Bromelain

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Bromelain, also known as pineapple extract, is derived from a pineapple plant that is native to the Americas but is now grown worldwide. Bromelain comes from the stem or fruit of pineapples and can be taken as a powder, cream, tablet, or capsule.

Throughout history, people in Central and South America have used bromelain for digestive issues. People also use bromelain for conditions such as nasal swelling, inflammation, osteoarthritis, cancer, and muscle soreness, as well as wound and burn care.

Also known as:  Ananas, Bromelaine, Bromélaïne, Bromelains, Bromelainum, Bromelin, Bromelina, Broméline, Concentré de Protéase Végétale, Enzyme d'Ananas, Extrait d'Ananas, Pineapple Enzyme, Pineapple Extract, Fruit Bromelain, Plant Protease Concentrate, Protease

Diseases and Conditions

Bromelain is a protein extract derived from pineapples. It’s been extensively used in folk medicine to manage pain and swelling, especially in post-operation care. It is also used for nasal sinuses and oral gums. Bromelain may possess anti-inflammatory properties that aid in muscle relaxation and may help alleviate the symptoms of arthritis. 

Orally, bromelain is used for acute postoperative and post-traumatic conditions of swelling and pain, especially of the nasal sinuses, dental gums, and other body parts. It is also used orally for:

  • Anti-inflammatory action
  • Allergic rhinitis
  • Prevention of epinephrine-induced pulmonary edema
  • Smooth muscle relaxation
  • Tendon pain
  • Knee pain
  • Stimulation of muscle contractions
  • Inhibition of blood platelet aggregation
  • Enhanced antibiotic absorption
  • Cancer prevention
  • Shortening of labor
  • Preventing urinary tract infections
  • Enhanced excretion of fat
  • Mild ulcerative colitis
  • Rheumatoid arthritis
  • Pityriasis lichenoides chronica

Topically, bromelain is used for burn debridement.

Safety

Bromelain is likely safe when used orally in doses of up to 240 mg daily for a year. Children may safely use bromelain products under the supervision of a physician. There is insufficient information on the safety of bromelain on pregnant and breastfeeding women, therefore it is best to avoid use while pregnant or breastfeeding.

Adverse reactions to bromelain are rare, although the most common side effects are diarrhea and gastric upset. Other possible side effects from topical application of bromelain include skin swelling, pruritus, and urticaria.

Bromelain has antiplatelet properties which may cause excessive bleeding; discontinue use at least 2 weeks before surgery. Individuals allergic to latex and pineapples have a higher risk of developing allergies to bromelain.

Medication Interactions

Some evidence suggests that bromelain might increase levels of amoxicillin. Combining bromelain with other drugs which have anticoagulant or antiplatelet activity may increase the risk of bruising and bleeding. Some of these drugs include:

  • Aspirin
  • Clopidogrel (Plavix)
  • Dalteparin (Fragmin)
  • Enoxaparin (Lovenox)
  • Heparin
  • Indomethacin (Indocin)
  • Ticlopidine (Ticlid)
  • Warfarin (Coumadin)

Supplement and Food Interactions

Bromelain is considered to have antiplatelet properties. Using bromelain with herbs and supplements that can potentially cause anticoagulant and antiplatelet activity, such as ginger, garlic, licorice, and poplar, may heighten the risk of bleeding. Additionally, metal ions like zinc may inhibit the enzymatic activity of bromelain. 

Dosage

The following dosages of bromelain have been used for these specific conditions:

  • For osteoarthritis, a combination enzyme product (Phlogenzym), which contains rutin 100 mg, trypsin 48 mg, and bromelain 90 mg, has been administered in two tablets three times daily doses.
  • For delayed onset muscle soreness, bromelain 300 mg three times daily immediately following an intense exercise regimen has been used.
  • For acute knee pain, bromelain 200 mg to 400 mg daily for thirty days has been used.

The exact dosage of bromelain or any other supplement requires a comprehensive analysis of each individual including age, sex, medical history, DNA, and lifestyle factors. 

Foods

Bromelain is obtained from the stem and fruit of the pineapple. This is the only food in which bromelain is naturally present.

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References

  1. https://nccih.nih.gov/health/bromelain
  2. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=895

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