Several preliminary trials have reported reduced pain and swelling, and/or faster healing in people with a variety of conditions using either bromelain,¹ papain from papaya, ^2,3 or a combination of trypsin and chymotrypsin.⁴ Double-blind trials have reported faster recovery from athletic injuries, including sprains and strains, and earlier return to activity using eight tablets daily of trypsin/chymotrypsin,^5,6,7,8 four to eight tablets daily of papain,⁹ eight tablets of bromelain (single-blind only),¹⁰ or a combination of these enzymes.¹¹ However, one double-blind trial using eight tablets per day of trypsin/chymotrypsin to treat sprained ankles found no significant effect on swelling, bruising, or overall function.¹²

Bromelain is measured in MCUs (milk clotting units) or GDUs (gelatin dissolving units). One GDU equals 1.5 MCU. Strong products contain at least 2,000 MCU (1,333 GDU) per gram (1,000 mg). A supplement containing 500 mg labeled “2,000 MCU per gram” would have 1,000 MCU of activity, because 500 mg is half a gram. Some doctors recommend 3,000 MCU taken three times per day for several days, followed by 2,000 MCU three times per day. Some of the research, however, uses smaller amounts, such as 2,000 MCU taken in divided amounts in the course of a day (500 MCU taken four times per day).

Supplementation with bromelain, an enzyme derived from pineapple stem, prior to and following a surgical procedure has been shown to reduce swelling, bruising, healing time, and pain.¹³ Bromelain supplementation has also been shown to accelerate the healing of soft-tissue injuries in male boxers.¹⁴ The amount of bromelain used in these studies was 40 mg four times per day, in the form of enteric-coated tablets. Enteric-coating prevents the stomach acid from partially destroying the bromelain. Most currently available bromelain products are not enteric-coated, and it is not known if such products would be as effective as enteric-coated bromelain.

Bromelain, an enzyme derived from pineapple, has been reported to relieve symptoms of acute sinusitis. In a double-blind trial, 87% of patients who took bromelain reported good to excellent results compared with 68% of those taking placebo.¹⁵ Other double-blind research has shown that bromelain reduces symptoms of sinusitis.^16,17 Research with bromelain for sinusitis generally uses the enteric-coated form. Enteric-coating prevents the stomach juices from partially destroying the bromelain. Most commercially available bromelain products today are not enteric-coated, and it is not known how the potency of these different products compares.

Studies conducted in the past have used bromelain compounds with therapeutic strengths measured in units called Rorer units (RU). Potency of contemporary bromelain compounds are quantified in either MCUs (milk clotting units) or GDUs (gelatin dissolving units); one GDU equals 1.5 MCU. One gram of bromelain standardized to 2,000 MCU would be approximately equal to 1 gram with 1,200 GDU of activity, or 8 grams with 100,000 RU of activity. Physicians sometimes recommend 3,000 MCU taken three times per day for several days, followed up by 2,000 MCU per day.¹⁸ Much of the research conducted has used smaller amounts likely to be the equivalent (in modern units of activity) of approximately 500 MCU taken four times a day.

Supplementation with bromelain, an enzyme derived from pineapple stem, prior to and following a surgical procedure has been shown to reduce swelling, bruising, healing time, and pain.¹⁹ Bromelain supplementation has also been shown to accelerate the healing of soft-tissue injuries in male boxers.²⁰ The amount of bromelain used in these studies was 40 mg four times per day, in the form of enteric-coated tablets. Enteric-coating prevents the stomach acid from partially destroying the bromelain. Most currently available bromelain products are not enteric-coated, and it is not known if such products would be as effective as enteric-coated bromelain.