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Brm7.0
Bromelain Research
Likely helpsHigh safety
30 peer-reviewed studies
What the evidence says
Likely helps
Bromelain appears to help in 5 of 5 studies with measurable effects — the evidence leans clearly favourable.
Most evidence is from high-quality meta-analyses and randomised trials published 2002–2025 with a typical study size of 134 participants.
Based on 30 studies · 5 meta-analyses · 8 RCTs · 8,176 total participants
Confidence
High
What the studies found
5helped· 25 more without graded effect data
By outcome
Therapeutic & clinical
Mostly mechanism / observational14 studies
Surgical recovery & post-op edemaFaster recovery from injuries and surgery · 3-7 days
Likely helps13 studies
InflammationReduced swelling and inflammation · 3-7 days
Mostly mechanism / observational6 studies
Safety profile
Mostly mechanism / observational6 studies
Pain & analgesia
Likely helps4 studies
Glucose & metabolic
Too few graded studies2 studies
Endurance & exercise performance
Too few graded studies1 study
By the numbers
Pulled from 28 studies with measurable effects
Likely real effects
71%
across studies
People studied
8,176
typical study: 134 people
Strongest designs
13
5 pooled, 8 randomised
Showed benefit
100%
5/5 studies
How long studies ran
1–4 weeks
3
1–3 months
1
3+ months
1
Populations Studied
Third molar surgery patients3
Various inflammatory conditions1
Cancer patients1
Cancer patients receiving treatment1
Active research area
16 studies in the last 5 years · Latest meta-analysis: 2024
200220132025
1Systematic ReviewCited 15×n=1,375 · large study2023
The general effect of bromelain supplementation on inflammation is inconsistent because of population heterogeneity, doses used, treatment duration, and parameters evaluated.
Pereira IC et al. · Clinical nutrition ESPEN (2023)
The general effect of bromelain supplementation on inflammation is inconsistent because of population heterogeneity, doses used, treatment duration, and parameters evaluated.
The observed effects are punctual and isolated, and further standardization is needed to establish doses, supplementation time, and which type of inflammatory condition is indicated.
2Systematic ReviewCited 9×n=3,008 · very large study2021
On the basis of existing evidence, there is no clear therapeutic benefit of enzymes neither as supportive therapy nor as part of antineoplastic therapy.
Gremmler L et al. · Anticancer research (2021)
On the basis of existing evidence, there is no clear therapeutic benefit of enzymes neither as supportive therapy nor as part of antineoplastic therapy.
3Cancer treatment side effectsSystematic Reviewn=239 · medium study2025
In general, it was possible to observe that supplementation was able to reduce side effects of adjuvant hormone therapy and chemotherapy, such as mucosal dryness, arthralgia, and peripheral neuropathy induced by chemotherapy.
Pereira IC et al. · Journal of medicinal food (2025)
Bromelain is an enzyme complex that regulates pathways associated with inflammation.
This review aims to evaluate the use of bromelain-containing supplements to improve the side effects of cancer treatment.
This systematic review was developed in PubMed, Web of Science, and Cochrane Library, using the terms: Cancer AND Bromelain. 239 studies were retrieved, and only three met our objective.
Bromelain reduced IL-1β, IL-6 and TNF-α secretion when immune cells were already stimulated in an overproduction condition by proinflammatory cytokines, generating a modulation in the inflammatory response through prostaglandins reduction and activation of a cascade reactions that trigger neutrophils and macrophages, in addition to accelerating the healing process.
Alves Nobre T et al. · Natural product research (2025)
Among these compounds, bromelain is highlighted, as a cysteine protease isolated from the Ananas comosus (pineapple) stem.
This review aimed to evaluate the anti-inflammatory activity of bromelain, as well as its pathways on inflammatory mediators, through a systematic review with in vitro studies on different cell lines.
The search was performed in PubMed, Science Direct, Scopus, Cochrane Library and Web of Science databases.
Our research suggests that bromelain possesses both prophylactic and curative qualities in terms of liver damage, as supported by its ability to decrease enzyme levels, enhance liver structure, reduce oxidative stress markers, and regulate lipid metabolism.
Pereira IC et al. · Clinical nutrition ESPEN (2025)
Our research suggests that bromelain possesses both prophylactic and curative qualities in terms of liver damage, as supported by its ability to decrease enzyme levels, enhance liver structure, reduce oxidative stress markers, and regulate lipid metabolism.
In summary, bromelain demonstrates a capacity to enhance liver function across a range of injury types.
6Chronic venous disease symptoms and edemaSystematic ReviewCited 1×2025
Dedicated clinical studies are needed to clarify the efficacy and safety of a combination of these molecules in CVD management.
Buso G et al. · VASA. Zeitschrift fur Gefasskrankheiten (2025)
No studies have evaluated the effects of bromelain and vitamin C alone or in combination, whereas both molecules were administered in combination with other nutritional supplements.
Overall, CVD-related symptoms and edema seem to improve with dietary supplement containing these two compounds, with no major safety issues reported.
Bromelain and vitamin C may thus represent attractive options in the management of patients with symptomatic CVD and/or presence of venous edema, provided optimal conservative treatment is in place.
Bromelain supplementation is effective in improving glycemic and lipid indices in diabetes.
Mohammed JS et al. · The Journal of pharmacy and pharmacology (2025)
Bromelain supplementation is effective in improving glycemic and lipid indices in diabetes.
However, further research is needed to clarify the underlying mechanisms, including bromelain's potential interaction with the incretin system and its role in modulating insulin resistance through various pathways.
Major health risks were not reported during the treatment with bromelain.
Leelakanok N et al. · Nutrition and health (2023)
Noticeable benefit
← WorseNo effectBetter →
Pain reduction from oral bromelain was slightly but significantly better than controls (mean difference in pain score = -0.27; 95% CI: -0.45, -0.08; n = 9; I2 = 29%).
Topical bromelain significantly reduced the time to complete debridement (mean difference in time = -6.89 days; 95% CI: -7.94, -5.83; n = 4; I2 = 2%).
Adverse events may be irrelevant and include burning sensation, pain, fever, and sepsis.
10Pain and trismus after third molar surgeryMeta-AnalysisCited 8×n=252 · medium study2019
A meta-analysis was performed for the outcomes pain and trismus and was based on the inverse variance method for continuous outcomes, considering the mean difference (MD) and corresponding 95% conf...
de A C Almeida R et al. · International journal of oral and maxillofacial surgery (2019)
A meta-analysis was performed for the outcomes pain and trismus and was based on the inverse variance method for continuous outcomes, considering the mean difference (MD) and corresponding 95% confidence interval (CI).
After the different stages of the selection process, five articles reporting data for a total 252 patients remained and were included in the review.
Per the studies included in this review, medicinal plants can be recommended as promising adjuvant therapies to conventional wound care to accelerate wound healing in patients with DFUs.
Ahmadian R et al. · Wounds : a compendium of clinical research and practice (2021)
A diabetic foot ulcer (DFU) is a chronic, nonhealing wound that occurs in approximately 15% to 25% of patients with diabetes, and amputation is necessary in approximately 5% to 24% of these patients.
Parameters such as ulcer width and depth, phagocytic function, tumor necrosis factor α level, epithelialization, vascularization, and wound closure were evaluated in clinical trials, several of which were significantly improved in patients compared with their baseline values or control group.
Fourteen studies were included in the present review.
Some alternative therapies show promise as potential treatments for sinusitis and rhinitis, mostly compared to placebo.
Wu AW et al. · International forum of allergy & rhinology (2020)
Some alternative therapies show promise as potential treatments for sinusitis and rhinitis, mostly compared to placebo.
Comparisons to traditional therapies are lacking.
For other alternative therapies, many websites included unsubstantiated claims of benefit and ignored potential side effects for which patients should be warned appropriately.
14Quality of life and pain after third molar surgeryMeta-AnalysisCited 10×2019
The currently available evidence suggests that bromelain has a beneficial effect in reducing pain and has a positive impact on patient quality of life after third molar surgery.
Mendes ML et al. · Medicina oral, patologia oral y cirugia bucal (2019)
Large benefit
← WorseNo effectBetter →
There was large effect size of bromelain on improving physical appearance (SMD -0.77, CI% 95 -1.11 to -0.42), social isolation (SMD -0.97, CI% 95 -1.74 to -0.21), and sleep quality (SMD -1.19, CI% 95 -1.97 to -0.40) during the first postoperative week.
Differences in pain intensity were found during the first 24h (SMD -0.49, CI 95% -0.82 to -0.17) and 7 days after surgery (SMD -0.52, CI 95% -0.79 to -0.24).
The currently available evidence suggests that bromelain has a beneficial effect in reducing pain and has a positive impact on patient quality of life after third molar surgery.
15Facial swelling, trismus, and pain after third molar surgeryMeta-AnalysisCited 22×2019
Bromelain conferred moderate relief of postoperative discomfort after third molar surgery.
Liu S et al. · Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (2019)
Noticeable benefit
← WorseNo effectBetter →
Likely real
The pooled results suggested that bromelain appears to be effective for decreasing facial swelling in the early and late stages after surgery (early-stage SMD, -0.24; 95% confidence interval [CI], -0.46 to -0.02; P = .03; late-stage SMD, -0.54; 95% CI, -0.84 to -0.24; P = .0004).
Bromelain alleviated postoperative pain 7 days after surgery (SMD, -0.54; 95% CI, -0.87 to -0.20; P = .002), but there was no significant difference in pain levels at the early stage.
Bromelain conferred moderate relief of postoperative discomfort after third molar surgery.
However, higher levels of evidence gleaned from large, well-designed, prospective, randomized, controlled trials are needed before any of these therapies can be recommended.
Griffin AS et al. · Ear, nose, & throat journal (2018)
We found that while many of the alternative therapies we reviewed might have a firm basis in science, they lack any clinical evidence to support their use specifically for CRS.
Some emerging therapies, such as therapeutic ultrasonography and phonophoresis, show some promise, based on a growing body of positive evidence.
In addition, the use of baby shampoo, thyme honey, and bromelain additives to saline lavage in CRS are all supported by clinical evidence, as is Sinupret, an oral preparation that contains echinacea.
17Post-procedure ecchymosis and edemaSystematic ReviewCited 30×2016
Based upon published studies, there is insufficient data to support use of arnica and bromelain post procedure, and the authors recommend additional research to determine the efficacy and safety of arnica and bromelain to prevent and/or treat ecchymosis and edema in patients.
Ho D et al. · Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (2016)
Based upon published studies, there is insufficient data to support use of arnica and bromelain post procedure, and the authors recommend additional research to determine the efficacy and safety of arnica and bromelain to prevent and/or treat ecchymosis and edema in patients.
18Various ENT conditionsSystematic ReviewCited 23×2007
The positive effects of spirulina in allergic rhinitis and of Vertigoheel in vertigo are based on good levels of evidence, but larger trials are required.
Karkos PD et al. · The Journal of laryngology and otology (2007)
The positive effects of spirulina in allergic rhinitis and of Vertigoheel in vertigo are based on good levels of evidence, but larger trials are required.
There is overwhelming evidence that G. biloba may play no role in tinnitus.
There is limited evidence for the use of multivitamins in sinus symptoms, and larger randomised trials are required.
Evidence that any herbal medicines are beneficial in the treatment of rhinosinusitis is limited, particularly in chronic rhinosinusitis.
Guo R et al. · Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2006)
Metanalysis of the two RCTs in acute sinusitis suggested that adjunctive use of bromelain significantly improves some symptoms of acute rhinosinusitis.
Evidence that any herbal medicines are beneficial in the treatment of rhinosinusitis is limited, particularly in chronic rhinosinusitis.
There is encouraging evidence that Sinupret and bromelain may be effective adjunctive treatments in acute rhinosinusitis.
20Clinical efficacy in chronic bacterial prostatitisRCTCited 14×n=2,015 · very large study2016
The combination of serenoa repens, selenium, lycopene + bromelain and methylsulfonylmethane extracts improved the clinical efficacy of levofloxacin in patients affected by CBP without the development of side effects.
Cai T et al. · Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica (2016)
Likely real
At the second follow-up visit (T2), questionnaire results demonstrated statistically significant differences between groups (p < 0.001).
One patient in Group A (2.5%) and 7 patients (17.9%) in Group B showed a symptomatic and microbiological recurrence (p = 0.02).
The combination of serenoa repens, selenium, lycopene + bromelain and methylsulfonylmethane extracts improved the clinical efficacy of levofloxacin in patients affected by CBP without the development of side effects.