Alfalfa (Medicago sativa)
Contents of this page:
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- Background
- Synonyms
- Evidence
- Dosing
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- Safety
- Interactions
- Methodology
- Selected references
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Alfalfa |
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Background
- Alfalfa is a legume that has
a long history of dietary and medicinal uses. 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, alfalfa weevil,
arc, buffalo herb, California clover, Chilean clover, Fabaceae
(family), feuille de luzerne (French), isoflavone, jatt, kaba yonca,
Leguminosae (family), lucerne, medicago, mielga, mu su,
phytoestrogen, purple medic, 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 evidence |
Grade* |
| 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 firm conclusion can be drawn.
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C |
| Diabetes
A small number of
animal 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.
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C |
| 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.
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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,
antifungal, antimicrobial, antioxidant, appetite stimulant, asthma,
bladder disorders, blood clotting disorders, boils, breast cancer,
cervical cancer, cough, diuresis (increased urination), estrogen
replacement, gastrointestinal tract disorders, gum healing after dental
procedures, increasing breast milk, indigestion, inflammation, insect
bites, jaundice, kidney disorders, menopausal symptoms, nutritional
support, peptic ulcer disease, prostate disorders, radiotherapy induced
skin damage, 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.
Adults (18 years and older)
- A dose of 5-10 grams of dried
herb three times daily has been taken by mouth.
- Two tablets (1 gram each) of
Cholestaid® (esterin processed alfalfa) taken by mouth three times
daily for up to two months, then 1 tablet three times daily, has
been recommended by the manufacturer.
- A dose of 5 to 10 milliliters
(one to two teaspoonfuls) of a 1:1 solution in 25% alcohol three
times daily has been taken by mouth.
- For treating high
cholesterol, 40 grams of heated seeds prepared three times daily
with food has been taken by mouth.
Children (younger than 18 years)
- Alfalfa supplements in
children are 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 Leguminosae
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.
- 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 a 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. In one case report,
vomiting occurring after the consumption of seaweed and organic
alfalfa was attributed to contamination of the capsules with high
amounts of entospore forming and streptomyces-like bacteria. Copper,
arsenic, and antimony have 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
- 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" effects 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®).
- Alfalfa may alter potassium
and calcium levels like other drugs.
- Many tinctures/liquid
extracts contain high levels of alcohol and may cause nausea or
vomiting when taken with metronidazole (Flagyl®) or disulfiram
(Antabuse®).
- Alfalfa may also interact
with drugs that alter the immune system.
Interactions with Herbs and Dietary Supplements
- Blood sugar levels may be
reduced. Caution is advised when using herbs or supplements that may
also lower blood sugar such as aloe or bitter melon. 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.
- Alfalfa has been reported to
contain vitamin K, and therefore may reduce the effects of herbs and
supplements that have blood-thinning effects that rely on depletion
of vitamin K.
- Because alfalfa contains
estrogen-like chemicals, the effects of other agents believed to
have estrogen-like properties, such as black cohosh, may be altered.
Alfalfa may also alter thyroid levels in herbs such as bladderwrack.
- Alfalfa may alter potassium
and calcium levels. It may also interact with iron, vitamin E, and
vitamin K.
- Alfalfa may interact with
therapies that alter the immune system or cause sun sensitivity.
- 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).
Selected references
- 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.
- Bengtsson AA, Rylander L, Hagmar L, et al. Risk
factors for developing systemic lupus erythematosus: a case-control
study in southern Sweden. Rheumatology (Oxford) 2002;41(5):563-571.
- Boue SM, Wiese TE, Nehls S, et al. Evaluation of
the estrogenic effects of legume extracts containing phytoestrogens.
J Agric Food Chem 4-9-2003;51(8):2193-2199.
- Burden and causes of foodborne disease in
Australia: Annual report of the OzFoodNet network, 2005. Commun Dis
Intell 2006;30(3):278-300.
- Farnsworth NR. Alfalfa pills and autoimmune
diseases. Am J Clin Nutr 1995;62(5):1026-1028.
- Hwang J, Hodis HN, 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.
- Lanza A, Tava A, Catalano M, et al. 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.
- Malinow MR, McLaughlin P, Naito HK, et al.
Regression of atherosclerosis during cholesterol feeding in Macaca
fascicularis. Am J Cardiol 1978;41:396.
- Malinow MR, McLaughlin P, Naito HK, et al.
Effect of alfalfa meal on shrinkage (regression) of atherosclerotic
plaques during cholesterol feeding in monkeys. Atherosclerosis
1978;30(1):27-43.
- Malinow MR, McLaughlin P, Stafford C. Alfalfa
seeds: effects on cholesterol metabolism. Experientia
5-15-1980;36(5):562-564.
- Malinow MR, Bardana EJ Jr, Goodnight SH Jr.
Pancytopenia during ingestion of alfalfa seeds. Lancet
3-14-1981;1(8220 Pt 1):615.
- Molgaard J, von Schenck H, Olsson AG. Alfalfa
seeds lower low density lipoprotein cholesterol and apolipoprotein B
concentrations in patients with type II hyperlipoproteinemia.
Atherosclerosis 1987;65(1-2):173-179.
- Srinivasan SR, Patton D, Radhakrishnamurthy B,
et al. Lipid changes in atherosclerotic aortas of Macaca
fascicularis after various regression regimens. Atherosclerosis
1980;37(4):591-601.
- Swanston-Flatt SK, Day C, Bailey CJ, et al.
Traditional plant treatments for diabetes. Studies in normal and
streptozotocin diabetic mice. Diabetologia 1990;33(8):462-464.
- Van Beneden CA, Keene WE, Strang RA, et al.
Multinational outbreak of Salmonella enterica serotype Newport
infections due to contaminated alfalfa sprouts. JAMA
1-13-1999;281(2):158-162.
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