Bromelain's Many Applications in Human Health
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Reprinted with permission of Life
Extension®
Powerful Relief from Inflammatory Pain and
Other Age-Related Disorders
Those suffering joint discomforts have endured horrific side
effects from FDA-approved drugs. New human studies from Europe
document how a low-cost plant enzyme can significantly relieve
joint tenderness and inflammation.
Scientifically reviewed by: Juanita Enogieru, MS, RD/N, in
May 2022. Written by: Steve Goodman.
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If you ever wonder why
pharmaceutical companies (and their collaborators at the
FDA) are so biased against dietary supplements, the
article you are about to read provides an eye-opening
answer.
Americans have long been
deceived to think that prescription drugs are the only
effective remedies for common age-related disorders.
Data about natural therapies remains largely censored,
as widespread dissemination of this knowledge would
reduce demand for highly profitable arthritis
medications.
While pharmaceutical companies
earned billions of dollars selling anti-inflammatory
drugs, the side effects caused by this class of
medications sent millions of Americans to hospitals and
mortuaries. As body counts mounted (and patents
expired), drug companies brought out so-called “safer”
arthritis drugs like Vioxx® and Bextra® that were later
withdrawn due to lethal adverse reactions.
Virtually all non-steroidal
anti-inflammatory drugs (NSAIDs) now carry a blanket
warning about potential increased risks of heart attack
and stroke with their use.
During these sordid decades of
medical history, several natural alternatives have been
available that were shown to work as well as NSAID drugs
without the side effects. One of the most overlooked
anti-inflammatory nutrients, however, may be the plant
enzyme bromelain. Perhaps the incredibly low price of
bromelain has precluded even natural health enthusiasts
from recognizing its multi-faceted benefits.
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Over the past seven years,
several human clinical studies reveal that bromelain-based
formulations are as effective and potentially even more
effective than anti-inflammatory prescription drugs in
relieving pain and inflammation.
This article reveals recent
discoveries showing a low-cost natural alternative to
expensive prescription anti-inflammatory drugs that
could help thousands of Americans suffering from pain
and inflammation each year.
Back in 1982, Durk Pearson and
Sandy Shaw wrote about the benefits of a plant enzyme
called bromelain in their best-seller book Life
Extension. Derived from pineapple stems, bromelain is
finally gaining recognition for its natural
pain-relieving effects. Scientists have recently shown
that bromelain provides powerful anti-inflammatory
properties without the problems associated with drug
therapy.1-3
Pain reliever drugs can be
prescribed or bought over-the-counter, but chronic use
can lead to side effects such as gastric ulcers and
liver-kidney damage. Bromelain has long been known to
contain powerful proteolytic (protein-digesting)
enzymes, which are beneficial in digestive enhancement.
New studies reveal that enteric-coated bromelain
provides potent systemic anti-inflammatory effects.
Athletes are increasingly
turning to bromelain to help manage sports injuries, and
those undergoing surgery are using it to speed their
recovery time.4,5 Bromelain also holds further promise
in managing varied conditions such as sinusitis and
inflammatory bowel disease.6,7
In addition to its
potent anti-inflammatory effects, scientists have recently
discovered that bromelain exhibits tumor-fighting properties
which are now being explored in the hope of finding a new
anti-cancer drug.8
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Reducing the Pain of Osteoarthritis
Poor joint health (osteoarthritis) is a
widespread cause of disability in the United States, especially
in the elderly. Joint pain prompts many of us to reach for
prescription drugs or over-the-counter non-steroidal
anti-inflammatory drugs (NSAIDs) to relieve the pain. However,
the withdrawal of prescription drugs, such as Vioxx® and Bextra®
from the market after they were found to raise the risk of heart
attacks and stroke; and the fear of gastrointestinal side
effects from over-the-counter therapies, such as ibuprofen; pave
the way for nutritional remedies in supporting optimum joint
health.
Numerous studies have shown that
bromelain can be as effective as anti-inflammatory drugs for
dealing with the pain of osteoarthritis.1 Direct head-to-head
trials have demonstrated greater levels of improvement and
decreased dependency on pharmaceuticals with bromelain.
In a recent blinded study from Germany,
researchers divided 90 patients with painful osteoarthritis of
the hip into two groups: one half receiving an oral enzyme
preparation containing bromelain for six weeks, while the other
half received the anti-inflammatory drug diclofenac (sold under
the brand name Voltaren® and generic names). They found that the
bromelain preparation was as effective as diclofenac in standard
scales of pain, stiffness and physical function, and better
tolerated than the drug comparator. The researchers concluded,
“[the bromelain preparation] may well be recommended for the
treatment of patients with osteoarthritis of the hip with signs
of inflammation as indicated by a high pain level.”2
Another study comparing a standardized
commercial enzyme preparation containing bromelain with
diclofenac reached the same conclusion. The study reported that
the supplement containing bromelain (90 mg, three times daily)
to be as effective as diclofenac (50 mg, twice daily) in
improving the symptoms of osteoarthritis of the knee. Patients
reported comparable reductions in joint tenderness, pain and
swelling, and improvement in range of motion at the end of the
study. The investigators found bromelain to be as good as
diclofenac on a standard pain assessment scale and to be better
than the drug in reducing pain at rest (by 41% for bromelain
versus 23% for the drug), improving restricted function (by 10%
for bromelain versus 0% for the drug), being rated by more
patients in improving symptoms (24% for bromelain versus
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19% for
the drug), and being evaluated by more physicians as having good
efficacy (51% for bromelain versus 37% for the drug). In
summary, the investigators determined bromelain to be an
effective and safe alternative to NSAIDs such as diclofenac for
painful osteoarthritis.3
In further research from the United
Kingdom, a three-month study looked at the dose-dependent
effects of bromelain, either 200 mg or 400 mg a day in
volunteers with mild acute knee pain. Pain evaluation was based
on patient symptom scores, which were reduced by 41% in the 200
mg bromelain group and by 59% in those receiving 400 mg of
bromelain, indicating a dose-response relationship. This was
also observed for scores of stiffness and physical function,
which decreased significantly in the higher-dose bromelain group
compared with those receiving 200 mg. The researchers also noted
that overall psychological well-being was significantly improved
in both bromelain groups, leading to their conclusion that this
natural therapy may be effective in improving general well-being
as well as symptoms in otherwise healthy adults suffering from
mild knee pain.10
Together, these findings reveal that
bromelain may provide safe, effective relief from acute and
chronic joint pain caused by arthritis and other conditions.
WHAT YOU NEED TO KNOW: BROMELAIN
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Growing evidence of the cardiovascular
and gastrointestinal risks associated with non-steroidal
anti-inflammatory (NSAID) drugs has left many people seeking
safe, effective strategies for relieving pain and inflammation.
Derived from the pineapple plant, the
protein-digesting enzyme bromelain demonstrates powerful effects
in alleviating pain, swelling, and inflammation.
In clinical trials, bromelain-based
formulations were more effective than an NSAID drug in relieving
arthritis pain. Supplementing with bromelain-based formulations
after injury or surgery also speeds healing and reduces pain.
Bromelain hastens the resolution of
sinusitis, and shows promise in fighting inflammatory bowel
disorders. Preliminary studies suggest that bromelain may even
help fight cancer.
Experts suggest consuming bromelain
between meals to capture its anti-inflammatory benefits. To
promote healthy digestive function, take bromelain with meals.
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Healing Injuries
Bromelain’s anti-inflammatory properties
have led to its main recognized medicinal use – as an effective
pain reliever and healing aid in the treatment of minor
injuries, such as sprains, strains, and other trauma.
Bromelain’s efficacy was studied in an
open-case observation study of patients who had suffered blunt
trauma to the musculoskeletal system. An orthopedist treated 59
subjects with conventional therapeutics plus bromelain for one
to three weeks. Bromelain significantly reduced the patients’
swelling, pain at rest and in motion, and tenderness at the site
of injury. Not only was bromelain effective, it was also well
tolerated.11
Speeding Post-Surgical Healing
In addition, bromelain may offer
important support for healing and pain relief after surgery.
Investigators administered a combination of bromelain, trypsin,
and rutoside (rutin) to patients for two weeks following surgery
to fix fractured long bones. Compared with surgical patients who
did not receive the supplement, the bromelain-treated group
showed a remarkable reduction in postoperative swelling.
Additionally, the supplemented individuals required less pain
medication during their recovery period, indicating a
significant analgesic effect and more rapid and comfortable
recovery.5
Sinus Support
Scientists have also investigated the
efficacy of bromelain in offering welcome relief from sinusitis,
the painful inflammation of the sinus cavities typically caused
by bacterial, fungal, or viral infection. Sinusitis often
follows an upper respiratory infection and can manifest with
symptoms such as nasal congestion and discharge, postnasal drip,
headache, cough, and sore throat.
Researchers compared bromelain with
standard therapies, both alone and in combination, in 116
children under the age of 11 suffering from acute sinusitis.
Remarkably, patients treated with bromelain alone experienced a
recovery that was significantly faster than patients in any of
the other groups.6
These findings confirmed those from an
earlier study showing that bromelain resolved inflammation of
the nasal mucosa in 85% of adults receiving bromelain, while
only 40% of adults receiving placebo showed a similar
improvement.12
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A recent research review noted that
bromelain may offer benefits for sinus health by thinning nasal
secretions and inhibiting the production of inflammatory
prostaglandins.13 In fact, the German Commission E has approved bromelain for the treatment of sinus and nasal swelling
following ear, nose, and throat surgery or trauma.
Inflammatory Bowel Disease
Preliminary findings suggest that
bromelain may also have applications in the management of the
inflammatory bowel disease ulcerative colitis, which is
characterized by abdominal cramping and pain, diarrhea, and
weight loss.
In 2000, the Annals of Internal Medicine
published an anecdotal report of two patients suffering from
ulcerative colitis who had not achieved significant improvement
with conventional therapy, but benefitted from bromelain
supplementation. Bromelain supplementation helped relieve
symptoms such as frequent diarrhea; and follow-up endoscopy
studies revealed healing of the gastrointestinal mucosa.7
This encouraging report prompted
researchers at North Carolina’s Duke University to explore
bromelain’s effects on an experimental mouse model of
inflammatory bowel disease. Animals treated with orally
administered bromelain beginning at five weeks of age displayed
decreased incidence and severity of spontaneous colitis.
Bromelain supplementation also decreased the clinical and
histological manifestations of inflammatory bowel disease in
animals with existing colitis. The investigators concluded that
their findings justified further studies of bromelain in the
management of inflammatory bowel disease.14
Skin Disorders
Bromelain is also effective in treating a
skin disorder called pityriasis lichenoides chronica, which is
characterized by the appearance of long-lasting, asymptomatic
skin lesions. The disease has no known cause and treatment
outcomes have proved unpredictable and non-optimal.15 In a
recent study, investigators treated eight patients who had this
disorder with bromelain for three months. At the end of
the treatment period, all patients showed complete clinical
recovery with no adverse effects. And although two patients
relapsed five to six months after stopping therapy, they
responded again to another brief cycle of therapy. The
investigators concluded that the efficacy of bromelain “could be
related to its anti-inflammatory, immuno-modulatory, and/or
antiviral properties.”15
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Fighting Cancer
Perhaps the most exciting news about
bromelain comes from the front lines of cancer research.
Several studies suggest that bromelain may hold an
important role as a novel anticancer therapy.
Scientists employed an animal model
system to look at bromelain’s ability to fight several
different types of cancer. First, laboratory animals
were inoculated with cancer cells derived from bone,
breast, blood (leukemia), lung, or skin (melanoma).
Next, the scientists administered bromelain to the
animals. The animals were compared with similar animals
that were also inoculated with tumor cells, but did not
receive bromelain. Bromelain significantly increased the
animals’ survival rates from all the cancers except
melanoma. Furthermore, bromelain significantly reduced
the number of lung metastases in the animals inoculated
with lung cancer cells, suggesting that it might play an
important role in fighting cancer growth.8
A recent study conducted in mice
further points to bromelain’s anticancer effects. Scientists utilized a mouse model of cancer, in which
skin tumors were induced by the application of two toxic
chemicals. Treating the animals with bromelain prior to
the two cancer-inducing chemicals delayed the onset of
tumor development, reduced the cumulative number of
tumors, tumor volume, and the average number of tumors
per mouse. The scientists believe that bromelain
protected against cancer by inducing proteins related to
apoptosis (programmed cell death) and by inhibiting
nuclear factor-kappab (NF-kb), a proinflammatory protein
involved in cancer and many other disease processes.16
While much remains to be learned
about bromelain’s applications in augmenting anticancer
therapy, scientists have proposed that bromelain may
work through several mechanisms; including boosting the
immune system’s anticancer activity, inhibiting tumor
metastasis (spread to other locations), and decreasing
tumor growth and invasive potential.17
Supplementing with Bromelain
The evidence of bromelain’s
efficacy is based on studies of its use as nutritional
supplement, extracted from the stems of the pineapple
plant. Although pineapple is a healthful food, it is not
practical to acquire therapeutic amounts of bromelain
merely by consuming pineapple fruit.
A wide range of dosing
recommendations exists for bromelain. For adults, the
German Commission E recommends 80-320 mg of bromelain,
two to three times per day.18 Other scientists have
noted that the typical oral bromelain dosage is within
the range of 500-1,000 mg per day, with up to 2,000
mg/day commonly used.13 For delayed-
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onset muscle soreness
following an intense exercise regime, 300 mg of
bromelain three times daily has been used.19
Scientists have noted that 200-400 mg of bromelain
daily for 30 days is effective for mild acute knee pain.10
The protein-digesting potency of bromelain products is
often measured in gelatin-digesting units (GDU) or in
milk-clotting units (MCU).
Experts generally advise
consuming enteric-coated bromelain supplements to
benefit from its anti-inflammatory effects. To enhance
food digestion, non-coated bromelain tablets, powder, or
capsules can be consumed along with other digestive
enzymes, such as lipase and amylase, at meal time.
BROMELAIN BASICS
The pineapple plant has been
used for centuries by many cultures for its medicinal
qualities. In 1891, a Venezuelan chemist named Vicente
Marcano isolated the enzyme bromelain from the pineapple
fruit. It was not until 1957, when high amounts of the
compound were found to be concentrated in the stem of
the pineapple, that bromelain became commercially
available as an herbal therapeutic.9
Bromelain is a general name
for a family of sulfur-containing, proteolytic
(protein-digesting) enzymes obtained from the pineapple
plant. While bromelain is present in both the fruit and
the stem of the pineapple, most commercially available
bromelain today is extracted from the stem of the
pineapple.
Safety Cautions
People with known allergies to
pineapples or pineapple juice should not take bromelain.
According to the National Library of Medicine, bromelain
could theoretically increase the risk of bleeding when
combined with drugs or natural agents that increase the
risk of bleeding; such as aspirin, warfarin (Coumadin®),
clopidogrel (Plavix®), ibuprofen (Advil®), ginkgo, or
garlic. In theory, bromelain could increase the
anti-inflammatory effects of nonsteroidal
anti-inflammatory drugs (NSAIDs) and could cause a
larger than expected fall in blood pressure from
angiotensin-converting enzyme (ACE) inhibitors such as
captopril (Capoten®).18
Human studies suggest that
bromelain may increase the absorption of some
antibiotics, such as amoxicillin and tetracycline,
increasing their levels in the body. Individuals with
existing medical conditions and those who use
medications should consult a physician before beginning
bromelain supplementation.18
Conclusion
Bromelain’s potent
anti-inflammatory actions hold a broad spectrum of
applications in human health. Not only can bromelain
help relieve the pain and inflammation of sprains,
injuries, arthritis, and surgery, but intriguing
evidence points to its value in alleviating sinusitis
and inflammatory bowel disease and even complementing
anticancer therapies. This versatile, effective
supplement promises to be a useful addition to every
family’s medicine cupboard.
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References
1. Brien S, Lewith G, Walker A, Hicks SM,
Middleton D. Bromelain as a treatment for osteoarthritis: a
review of clinical studies. Evid Based Complement Alternat Med.
2004 Dec;1(3):251-7.
2. Klein G, Kullich W, Schnitker J,
Schwann H. Efficacy and tolerance of an oral enzyme combination
in painful osteoarthritis of the hip. A double-blind, randomised
study comparing oral enzymes with non-steroidal
anti-inflammatory drugs. Clin Exp Rheumatol. 2006
Jan-Feb;24(1):25-30.
3. Akhtar NM, Naseer R, Farooqi AZ, Aziz
W, Nazir M. Oral enzyme combination versus diclofenac in the
treatment of osteoarthritis of the knee—a double-blind
prospective randomized study. Clin Rheumatol. 2004
Oct;23(5):410-5.
4. Kerkhoffs GM, Struijs PA, de Wit C,
Rahlfs VW, Zwipp H, van Dijk CN. A double blind, randomized,
parallel group study on the efficacy and safety of treating
acute lateral ankle sprain with oral hydrolytic enzymes. Br J
Sports Med. 2004 Aug;38(4):431-5.
5. Kamenícek V, Holán P, Franĕk P.
Systemic enzyme therapy in the treatment and prevention of
post-traumatic and postoperative swelling. Acta Chir Orthop
Traumatol Cech. 2001;68(1):45-9.
6. Braun JM, Schneider B, Beuth HJ.
Therapeutic use, efficiency and safety of the proteolytic
pineapple enzyme Bromelain-POS in children with acute sinusitis
in Germany. In Vivo. 2005 Mar-Apr;19(2):417-21.
7. Kane S, Goldberg MJ. Use of bromelain
for mild ulcerative colitis. Ann Intern Med. 2000 Apr
18;132(8):680.
8. Baez R, Lopes MT, Salas CE, Hernandez
M. In vivo antitumoral activity of stem pineapple (Ananas
comosus) bromelain. Planta Med. 2007 Oct;73(13):1377-83.
9. Available at:
http://en.wikipedia.org/wiki/Bromelain. Accessed October 29,
2007.
10. Walker AF, Bundy R, Hicks SM,
Middleton RW. Bromelain reduces mild acute knee pain and
improves well-being in a dose-dependent fashion in an open study
of otherwise healthy adults. Phytomedicine. 2002 Dec;9(8):681-6.
11. Masson M. Bromelain in blunt injuries
of the locomotor system. A study of observed applications in
general practice. Fortschr Med. 1995 Jul 10;113(19):303-6.
12. Taub SJ. The use of bromelains in
sinusitis: a double-blind clinical evaluation. Eye Ear Nose
Throat Mon. 1967 Mar;46(3):361-2 passim.
13. Helms S, Miller A. Natural treatment
of chronic rhinosinusitis. Altern Med Rev. 2006
Sep;11(3):196-207.
14. Hale LP, Greer PK, Trinh CT,
Gottfried MR. Treatment with oral bromelain decreases colonic
inflammation in the IL-10-deficient murine model of inflammatory
bowel disease. Clin Immunol. 2005 Aug;116(2):135-42.
15. Massimiliano R, Pietro R, Paolo S,
Sara P, Michele F. Role of bromelain in the treatment of
patients with pityriasis lichenoides chronica. J Dermatolog
Treat. 2007;18(4):219-22.
16. Kalra N, Bhui K, Roy P, et al.
Regulation of p53, nuclear factor kappab and cyclooxygenase-2
expression by bromelain through targeting mitogen-activated
protein kinase pathway in mouse skin. Toxicol Appl Pharmacol.
2007 Aug 23 [Epub ahead of print].
17. Maurer HR. Bromelain: biochemistry,
pharmacology and medical use. Cell Mol Life Sci. 2003
Aug;58(9):1234-45.
18. Available at:
http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-bromelain.html.
Accessed October 29, 2007.
19. Stone MB, Merrick MA, Ingersoll CD,
Edwards JE. Preliminary comparison of bromelain and ibuprofen
for delayed onset muscle soreness management. Clin J Sport Med.
2002 Nov;12(6):373-8.
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