Bromelain is one of those supplements that sounds almost too good to be true. A natural enzyme from pineapples that supposedly helps with digestion, reduces inflammation, speeds wound healing, and clears sinuses? The marketing claims are impressive. But what does the actual research say?

I’ve gone through the clinical studies to separate what’s reasonably supported from what’s mostly speculation. The picture that emerges is more nuanced than either the enthusiastic supplement sellers or the dismissive sceptics would have you believe.

What is bromelain?

Bromelain is a mixture of protein-digesting enzymes extracted from pineapples. Unlike most enzymes, which come from the fruit itself, commercial bromelain is typically extracted from the stem, where it’s more concentrated.

The term “bromelain” actually refers to a complex mixture containing multiple proteases (protein-breaking enzymes) along with phosphatase, glucosidase, cellulase, peroxidase, and various glycoproteins 1. The proteases are considered the most pharmacologically active components.

People have known about bromelain’s chemical properties since 1875. Its ability to break down proteins made it useful long before anyone thought about health supplements. The food industry uses it to tenderise meat. The beauty industry uses it in exfoliating products. The textile industry uses it to soften fibres.

What makes bromelain interesting from a supplement perspective is that it actually survives digestion reasonably well. Studies show it maintains its enzymatic activity after passing through the stomach and intestines, with a half-life of about 6 to 9 hours 2. Peak blood concentrations appear roughly an hour after ingestion.

This distinguishes bromelain from many other enzymes, which get denatured (destroyed) by stomach acid before they can do anything useful.

Where does bromelain come from?

Bromelain can technically be extracted from any part of the pineapple plant, including the fruit, stem, leaves, and skin. However, commercial supplements use stem bromelain almost exclusively because it’s far more concentrated than fruit bromelain.

The extraction process involves ultrafiltration, centrifugation, and freeze-drying (lyophilisation). Two-step fast protein liquid chromatography further purifies the compound. This purification matters because impurities like phosphatase and glucosidase can interfere with bromelain’s mechanisms of action.

If you’re wondering whether eating pineapple gives you the same benefits as taking supplements, the answer is probably not. Fresh pineapple contains relatively little bromelain compared to concentrated supplements, and most of it is in the stem that you’d normally throw away.

What are the potential benefits of bromelain?

1. May help with recovery after dental surgery

Having an impacted tooth removed is not a pleasant experience. Impacted teeth, which don’t erupt properly due to lack of space or wrong positioning, most commonly affect wisdom teeth (third molars). The surgery involves lifting soft tissue, which inevitably causes damage and swelling.

A meta-analysis of 6 randomised controlled trials involving 312 patients who had impacted lower wisdom teeth removed found that oral bromelain helped reduce postoperative pain and improved quality of life measures including eating ability, social functioning, and sleep quality 3. Patients taking bromelain also needed less pain medication on average.

However, bromelain didn’t significantly help with facial swelling or trismus (the medical term for when you can’t open your mouth properly due to muscle spasms).

My take: If you’re having wisdom teeth removed, bromelain seems worth considering for pain management. It’s not a miracle, but the evidence suggests modest benefits. I wouldn’t expect it to prevent swelling or stiffness, though.

2. Used clinically for burn wound debridement

This is where bromelain has the strongest clinical backing, though it’s used as a regulated medical product rather than a supplement.

Burn treatment requires removing dead tissue (eschar) before wounds can heal properly. Traditional methods involve surgical excision, which can damage healthy tissue. Bromelain-based products offer an enzymatic alternative.

A randomised controlled trial with 182 patients who had deep burns on their hands compared bromelain-based debridement (using a product called NexoBrid) against standard surgical care. The bromelain group had significantly less need for surgical wound excision and skin grafts, and fewer patients required urgent escharotomy (emergency cutting to relieve pressure) 4.

Worth noting: This application uses concentrated pharmaceutical-grade bromelain applied directly to burns under medical supervision. It’s not the same as taking oral supplements, and definitely not something to attempt at home.

3. Limited evidence for a rare skin condition

Pityriasis lichenoides chronica is a rare skin disorder characterised by gradually developing small, flat, red-to-brown papules that eventually flatten and resolve over time. It typically affects adolescents and young men, and its cause remains unknown.

One small study followed 8 patients with this condition who took oral bromelain for 3 months. All achieved complete symptomatic recovery without side effects during treatment 5. The researchers speculated that bromelain’s anti-inflammatory and immunomodulatory properties might explain the benefit.

The catch: Eight patients with no control group is not strong evidence. This is interesting preliminary data, not a proven treatment. If you have this condition, discuss it with a dermatologist before trying bromelain.

4. Cardiovascular disease: probably not helpful

Given bromelain’s anti-inflammatory properties, researchers have investigated whether it might help with cardiovascular risk factors in diabetic patients, who have substantially elevated heart disease risk.

A randomised, double-blind controlled study followed 68 people with diabetes for 12 weeks. Those taking bromelain showed no improvement compared to placebo in fibrinogen levels, lipid profiles, blood pressure, blood sugar, or C-reactive protein (an inflammation marker) 6.

Reality check: If you’re hoping bromelain will help your heart health, the evidence doesn’t support that. This is one area where the theoretical anti-inflammatory benefits haven’t translated into measurable clinical outcomes.

5. May help with osteoarthritis pain

Osteoarthritis affects roughly a quarter of people over 65, causing chronic pain and reduced mobility as joint cartilage breaks down. Finding safe, long-term treatments remains challenging.

A controlled study compared 40 osteoarthritis patients taking either bromelain (500mg daily) or the anti-inflammatory drug diclofenac. After 4 weeks, both groups showed significant improvements in WOMAC osteoarthritis index scores and pain subscales, with no significant difference between them 7. The bromelain group also showed reduced markers of oxidative stress and the inflammatory hormone PGE2.

Other supplements used for joint health include glucosamine and curcumin, which have more extensive research backing them.

My assessment: The results are encouraging but based on a small sample. Bromelain might be worth trying for mild-to-moderate osteoarthritis if you want to avoid or reduce reliance on anti-inflammatory drugs, but I wouldn’t count on it replacing proven treatments.

6. Supports digestive function

This is perhaps bromelain’s most straightforward application. As a protease, it breaks down proteins, which is exactly what digestion requires.

Unlike many digestive enzymes, bromelain maintains activity across the varying pH environments of the digestive tract. It works in both the acidic stomach and the more alkaline intestines 8. This makes it useful as a digestive enzyme supplement, particularly for people with pepsin or trypsin deficiencies.

In practice: If you experience digestive discomfort after protein-rich meals, bromelain is a reasonable supplement to consider. This is one of the more established uses and explains why it’s often included in digestive enzyme blends.

7. Exercise recovery: jury still out

Delayed onset muscle soreness (DOMS) peaks 24 to 48 hours after unfamiliar or intense exercise, particularly eccentric movements that lengthen muscles under tension. Anyone who’s walked downstairs the day after their first leg workout knows the feeling.

Some small studies have looked at protease supplements (including bromelain) for exercise recovery. One found that taking protease supplements helped reduce blood inflammation markers, limit muscle damage indicators, and maintain strength output 9. Another reported that proteases helped reduce muscle soreness and restore function after intense exercise 10.

The problem: These studies used mixed protease formulations, not bromelain alone. Whether bromelain specifically helps with exercise recovery remains unclear. The research just isn’t there yet.

8. May improve sinusitis symptoms

Chronic sinusitis affects roughly 14% of the US population annually, causing persistent symptoms like nasal congestion, facial pain, headaches, and runny nose. It’s miserable, and treatment options are limited.

A German epidemiological study of 116 children under 11 with acute sinusitis found that those given bromelain alone recovered faster than those receiving standard drug treatment 11.

Preliminary observations in adult patients with chronic sinusitis (with or without nasal polyps) found that bromelain improved overall symptom scores, rhinoscopy findings, and quality of life measures before planned surgery 12.

My take: For chronic sinus problems, bromelain seems worth trying alongside standard treatments. The mechanism makes sense: bromelain’s ability to break down proteins might help thin mucus and reduce inflammation in sinus passages.

What are the side effects of bromelain?

Animal studies suggest bromelain is generally safe, but human users occasionally report:

Nausea and vomiting
Diarrhoea
Indigestion and loss of appetite
Palpitations
Headache
Muscle pain
Dizziness and drowsiness
Uterine bleeding and menorrhagia (heavy periods)

These side effects are more common at higher doses. Most people taking standard supplement doses don’t experience significant problems.

Safety precautions: 5 contraindications

1. Pregnancy, breastfeeding, and impaired kidney or liver function

There’s insufficient safety data for these groups. The conservative approach is to avoid bromelain until more research clarifies the risks.

2. Pineapple or related allergies

If you’re allergic to pineapple, you should obviously avoid bromelain. Cross-reactivity can also occur with allergies to natural latex, wheat, celery, papain, carrot, fennel, pollen, or grass 13. Common allergic reactions include coughing, breathing difficulty, itching, nasal congestion, and in severe cases, angioedema or anaphylactic shock.

3. Blood-thinning medications

Bromelain has anticoagulant (blood-thinning) effects. Combining it with anticoagulant medications may increase bleeding and bruising risk. Relevant medications include:

Warfarin
Aspirin
Clopidogrel
Diclofenac, ibuprofen, naproxen (NSAIDs)
Dalteparin, enoxaparin, heparin (injectable anticoagulants)
Ginkgo biloba supplements

4. Surgery

Due to bleeding concerns, stop taking bromelain at least 2 weeks before any planned surgical procedure.

5. Certain antibiotics and sedatives

Bromelain may affect how the body absorbs certain medications, potentially interfering with their action. This includes antibiotics like amoxicillin, demeclocycline, minocycline, and tetracycline, as well as sedative medications.

Dosage recommendations

The appropriate dose depends on what you’re using bromelain for.

For digestive support: 200 to 2,000mg taken after meals.

For osteoarthritis: 400mg once or twice daily.

For allergies: 1,000mg daily, often combined with quercetin.

For surgical recovery: 2,000mg once or twice daily.

Bromelain is measured in GDU (gelatin digesting units) or MCU (milk clotting units), which indicate enzymatic activity rather than just weight. Higher activity values generally mean more potent supplements.

As with any supplement, discuss bromelain with your doctor or pharmacist before starting, particularly if you take other medications or have health conditions.

References

Pavan R, et al. Properties and therapeutic application of bromelain: a review. Biotechnol Res Int. 2012.
Maurer HR. Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci. 2001.
de Souza GM, et al. Effect of bromelain on pain and swelling after mandibular third molar surgery. Clin Oral Investig. 2019.
Shoham Y, et al. Enzymatic debridement of deep burns with bromelain-based agent. J Burn Care Res. 2018.
Massimiliano R, et al. Bromelain treatment in pityriasis lichenoides chronica. J Dermatolog Treat. 2007.
Hu W, et al. The effect of bromelain on cardiovascular risk factors in type 2 diabetes. Complement Ther Med. 2016.
Kargari N, et al. Bromelain in osteoarthritis: a randomised controlled study. Clin Rheumatol. 2016.
Bhattacharyya BK. Bromelain: an overview. Nat Prod Radiance. 2008.
Miller PC, et al. Effects of protease supplementation on muscle soreness. J Pain Res. 2009.
Beck TW, et al. Protease supplementation and recovery from eccentric exercise. J Strength Cond Res. 2004.
Braun JM, et al. Therapeutic use of bromelain in pediatric acute sinusitis. In Vivo. 2005.
Büttner L, et al. Bromelain in chronic rhinosinusitis. Laryngorhinootologie. 2013.
Gailhofer G, et al. Bromelain allergy. J Allergy Clin Immunol. 2002.