Bromelain is an anti inflammatory enzyme derived from the pineapple plant
and is one of a group of enzymes capable of digesting protein (proteolytic
enzymes).
Numerous studies, mostly on animals, have demonstrated
its effectiveness in conditions ranging from sinusitis to cardiovascular
disease. In humans, double-blind, placebo-controlled trials have shown
bromelain to be very useful in treating facial bruising (in boxers) as
well as in the treatment of symptoms associated with sinusitis. The German
E Commission acknowledges the use of bromelain for acute postoperative and
post-traumatic conditions of swelling, especially of the nasal and
paranasal sinuses.
In addition to the anti-inflammatory properties,
bromelain is often used as a digestive aid for breaking down proteins. It
is widely believed that most orally ingested enzymes are destroyed by the
digestive juices prior to being absorbed. However, there is evidence that
significant amounts of bromelain can be absorbed intact.
The protease enzymes that are extracted from the stem and fruit of
pineapples are called Bromelain. The commercial supplement is usually
obtained only from the stem of the pineapple, which contains a higher
concentration of the enzymes than the fruit.
The German E Commission acknowledges the use of bromelain for acute
postoperative and post-traumatic conditions of swelling, especially of the
nasal and paranasal sinuses. Traditional use of bromelain as a digestive
aid is more common as enzymatic and anti-inflammatory actions are cited as
reasons for efficacy.
Bromelain is a mixture of protein processing
enzymes that aids in digestion while enhancing the absorption of nutrients
from food and supplements. Enzymes are the key in digestion which causes
the chemical breakdown of foods. This enzymatic action occurs in four
areas of the body: the salivary glands, the stomach, the pancreas and the
wall of the small intestines.
Bromelain, a proteolytic enzyme,
breaks down and digests foods. Specifically, it has the ability to digest
fat, thereby making it an excellent supplement to aid in weight loss.
Bromelain seems to travel to any place in the body with excess fat and
digest the fatty cells. In addition to breaking down fats, bromelain
dissolves damaged protein (scar tissue) and speeds the healing rate of
bruises.
There are various products available which can help
relieve gastric juices, including glutamic acid which supplies
hydrochloric acid, lactobacillus acidophilus which provides friendly
bacteria to help restore the intestinal flora, and various digestive
enzyme formulations required for proper digestive
functions.
It has been researched that Bromelain exerts a wide
variety of benefic effects on sports injuries, including reducing
inflammation in cases of injury or trauma and prevention of swelling after
trauma. Studies show that in boxers who have used bromelain all signs of
bruising cleared completely within four days.
Bromelain
can prevent abnormal high levels of fibrinogen that can cause
blood clots to form spontaneously and lead to heart attack.
Bromelain is a mixture of protein digesting enzymes from
pineapple. The effectiveness of bromelain is evaluated on its ability to
clot milk. For most indications, the recommended MCU's range is 1200 to
1800.(15) Bromelain is absorbed orally and experiments with dogs resulted
in peak levels at 10 hours, while detectable levels were still found after
48 hours. There is good evidence that in animals and humans up to 40% of
an oral dose of bromelain is absorbed in tact.(15)
The most
commonly associated use of bromelain is for assisted protein digestion due
to pancreatic insufficiency. This condition can lead to poor protein
digestion, malabsorption of dietary protein, and intestinal putrefaction
of undigested protein with disturbed intestinal effects. In the older
person, poor protein absorption may contribute to immune shortfalls in
antibodies, since maintaining optimal amounts of plasma amino acids is
required for timely antibody production. Furthermore, chronic putrefaction
by-products may also overload the immune system. It may be possible for
some food allergies to stem from undigested protein particles that are
able to gain systemic distribution.
Bromelain is a safe supplement
that can be used at meal times to evaluate its usefulness in enhanced
protein digestion, and continued if there are beneficial effects.
Pancreatic insufficiency may present greater digestion challenges than can
be corrected by bromelain alone, thus in some cases lipase and amylase
enzymes may also be required. Beyond a digestive role, bromelain is a
natural agent for safely modulating key factors that drive local
inflammation, and is used in cases of work and sport injury, sprains,
strains, arthritis, and other inflammatory conditions.(15) Tissue injury
results in elevated kinin levels and formation of fibrin. Fibrin is able
to promote local inflammation by forming a
matrix barrier that isolates the affected tissue area, limiting site
drainage and contributing to edema.
Bromelain enhances plasmin's
fibrinolytic action for modulating exaggerated fibrin effects, thus
helping to manage the degree of inflammation discomfort. Kinin also
contributes to the discomfort of inflammation by increasing vascular
permeability, also contributing to edema. Furthermore, kinins magnify
pain. By decreasing kinin levels, bromelain exerts a significant
modulating effect over the pain and the course of local inflammation.
Other inflammatory regulatory agents like prostaglandins are favorably
modulated by bromelain.(15)
In arthritis, its anti-inflammatory effects are often enhanced
with curcumin.(15,16) Compared against phenylbutazone, curcumin
demonstrates its own ability for managing the morning stiffness, walking
time, and joint swelling of rheumatoid arthritis.(18) Bromelain is
especially effective in combination with curcumin in reducing the need for
corticosteroids in RA.(15) Bromelain has been successfully used to manage
thrombophlebitis and deep vein thrombosis, as well as cellulites, bruises,
and edema.(15) Double blinded clinical investigations have demonstrated
that bromelain is able to reduce all of the inflammatory symptoms of
thrombophlebitis, including pain, edema, redness, tenderness, elevated
skin temperature, and disability.(15, 19, 20)
Better management of
varicose veins may also be afforded by bromelain, which enhances plasmin's
fibrinolytic action. In part, varicose veins are associated with fibrin
deposits, due to insufficient plasminogen activator from the vein
endothelial wall. When plasmin levels are inadequate, a balanced
fibrinolytic action fails to effectively modulate fibrin homeostasis,
contributing to the appearance of the varicose hard lumpy look.(15, 16)
Various claims are made for the value of bromelain supplementation, but
much of the research underpinning these claims was carried out in the
1960s and 1970s, and there are almost no well-controlled human studies.
Bromelain has been associated with improvement in symptoms of sinusitis,
acceleration of wound healing, potentiation of antibiotic action, healing
of gastric ulcers, treatment of inflammation and soft tissue injuries,
reduction in severity of angina, reduction in sputum production in
patients with chronic bronchitis and pneumonia and decrease in symptoms of
thrombophlebitis.(1)
Sinusitis
Two double-blind,
placebo-controlled studies showed that bromelain 160 mg (400 000 units)
could reduce some symptoms of sinusitis.(2,3) However, headache was not
improved in either study.
Musculoskeletal Injuries
In
a double-blind, placebo-controlled trial,(4) 146 boxers with bruises to
the face and haematomas to the eyes, lips, ears, arms and chest received
either 160 mg bromelain daily or placebo for 14 days. At day 4, 78% of the
bromelain treated group were completely cured of their bruises compared
with 15% of the placebo group. However, this result was not tested for
statistical significance.
Surgical
Procedures
Bromelain has been reported in at least two
studies(5,6) to reduce the degree and duration of swelling and oral pain
with oral surgery. However, one study was not controlled and the other had
no statistical analysis.
Antibacterial
Bromelain
could be useful an antidiarrhoeal agent. In an in vitro study(7) bromelain
was shown to prevent intestinal fluid secretion mediated by Escherichia
coli and Vibrio cholera, and in other studies(8,9) to protect piglets from
diarrhoea. However, there are no human studies to
date.
Cardiovascular Disease
Bromelain has been
reported to reduce the severity of angina(10) and several in vitro
studies(11,12) have demonstrated that bromelain reduces platelet
aggregation.
Ulcerative Colitis
A letter from two US
consultants(13) stated that two patients with ulcerative colitis achieved
complete clinical and endoscopic remission after initiation of therapy
with bromelain.
Cystitis
One double-blind study in
humans revealed that bromelain was effective in treating non-infectious
cystitis.(14)
Conclusion
Many claims have been made
for bromelain, based largely on studies conducted during the 1960s and
1970s. Many of the published trials are uncontrolled human studies or
animal or in vitro studies, and well-controlled clinical trials are
required to establish the role of bromelain as a potential supplement.
No problems have been reported, but based on the potential pharmacological
activity of bromelain, i.e. that it may inhibit platelet aggregation,
bromelain should be used with caution in patients with a history of
bleeding or haemostatic disorders.
Hypersensitivity to
bromelain.
Those allergic to pineapple should use with caution.
Bromelain is inhibited by oxidizing agents like
hydrogen peroxide, methyl bromide, and iodoacetate, and by metal ions of
lead, mercury, cadmium, copper, and iron.(15) Magnesium and cysteine
activate bromelain.(15)
Doses of bromelain as high as nearly 2000 mg have been
given with no adverse side effects, and there is no established LD50, even
when using up to10 grams per kilogram of body weight.(15)
Chronic use appears to be well tolerated, but idiosyncratic allergy may be
possible.
Possible but unconfirmed reactions may include nausea,
vomiting, diarrhea, metrorrhagia, and menorrhagia.(15,17)
1. Anonymous. Bromelain. Altern Med Rev 1998; 3: 302-308. 2. Ryan RE.
A double-blind clinical evaluation of bromelains in the treatment of acute
sinusitis. Headache 1967; 7: 13-17. 3. Seltzer AP. Adjunctive use of
bromelains in sinusitis: A controlled study. Eye Ear Nose Throat Mon 1967;
46: 1281-1288. 4. Blonstein JL. Control of swelling in boxing
injuries. Practitioner 1960; 185: 78. 5. Tassman GC, Zafran JN, Zayon
GM. Evaluation of a plant proteolytic enzyme for the control of
inflammation and pain. J Dent Med 1964; 19: 73-77. 6. Tassman GC,
Zafran JN, Zayon GM. A double blind crossover study of a plant proteolytic
enzyme in oral surgery. J Dent Med 1965; 20: 51-54. 7. Mynott TL,
Guandalini S, Raimondi F, et al. Bromelain prevents secretion caused by
Vibrio cholera and Escherichia coli enterotoxins in rabbit ileum in vitro.
Gastroenterology 1997; 113: 175-184. 8. Mynott TL, Luke RKJ, Chandler
DS. Oral administration of protease inhibits enterotoxigenic Escherichia
coli (ETEC) activity in piglet small intestine. Gut 1996; 38: 28-32.
9. Chandler DS, Mynott TL. Bromelain protects piglets from diarrhoea
caused by oral challenge with K88-positive enterotoxigenic Escherichia
coli. Gut 1998; 43: 196-202. 10. Nieper HA. Effect of bromelain on
coronary heart disease and angina pectoris. Acta Med Empirica 1978; 5:
274-278. 11. Heinicke RM, Van der Wal M, Yokoyama MM. Effect of
bromelain (Ananase) on human platelet aggregation. Experientia 1972; 28:
844-845. 12. Metzig C, Grabowska E, Eckert K, et al. Bromelain
proteases reduce human platelet aggregation in vitro, adhesion to bovine
endothelial cells, and thrombus formation in rat vessels in vivo. In Vivo
1999; 13: 7-12. 13. Kane S, Goldberg MJ. Use of bromelain for mild
ulcerative colitis [letter]. Ann Intern Med 2000; 132: 680. 14. Lotti
T, Mirone V, Imbimbo C, et al. Controlled clinical studies of nimesulide
in the treatment of urogenital inflammation. Drugs 1993; 46 (suppl. 1):
144-146. 15. Murray, Michael T., The Healing Power of Herbs, Prima
Publishing, Rocklin, CA, 1995 16. Whitaker, Julian, Dr.
Whitaker's Guide to Natural Healing, Prima Publishing,
Rocklin, CA, 1995 17. Ananase (Rorer), In: Physicians
Desk Reference, Medical Economics Company, Oradell, NJ,
1982, p. 1645 18. Deodhar, S.D., et al, Preliminary
studies on antirheumatic activity of curcumin (diferuloyl
methane), Indian Journal of Medical Research, 71:632-634,
1980 19. Seligman, B., Bromelain: An anti-inflammatory
agent, Angiology, 13, 508-510, 1962 20. Seligman, B.,
Oral bromelains as adjuncts in the treatment of acute
thrombophlebitis, Angiology, 20, 22-26, 1969
Our thanks to the
following information resources: WholeheatlthMD.com,
Medicinescomplete.com, American Botanical Council (Herbalgram.org),
VitaminsDiary.com, Vitacost.com.
Botanical Latin Name: Ananus comosus Plant Part: Pineapple Stem
These statements have not been evaluated by the Food and Drug Administration (FDA). Products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
