For SURGERY RECOVERY, quercetin with bromelain helps to remove damaged cells and enhance wound repair. It rejuvenates fibroblast cells that form new connective tissue for healing. Quercetin and bromelain can both reduce inflammation due to cell trauma and anesthetics, and can prevent inflammatory tissue damage. Their demonstrated antioxidant actions neutralize free radicals, helping to clear drug residues. Quercetin can boost energy and mitochondrial function, and improve oxygen delivery to speed healing.
A recent 2020 review indicates why there is rapidly escalating research and development, and a need for advancement in the field of wound care. According to the Wound Care Market by Product report, as of 2019, the wound care market size was valued at $9.3 million and is expected to reach $15.3 million by 2027.1 Numerous factors are driving this growth including the increasing aged population; rapid increase in the incidence of chronic diseases, such as diabetes; increasing prevalence of acute wounds; changes in lifestyle factors; and attempts to reduce the duration of hospital stays to rein in surgical costs.
Several challenges include finding useful remedies to correct impaired healing, to overcome chronic wounds where surgical sites simply do not heal, and also to avoid bacterial infection and minimize severe pain. Concurrently, as the public becomes more uneasy about drug side effects and scientific research validates the efficacy of natural remedies, their use continues to rise.2 In 2010, more than 22,000 deaths occurred from incorrect dosing of pharmaceuticals, 74% of which were unintentional.3 Many more people died from side effects or drug interactions. In contrast, the U.S. National Poison Data System reported zero deaths from dietary supplements or herbs.4
The blend of quercetin combined with bromelain contributes particular biological activities to further the new frontier in wound therapy.5 Traditional medicinal plants have long been used in the management of wounds, and the wound healing properties of botanical extracts have been confirmed through in vitro and in vivo studies.
What is Quercetin?
Quercetin is a flavonol, one member of the flavonoid family of plant-derived antioxidants that give plants their color. Flavonoids belong to a class of micronutrients called polyphenols, which have powerful health benefits. Quercetin is sometimes referred to as the “master flavonoid” both because it is well-researched, and because it is abundant in dark, vibrant-colored vegetables, fruits, nuts, honey, and medicinal herbs.
“Although there are several dietary sources of quercetin, it is hard to consume sufficient quantities in food to reach a therapeutic level.”
Dr. Rachelle Herdman, Custom Health Guide
How does Quercetin impact surgery recovery?
For effective wound repair, quercetin shows numerous promising benefits through several mechanisms:
- Quercetin clears cells that were damaged by surgery, and removes senescent or aging cells which could otherwise delay the healing process.
- It scavenges free radicals: This antioxidant action reduces tissue and DNA damage allowing for faster healing.
- By mitigating oxidative stress on red blood cells, quercetin helps to increase oxygen delivery to healing tissues.
- Quercetin increases the number and function of mitochondria, the energy-producing factories found in cells. This provides a boost to tissue repair mechanisms, especially valuable for surgery recovery.
- Quercetin calms inflammation arising from surgery tissue damage, and down-regulates the enzymes and hormones responsible for excessive inflammatory responses.
- Quercetin shields DNA from drug-induced injury.
Quercetin removes damaged or aging cells
The removal of aging cells and those impaired by surgery is crucial for healthy wound resolution. If damaged cells build up, delayed healing can occur. After the trauma of surgery, increasing amounts of dysfunctional, non-dividing senescent cells accumulate. Normally, these damaged cells are removed by the immune system, but with surgery trauma, illness, and age, this function declines, and more and more of these cells build up.
If senescent and damaged cells accumulate, they cause chronic and excessive inflammation. This leads to an altered intracellular signaling environment through an unhealthy mix of inflammatory mediators such as cytokines, chemokines, and proteins, all of which can disrupt wound repair. These are known collectively as the senescence-associated secretory phenotype. The specific type of inflammation that follows can impede post-operative wound healing, and is believed to be one driver of the aging process.
Quercetin is especially under current study for wound repair because of its powerful ability to remove senescent cells. It induces apoptosis, or appropriate cell death, helping to clear failing old cells: This stimulates new cell development and thus directly enhances surgical healing.
Quercetin’s antioxidant action
The trauma of surgery generates more free radicals in the body. The resulting oxidative stress blocks healing and scar formation, and increases post-operative infection risk. Over time it can cause lasting damage to cells and connective tissues, muscles, and organs. Quercetin enhanced by bromelain has powerful antioxidant effects: By neutralizing free radicals, it limits post-operative tissue and DNA damage, which allows faster healing.
Free radicals are unstable molecules that form when atoms or molecules gain or lose electrons. They can be produced naturally during normal metabolic processes, such as clearing cellular waste, exercise, and mounting an inflammatory response; or from exposure to external environmental sources such as air pollutants, drugs, and industrial chemicals. These rogue free radicals have unpaired electrons, which roam the body seeking other atoms or molecules to bond to. If they attach to tissues, free radicals cause injury to cells, lipids, proteins, and DNA, called oxidative stress.
Quercetin’s antioxidant actions show promising benefits for quenching oxygen free radicals and reactive molecules of nitrogen. It can boost our innate mechanisms to minimize oxidative injury, and it can shield tissues from oxidative damage.
Antioxidants are natural substances, either made in our bodies, or from plant or mineral sources, that shield tissues from scavenging free radicals, reduce oxidative stress and cell damage, and decrease harmful lipid peroxides. They are protective against many chronic ailments including heart disease, diabetes, cataracts, macular degeneration, and arthritis.
Antioxidants boost our cells’ own protective glutathione levels, and enhance the actions of superoxide dismutase and catalase enzymes. These are enzymes that neutralize or block cell damage from superoxide, a major type of reactive oxygen free radical. For surgery recovery, higher tissue levels of antioxidants also offset oxidative injury from anesthetics, drugs, and painkiller medicines.
Quercetin boosts oxygen delivery and protects red blood cells
Red blood cells are also protected by quercetin from oxidative stress and free radical injury. This can boost healthy oxygen delivery to healing tissues as red cells work at optimal performance, unhampered by rogue oxygen or nitrogen radicals. Better oxygen supply leads to faster healing, stronger scar formation, and better resistance to wound infection.
Quercetin supports mitochondria and tissue repair
Quercetin increases the number and improves the function of mitochondria, the powerhouse energy-producing organelles within every cell. Increased energy availability brings a profound boost to the tissue healing process, which has a high fuel demand. Higher energy supply to a wound area speeds healing and surgery recovery.
Quercetin calms inflammation
Inflammation is a necessary step in wound healing, but if excessive, it can increase pain and block full repair and recovery. Too much inflammation increases infection risk, reduces immune activity, and weakens the connective tissue that knits injured skin, organs, and muscles back together. Quercetin has the potent ability to calm inflammation arising from surgery trauma, and to balance the body’s inflammatory pathways. This helps to down-regulate enzymes and hormones responsible for excessive inflammatory responses.
The science behind Quercetin and surgery recovery
In vitro research and human epidemiologic studies clarify the long list of desirable health benefits from quercetin. These include antibacterial actions and protection for the immune and cardiovascular systems via its antioxidant and anti-inflammatory benefits.
For surgery healing, quercetin cuts infection risk from wound contamination, reduces delayed wound closure related to oxidative damage, and enhances blood flow and micro-circulation to healing wounds. An extra benefit for surgery recovery is quercetin’s ability to help heal tiny injuries that occur on a microscopic level in connective and muscle tissues.
Numerous clinical trials on quercetin and surgery healing are taken from studies on prolonged and intensive exercise which exacerbates the oxidative damage, inflammation, and tissue trauma that mimics the stressful effect of trauma and surgery. Quercetin can help wound healing by mechanisms resembling its benefits for athletes.
Quercetin combined with bromelain further benefits surgical patients as it can reduce the risk of post-operative complications caused by oxidative damage or inflammation.
A fascinating 2010 study showed how quercetin helps to rejuvenate fibroblasts, the ubiquitous connective tissue cells that make collagen and fibrous material for wound healing after surgery. This research specifically identified quercetin as a proteasome activator with antioxidant properties that improves the functions and viability of human cells, and prolongs their lifespans. Most importantly, when quercetin was supplemented to already senescent fibroblasts, a rejuvenating effect was observed. This proved that quercetin promoted physiological alterations that make cells younger and longer-lived.6
Quercetin shields DNA from damage, which allows for optimal protein formation for tissue repair coded by DNA. A landmark 2004 study was carried out to investigate the protective effects of quercetin against a mutagenic drug that can cause DNA damage. Quercetin’s DNA-shielding effect was found to be dose dependent, meaning that higher quercetin doses brought increased benefit and less DNA corruption. In human lymphocyte white blood cells, quercetin protected DNA against damage induced by the drug.7 By helping to maintain robust DNA, quercetin speeds the healing process, reduces the risk of dehiscence or wound separation where the edges come apart, and improves collagen and connective tissue formation.
The impact of quercetin on wound recovery was investigated in a 2018 study. Scientists investigated the mechanism of pressure ulcer formation to better understand how to prevent or relieve those chronic skin lesions that can be so stubborn to heal. Pressure ulcers, or bedsores, are open wounds on the skin and underlying tissue resulting from prolonged pressure, most often after surgery. Pressure ulcers generally occur over bony prominences, such as the heels, ankles, hips, and tailbone.
Quercetin treatment significantly accelerated pressure ulcer wound closure. It was particularly effective in reducing immune cell infiltration and pro-inflammatory cytokine production, preventing excessive inflammation which could impede wound closure. It improved the wound healing process by suppressing the MAPK pathway: This chain of proteins in cells could otherwise block healing, communicating a signal from cell surface receptors to the DNA within the nucleus. The study results confirmed that quercetin is a therapeutic agent for helping to heal pressure ulcers.8
In 2004, an important study confirmed the protective effects of quercetin against nerve damage, or neurodegeneration, which can occur post-operatively, caused by oxidative stress. The results showed that nerve cell viability was clearly improved with quercetin, and the nerve-protective effect of quercetin was higher than vitamin C. Quercetin was also observed to decrease free radical damage to the outer membranes that sheath neuronal cells more effectively than vitamin C. These results indicate that quercetin, in addition to many other biological benefits, contributes significantly to shielding neuronal cells from toxic injury induced by oxidative stress after surgery.9
“Improving quercetin’s assimilation is essential to receiving the full benefits, as it is poorly absorbed on its own. Although its bioavailability is low and it can be a challenge to get adequate amounts into our tissues, there are solutions!”
Dr. Rachelle Herdman, Custom Health Guide
Two main factors greatly improve the absorption of quercetin: combining it with bromelain; and using phytosome technology.
Bromelain is a plant-based complex of protein-digesting enzymes originally found in pineapple, also known as proteases, that break down proteins into their constituent amino acids. Because it enhances absorption, bromelain helps to move quercetin from the digestive tract into the bloodstream. A clinically effective dose of bromelain enhances quercetin absorption, and it magnifies the efficacy of quercetin.
Phytosome technology is a method of combining a nutrient with other natural plant substances to greatly enhance absorption, and to protect the nutrient from breakdown by gut enzymes. Quercetin is even more effectively assimilated and brings greater benefits in a phytosome form when bonded to sunflower-sourced phospholipids. Because these phospholipids are also chief components of human cell membranes, the phytosome complex they form with quercetin is easily recognized by the body.
In addition, quercetin absorption is boosted because this phospholipid phytosome complex is protected from destruction by digestive secretions and gut bacteria. The phytosome complex chaperones quercetin highly efficiently across the epithelial cell membrane barrier of the intestine into the bloodstream, so that greater amounts of quercetin reach the tissues, making quercetin much more available for cells to use.
Bromelain is also a highly effective anti-inflammatory and pain-reliever in its own right. It supports post-operative healing by reducing excessive inflammation and by relieving joint and connective tissue pain.
Bromelain’s potency as an anti-inflammatory agent equals the common non-steroidal anti-inflammatory drugs, but without their side effects such as ulcers or kidney damage. It effectively relieves pain, which is known to speed surgical healing, and it prevents excessive inflammation from causing tissue damage. In Europe, bromelain is approved for oral and topical use for surgical wounds, inflammation due to trauma and surgery, and debridement of deep burns. A 2017 medical review called for more clinical trials to further clarify bromelain’s utility as an anti-inflammatory agent in surgical care.10
Bromelain also directly supports surgical recovery by facilitating protein assimilation. Protein is essential for tissue repair, muscle formation, and for every metabolic enzyme in the body. Bromelain frees up amino acids, the protein building blocks, so that they are better absorbed. Additionally, research confirms that bromelain induces the breakdown of stored fat, which provides steady energy for tissue repair.11
Our patients’ experience with Quercetin with Bromelain
In our clinic, quercetin with bromelain is significantly helpful for our patients undergoing surgery and also for healing chronic wounds and athletic injuries. People report faster tissue repair, especially of stubborn sores or post-operative delayed healing. They notice less pain and reduced need for analgesic drugs, and lower infection rates, all of which makes surgery recovery an easier process for them.
Recommendation: Quercetin 500mg in a sunflower phospholipid phytosome complex, with bromelain 200mg, taken once or twice daily, best between meals; or as directed by your healthcare provider.
- Global Advanced Wound Care Market by Product Opportunity Analysis and Industry Forecast, 2020–2027.
- (NPDS): 27th Annual Report. Clinical Toxicology (2010). 48, 979-1178.
- Jones CM, Mack KA, Paulozzi LJ. Pharmaceutical overdose deaths, United States, 2010. JAMA. 2013;309(7):657–659.
- Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL. 2009 Annual Report of the American Association of Poison Control Centers’ National Poison Data System.
- Polerà, Nicoletta, et al. “Quercetin and its Natural Sources in Wound Healing Management.” Current medicinal chemistry (2019).
- Chondrogianni, Niki, et al. “Anti-ageing and rejuvenating effects of quercetin.” Experimental gerontology 45.10 (2010): 763-771.
- Ündeğer, Ülkü, et al. “The modulating effects of quercetin and rutin on the mitomycin C induced DNA damage.” Toxicology letters 151.1 (2004): 143-149.
- Yin, Guimei, et al. “Topical application of quercetin improves wound healing in pressure ulcer lesions.” Experimental dermatology 27.7 (2018): 779-786.
- Heo, Ho Jin, and Chang Yong Lee. “Protective effects of quercetin and vitamin C against oxidative stress-induced neurodegeneration.” Journal of Agricultural and Food Chemistry 52.25 (2004): 7514-7517.
- Abdul Muhammad, Zehra, and Tashfeen Ahmad. “Therapeutic uses of pineapple-extracted bromelain in surgical care-A review.” JPMA: Journal of the Pakistan Medical Association 67.1 (2017): 121.
- Dave, Sandeep, et al. “Inhibition of adipogenesis and induction of apoptosis and lipolysis by stem bromelain in 3T3-L1 adipocytes.” PLoS One 7.1 (2012): e30831
- Boots, A. W., Haenen, G. R., Bast, A. (2008). Health effects of quercetin: from antioxidant to nutraceutical. European Journal of Pharmacology, 585(2), 325-337.
- Hanasaki, Y., Ogawa, S., Fukui, S. (1994). The correlation between active oxygens scavenging and antioxidative effects of flavonoids. Free Radical Biology and Medicine, 16(6), 845-850.
- van Deursen, J. M. (2014). The role of senescent cells in ageing. Nature, 509(7501), 439-446.