What Is It?
Bromelain is the name of a group of powerful protein-digesting, or proteolytic, enzymes that are found in the pineapple plant (Ananas comosus). Discovered in 1957, and widely studied since then, bromelain is particularly useful for reducing muscle and tissue inflammation and as a digestive aid. Supplements are made from enzymes found in the pineapple stem.
Bromelain is a natural blood thinner and anti-inflammatory. It works by breaking down fibrin, a blood-clotting protein that can impede good circulation and prevent tissues from draining properly. Bromelain also blocks the production of compounds that can cause swelling and pain. When inflammation is reduced, blood can move more easily to a traumatized area, easing pain and speeding healing.
Specifically, bromelain may help to:
Treat sprains, strains, and muscle aches and pains. Bromelain reduces swelling, bruising, redness, and tenderness that can result from tissue injuries or muscle aches and pains, or from surgery. In a 1995 German study, 59 people with strains and torn ligaments were given bromelain for one to three weeks; researchers found that the supplement caused a significant reduction in swelling, tenderness, and pain, both at rest and during movement. The results were comparable to those of people taking NSAIDs such as aspirin. Bromelain also has an anti-inflammatory effect on the muscles and can help excess fluid drain from the site of a muscle injury.
Alleviate back pain and chronic joint pain associated with arthritis. In addition to easing the aching and stiffness of back muscles, bromelain also seems to relieve pain in chronically inflamed joints. It has been found that in some arthritis patients, smaller amounts of corticosteroids (such as prednisone) were needed when bromelain was taken at the same time.
Aid digestion and reduce heartburn. Bromelain can enhance the effect of such digestive enzymes as trypsin or pepsin (especially when the pancreas is producing insufficient amounts of them). Bromelain can also ease the pain of heartburn and lessen the effects of diarrhea when these conditions are caused by a shortage of digestive enzymes.
Reduce the swelling and pain of gout. In some studies, bromelain relieved the joint and tissue swelling and severe pain related to an attack of gout. If taken regularly, bromelain may also prevent recurrent gout attacks.
Ease chronic bronchitis, sinusitis, and respiratory allergies. In individuals with chronic bronchitis, bromelain has been shown to suppress cough and ease congestion. Patients with sinusitis and allergies that affect the sinuses have also responded to bromelain therapy; it helps reduce inflammation and fluid retention in the nasal membranes.
Relieve carpal syndrome tunnel. Bromelain reduces tissue swelling that causes the finger numbness, shooting pains, and weakness in the hand associated with this repetitive stress injury.
Lessen the swelling and accelerate the healing of cuts and scrapes, and insect bites and stings. The enzymes in bromelain reduce the inflammation of skin wounds, insect bites, and stings, and also promote healing.
Reduce the symptoms of eczema. Bromelain taken with the flavonoid quercetin can relieve the red and often intensely itchy rashes of eczema. Note: Bromelain has been found to be useful for a number of other disorders. For information on these additional ailments, see our Dosage Recommendations Chart for Bromelain.
–Bromelain’s activity is measured in GDUs (gelatin digesting units) or MCUs (milk clotting units). One GDU equals roughly 1.5 MCUs. To figure your bromelain dosage, use a product’s GDUs or MCUs as a guideline. Although milligram (mg) dosages are listed below, be aware that these amounts can vary greatly from brand to brand.
For inflammation, muscle and joint pain, and injuries: Take 500 mg three times a day between meals; this 1,500 mg should supply 6,000 GDU or 9,000 MCU daily.
For indigestion and heartburn: Take 500 mg three times a day with meals; this 1,500 mg should supply 6,000 GDU or 9,000 MCU daily.
For gout: During acute flare-ups, take 500 mg every three hours until the attack subsides. To prevent further gout attacks, decrease the bromelain to 500 mg twice a day (this 1,000 mg should supply 4,000 GDU or 6,000 MCU daily) and add 500 mg of quercetin twice a day. Quercetin reduces the high uric acid levels that can cause the inflammation and pain of gout; this flavonoid is more readily absorbed in combination with bromelain.
For upper respiratory infections, sinusitis, and allergies: Take 500 mg twice a day between meals; this 1,000 mg should supply 4,000 GDU or 6,000 MCU daily.
For carpal tunnel syndrome: During the acute phase, take 1,000 mg twice a day between meals until symptoms ease; this 2,000 mg should supply 8,000 GDU or 12,000 MCU daily. (During the acute phase, bromelain is most effective if combined with with 50 mg of vitamin B6 in 100 mg pills taken three times a day. Once symptoms subside, reduce the bromelain to 500 mg twice a day; this 1,000 mg should supply 4,000 GDU or 6,000 MCU daily.
For cuts and scrapes: Take 500 mg three times a day between meals for five days; this 1,500 mg should supply 6,000 GDU or 9,000 MCU daily.
For insect bites and stings: Take 500 mg three times a day between meals until symptoms decrease; this 1,500 mg should supply 6,000 GDU or 9,000 MCU daily.
For eczema: Take 500 mg of bromelain twice a day between meals (this 1,000 mg should supply 4,000 GDU or 6,000 MCU daily) and 300 mg of quercetin three times a day. Be sure to check out our Dosage Recommendations Chart for Bromelain, which lists therapeutic dosages for specific ailments at a glance.
Guidelines for Use
Take bromelain on an empty stomach (between meals), unless you’re using it as a digestive aid, in which case you should take it just before eating.
Check labels carefully. Products that list only weight (mg) but not activity units (GDUs or MCUs) may lack potency.
Consider combination products. Because bromelain enhances the effect of different compounds, for convenience they are sometimes sold together. Common pairings include bromelain and quercetin and bromelain and turmeric.
Use caution when combining bromelain with anticoagulants (blood thinners), such as enoxaparin or warfarin. This enzyme is a natural blood thinner and may increase the medication’s effect.
Note: For information on interactions with specific generic drugs, see our WholeHealth Chicago Drug/Nutrient Interactions Chart.
Possible Side Effects
Bromelain is generally considered safe, even at high doses.
Avoid taking if you have a active gastric or duodenal ulcer.
Some people have occasionally reported nausea, vomiting, diarrhea, excess menstrual bleeding, or skin rash when taking medicinal doses of bromelain.
Bromelain can cause an allergic reaction (red or itchy eyes, sneezing, running nose, irritated throat) in people who are sensitive to it.
Check with your doctor before taking bromelain if you’re on prescription anti-inflammatory medication.
Arthritis 500 mg 3 times a day between meals
Back Pain 500-1,000 mg (providing 1,000-2,000 GDU) 3 times a day between meals
Bronchitis 500 mg twice a day between meals
Carpal Tunnel Syndrome During acute phase, 1,000 mg 3 times a day until symptoms ease. When symptoms begin to subside, reduce dose to 500 mg twice a day. Take between meals.
Chronic Pain 500-1,500 mg 3 times a day between meals
Gout During acute flare-ups, 500-1,000 mg every 3 hours until the attack subsides. To prevent further attacks, 500 mg twice a day between meals with 500 mg quercetin twice a day.
Heartburn 500 mg 3 times a day with meals
Lupus 500-1,000 mg 3 times a day between meals
Muscle Aches and Pains 500 mg 3 times a day between meals
Sinusitis 500 mg 3 times a day between meals
Strains and Sprains 500 mg 3 times a day between meals
David Edelberg, M.D.
Bromelain is a natural anti-inflammatory that comes from pineapple, so you shouldn’t use bromelain if you’re allergic to that fruit. Bromelain blocks the production of compounds that can cause swelling and pain.
HOW IT HELPS BACK PAIN
I often suggest that patients keep a bottle of bromelain in a first aid kit. It can usually be beneficial any time you might take aspirin or Motrin. If your doctor is suggesting an NSAID for your back pain, for instance, consider substituting bromelain, either singly or in combination with other natural herbal anti-inflammatory agents, such as boswellia, yucca, devil’s claw, ginger, or turmeric.
WHAT TO LOOK FOR
The effectiveness of bromelain is measured in special units called MCUs (milk clotting units) or GDUs (gelatin digesting units). One GDU equals roughly 1.5 MCUs. Because milligram dosages of bromelain can vary from brand to brand, you need to make sure the product you buy has enough MCUs or GDUs to add up to the daily totals you need. As a rule of thumb, 1,500 mg of bromelain (that’s the fairly standard dose of 500 mg three times a day) should supply 6,000 GDU or 9,000 MCU daily. There are also a number of useful combination products that contain bromelain.
Take bromelain between meals for best absorption, unless you’re using it to aid digestion. The bottom line on bromelain is that it’s generally very safe. Remember, basically it’s only pineapple!
For product recommendations and orders from the Natural Apothecary click here or call 773-296-6700, ext. 2001.
David Edelberg, MD