Do bromelain supplements work?
For most uses, the proof is thin. The best hint is less pain after wisdom tooth removal. But bromelain’s clearest result isn’t from a tablet. It’s from a gel used on severe burns.
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Do bromelain supplements work?
Not for most things they’re sold for. Bromelain is promoted for wisdom tooth pain, sinusitis, arthritis and sore muscles. But only a small number of studies have tested it by mouth.
A 2023 review pooled the trials. Pain eased slightly but significantly more with bromelain than in the groups it was compared with.
| Use | What trials found | Verdict |
|---|---|---|
| Pain after wisdom tooth removal | Two reviews of 6 trials each. Both found less pain 7 days after surgery. They disagree on swelling. | May help a little |
| Sinusitis | One review says it may help. US health officials say the research is too weak to recommend it. | Unclear |
| Knee arthritis | A 12-week trial of 800 mg a day found no clear difference from dummy pills. | No clear help |
| Heart disease | A 2023 review found it was not effective. | No |
| Sore muscles after exercise | Very little research. | Unknown |
Sources: Mendes 2019; Liu 2019; Leelakanok 2023; Brien 2006; NCCIH
Had a wisdom tooth out? The hint is for pain. Neither review found it helped jaw stiffness, which doctors call trismus.
One review found less facial swelling, and the other found no evidence of it.
Ask your dentist before adding it to the painkillers they suggest.
What is bromelain?
It’s a group of enzymes from the stem and fruit of the pineapple. Enzymes are proteins that speed up a job. This group’s job is breaking down other proteins.
Think of it as scissors for protein. The question with a tablet is whether the scissors still cut once you’ve swallowed them.
Your gut may break some of it down. Even so, the 2023 review found bromelain in the blood after people took it by mouth, still able to break down protein. That doesn’t show the tablet eases pain or swelling, which is what the trials above tested.
Many products mix bromelain with other ingredients. Then its own effect is unclear.
Before you buy bromelain tablets
- Check the label lists bromelain on its own, if you want to know what it does.
- Take any medicine? Ask a pharmacist or GP before you start.
- On warfarin? Tell your doctor about any supplement you take or plan to start.
- Skip it if you’re allergic to pineapple.
- Pregnant or breastfeeding? Little is known about its safety, so ask your midwife or GP first.
Sources: NCCIH; NHS: warfarin; Sanlier 2026
Where does bromelain clearly work?
On severe burns. The gel is NexoBrid, a burns medicine made from pineapple stem enzymes. It’s approved in the EU, and since 2022 in the US.
It clears eschar, the thick, dry, dead skin that covers severe burns. Across 4 studies, bromelain on the skin cleared it about 7 days sooner.
It isn’t something you can buy. Trained staff apply it to a clean wound in a specialist burns centre.
So if a seller points to burns research, that’s the gel, not their tablet. Ask them which trial tested the tablet itself.
Does bromelain help knee pain or arthritis?
Not that trials have shown. In one trial, 47 people with moderate to severe knee arthritis took 800 mg a day or dummy pills for 12 weeks.
Only 31 finished. There was no clear difference in their overall knee scores for pain, stiffness and daily tasks. The authors said a follow-up trial is needed.
The NHS calls exercise one of the most important treatments for osteoarthritis. Mix exercises that build muscle with ones that build general fitness.
Weighing up other pills? See joint supplements, glucosamine and boswellia.
Are bromelain tablets safe?
By mouth, it seems to be well tolerated. The most common side effects are stomach upset and diarrhoea. Wind, feeling sick and headaches have also been reported.
It may also make bleeding more likely if you take a blood thinner. The evidence for this is limited, but it matters if you take one.
| If you | Why | What to do |
|---|---|---|
| Take warfarin, heparin, aspirin or ibuprofen-type painkillers (NSAIDs) | Bromelain may raise the risk of bleeding with them. | Ask your GP or pharmacist first. |
| Have a bleeding disorder | A 2026 review advises against it, as a precaution. | Don’t start without your GP’s advice. |
| Are allergic to pineapple | Germany’s herbal medicine panel, Commission E, says not to use it. | Skip it. |
| Are pregnant or breastfeeding | Little is known about its safety. | Ask your midwife or GP first. |
| Take any other medicine | Some herbs and medicines interact in harmful ways. | Ask a pharmacist first. |
Sources: NCCIH; Sanlier 2026; NHS: warfarin
Never stop or change a prescribed medicine without your prescriber.
More on supplements that can change blood tests and herbal supplements and your liver.
When to speak to a GP
Get help instead of reaching for a supplement if:
- Your sinusitis isn’t better after 3 weeks of treating it yourself, or 7 days of treatment from a pharmacy or GP, or it keeps coming back. See a GP.
- You have sinusitis and you’re very unwell, painkillers don’t help, symptoms get worse or you have a weak immune system. Ask for an urgent GP appointment or call 111.
- After a wisdom tooth removal, bleeding won’t stop, or pain and swelling are severe or getting worse and painkillers aren’t helping. Pain with a bad taste, a high temperature or feeling unwell counts too. Ask for an urgent dentist appointment or call 111.
- You take warfarin and have signs of bleeding, such as blood in your pee or poo, bruising or nosebleeds you can’t explain, or coughing up or vomiting blood. A sudden bad headache with confusion, slurred speech, trouble moving your arms or legs, or feeling or being sick counts too. Call 111.
- Your lips, mouth, throat or tongue suddenly swell, you’re struggling to breathe or swallow, or your skin, tongue or lips turn blue, grey or pale. Sudden confusion, drowsiness or dizziness counts too, or someone faints and can’t be woken up. Call 999.
With sinusitis, a pharmacist can give the same treatments as a GP. It usually clears up on its own within 4 weeks.
After a wisdom tooth removal, some pain and swelling is usual for up to 2 weeks. The NHS says to take paracetamol or ibuprofen for the pain.