied by a decline in hormone secretion, immune system function, and enzyme production. Aging symptoms could be, at least partially, the result of these enzyme reductions. It has been demonstrated that bromelain combats arthritis, high blood pressure, cancer, and many other disorders associated with aging. It is also effective against wrinkles. Bromelain is widely incorporated into lotions, creams, scrubs, facial masks, and other skin care products, where it helps remove dead skin cells.
Safety dosage
Adult from 18 year(s): 240 mg - 3200 mg
Doses up to 240 mg per day have been used safely for one year. Higher doses up to 3,200 mg per day have been used short-term, safely.
Interactions
Médicaments
Amoxicillin: moderate interaction
Some evidence suggests that bromelain might increase levels of amoxicillin.
Antiplatelet/Anticoagulant: moderate interaction
Theoretically, combining bromelain with an anticoagulant or antiplatelet treatment may increase bleeding risk.
Tetracycline: minor interaction
Some data suggests that bromelain might increase the absorption and levels of tetracyclines.
Plantes ou autres actifs
Bromelain: moderate interaction
Potatoes and soy contain a protein inhibitor of proteolytic enzymes. Theoretically, their consumption could inhibit the activity of bromelain.
Precautions
Pregnant women: avoid
Avoid use due to lack of reliable information.
Breastfeeding women: avoid
Avoid use due to lack of reliable information.
High blood pressure: avoid
It is likely that in people suffering from hypertension, long-term administration of bromelain can cause tachycardia.
Contraindications
Allergies: prohibited
People allergic to pineapple or other members of the bromeliad family may also have allergic reactions to bromelain.
Surgical intervention: prohibited
Bromelain has antiplatelet effects. Thus, it may cause excessive bleeding in case of supplementation preceding surgical intervention. Please discontinue bromelain at least 2 weeks before any surgical procedure.