Bromelain This fact sheet provides basic information about bromelain— common names, usefulness and safety, and resources for more information.
Common Names—bromelain, pineapple extract Latin Name for the Pineapple Plant—Ananas comosus L. Background •
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• © Steven Foster
Bromelain is a mixture of enzymes found in the pineapple plant. Pineapple is native to the Americas but is now grown throughout the world in tropical and subtropical regions. Historically, natives of Central and South America used pineapple for a variety of ailments, such as digestive disorders. Currently, bromelain is used as a dietary supplement for nasal swelling and inflammation, osteoarthritis, cancer, poor digestion, and muscle soreness. Topical (applied to the skin) bromelain is used for wounds and burns. Bromelain is obtained from the stem or fruit of the pineapple. It is sold in the form of a powder, cream, tablet, or capsule, and it may be used alone or in combination with other ingredients.
How Much Do We Know? •
There have been several studies on the use of bromelain for nasal swelling and inflammation and for removing dead skin from burns. Little research has been done on other uses of bromelain.
What Have We Learned? •
• U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary and Integrative Health
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A systematic review of the evidence indicates that bromelain is helpful in relieving symptoms of acute nasal and sinus inflammation when used in combination with standard medications. Research in human and animal studies has found that topical bromelain preparations may help remove dead skin from burns. However, not enough evidence exists to show whether topical bromelain helps to treat burns and other wounds. There is conflicting evidence about whether bromelain, alone or in combination with other ingredients, is helpful for osteoarthritis and for muscle soreness after exercise.
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There is not enough evidence to determine if bromelain is effective for the other conditions for which it has been used, including cancer and gastrointestinal problems. NCCIH-funded research is examining bromelain for inflammatory conditions and asthma.
What Do We Know About Safety? • •
There have been some reports of gastrointestinal problems, increased heart rate, and menstrual problems in people who have taken bromelain orally. Allergic reactions may occur in individuals who are sensitive or allergic to pineapples or who may have other allergies.
Keep in Mind •
Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care. For tips about talking with your health care providers about complementary health approaches, see NCCIH’s Time to Talk campaign at nccih.nih.gov/timetotalk.
For More Information Visit the NCCIH Web site at nccih.nih.gov and view Using Dietary Supplements Wisely (nccih.nih.gov/health/supplements/wiseuse.htm). NCCIH Clearinghouse Toll-free in the U.S.: 1-888-644-6226 TTY (for deaf and hard-of-hearing callers): 1-866-464-3615 E-mail: info@nccih.nih.gov PubMed® Web site: www.ncbi.nlm.nih.gov/pubmed NIH Office of Dietary Supplements Web site: ods.od.nih.gov NIH National Library of Medicine’s MedlinePlus Bromelain Listing: www.nlm.nih.gov/medlineplus/druginfo/natural/895.html
Key References Brien S, Lewith G, Walker AF, et al. Bromelain as an adjunctive treatment for moderate-to-severe osteoarthritis of the knee: a randomized placebo-controlled pilot study. QJM: Monthly Journal of the Association of Physicians. 2006;99(12):841-850. Brien S, Lewith G, Walker A, et al. Bromelain as a treatment for osteoarthritis: a review of clinical studies. Evidence-Based Complementary and Alternative Medicine. 2004;1(3):251-257. Bromelain Monograph. Alternative Medicine Review. 2010;15(4):361-368. Bromelain. In: Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:33-35. Bromelain. Natural Medicines Comprehensive Database Web site. Accessed at naturaldatabase.com on June 10, 2014.
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Bromelain (Ananas comosus, Ananas sativus). Natural Standard Database Web site. Accessed at www.naturalstandard.com on June 10, 2014. Guo R, Canter PH, Ernst E. Herbal medicines for the treatment of rhinosinusitis: a systematic review. Otolaryngology—Head and Neck Surgery. 2006;135(4):496-506. Miller PC, Bailey SP, Barnes ME, et al. The effects of protease supplementation on skeletal muscle function and DOMS following downhill running. Journal of Sports Sciences. 2004;22(4):365-372. Orsini RA. Bromelain. Plastic and Reconstructive Surgery. 2006;118(7):1640-1644. Stone MB, Merrick MA, Ingersoll CD, et al. Preliminary comparison of bromelain and ibuprofen for delayed onset muscle soreness management. Clinical Journal of Sport Medicine. 2002;12(6):373-378.
This publication is not copyrighted and is in the public domain. Duplication is encouraged. NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH. National Institutes of Health ♦♦♦ U.S. Department of Health and Human Services
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D493 Created August 2014 Updated January 2015