Bromelain

Bromelain has anti-inflammatory and proteolytic properties that could influence allergic/inflammatory processes (and it’s been studied for sinusitis, wound healing and inflammation), but for food allergy the evidence is limited and mixed — and some preclinical work even suggests bromelain can promote sensitization in mice.

• Proteolytic action. Bromelain is a mixture of proteases (protein-digesting enzymes) from pineapple. The idea: by breaking down proteins it might degrade allergenic proteins or alter their uptake/processing in the gut and therefore reduce antigenic stimulation. However, whether oral bromelain survives the stomach and digests meaningful amounts of food allergen in humans is uncertain. MDPI RSC Publishing
• Anti-inflammatory / immunomodulatory effects. Bromelain has been shown to reduce inflammatory markers (cytokines, leukocyte migration) in vitro and in some human studies of inflammatory conditions — this could theoretically blunt allergic inflammation. These anti-inflammatory actions are the main rationale for testing it in allergic rhinitis/sinusitis, not specifically IgE-mediated food allergy. ScienceDirect RSC Publishing
• Important counterpoint (preclinical): some animal studies show that proteases such as bromelain can break oral tolerance and act as adjuvants that promote allergic sensitization in mice (i.e., increase Th2 responses and IgE against the protease/food). That’s a direct warning that effects may not be protective in the context of food allergy. World Allergy Organization JournalSpringerLink

Summary: Mechanistic reasons exist (proteolysis + anti-inflammatory action) that make bromelain plausible as an adjunct for inflammatory allergic symptoms (e.g., sinusitis), but mechanistic evidence does not prove it treats IgE-mediated food allergy — and preclinical data raise concern that it could increase sensitization.

There is no accepted clinical protocol for using bromelain specifically to treat food allergy. What follows are dosing ranges and regimens that have been used in human studies for inflammatory or ENT conditions — they do not establish efficacy for food allergy; they are included only to show how bromelain has been administered in trials.

• Common human dose ranges reported: 40–2,000 mg per day (many supplements and studies use 40–400 mg/day; some trials for inflammatory conditions use higher daily totals). WebMD summarizes commonly used adult doses of about 40–400 mg daily, with studies up to higher amounts depending on formulation. WebMD Vogue
• Formulations/units: bromelain products are variably standardized (e.g., “FIP units” or mg of extract). Clinical studies use product-specific units — you should follow the product label or the dose used in the particular trial you’re trying to emulate. b-ent.be RSC Publishing
• Typical clinical-study guidance: many studies using bromelain for sinusitis, wound healing or inflammation gave it orally once or split twice daily for weeks to months (example: daily dosing for several weeks). Again: this is for other conditions, not validated for food allergy. b-ent.be ScienceDirect

If someone is considering trying bromelain for allergic symptoms (not recommended for treating systemic food allergy), best practice: talk to your clinician first, use a quality product with known activity units, start at the lower end of commonly used doses (e.g., one 40–200 mg dose), and monitor for adverse effects. Do not replace avoidance, epinephrine, or an allergist-directed plan for true food allergy.

• Systematic reviews & mechanism reviews: Recent reviews summarize many bromelain studies across indications and note anti-inflammatory/immunomodulatory potential — but these reviews conclude the evidence for many clinical indications is still limited and more rigorous RCTs are needed. (Good overviews: MDPI review and Royal Society of Chemistry review). MDPI RSC Publishing
• Randomized trials — mostly non-food-allergy indications: bromelain has been trialed (alone or within combination phytotherapeutic products) for sinusitis / upper respiratory symptoms, post-surgical swelling/pain, and general inflammatory marker reductions. A few small RCTs and pilot studies suggest symptom improvement in some ENT/inflammatory uses, but these trials are heterogeneous, often small, and usually do not assess IgE-mediated food allergy outcomes. Examples: a pilot study of bromelain tablets in chronic rhinosinusitis and RCTs of bromelain-containing products for upper respiratory allergic symptoms. b-ent.be JACI Online
• No convincing clinical RCT evidence that bromelain treats IgE-mediated food allergy. Searches of the literature find animal/preclinical models and human studies for allergic rhinitis/sinusitis, but not high-quality RCTs showing bromelain prevents or treats systemic food allergy (anaphylaxis, IgE reactivity) in humans. Where there is direct food-allergen research, it’s mainly preclinical (mouse models), and some of those show sensitization rather than protection. World Allergy Organization JournalFrontiers

Interpretation: clinically useful evidence exists for some inflammatory/ENT uses but not for treating food allergy. If your goal is to manage food-allergic reactions, current evidence does not support replacing standard-of-care allergy management (avoidance, epinephrine when indicated, immunotherapy under specialist supervision).