Bromelain: Benefits, Dosage, Contraindications

Updated on

Bromelain is a proteolytic enzyme, meaning it breaks down proteins, found in the stem and fruit of pineapple. It derives its name from the botanical family Bromeliaceae, to which pineapple belongs. It mainly cleaves peptide, amide, and ester bonds involving lysine, alanine, tyrosine, glycine, and other basic amino acids. Researcher Heinicke revealed in 1957 that the stem contains much more bromelain than the fruit itself. Bromelain extracted from the stem is particularly stable and active over a certain pH range (6.0 and 7.0). It remains stable at low temperatures and can be efficiently extracted from pineapple by-products, making it an economical and ecological source. Stem-extracted bromelain is the most used in nutraceuticals and has superior proteolytic activity compared to that extracted from the fruit. Bromelain is widely used in food processing to prepare precooked cereals, produce protein hydrolysates, or tenderize meat... It is also used as a therapeutic agent for its anti-inflammatory effects, which make it useful in treating conditions such as osteoarthritis or tendinitis. Furthermore, it has antithrombotic properties and can improve blood circulation, thus reducing the risk of clots. Due to its ability to help in the breakdown of proteins, it is often used as a dietary supplement to improve digestion. It is also used to accelerate recovery after surgical operations and is being studied for its potential effects in cancer treatment.

Other name(s) 

Bromelin, Pineapple

Scientific name(s)

Ananas comosus

Family or group: 

Enzymes


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


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

posologieTopical

populationAdults

formulationgel


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

posologieOral

posologie200 - 2000 mg

populationAdolescents, Adults, Seniors

formulationdry extract


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

posologieOral

posologie180 mg

formulationdry extract


Synergies


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

posologieOral

posologie100 mg

formulationdry extract


Synergies


Properties


Anti-inflammatory

full-leaffull-leaffull-leafempty-leaf

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

Wound healing, Osteoarthritis, Edema, Tendinitis

Antiplatelet/Anticoagulant

full-leaffull-leaffull-leafempty-leaf

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

Angina, Venous thrombosis

Digestive Effect

full-leaffull-leafempty-leafempty-leaf

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

Digestive disorders

Immunomodulator

full-leaffull-leafempty-leafempty-leaf

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

full-leafempty-leafempty-leafempty-leaf

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

Wound healing

Anticancer

full-leafempty-leafempty-leafempty-leaf

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

full-leafempty-leafempty-leafempty-leaf

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.