Last updated by Dr Sarah Brewer on
Bromelain consists of a group of protein-digesting enzymes (sulphur-containing proteases) derived from the stem of the pineapple plant. Bromelain may be taken with meals to aid the digestion of protein, but when taken between meals it is also absorbed intact into the circulation where it acts as an anti-inflammatory pain killer.
Bromelain health benefits
Bromelain reduces the production of inflammatory chemicals (cytokines) by immune cells. This action of bromelain suppresses the migration of white blood cells into areas of inflammation. As a result, bromelain helps damp down pain, stiffness and swelling in conditions as wide-ranging as osteoarthritis, sinusitis, ulcerative colitis, urinary tract infections and immune skin conditions.
Bromelain is popular among athletes for reducing delayed-onset muscle soreness, and for treating sprains and strains.
Bromelain has also been found to reduce platelet clotting in laboratory tests and may have a similar blood-thinning action to aspirin but without the side effects, and without increasing the risk of bleeding.
Bromelain for knee pain
Bromelain’s anti-inflammatory, pain-killing action helps to relieve joint pain and swelling.
Treatment with bromelain for 3 to 4 weeks can reduce pain and swelling due to mild acute knee pain due to injuries. When taken longer term, bromelain can reduce the pain of hip or knee arthritis.
In 40 people with mild-to-moderate knee osteoarthritis, taking bromelain tablets (500 mg per day for 16 weeks) was as effective as taking the non-steroidal anti-inflammatory drug, diclofenac (100 mg/day). There were no differences in pain, stiffness and physical function scores between bromelain and diclofenac at either 4 weeks or 16 weeks.
Bromelain was well tolerated but two of those taking diclofenac had to stop treatment due to side effects. The researchers concluded that bromelain was as effective as diclofenac in reducing symptoms of mild-to-moderate knee osteoarthritis after 4 weeks treatment.
Bromelain for healing
Bromelain helps to reduce the pain, swelling and inflammation associated with injuries such as bruising, sprains, minor wounds, surgery and sun burn. Bromelain is sometimes recommended before liposuction to reduce post-operative swelling and bruising, and as a supplement to take after childbirth to boost healing.
A study involving 45 people undergoing surgery to remove an impacted third molar (under local anesthetic) found that bromelain was as effective as diclofenac for pain relief, and did not increase the risk of bleeding.
Bromelain for sinusitis
Bromelain is a traditional treatment for sinusitis as it can reduce inflammation, pain and swelling as well as helping to thin mucus and reduce excess phlegm.
In people with chronic inflammation of the nose and sinuses (rhinosinusitis) taking bromelain improved symptoms at a daily dose of six 500mg tablets (total 3g per day) with no side effects.
Another study involving 116 children with sinusitis found that adding bromelain to standard treatment led to a faster recovery (within 6.6 days compared with 8 days) in those receiving standard therapy alone.
Bromelain for delayed onset muscle soreness (DOMS)
Bromelain is widely taken to reduce exercise-induced muscle damage and inflammation, and to enhance exercise recovery.
Bromelain was tested in 15 highly trained cyclists taking part in a six-day race. They took bromelain (1000 mg a day) or placebo across six days of competitive racing. Those taking bromelain had reduced subjective feelings of fatigue, and there was a trend for bromelain to maintain testosterone levels during the race period.
A typical dose for bromelain is 500mg once a day. Higher doses of 500mg taken three times a day (and even up to 6 times a day) have been used in clinical trials.
Bromelain side effects
Bromelain has a blood thinning action that may enhance bleeding time by making platelets less sticky. However, even when bromelain was combined with low molecular weight heparin in 260 patients undergoing hip and knee surgery, bromelain did not increase the risk of haemorrhage.
Some surgeons and anaesthetists prefer you not to take bromelain before or after surgery, so always check first.
In rare cases, allergic reactions have occurred to bromelain.
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