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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Bextra® that were later withdrawn due to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.
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
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 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.
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
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
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-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.
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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