Bromelain
Pineapple-derived enzyme with RCT signal for sinusitis symptoms and post-surgical swelling.
Why
Bromelain is a mixture of proteolytic enzymes from pineapple stem (Ananas comosus). Two RCT bodies are most relevant. In acute sinusitis: a Cochrane-style review found shorter duration of nasal symptoms versus placebo. In post-surgical swelling: meta-analyses report reduced oedema and bruising after dental, orthopaedic and rhinoplasty procedures. Smaller evidence exists for adjunctive use in osteoarthritis.
How it works
Proteolytic activity on inflammatory mediators (kininogen, bradykinin), fibrinolytic effect on tissue fibrin, and modulation of prostaglandin balance, collectively reducing tissue oedema and inflammatory pain.
Expected onset · Acute symptom relief within days; surgical-recovery effects over 1–2 weeks
How to take
Dosage
500–2,000 mg/day (200–800 GDU activity), divided 2–3 times daily on an empty stomach for systemic effect, with food when used as a digestive enzyme.
Timing
On empty stomach for systemic effect; with meals for digestive use
On the label
Activity matters more than weight, look for stated 'GDU' (gelatin digesting units) or 'FIP' units per dose. Enteric coating preserves activity for systemic use.
Ideal for
Adults with acute sinusitis symptoms, recovering from minor surgery or sports trauma, or seeking an NSAID-sparing adjunct.
Safety
Evidence
Guo 2006 Otolaryngol Head Neck Surg systematic review: bromelain shortened duration of nasal symptoms in acute sinusitis vs placebo across multiple RCTs. Brien 2004 systematic review of OA: 4 of 5 small RCTs showed bromelain reduced WOMAC pain comparably to diclofenac with fewer GI side effects. Effect size modest; activity standardisation is the practical limit.
Where to get it
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