Alfalfa

Good for the digestive system, alkalizes and detoxifies the body.

View All Products Containing Alfalfa

 

Background

 

Alfalfa is a legume with, has a long history of dietary and medicinal use. A small number of animal and preliminary human studies report that alfalfa supplements may lower blood levels of cholesterol and glucose. However, most research has not been well designed. Therefore, there is not enough reliable evidence available to form clear conclusions in these areas.

 

Alfalfa supplements taken by mouth appear to be generally well tolerated. However, ingestion of alfalfa tablets has been associated with reports of a lupus-like syndrome or lupus flares. These reactions may be due to the amino acid L-canavanine which appears to be present in alfalfa seeds and sprouts, but not in the leaves. There are also rare cases of pancytopenia (low blood counts), dermatitis (skin inflammation), and gastrointestinal upset.

 

Synonyms

 

Al-fac-facah, arc, alfalfa weevil, buffalo herb, California clover, Chilean clover, Fabaceae, feuille de luzerne, isoflavone, jatt, kaba yonca, Leguminosae, lucerne, medicago, mielga, mu su, purple medic, phytoestrogen, purple medick, purple medicle, sai pi li ka, saranac, Spanish clover, team, weevelchek, yonja.

 

Evidence

 

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidenceGrade*
High cholesterol

 

Reductions in blood levels of total cholesterol and low-density lipoprotein ("bad cholesterol") have been reported in animal studies and in a small number of human cases. High-density lipoprotein ("good cholesterol") has not been altered in these cases. Although this evidence is promising, better research is needed before a firm conclusion can be reached. 		C
Atherosclerosis (cholesterol plaques in heart arteries)

 

Several studies in animals report reductions in cholesterol plaques of the arteries after use of alfalfa. Well-designed research in humans is necessary before a conclusion can be drawn. 		C
Diabetes

 

A small number of rat studies report reductions in blood sugar levels following ingestion of alfalfa. Human data are limited, and it remains unclear if alfalfa can aid in the control of sugars in patients with diabetes or hyperglycemia. 		C

 

*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.

 

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Allergies, antioxidant, appetite stimulant, asthma, bladder disorders, blood clotting disorders, boils, breast cancer, cervical cancer, cough, convalescence, diuresis (increasing urination), estrogen replacement, gastrointestinal tract disorders, gum healing after dental procedures, hay fever, increasing breast milk, indigestion, inflammation, insect bites, jaundice, kidney disorders, menopausal symptoms, nutritional support, prostate disorders, rheumatoid arthritis, scurvy, skin damage from radiation, stomach ulcers, thrombocytopenic purpura, uterine stimulant, vitamin supplementation (vitamins A,C,E,K), wound healing.

Dosing

 

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization
There are no standard or well-studied doses of alfalfa, and many different doses are used traditionally. Safety of use beyond 8 weeks has not been proven in studies.

 

Adults (18 years and older)
Dried herb: 5 to 10 grams of dried herb taken by mouth three times daily has been used.

 

Tablets: Two tablets (one gram each) of Cholestaid® (esterin processed alfalfa) taken by mouth three times daily for up to two months, then one tablet three times daily, has been recommended by the manufacturer.

 

Liquid extract: 5 to 10 milliliters (one to two teaspoonfuls) of a 1:1 solution in 25% alcohol taken by mouth three times daily has been used.

 

Seeds: For treating high cholesterol, 40 grams of heated seeds prepared three times daily and taken by mouth with food has been used.

 

Children (younger than 18 years)
There is not enough scientific data to recommend alfalfa supplements for use in children, and it is not recommended due to potential side effects.

 

Safety

 

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Alfalfa should be avoided in people with allergies to members of the Fabaceae or Leguminous plant families. Caution is warranted in individuals with grass allergies.

 

Side Effects and Warnings
Alfalfa appears to be well tolerated by most individuals, although rare serious adverse effects have been reported.

 

Mild gastrointestinal symptoms may occur, such as stomach discomfort, diarrhea, gas, or larger/more frequent stools. Dermatitis (skin inflammation/redness) has been reported, and may be due to alfalfa allergy.

 

Based on animal studies and a human case report blood sugar levels may be reduced. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.

 

Lupus-like effects have been associated with alfalfa use, including antinuclear antibodies in the blood, muscle pains, fatigue, abnormal immune system function, and kidney abnormalities. Therefore, people with a history of lupus (systemic lupus erythematosus), or family history of lupus should avoid alfalfa supplements.

 

Other rarely reported adverse effects include abnormal blood cell counts (pancytopenia) and lowered potassium levels (hypokalemia). In theory, thyroid hormone levels may be increased, gout flares may be stimulated, and estrogen-like effects may occur.

 

Contamination of alfalfa products with potentially dangerous bacteria (including Escherichia coli 0157:H7, Salmonella, and Listeria monocytogenes ) has been reported. One case report exists of seaweed and organic alfalfa associated with vomiting found to be caused by contamination of the capsules with high amounts of entospore forming and streptomyces-like bacteria. Copper, arsenic and antimony has been found in alfalfa plants.

 

Many tinctures/liquid extracts contain high levels of alcohol, and should be avoided when driving or operating heavy machinery.

 

Pregnancy and Breastfeeding
Alfalfa supplements are not recommended during pregnancy and breastfeeding due to insufficient evidence and a theoretical risk of birth defects or spontaneous abortion. Amounts found in food are generally believed to be safe. Traditionally, alfalfa is believed to stimulate breast milk production, although this has not been well studied.

 

Tinctures/liquid extracts may contain high levels of alcohol, and should be avoided during pregnancy.

 

Interactions

 

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs
Based on animal studies and a human case report, blood sugar levels may be reduced. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

 

Alfalfa contains vitamin K, and therefore may reduce the "blood thinning" effect of the drug warfarin (Coumadin®). Alfalfa may add to the effects of cholesterol-lowering medications such as atorvastatin (Lipitor®) or simvastatin (Zocor®).

 

Alfalfa may increase the risk of severe sunburns when used with drugs that increase sun sensitivity, such as chlorpromazine (Thorazine®). Due to estrogen-like chemicals in alfalfa, the side effects of drugs that contain estrogens may be increased (such as birth control pills or hormone replacement therapy). In theory, alfalfa may increase thyroid hormone levels and may alter the effects of thyroid drugs such as thyroxine (Synthroid®, Levoxyl®).

 

Many tinctures/liquid extracts contain high levels of alcohol, and may cause nausea or vomiting when taken with metronidazole (Flagyl®) or disulfiram (Antabuse®).

 

Interactions with Herbs and Dietary Supplements
Based on animal studies and a human case report, blood sugar levels may be reduced. Caution is advised when using herbs or supplements that may also lower blood sugar. Possible examples include Aloe vera , American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, gymnema, horse chestnut seed extract (HCSE), maitake mushroom, marshmallow, milk thistle, Panax ginseng, rosemary, shark cartilage, Siberian ginseng, stinging nettle, and white horehound. Blood glucose levels may require monitoring, and doses may need adjustment.

 

Alfalfa may add to the effects of cholesterol-lowering agents such as fish oil, garlic, guggul, red yeast and niacin.

 

Because alfalfa contains estrogen like chemicals, the effects of other agents believed to have estrogen-like properties may be altered. Possible examples include black cohosh, bloodroot, burdock, hops, kudzu, licorice, pomegranate, red clover, soy, thyme, white horehoumd, and yucca.

 

Alfalfa may contain significant levels of zinc, copper, manganese, and selenium.

 

Methodology

 

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Michelle Harrison, PharmD (New England Medical Center); Mamta Vora, PharmD (Northeastern University); Ethan Basch, MD (Memorial Sloan Kettering Cancer Center); David Kroll, PhD (Duke University); David Sollars, MAc, HMC (New England School of Acupuncture); Michael Smith, M.R.PharmS, ND (Canadian College of Naturopathic Medicine); Cathi Dennehy, PharmD (University of California San Francisco); Philippe Szapary, MD (University of Pennsylvania); Richard Liebowitz, MD (Duke University); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mary Giles, PharmD (University of Rhode Island).

 

Selected references

 

  1. Alcocer-Varela, J., Iglesias, A., Llorente, L., and Alarcon-Segovia, D. Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa. Arthritis Rheum. 1985;28(1):52-57.
  2. Anon. From the Centers for Disease Control and Prevention. Outbreaks of Escherichia coli O157:H7 infection associated with eating alfalfa sprouts--Michigan and Virginia, June-July 1997. JAMA 9-10-1997;278(10):809-810.
  3. Backer, H. D., Mohle-Boetani, J. C., Werner, S. B., Abbott, S. L., Farrar, J., and Vugia, D. J. High incidence of extra-intestinal infections in a Salmonella Havana outbreak associated with alfalfa sprouts. Public Health Rep. 2000;115(4):339-345.
  4. Bengtsson, A. A., Rylander, L., Hagmar, L., Nived, O., and Sturfelt, G. Risk factors for developing systemic lupus erythematosus: a case-control study in southern Sweden. Rheumatology.(Oxford) 2002;41(5):563-571.
  5. Boue, S. M., Wiese, T. E., Nehls, S., Burow, M. E., Elliott, S., Carter-Wientjes, C. H., Shih, B. Y., McLachlan, J. A., and Cleveland, T. E. Evaluation of the estrogenic effects of legume extracts containing phytoestrogens. J Agric.Food Chem. 4-9-2003;51(8):2193-2199.
  6. Dong, Y., Iniguez, A. L., Ahmer, B. M., and Triplett, E. W. Kinetics and strain specificity of rhizosphere and endophytic colonization by enteric bacteria on seedlings of Medicago sativa and Medicago truncatula. Appl.Environ.Microbiol. 2003;69(3):1783-1790.
  7. Elakovich, S. D. and Hampton, J. M. Analysis of coumestrol, a phytoestrogen, in alfalfa tablets sold for human consumption. J Agric.Food Chem. 1984;32(1):173-175.
  8. Farber, J. M., Carter, A. O., Varughese, P. V., Ashton, F. E., and Ewan, E. P. Listeriosis traced to the consumption of alfalfa tablets and soft cheese. N.Engl.J Med 2-1-1990;322(5):338.
  9. Farnsworth, N. R. Alfalfa pills and autoimmune diseases. Am J Clin Nutr. 1995;62(5):1026-1028.
  10. Gill, C. J., Keene, W. E., Mohle-Boetani, J. C., Farrar, J. A., Waller, P. L., Hahn, C. G., and Cieslak, P. R. Alfalfa seed decontamination in a Salmonella outbreak. Emerg.Infect.Dis. 2003;9(4):474-479.
  11. Howard, M. B. and Hutcheson, S. W. Growth dynamics of Salmonella enterica strains on alfalfa sprouts and in waste seed irrigation water. Appl.Environ.Microbiol. 2003;69(1):548-553.
  12. Hwang, J., Hodis, H. N., and Sevanian, A. Soy and alfalfa phytoestrogen extracts become potent low-density lipoprotein antioxidants in the presence of acerola cherry extract. J Agric.Food Chem. 2001;49(1):308-314.
  13. Jackson, I. M. Abundance of immunoreactive thyrotropin-releasing hormone-like material in the alfalfa plant. Endocrinology 1981;108(1):344-346.
  14. Kaufman W. Alfalfa seed dermatitis. JAMA 1954;155(12):1058-1059.
  15. Lanza, A., Tava, A., Catalano, M., Ragona, L., Singuaroli, I., Robustelli della Cuna, F. S., and Robustelli della, Cuna G. Effects of the Medicago scutellata trypsin inhibitor (MsTI) on cisplatin-induced cytotoxicity in human breast and cervical cancer cells. Anticancer Res 2004;24(1):227-233.
  16. Liao, C. H. and Fett, W. F. Isolation of Salmonella from alfalfa seed and demonstration of impaired growth of heat-injured cells in seed homogenates. Int.J.Food Microbiol. 5-15-2003;82(3):245-253.
  17. Mahon, B. E., Ponka, A., Hall, W. N., Komatsu, K., Dietrich, S. E., Siitonen, A., Cage, G., Hayes, P. S., Lambert-Fair, M. A., Bean, N. H., Griffin, P. M., and Slutsker, L. An international outbreak of Salmonella infections caused by alfalfa sprouts grown from contaminated seeds. J Infect.Dis 1997;175(4):876-882.
  18. Malinow MR, McLaughlin P, Naito HK, and et al. Regression of atherosclerosis during cholesterol feeding inMacaca fascicularis. Am J Cardiol 1978;41:396.
  19. Malinow, M. R., McLaughlin, P., Naito, H. K., Lewis, L. A., and McNulty, W. P. Effect of alfalfa meal on shrinkage (regression) of atherosclerotic plaques during cholesterol feeding in monkeys. Atherosclerosis 1978;30(1):27-43.
  20. Malinow, M. R., McLaughlin, P., and Stafford, C. Alfalfa seeds: effects on cholesterol metabolism. Experientia 5-15-1980;36(5):562-564.
  21. Malinow, M. R., Bardana, E. J., Jr., and Goodnight, S. H., Jr. Pancytopenia during ingestion of alfalfa seeds. Lancet 3-14-1981;1(8220 Pt 1):615.
  22. Malinow, M. R., Bardana, E. J., Jr., Pirofsky, B., Craig, S., and McLaughlin, P. Systemic lupus erythematosus-like syndrome in monkeys fed alfalfa sprouts: role of a nonprotein amino acid. Science 4-23-1982;216(4544):415-417.
  23. Mohle-Boetani J, Werner B, Polumbo M, and et al. From the Centers for Disease Control and Prevention. Alfalfa sprouts-- Arizona, California, Colorado, and New Mexico, February-April, 2001. JAMA 2-6-2002;287(5):581-582.
  24. Molgaard, J., von Schenck, H., and Olsson, A. G. Alfalfa seeds lower low density lipoprotein cholesterol and apolipoprotein B concentrations in patients with type II hyperlipoproteinemia. Atherosclerosis 1987;65(1-2):173-179.
  25. Morimoto, I., Shiozawa, S., Tanaka, Y., and Fujita, T. L-canavanine acts on suppressor-inducer T cells to regulate antibody synthesis: lymphocytes of systemic lupus erythematosus patients are specifically unresponsive to L-canavanine. Clin Immunol.Immunopathol. 1990;55(1):97-108.
  26. Ponka A, Andersson Y, Siitonen A, and et al. Salmonella in alfalfa sprouts. Lancet 1995;345:462-463.
  27. Prete, P. E. The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum. 1985;28(10):1198-1200.
  28. Roberts, J. L. and Hayashi, J. A. Exacerbation of SLE associated with alfalfa ingestion. N.Engl.J Med 6-2-1983;308(22):1361.
  29. Srinivasan, S. R., Patton, D., Radhakrishnamurthy, B., Foster, T. A., Malinow, M. R., McLaughlin, P., and Berenson, G. S. Lipid changes in atherosclerotic aortas of Macaca fascicularis after various regression regimens. Atherosclerosis 1980;37(4):591-601.
  30. Swanston-Flatt, S. K., Day, C., Bailey, C. J., and Flatt, P. R. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33(8):462-464.
  31. Taormina, P. J., Beuchat, L. R., and Slutsker, L. Infections associated with eating seed sprouts: an international concern. Emerg.Infect.Dis 1999;5(5):626-634.
  32. Van Beneden, C. A., Keene, W. E., Strang, R. A., Werker, D. H., King, A. S., Mahon, B., Hedberg, K., Bell, A., Kelly, M. T., Balan, V. K., Mac Kenzie, W. R., and Fleming, D. Multinational outbreak of Salmonella enterica serotype Newport infections due to contaminated alfalfa sprouts. JAMA 1-13-1999;281(2):158-162.
  33. Winthrop, K. L., Palumbo, M. S., Farrar, J. A., Mohle-Boetani, J. C., Abbott, S., Beatty, M. E., Inami, G., and Werner, S. B. Alfalfa sprouts and Salmonella Kottbus infection: a multistate outbreak following inadequate seed disinfection with heat and chlorine. J.Food Prot. 2003;66(1):13-17.

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