Promotes Joint Pain Relief, Digestive Health, Healthy Cholesterol,
and Reduces the Symptoms of Allergies

Formula 3303.     100 tablets.      1-8 between meals.

 

Quercetin-Bromelain Complex is designed to promote the health of the digestive and immune systems and to provide critical anti-inflammatory support.  

Quercetin, a bioflavonoid, provides joint care and pain relief, as well as various other benefits to overall good health, including lowered cholesterol, reduced risk of heart disease, and anti-histamine effects which help reduce asthma attacks and allergic reactions. 

 

Quercetin protects the gastro-intestinal tract from legions, oxidation, and allergens, while manganese ascorbate, a form of vitamin C, and bromelain, an anti-inflammatory nutrient, assist quercetin to provide the most potent benefits of this natural bioflavonoid.  Studies show that quercetin may even lower the risk of lung cancer (see below).

 

University of Maryland Medical Center's Report on Quercetin

(Click to See Ingredients.)

 

QUERCETIN AS AN ANTIOXIDANT:

 

Quercetin prevents dangerous buildups of oxidized LDL ("bad") cholesterol in the cardio-vascular system.  LDL cholesterol can be oxidized by excess free radicals, naturally occuring particles which become toxic when radiation, pollution, smoking, and other factors increase their numbers. Oxidized LDL cholesterol can be deposited in the arteries, causing a buildup of plaque which can lead to heart attack or stroke. Quercetin protects LDL cholesterol from oxidation, reducing the risk of heart attack or stroke.

 

Macular degeneration, a wearing down of the eyes, is also thought to be caused by free radicals.  Quercetin may help fight this process as well.  In addition, people with arthritis have experienced relief while taking quercetin supplements, as it may reduce the type of inflammation which causes joint pain.

 

With vitamin C, quercetin helps prevent the production of arachidonic acid, a pro-inflammatory omega-6 fatty acid.  This also helps prevent the occurrence of lesions in the intestinal tract.  Lesions may allow biological toxins to enter into the body’s systems, causing infection or illness.  By preventing these lesions, quercetin supports a healthy immune response.

 

 

BROMELAIN:

Bromelain both prevents allergens from passing through the gastro-intestinal tract, and helps break down large protein molecules, supporting the metabolism.

Bromelain is a mixture of enzymes which digest proteins in the body.  Bromelain is extracted from pineapple plants grown in Hawaii, Brazil, Paraguay, Japan, and Taiwan.  It is commonly used to treat wounds, whether following surgery or physical injury.  In Germany the substance is used to fight infections, especially acute bronchitis and sinusitis.  Bromelain is also effective against upset stomachs, heartburn, and indigestion. 

Bromelain works by acting as a blood thinner and by increasing white blood cell activity.  The effect of these combined activities is that Bromelain has the power to reduce swelling, bruising, and pain following injury, and also decrease healing time.  Bromelain is recommended for patients recovering from surgery and for athletes who wish to reduce the risk of serious injury during heavy exercise.

Some risks are involved with the taking of bromelain because it is a blood thinner.  Do not take bromelain with prescription blood thinners.  In addition, bromelain can react with certain antibiotics.

“Beneficial therapeutic effects of bromelain have been suggested or proven in several human inflammatory diseases…including arthritis and inflammatory bowel disease.” 

----Study cited in International Immunopharmacology, April 2005

Quercetin, vitamin C, and bromelain are all dietary nutrients that help support the immune system. They inhibit the absorption of substances into the body that may induce the allergic response. In addition, quercetin is used by the body to help reduce the allergic immune response in the intestinal tract, providing nutritional support to normal inflammation processes.

 

(Click to read the Report on Bromelain from the University of Maryland Medical Center)

 

 

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REFERENCES:

Heinicke RM, et al. Effect of bromelain on clinical laboratory tests after oral administration. Jpn Heart J. 1971; 12(6):517-527.

James JM, Sixbey JP, Helm RM, Bannon GA, Burks AW. Wheat alphaamylase inhibitor: A second route of allergic sensitization. J Allergy Clin Immunol 1997; 99:239-234.

Lastra CA., Martin MJ, Motilva V. Antiucler and gastroprotective effects of quercetin: a gross and histologic study. Pharmacology 1994; 48:56-62.

Lozoya X, Meckes M., Abou-Zaid M, Tortoriello J, Nozzolillo C, Arnason JT. Quercetin glycosides in Psidium guajava L. leaves and determination of a spasmolytic principle. Arch Med Res Spring 1994; 25(1):11-15.

Martensson J, Jain A, Meister A. Glutathione is required for intestinal function. Proc Nat Aca Sci. 1990;87:1715-1719.

Masson M. [Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice]. Fortschr Med 1995; 113(19):303-306.

Skaper S.D., Fabris M., Ferrari V., Carbonare M.D. and Leon A. Quercetin protects cutaneous tissue-associated cell types including sensory neurons from oxidative stress induced by glutathione depletion: cooperative effects of ascorbic acid. Fr Rad Biol Med 1997; 22(4):669-678.

Welton AF, Tobias LD, Fiedler-Nagy C, et al. Effects of flavonoids on arachidonic acid metabolism Prog Clin Biol Res 1986; 213:231-242.

Williamson G, Plumb G.W., Uda Y., Price K.R. and Rhodes M.J. Dietary quercetin glycosides: antioxidant activity and induction of the anticarcinogenic phase II marker enzyme quinone reductase in HepaIcIc7 cells. Carcinogensis 1996; 17(11):2385-2387.

 

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Dietary Flavonoids and Cancer Risk:

 

Evidence From Human Population Studies

Marian L. Neuhouser.  Nutrition and Cancer 2004, Vol. 50, No. 1, Pages 1-7 (doi:10.1207/s15327914nc5001_1)

Abstract: High dietary intake of fruits and vegetables is consistently associated with a reduced risk of common human cancers, including cancers of the lung, breast, prostate, and colon. It is unknown which bioactive compound or compounds in plant foods provide the chemoprotective effects. One class of compounds currently under investigation is flavonoids, a large group of compounds with similar structure, consisting of two phenolic benzene rings linked to a heterocyclic pyran or pyrone. Although there are numerous in vitro and animal model data suggesting that flavonoids influence important cellular and molecular mechanisms related to carcinogenesis, such as cell cycle control and apoptosis, there are limited data from human population studies. This article reviews data from four cohort studies and six case-control studies, which have examined associations of flavonoid intake with cancer risk. There is consistent evidence from these studies that flavonoids, especially quercetin, may reduce the risk of lung cancer. Further research using new dietary databases for food flavonoid content is needed to confirm these findings before specific public health recommendations about flavonoids can be formulated.Cited by Marta Rossi, Werner Garavello, Renato Talamini, Carlo La Vecchia, Silvia Franceschi, Pagona Lagiou, Paola Zambon, Luigino Dal Maso, Cristina Bosetti, Eva Negri . (2007)

 

 

 

Flavonoids and risk of squamous cell esophageal cancer.

 

International Journal of Cancer 120:7, 1560
CrossRef
Aimée R. Kreimer, Giorgia Randi, Rolando Herrero, Xavier Castellsagué, Carlo La Vecchia, Silvia Franceschi . (2006) Diet and body mass, and oral and oropharyngeal squamous cell carcinomas: Analysis from the IARC multinational case–control study. International Journal of Cancer 118:9, 2293

Barry Halliwell . (2006) Polyphenols: antioxidant treats for healthy living or covert toxins?. Journal of the Science of Food and Agriculture 86:13, 1992

A Q Haddad, V Venkateswaran, L Viswanathan, S J Teahan, N E Fleshner, L H Klotz . (2006) Novel antiproliferative flavonoids induce cell cycle arrest in human prostate cancer cell lines. Prostate Cancer and Prostatic Diseases 9:1, 68

Renato Talamini, Jerry Polesel, Maurizio Montella, Luigino Dal Maso, Anna Crispo, Luigi G. Tommasi, Francesco Izzo, Marina Crovatto, Carlo La Vecchia, Silvia Franceschi . (2006) Food groups and risk of hepatocellular carcinoma: A multicenter case-control study in Italy. International Journal of Cancer 119:12, 2916

G Deep, R P Singh, C Agarwal, D J Kroll, R Agarwal . (2006) Silymarin and silibinin cause G1 and G2–M cell cycle arrest via distinct circuitries in human prostate cancer PC3 cells: a comparison of flavanone silibinin with flavanolignan mixture silymarin. Oncogene 25:7, 1053

Chung-Pu Wu, Anna Maria Calcagno, Stephen B. Hladky, Suresh V. Ambudkar, Margery A. Barrand . (2005) Modulatory effects of plant phenols on human multidrug-resistance proteins 1, 4 and 5 (ABCC1, 4 and 5). FEBS Journal 272:18, 4725

 

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University of Maryland Medical Center:

Quercetin

Overview
Quercetin belongs to a group of plant pigments called flavonoids that are largely responsible for the colors of many fruits, flowers, and vegetables. Flavonoids, such as quercetin, provide many health-promoting benefits. They act as antihistamines (which are useful in reducing allergy symptoms) and help reduce inflammation associated with various forms of arthritis. Quercetin also works as an antioxidant by scavenging damaging particles in the body known as free radicals. These particles occur naturally in the body but can damage cell membranes, interact with genetic material, and possibly contribute to the aging process as well as the development of a number of conditions including heart disease and cancer. Antioxidants such as quercetin can neutralize free radicals and may reduce or even help prevent some of the damage they cause.

Uses
Quercetin offers a variety of potential therapeutic uses, primarily in the prevention and treatment of the conditions listed below. Of note is that quercetin seems to work better when used in conjunction with bromelain, a digestive enzyme found in pineapples, particularly for allergies and inflammation.

ALLERGIES, ASTHMA, HAYFEVER AND HIVES
Quercetin inhibits the production and release of histamine and other allergic/inflammatory substances. Histamine is a substance that contributes to allergy symptoms such as a runny nose, watery eyes, hives, and swelling of soft tissue including the face and lips.

HEART DISEASE
Test tube, animal, and some population-based studies suggest that the flavonoids quercetin, resveratrol, and catechins (all found in high concentration in red wine) may help reduce the risk of atherosclerosis (plaque buildup in the arteries that can lead to heart attack or stroke). By acting as antioxidants, these nutrients appear to protect against the damage caused by LDL ("bad") cholesterol and may help prevent death from heart disease. Additional rigorous studies in people are needed to confirm these findings.

HIGH CHOLESTEROL
Flavonoids, like quercetin, from red wine or orange juice may help lower cholesterol levels.

EYE DISORDERS
Free radicals are thought to contribute to the development of certain eye disorders including cataracts and macular degeneration (a disorder that leads to lens damage and possibly blindness). Flavonoids, such as quercetin, neutralize free radicals and may play a role in the prevention and/or treatment of these eye conditions.

In a study of 3,072 adults with symptoms of macular degeneration, moderate red wine consumption (a source of quercetin) offered some protection against the development and progression of the disease. Dark berries, such as blueberries, blackberries, and dark cherries, are also high in flavonoids. Some suggest that eating these fruits regularly may also offer benefit for preventing macular degeneration.

Similarly, animal studies suggest that quercetin inhibits the activity of compounds that contribute to the development of cataracts.

ARTHRITIS
According to laboratory and animal studies, quercetin has anti-inflammatory properties. In test tubes, for example, quercetin inhibits the type of inflammation that can occur in the joints of those with arthritis. In addition, there are reports of people with rheumatoid arthritis who experienced an improvement in their symptoms when they switched from a typical Western diet to a vegan diet with lots of uncooked berries, fruits, vegetables, nuts, roots, seeds, and sprouts containing, amongst other antioxidants, quercetin.

FIBROMYALGIA
Similar to the case reports for arthritis, people with fibromyalgia who switched from a typical Western diet to a vegan diet high in flavonoids such as quercetin experienced improvement in their symptoms.

PROSTATE HEALTH
Some studies suggest that quercetin improves pain and other symptoms in men with chronic prostatitis (inflammation of the prostate). In addition, preliminary laboratory studies indicate that quercetin may inhibit the growth of prostate cancer cells in test tubes. How this will ultimately translate to prevention or treatment of prostate cancer in men is unknown at this time.

CANCER
Quercetin and other flavonoids from fruits and vegetables have long been considered important substances to possibly help prevent cancer. New laboratory studies are suggesting that this belief may be accurate. Quercetin and other flavonoids have been shown in animal and test tube studies to inhibit the growth of cancer cells, including those from breast, colon, prostate, and lung tumors.

One study evaluating quercetin in humans included 11 people with various forms of cancer. This study found that quercetin reduced the actual tumor size in two people and inhibited the activity of a protein that plays a role in tumor growth in nine of the 11 people. More studies are needed to further explore the possible beneficial effects of quercetin in people.

Researchers are also hopeful that quercetin and other flavonoids may prove to enhance the action of anti-cancer drugs. This issue, however, of using anti-oxidants at the same time as chemotherapy or radiation to treat cancer is controversial. Until more is known, it should likely be avoided.

CANKER SORES
Quercetin may reduce the frequency of mouth sores and produce mild symptomatic relief.

OTHER
Researchers have been evaluating medicinal plants in the Democratic Republic of Congo that have been used traditionally to treat diarrhea and dysentery. What they have found is that flavonoids, such as quercetin, are among the active ingredients in these plants. Studies in Russia regarding the use of quercetin, along with other supplements and/or conventional medications, to treat dysentery caused by infections such as Shigella have shown some promise.

Dietary Sources
Fruits and vegetables -- particularly citrus fruits, apples, onions, parsley, tea, and red wine -- are the primary dietary sources of quercetin. Olive oil, grapes, dark cherries, and dark berries, such as blueberries, blackberries, and bilberries are also high in flavonoids including quercetin.

Available Forms
Quercetin supplements are available in several strengths in powder or capsule form.

They are often packaged with bromelain (an enzyme found in pineapple) as an anti-inflammatory agent. Bromelain exerts anti-inflammatory and anti-allergy activity of its own and also increases the absorption of quercetin. Other flavonoid-rich extracts include those from grape seed, bilberry, Ginkgo biloba, and green tea.

Precautions
No adverse effects from the use of quercetin have been reported. However, because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider.

Possible Interactions
If you are currently being treated with any of the following medications, you should not use quercetin supplements without first talking to your healthcare provider.

CHEMOTHERAPY
Test tube and animal studies suggest that quercetin may enhance the effects of doxorubicin and cisplatin, two chemotherapy medications used to treat cancer. More research is needed to determine if quercetin has any application to people being treated with either of these agents. In addition, use of antioxidants at the same time as chemotherapy is somewhat controversial. Therefore, more research is needed before conclusions about safety and effectiveness can be drawn.

Supporting Research
Cai J, Nelson KC, Wu M, Sternberg P Jr, Jones DP. Oxidative damage and protection of the RPE. Prog Retin Eye Res. 2000;19(2):205-221.

Chan MM, Mattiacci JA, Hwang HS, Shah A, Fong D. Synergy between ethanol and grape polyphenols, quercetin, and resveratrol, in the inhibition of the inducible nitric oxide synthase pathway. Bio Pharm. 2000;60(10):1539-1548.

Constant J. Alcohol, ischemic heart disease, and the French paradox. Clin Card. 1997;20(5):420-424.

Duthie SJ, Collins AR, Duthie GG, Dobson VL. Quercetin and myricetin protect against hydrogen peroxide-induced DNA damage (strand breaks and oxidised pyrimidines) in human lymphocytes. Mutat Res. 1997;393(3):223-231.

Ferry DR, Smith A, Malkhandi J, et al. Phase I clinical trial of the flavonoid quercetin pharmacokinetics and evidence for in vivo tyrosine kinase inhibition. Clin Cancer Res. 1996;2(4):659-668.

Gross M, Pfeiffer M, Martini M, Campbell D, Slavin J, Potter J. The quantitation of metabolites of quercetin flavonols in human urine. Cancer Epidemiol Biomarkers Prevent. 1996;5(9):711-720.

Guardia T, Rotelli AE, Juarez AO, Pelzer LE. Anti-inflammatory properties of plant flavonoids. Effects of rutin, quercetin, and hesperidin on adjuvant arthritis in rat. Farmaco. 2001;56(9):683-687.

Hanninen, Kaartinen K, Rauma AL, Nenonen M, Torronen R, Hakkinen AS, Adlercreutz H, Laakso J. Antioxidants in vegan diet and rheumatic disorders. Toxicology. 2000;155(1-3):45-53.

Hayek T, Fuhrman B, Vaya J, Rosenblat M, Belinky P, Coleman R et al. Reduced progression of atherosclerosis in apolipoprotein E-deficient mice following consumption of red wine, or its polyphenols quercetin or catechin, is associated with reduced susceptibility of LDL to oxidation and aggregation. Arterioscler Thromb Vasc Biol. 1997;17(11):2744-2752.

Head KA. Natural therapies for ocular disorders. Part 1: diseases of the retina. Alt Med Rev. Oct. 1999;(4):5:342-359.

Hofmann J, Fiebig HH, Winterhalter BR, Berger DP, Grunicke H. Enhancement of the antiproliferative activity of cis-diamminedichloroplatinum (II) by quercetin. Int J Cancer. 1990;45(3):536-539.

Hollman PC, Van Trijp JM, Mengelers MJ, De Vries JH, Katan, MB. Bioavailability of the dietary antioxidant flavonol quercetin in man. Cancer Lett. 1997;114(1-2):139-140.

Knekt P, Isotupa S, Rissanen H, Heliovaara M, Jarvinen R, Hakkinen S et al. Quercetin intake and the incidence of cerebrovascular disease. Eur J Clin Nut. 2000;54(5):415-417.

Knekt P, Jarvinen R, Reunanen A, Maatela J. Flavonoid intake and coronary mortality in Finland: a cohort study. BMJ (Clinical Research Ed.). 1996;312(7029):478-481.

Kurowska EM, Spence JD, Jordan J, Wetmore S, Freeman DJ, Piche LA, Serratore P. HDL-cholesterol-raising effect of orange juice in subjects with hypercholesterolemia. Am J Clin Nutr. 2000;72(5):1095-1100.

Lamson DW, Brignall MS. Antioxidants and cancer III: quercetin. Alt Med Rev. 2000;5(3):196-208.

Lee E, Choi EJ, Cheong H, Kim YR, Ryu SY, Kim KM. Anti-allergic actions of the leaves of Castanea crenata and isolation of an active component responsible for the inhibition of mas cell degranulation. Arch Pharm Res. 1999;22(3):320-323.

Longanga OA, Vercruysse A, Foriers A. Contribution to the ethnobotanical, phytochemical and pharmacological studies of traditionally used medicinal plants in the treatment of dysentery and diarrhoea in Lomela area, Democratic Republic of Congo (DRC). J Ethnopharmacol. 2000;71(3):411-423.

Otshudi AL, Foriers A, Vercruysse A, Van Zeebroeck A, Lauwers S. In vitro antimicorbial activity of six medicinal plants traditionally used for the treatment of dysentery and diarrhoea in Democratic Republic of Congo (DRC). Phytomedicine. 2000;7(2):167-172.

Otsuka H, Inaba M, Fuikikura T, Kunitomo M. Histochemical and functional characteristics of metachromatic cells in the nasal epithelium in allergic rhinitis: studies of nasal scrapings and their dispersed cells. J Allergy Clin Immunol. 1995;96(4):528-536.

Owen RW, Giacosa A, Hull WE, Haubner R, Spiegelhalder B, Bartsch H. The antioxidant/anticancer potential of phenolic compounds isolated from olive oil. Eur J Cancer. 2000a;36(10):1235-1247.

Owen RW, Mier W, Giacosa A, Hull WE, Spiegelhalder B, Bartsch H. Identification of lignans as major components in the phenolic fraction of olive oil. Clin Chem. 2000b;46(7):976-988.

Piantelli M, Maggiano N, Ricci R, et al. Tamoxifen and quercetin interact with type II estrogen binding sites and inhibit the growth of human melanoma cells. J Invest Dermatol. 1995;105(2):248-53.

Rodgers EH, Grant MH. The effect of the flavonoids, quercetin, myricetin, and epicatechin on the growth and enzyme activities of MCF7 human breast cancer cells. Chem Bio Interactions. 1998;116(3):213-228.

Sanderson J, McLauchlan WR, Williamson G. Querctein inhibits hydrogen peroxide-induced oxidation of the rat lens. Free Radic Biol Med. 1999;26(5-6):639-645.

Scambia G, Ranelletti FO, Benedetti Panici P, et al. Quercetin potentiates the effect of adriamycin in a multi-drug-resistant MCF-7 human breast-cancer cell line: P-glycoprotein as a possible target. Cancer Chemother Pharmacol. 1994;34:459-464.

Shils ME, Olson JA, Shike M, Ross AC. Modern Nutrition in Health and Disease. 9th ed. Baltimore, Md: Williams & Wilkins; 1999:1274-1277.

Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology. 1999;54(6):960-963.

Thornhill SM, Kelly AM. Natural treatment of perennial allergic rhinitis. Alt Med Rev. 2000;5(5):448-454.

Trcihopoulou A, Katsouyanni K, Stuver S, Tzala L, Cnardellis C, Rimm E, Trichopoulos D. Consumption of olive oil and specific food groups in relation to breast cancer risk in Greece. J National Cancer Inst. 1995;87(2):110-116.

Van Golde PH, Sloots LM, Vermeulen WP, et al. The role of alcohol in the anti low density lipoprotein oxidation activity of red wine. Atherosclerosis. 1999;147(2):365-370.

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Xing N, Chen Y, Mitchell SH, Young CY. Quercetin inhibits the expression and function of the androgen receptor in LNCaP prostate cancer cells. Carcinogenesis. 2001;22(3):409-414.

Young JF, Nielsen SE, Haraldsdottir J, et al. Effect of fruit juice intake on urinary quercetin excretion and biomarkers of antioxidative status. Am J Clin Nutr. 1999; 69(1):87-94.

 

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REPORT ON BROMELAIN:

From the University of Maryland Medical Center

Overview
Bromelain is a mixture of protein-digesting enzymes found in pineapples (Ananas comosus). Bromelain supplements contain active substances that aid digestion and help reduce inflammation.

Uses
Bromelain is useful in the treatment of a wide range of conditions, but it is particularly effective in relieving inflammation associated with infection and physical injuries.

 

Studies have shown that bromelain may help in the treatment of the following:

SURGICAL PROCEDURES AND SPORTS INJURIES
Although studies show mixed results, bromelain supplements may reduce swelling, bruising, healing time, and pain following surgery and physical injuries. In fact an authoritative body in Germany called the Commission E (similar to the U.S. Food and Drug Administration) approved the use of bromelain for these purposes.

WOUNDS AND BURNS
Some studies of animals indicate that bromelain (applied to the surface of the skin) may be useful in removing dead tissue from third-degree burns (particularly burns that go through all layers of the skin). This application has not yet been tested on people, but traditional and current day practices in Japan, Hawaii and Taiwan include use of topical bromelain to clean wounds and burns. Similarly, some clinicians may recommend this topical agent to reduce swelling from insect bites or stings.

NASAL AND SINUS CONGESTION
Although not all experts agree, bromelain supplements may help suppress cough, reduce nasal mucus associated with sinusitis, and relieve the swelling and inflammation caused by hay fever. Bromelain is approved by the German Commission E for the treatment of sinus and nasal swelling following ear, nose, and throat surgery or trauma.

DIGESTION
The protein-digesting enzymes found in bromelain help promote and maintain proper digestion and may relieve symptoms of stomach upset or heartburn, particularly when used in conjunction with other enzymes such as amylase (which digests starch) and lipase (which digests fat). Similarly, an animal study suggests that the antibacterial effects of bromelain may help to control diarrhea caused by bacteria. Studies in people are needed.

ARTHRITIS AND OTHER INFLAMMATORY CONDITIONS
Bromelain supplements may be as effective as some commonly used nonsteroidal anti-inflammatory (NSAID) medications (such as ibuprofen and diclofenac) for reducing pain associated with osteoarthritis. Similarly, preliminary studies suggest that bromelain may also help reduce the pain associated with rheumatoid arthritis. Plus, long-standing use of bromelain suggests that this enzyme may be helpful as part of the treatment for other connective tissue disorders including scleroderma (build up of tough scar-like tissue in the skin and, at times, internal organs), bursitis, and tendinitis.

INFECTION
Some scientific evidence from test tubes and animals suggests that bromelain can fight against infectious agents such as viruses and bacteria. Therefore, bromelain may prove a useful addition to conventional treatment of bronchitis, pneumonia, and urinary tract infections. More research is needed.

AMYLOIDOSIS
Amyloid is a protein-like substance that can build up and cause damage to many organs in the body such as the kidneys, liver, or heart. This build-up of amyloid is called amyloidosis. In one laboratory study, researchers examined the tissue of one person with a strong family history of amyloidosis. They found that bromelain may help breakdown amyloid deposits in kidney tissue. This very preliminary finding does not indicate how this information will translate to treatment or prevention of amyloidosis for people in general. Much more research is needed.

Dietary Sources
Bromelain is found in the common pineapple plant.

Available Forms
Bromelain is available in tablet or capsule form for oral use. It may also be used topically to treat severe burns.

Precautions
Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider. Bromelain is generally recommended for no longer than 8 to 10 days in a row.

Possible side effects from bromelain include nausea, vomiting, diarrhea, and excessive menstrual bleeding.

Individuals who are allergic to pineapples should not use bromelain supplements because skin reactions and/or asthma-like symptoms may occur.

Pregnant women and individuals with bleeding disorders, high blood pressure, and liver or kidney disease should consult a healthcare provider before taking bromelain.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use bromelain without first talking to your healthcare provider.

ANTIBIOTICS
In a clinical study, the combination of bromelain and amoxicillin increased the levels of this antibiotic in the blood. Some studies suggest that bromelain may increase the body's ability to absorb tetracycline, but results of other studies have been conflicting. Until studies confirm these results, it would be wise to avoid combining bromelain and tetracycline.

Studies with bromelain and tetracycline have produced mixed results. Some research suggests that bromelain increases levels of tetracycline in the body, while others indicate that it may cause more of the antibiotic to be excreted in the urine.

BLOOD-THINNING MEDICATIONS
People taking aspirin, warfarin, or other medications that thin the blood should use bromelain with extreme caution because of a possible risk of bleeding when used together.


Supporting Research
Adachi N, Koh CS, Tsukada N, Shoji S, Yanagisawa N. In vitro degradation of amyloid material by four proteases in tissue of a patient with familial amyloidotic polyneuropathy. J Neurol Sci. 1988;84(2-3):295-299.

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Bradbrook JD. The effect of bromelain on the absorption of orally administered tetracycline. Br J Clin Pharmacol. 1978;6(6):552-554.

Bromelain. Alt Med Rev. August 1998;3:302–305.

Brunton J. Pharmagnosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing; 1995.

Desser L, Rehberger A, Kokron E, Paukovits W. Cytokine synthesis in human peripheral blood mononuclear cells after oral administration of polyenzyme preparations. Oncology. 1993;50:403–407.

Felton GE. Fibrinolytic and antithrombotic action of bromelain may eliminate thrombosis in heart patients. Med Hypotheses. 1980;6(11):1123-1133.

Harborne J, Baxter H, eds. Phytochemical Dictionary: A Handbook of Bioactive Compounds from Plants. London, England: Taylor & Francis; 1993:376.

Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. A randomized, double-blind study versus diclofenec. Clin Drug Invest. 2000;19(1):15-23.

Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc. 1996.

Majima M, Kawashima N, Hiroshi I, Katori M. Effects of an orally active non-peptide bradykinin B2 receptor antagonist, FR173657, on plasma exudation in rat carrageenan-induced pleurisy. Br J Pharmacol. 1997;121(4):723-730.

Masson M. Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice. Fortschr Med. 1995;113:303–306.

Mori S, Ojima Y, Hirose T, Sasaki T, Hashimoto Y. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet Gynaecol Jpn. 1972;19(3):147-153.

Murray MT, Pizzorno JE. Bromelain. In: Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. Vol 1. 2nd ed. Edinburgh: Churchill Livingstone; 1999:619-622.

Mynott TL, Guandalini S, Raimondi F, Fasano A. Bromelain prevents secretion cased by Vibrio cholerae and Escherichia coli enterotoxins in rabbit ileum in vitro. Gastroenterol. 1997;113(1):175-184.

Reynolds JEF, ed. Martindale: The Extra Pharmacopoeia. 31st ed. London, England: Royal Pharmaceutical Society; 1996:1681.

Rimoldi R, Ginesu F, Giura R. The use of bromelain in pneumological therapy. Drugs Exp Clin Res. 1978;4:55-56.

Sanders HJ. Therapy of chlamydia infections with tetracyclines. Int J Exp Clin Chemother. 1990;3(2):101-106.

Schulz V, Hänsel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. New York: Springer; 1998.

Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol. 1998;22:191–203.

Tinozzi S, Venegoni A. Effect of bromelain on serum and tissue levels of amoxicillin. Drugs Exptl Clin Res. 1978; 4(1):39-44.

Uhlig G, Seifert J. The effect of proteolytic enzymes (traumanase) on posttraumatic edema. Fortschr Med. 1981;99:554–556.

Walker JA, Cerny FJ, Cotter JR, Burton HW. Attentuation of contraction-induced skeletal muscle injury by bromelain. Med Sci Sports Exerc. 1992;24:20–25.

MedLine, from the National Institutes of Health

Bromelain
URL of this page: http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-bromelain.html

Background
Classified as an herb, bromelain is a sulfur-containing proteolytic digestive enzyme that is extracted from the stem and the fruit of the pineapple plant ( Ananas comosus , family Bromeliaceae) . 

When taken with meals, bromelain is believed to assist in the digestion of proteins. When taken on an empty stomach, it is believed to act medicinally as an anti-inflammatory agent.
The expert panel, the German Commission E approved bromelain for the treatment of swelling/inflammation of the nose and sinuses caused by injuries and surgery in 1993.

Synonyms
Ananas sativus, Ananase®, Bromelain-POS, bromeline (pleural), Bromelainum, Bromeliaceae (family), Bromelin, Bromelins, Debridase, Phlogenzym (rutoside, bromelain, and trypsin), ERC (enzyme-rutosid combination -rutosid, bromelain, trypsin), plant protease concentrate, pineapple, pineapple extract, Traumanase®.

Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence          Grade*

INFLAMMATION
Several preliminary studies suggest that when taken by mouth, bromelain can reduce inflammation or pain caused by inflammation. Better quality studies are needed to confirm these results.          B

SINUSITIS (SINUS INFLAMMATION)
It is proposed that bromelain may be a useful addition to other therapies used for sinusitis (such as antibiotics) due to its ability to reduce inflammation/swelling. Studies report mixed results, although overall bromelain appears to be beneficial for reducing swelling and improving breathing. Better studies are needed before a strong recommendation can be made.        B

BURN DEBRIDEMENT
A bromelain-derived debriding agent, Debridase, has been studied on deep second degree and third degree burns with positive results. Further results are needed to confirm these results.   C

DIGESTIVE ENZYME/PANCREATIC INSUFFICIENCY
Bromelain is an enzyme with the ability to digest proteins. However, there is little reliable scientific research on whether bromelain is helpful as a digestive aid. Better study is needed before a firm conclusion can be made.             C

OSTEOARTHRITIS OF THE KNEE (OA)
In one study of a combination product ERC (enzyme-rutosid combination -rutosid, bromelain, trypsin) results showed that ERC may be considered as an effective and safe alternative to prescription anti-inflammatory drugs (NSAIDs) such as diclofenac in the treatment of painful episodes of OA of the knee. Further well-designed clinical trials of bromelain alone are needed to confirm these results.    C

*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.

USES BASED ON TRADITION OR THEORY
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acquired immune deficiency syndrome (AIDS), acute lateral ankle sprain, allergic rhinitis (hay fever), amyloidosis, angina, appetite suppressant, anthelmintic effects. atherosclerosis ("hardening" of the arteries), autoimmune disorders, back pain, blood clot treatment, bronchitis, bruises, bursitis, cancer prevention, carpal tunnel syndrome, cellulitis/skin infections, colitis, common cold, cough, diarrhea, epididymitis, episiotomy pain (after childbirth), food allergies, food lodged in the esophagus, frostbite, gout, heart disease, hemorrhoids, immune system regulation, antibiotic absorption problems in the gut, infections, indigestion, injuries, joint disease, "leaky gut" syndrome, menstrual pain, pain (general), pancreatic problems with food digestion, Peyronie's disease (abnormal curvature, pain, and scar tissue in the penis), platelet inhibition (blood thinner), pneumonia, poor absorption of digested food, poor blood circulation in the legs, upper respiratory tract infection, sciatica, scleroderma, shingles pain/post-herpetic neuralgia, shortening of labor, smooth muscle relaxation, sports or other physical injuries, staphylococcal bacterial infections, stimulation of muscle contractions, stomach ulcer/stomach ulcer prevention, swelling (after surgery or injury), tendonitis, thick mucus, thrombophlebitis, treatment of scar tissue, ulcerative colitis, varicose veins, wound healing.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
There are multiple reports of allergic and asthmatic reactions to bromelain products, including throat swelling and difficulty breathing. Allergic reactions to bromelain may occur in individuals allergic to pineapples or other members of the Bromeliaceae family, and in people who are sensitive/allergic to honeybee venom, latex, birch pollen, carrot, celery, fennel, cypress pollen, grass pollen, papain, rye flour, or wheat flour.

Side Effects and Warnings
Few serious side effects have been reported with the use of bromelain. The most common side effects reported are stomach upset and diarrhea. Other reported reactions include increased heart rate, nausea, vomiting, irritation of mucus membranes, and menstrual problems.

In theory, bromelain may increase the risk of bleeding. Caution is advised in people who have bleeding disorders or who are taking drugs that increase the risk of bleeding. Dosing adjustments may be necessary. Bromelain should be used with caution in people with stomach ulcers, active bleeding, a history of bleeding, taking medications that thin the blood, or prior to some dental or surgical procedures.

Bromelain may increase heart rate at higher doses, and should be used cautiously in people with heart disease. Some experts warn against bromelain use by people with liver or kidney disease, although there is limited scientific information in these areas. Bromelain may cause abnormal uterine bleeding or heavy/prolonged menstruation.

Pregnancy and Breastfeeding
Bromelain is not recommended during pregnancy or breastfeeding, as little safety information is available. Bromelain may cause abnormal uterine bleeding.

Interactions
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs
In theory, bromelain may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). In addition, bromelain theoretically may add to the anti-inflammatory effects of NSAIDs.

Human studies suggest that bromelain may increase the absorption of some antibiotics, notably amoxicillin and tetracycline, and increase levels of these drugs in the body. Bromelain may increase the actions of the chemotherapy (anti-cancer) drugs 5-fluorouracil and vincristine, although reliable scientific research in this area is lacking. In theory, use of bromelain with blood pressure medications in the "ACE inhibitor" class such as captopril (Capoten®) or lisinopril (Zestril®) may cause larger drops in blood pressure than expected.

Some experts suggest that bromelain may cause drowsiness or sedation, and may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

Bromelain may also interact with heartbeat regulating medications, magnesium and nicotine.

Interactions with Herbs and Dietary Supplements
In theory, bromelain may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of  Ginkgo biloba , fewer cases with garlic, and less cases with saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Bromelain and the enzyme trypsin are suggested to have stronger anti-inflammatory effects when combined, based on preliminary animal research. It has been suggested that zinc might block the effects of bromelain in the body, while magnesium may increase the effects, although scientific research in these areas is lacking.

Bromelain may also interact with herbs and supplements that effect the heart, antibacterials, soy, sedatives and tobacco.

Methodology
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD, MSc, MPhil (Memorial Sloan-Kettering Cancer Center); Cynthia Dacey, PharmD (Northeastern University); Mary McGarry, PharmD (University of Rhode Island); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration).

Selected references
1.         Balakrishnan V, Hareendran A, Nair CS. Double-blind cross-over trial of an enzyme preparation in pancreatic steatorrhoea. J Assoc Physicians India 1981;29(3):207-209.

2.         Braun JM, Schneider B, Beuth HJ. Therapeutic use, efficiency and safety of the proteolytic pineapple enzyme Bromelain-POS in children with acute sinusitis in Germany. In Vivo 2005;19(2):417-421.

3.         Cirelli MG. Five years of clinical experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clinical Medicine 1967;74(6):55-59.

4.         Cowie DH, Fairweather DV, Newell DJ. A double-blind trial of bromelains as an adjunct to vaginal plastic repair operations. J Obstet Gynaecol Br Commonw. 1970;77(4):365-368.

5.         Gylling U, Rintala A, Taipale S, et al. The effect of a proteolytic enzyme combinate (bromelain) on the postoperative oedema by oral application. A clinical and experimental study. Acta Chir Scand. 1966;131(3):193-196.

6.         Howat RC, Lewis GD. The effect of bromelain therapy on episiotomy wounds--a double blind controlled clinical trial. J Obstet.Gynaecol.Br.Commonw. 1972;79(10):951-953.

7.         Mader H. [Comparative studies on the effect of bromelin and oxyphenbutazone in episiotomy pains]. Schweiz Rundsch.Med Prax. 8-28-1973;62(35):1064-1068.

8.         Mori S, Ojima Y, Hirose T, et al. The clinical effect of proteolytic enzyme containing bromelain and trypsin on urinary tract infection evaluated by double blind method. Acta Obstet.Gynaecol.Jpn. 1972;19(3):147-153.

9.         Rosenberg L, Lapid O, Bogdanov-Berezovsky A, et al. Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report. Burns 2004;30(8):843-850.

10.       Ryan RE. A double-blind clinical evaluation of bromelains in the treatment of acute sinusitis. Headache 1967;7(1):13-17.

11.       Seligman B. Oral bromelains as adjuncts in the treatment of acute thrombophlebitis. Angiology 1969;20(1):22-26.

12.       Seltzer AP. Adjunctive use of bromelains in sinusitis: a controlled study. Eye Ear Nose Throat Mon. 1967;46(10):1281, 1284, 1286-1288.

13.       Tassman GC, Zafran JN, Zayon GM. A double-blind crossover study of a plant proteolytic enzyme in oral surgery. J Dent Med 1965;20(2):51-54.

14.       Taub SJ. The use of bromelains in sinusitis: a double-blind clinical evaluation. Eye Ear Nose Throat Mon. 1967;46(3):361.

15.       Weiss S, Scherrer M. [Crossed double-blind trial of potassium iodide and bromelain (Traumanase) in chronic bronchitis]. Schweiz.Rundsch.Med Prax. 10-24-1972;61(43):1331-1333. December 01, 2006.

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