Bromelain

Proteolytic anti-inflammatory action. Bromelain is a complex of proteolytic (protein-digesting) enzymes from pineapple. It appears to reduce inflammation by cleaving inflammatory mediators, modulating cytokine production, reducing bradykinin and other pro-inflammatory factors, and altering immune cell activity. These combined effects can lower pain, swelling and stiffness in inflamed joints. MDPI

Fibrinolytic and anti-edema effects. Bromelain has fibrinolytic activity (can influence fibrin and clot-related pathways) that may help reduce soft-tissue swelling and promote resolution of inflammatory exudates. MDPI

Analgesic and immune-modulating effects. Some studies report reduced pain scores and improved functional outcomes in osteoarthritis patients, thought to come from a mix of direct anti-inflammatory and immune-modifying activity. Wiley Online Library

Important: There is no single universal “approved” bromelain regimen for arthritis. Different preparations and doses have been trialed. Below are commonly reported regimens from clinical studies and reliable guidance sources.

Common clinical trial doses

• 800 mg/day total (e.g., 400 mg twice daily) — used in a randomized, double-blind trial for knee osteoarthritis. That trial used 800 mg/day for 12 weeks. Some participants had symptom improvement vs placebo. Oxford Academic
• Phlogenzym® / enzyme combinations — several studies tested multi-enzyme preparations that include bromelain (with trypsin, rutin, etc.). Doses varied; one reported symptomatic improvement after ~3 weeks. These products are combination formulations rather than “pure” bromelain. ScienceDirect

Typical supplement dosing guidance (consumer resources & reviews)

• Many consumer/medical summaries report 40–400 mg/day used in various contexts; however, arthritis trials commonly used higher doses (e.g., 400 mg twice daily). Always follow the product label and a clinician’s advice. WebMD

How to take it

• Oral tablets/capsules are the typical route used in osteoarthritis trials.
• Take with water; some sources suggest taking on an empty stomach if aiming for systemic (anti-inflammatory) effects because bromelain’s proteolytic activity can be reduced when taken with protein-rich meals — but trial protocols vary. Check the product label and trial protocol for exact instructions. MDPI

Duration

• Most trials run weeks to a few months (commonly 3–12 weeks). Benefits, when seen, are generally evaluated across weeks rather than days. Oxford Academic

Practical note: if someone and their clinician decide to try oral bromelain for osteoarthritis, commonly studied regimens are around 400 mg twice daily (≈800 mg/day) for several weeks. But product formulations differ (pure bromelain vs enzyme blends), so follow the specific product’s clinical data/label and consult your clinician before starting.

Randomized controlled trial — knee osteoarthritis (800 mg/day)

• A randomized, double-blind, placebo-controlled trial of bromelain 800 mg/day for moderate–severe knee OA (12 weeks) examined symptoms and function. This is one of the better-designed single-ingredient trials. Oxford Academic

Klein & Kullich — Phlogenzym (proteolytic enzyme mix) trial

• Randomized double-blind trial of a proteolytic enzyme preparation containing bromelain (Phlogenzym®) reported significant symptom decreases in knee OA after 3 weeks in 73 patients versus control. Note: this is a combination product (bromelain + other enzymes). ScienceDirect+1

Systematic reviews / reviews

• Review of clinical studies summarizing multiple trials with bromelain (and enzyme combinations) for osteoarthritis; concludes there is some evidence of benefit for pain and function but highlights variability between products, doses and study quality. Wiley Online Library
• Recent narrative/systematic reviews describe anti-inflammatory mechanisms and summarize clinical data suggesting bromelain can reduce inflammatory markers and improve symptoms in some patients, but they call for larger, well-standardized RCTs. ScienceDirect+1

ClinicalTrials.gov entry (Wobenzym® study)

• A randomized double-blind placebo-controlled crossover trial investigated the mechanism and effects of an oral enzyme therapy containing bromelain (Wobenzym®) in osteoarthritis subjects (reported completion). This highlights ongoing/modern clinical interest in enzyme therapies containing bromelain. ClinicalTrials

Summary: multiple randomized trials and reviews suggest potential benefit of bromelain (or bromelain-containing enzyme blends) for osteoarthritis pain and function. However, heterogeneity in products, doses, and study quality means evidence is promising but not definitive; larger modern RCTs with standardized pure-bromelain products would strengthen conclusions. Wiley Online Library