Ananas comosus · supplement
Evidence tier: limited
A natural anti inflammatory enzyme, useful for inflammation, sinus congestion, and post exercise recovery.
Bromelain is a protease, a mixture of protein cutting enzymes. Swallowed at a small dose it works in the digestive tract, helping break proteins down into smaller peptides, which is the least contested thing it does and is exactly what the PlantRx product claims. Swallowed at a large dose, a fraction is thought to be absorbed intact and to act systemically, where the proposed effects are anti inflammatory (reduced prostaglandin E2 and thromboxane A2, inhibited neutrophil migration) and fibrinolytic (raised fibrinolytic activity, lowered fibrinogen). The seed's COX-2 mechanism is not supported by any named authority in this pass.
Limited, and route dependent. The one genuinely established use is not oral at all: applied topically in clinical settings bromelain removes dead and damaged tissue from burns, which is its approved indication in Europe (Memorial Sloan Kettering, NIH LiverTox). Swallowed, the best supported use is after wisdom tooth surgery, and even there the reviewers contradict each other. Two meta analyses of the same literature disagree on swelling: one found no evidence bromelain reduced trismus or facial swelling (PMID 30573710), the other found it did reduce pain, edema and trismus (PMID 30484910). The individual trials break the tie awkwardly: the best randomised controlled trial found bromelain significantly reduced pain at every interval and matched diclofenac on quality of life, while its reduction in swelling was not significant (PMID 24589242). Net: pain and quality of life are the reliable outcomes, and swelling and trismus are not, which is the reverse of how bromelain is sold. In cosmetic and periocular surgery the evidence is negative: a 2025 systematic review of 29 randomised trials in 2,287 patients found bromelain showed no significant benefits (PMID 41264874). The osteoarthritis evidence is not bromelain's evidence, it belongs to an enzyme combination of bromelain plus trypsin plus rutoside (PMID 40803821), and no systematic review of bromelain monotherapy in osteoarthritis was found. Sinusitis could not be verified at systematic review level. The safety headline is bleeding: bromelain raises serum fibrinolytic activity and lowers plasma fibrinogen in humans, and MSK's instruction is not to use it with warfarin or other blood thinners. It also raises the blood levels of tetracycline and amoxicillin, which is an overdose risk rather than a treatment failure risk. Pineapple allergy and latex fruit cross reactivity are real contraindications and are dose independent. The liver, unusually for a botanical, is clean: LiverTox likelihood score E.
Typical oral doses run from 200 to 2000 mg daily across commercial formulations (NIH LiverTox), with trial doses around 1,000 mg daily. PlantRx uses 15 mg, which is between 13 and 133 times below the therapeutic range. At 15 mg bromelain is a digestive protease, not an anti inflammatory or post surgical dose, so the post surgical and osteoarthritis evidence does not transfer to the PlantRx product.
500 to 2000 GDU/g, 2 to 3 times daily on empty stomach for systemic effect, or with meals for digestion.
Significant anticoagulant interaction. Avoid before surgery.
Pregnancy: caution
Breastfeeding: caution
Active compounds: cysteine proteinases (endopeptidases), phosphatases, glucosidases, peroxidases, cellulases
Remedies using Bromelain · Browse by body system · Check it against what you take
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.