What is pawpaw?

What is pawpaw and what is it used for? In the Caribbean, pawpaw means Carica papaya, the tropical fruit tree. The ripe orange fruit is an everyday food.

It goes by other names too. It is papay in Haiti, papaya or lechosa in the Dominican Republic, and papaw in Jamaica.

The plant is also used as a home remedy. Healers have used the green fruit, its milky sap, the seeds and the leaves. These parts are far stronger than ripe fruit, and they carry real risks.

Here is the short verdict. Ripe papaya is a safe and nutritious food for most people. For the medicinal uses, human evidence is thin.

The main exception is leaf extract for dengue fever. Small trials exist, but they are not conclusive.

Long traditional use is not proof that a remedy works. It is also not proof that it is safe. This page says so once, and it applies to everything below.

One more thing before you read on. American pawpaw (Asimina triloba) is a different plant from a different part of the world. It contains nerve toxins and is not covered here.

If a product says Asimina, this page does not apply.

How does pawpaw work?

How is pawpaw supposed to work? Different parts of the plant act in different ways. Most of the proof comes from labs, not people.

The milky sap of the green fruit is rich in papain and chymopapain. These are enzymes that break protein apart. In test tubes they digest meat fibres, which is why papain is sold as meat tenderiser.

Whether swallowed papain helps your digestion is less clear. Stomach acid breaks down many enzymes before they can act. Small human studies of papaya preparations for bloating exist, but they are few and short.

Papaya seeds contain benzyl isothiocyanate. In test tubes and in animals, this compound kills some worms and parasites. Whether seeds clear worms in people is not established.

Papaya leaf contains carpaine and other plant compounds. In lab work and in small trials, leaf extract appears to help platelet counts recover faster in dengue fever.

Platelets are the blood cells that help you clot. The reason why leaf extract may help them is still not understood.

The ripe fruit works simply as food. It supplies vitamin C, folate, fibre and the orange pigments beta-carotene and lycopene. These nutrients are well established, and the fibre adds bulk to stool.

What forms does pawpaw come in?

What forms does pawpaw come in? Most readers will meet it as fruit, but medicinal forms are also sold.

Food forms: - Fresh ripe fruit, eaten plain or in juice - Green unripe fruit, cooked as a vegetable in soups and stews - Dried seeds, ground and used like pepper

Remedy forms: - Dried leaf, brewed as a bitter tea - Leaf extract tablets and syrups, sold mainly in Asia for dengue - Papain capsules, often inside digestive enzyme blends - Fermented papaya powder sachets - Papain creams, gels and meat tenderiser powder used on skin

Strength varies hugely between these forms. A slice of ripe fruit and a strong leaf brew are not the same thing. Supplement labels rarely say how much papain or carpaine is inside.

Where it comes from:

Where does pawpaw come from? The tree is native to southern Mexico and Central America. It spread through the Caribbean long before European contact, and Taino and Arawak peoples grew it.

Spanish and Portuguese ships then carried it across the tropics. Caribbean households treated the plant as both food and medicine.

The green fruit sap was rubbed into tough meat to soften it. Seeds were chewed or ground and taken for intestinal worms.

Leaf tea was given for fever, and was later reached for during dengue outbreaks. Leaves were also wrapped on sores and boils as a poultice.

The unripe fruit held a separate reputation. It was used in some communities to bring on a late period or to end a pregnancy. That history is recorded here as history, and it is the reason pregnancy appears in the safety list.

None of these customs were tested the way medicines are tested today. They are described, not recommended.

What does pawpaw help with?

• Dengue fever with low platelets: This is the use with the most human research, and it is still not settled. Caribbean and Asian households have given papaya leaf tea during dengue outbreaks. Several small trials, mostly in India and Malaysia, tested standard leaf extract tablets. Platelet counts tended to recover a day or so faster than with usual care alone. Most of these trials were small and open-label, which means everyone knew who got what. They did not show fewer deaths or fewer severe cases. Dengue can turn dangerous fast, so leaf extract is not a substitute for medical care.
• Constipation and bloating: Ripe papaya is a reasonable high-fibre food for sluggish bowels. The fibre and water content add bulk, which is a plain food effect rather than a drug effect. One small study of a papaya-based preparation reported less constipation and bloating over several weeks. It was industry-linked and has not been widely repeated. So: the fruit may help, the supplement claim is weak.
• Indigestion: Papain capsules are sold for heavy meals and fullness after eating. The idea is that the enzyme helps break down protein in the gut. In test tubes papain does digest protein. In people the evidence is thin, and stomach acid may destroy much of it first. If your indigestion is frequent or painful, that needs a diagnosis, not an enzyme capsule.
• Intestinal worms: Ground papaya seed is a long-standing Caribbean worm remedy. Benzyl isothiocyanate in the seeds kills some worms in test tubes and in animals. Human testing is limited to a few small studies, including work in children in Nigeria. Results were mixed and the studies were weak. Modern worm medicines are cheap, tested and reliable. A suspected worm infection deserves a proper test and treatment.
• Wound cleaning with topical papain: Papain ointments were once used to strip dead tissue from wounds and ulcers. The enzyme does break down dead protein on contact. In 2008 the US Food and Drug Administration ordered papain-urea wound products off the market. The reason was serious allergic reactions, including drops in blood pressure. That history is the best argument against putting papain on broken skin at home.
• General nutrition: This one is simple and solid. A cup of ripe papaya supplies plenty of vitamin C, plus folate, potassium and fibre. The orange pigments beta-carotene and beta-cryptoxanthin are absorbed well from papaya. Your body can turn some of them into vitamin A. As a fruit, papaya earns its place. No supplement claim is needed.

Which foods are rich in pawpaw?

1. Fresh ripe papaya
2. Papaya juice and smoothies
3. Green papaya cooked in soups and stews
4. Green papaya salad
5. Ground papaya seed used as a pepper substitute
6. Meat tenderiser powder containing papain

Practical Tips:

Eating ripe papaya is the lowest-risk way to use this plant. It brings vitamin C, fibre and carotene pigments with no concentrated enzyme dose.

Green papaya is widely eaten cooked, which is normal in many kitchens. Pregnant readers should still see the safety list below.

Seeds taste sharp and peppery. People who grind them as a spice use small amounts, not spoonfuls.

What are the side effects of pawpaw?

• Loose stools or diarrhoea
• Stomach cramps or nausea
• Itchy mouth, lips or throat after eating the fruit
• Skin rash or itching from handling the sap
• Allergic reaction, which can be severe
• Yellow-orange tint to the palms and soles after very high intake
• Possible easier bruising or bleeding with papain supplements

Good to know:

How common and how serious? Ripe papaya upsets very few people. Most reactions are mild and settle.

Allergy is the real concern. Papain is a known allergen, and reactions have included anaphylaxis, a whole-body reaction that blocks breathing.

If you react to natural rubber latex, you are more likely to react to papaya. Avocado, banana, kiwi and chestnut often come with the same cross-reaction.

The orange skin tint is harmless and fades. It comes from carotene pigments, not from liver trouble.

How much pawpaw should you take?

• Recommended daily: Is there a standard dose? Not really, and that differs by form. Ripe fruit is food. People eat a slice or a cup, the way they eat any fruit. Papain capsule labels usually carry 100 to 500 mg per capsule, taken with meals. That is what labels tend to say. It is not advice for you, and the amount of active enzyme varies between brands. This page gives no amount for papaya seeds, green fruit latex or leaf brews. The strength of a home brew cannot be known, and the leaf trials were run under medical supervision in hospital. Dengue in particular needs a doctor, not a home measurement.
• Best time of day: Does timing matter? For the fruit, no. Eat it whenever you like. Digestive enzyme products are usually labelled for use at mealtimes, since that is when food is in the gut. There is no evidence that morning or night changes anything else.
• With or without food: With food is the usual guidance for papain and enzyme blends. That is simply where the food is. Seeds and strong leaf brews can irritate an empty stomach. Fresh fruit suits any time.
• Time to effect: How fast would you notice anything? Fibre effects on the bowels, if they come at all, show up within a day or two. An enzyme capsule would act during the meal itself, or not at all. In the dengue trials, platelet differences showed over two to five days. It is quite possible you notice nothing. Many people take papaya supplements and feel no change.
• How long to take it: How long do people take it? Ripe fruit can be part of your diet forever, like any fruit. Supplement makers usually frame papain capsules as something taken with meals for a few weeks. Long-term safety data in people is lacking. Leaf extract was given for only a few days in the dengue trials. Nobody has tested long-term leaf use, so no sensible duration can be stated.