What is it?
Alfalfa is used for kidney conditions, bladder and prostate conditions, and to increase urine flow. It is also used for high cholesterol, asthma, osteoarthritis, rheumatoid arthritis, diabetes, upset stomach, and a bleeding disorder called thrombocytopenic purpura. People also take alfalfa as a source of vitamins A, C, E, and K4; and minerals calcium, potassium, phosphorous, and iron.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for ALFALFA are as follows:
Insufficient evidence to rate effectiveness for...
- High cholesterol. Taking alfalfa seeds seems to lower total cholesterol and “bad” low-density lipoprotein (LDL) cholesterol in people with high cholesterol levels.
- Kidney problems.
- Bladder problems.
- Prostate problems.
- Upset stomach.
- Other conditions.
How does it work?
Are there safety concerns?
Alfalfa might also cause some people's skin to become extra sensitive to the sun. Wear sunblock outside, especially if you are light-skinned.
Special precautions & warnings:Pregnancy or breast-feeding: Using alfalfa in amounts larger than what is commonly found in food is POSSIBLY UNSAFE during pregnancy and breast-feeding. There is some evidence that alfalfa may act like estrogen, and this might affect the pregnancy.
“Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Alfalfa might cause the immune system to become more active, and this could increase the symptoms of auto-immune diseases. There are two case reports of SLE patients experiencing disease flare after taking alfalfa seed products long-term. If you have an auto-immune condition, it’s best to avoid using alfalfa until more is known.
Hormone-sensitive condition such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Alfalfa might have the same effects as the female hormone estrogen. If you have any condition that might be made worse by exposure to estrogen, don’t use alfalfa.
Diabetes: Alfalfa might lower blood sugar levels. If you have diabetes and take alfalfa, monitor your blood sugar levels closely.
Kidney transplant: There is one report of a kidney transplant rejection following the three-month use of a supplement that contained alfalfa and black cohosh. This outcome is more likely due to alfalfa than black cohosh. There is some evidence that alfalfa can boost the immune system and this might make the anti-rejection drug cyclosporine less effective.
Are there interactions with medications?
- Warfarin (Coumadin)
- Alfalfa contains large amounts of vitamin K. Vitamin K is used by the body to help blood clot. Warfarin (Coumadin) is used to slow blood clotting. By helping the blood clot, alfalfa might decrease the effectiveness of warfarin (Coumadin). Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
- Birth control pills (Contraceptive drugs)
- Some birth control pills contain estrogen. Alfalfa might have some of the same effects as estrogen. However, alfalfa is not as strong as the estrogen in birth control pills. Taking alfalfa along with birth control pills might decrease the effectiveness of birth control pills. If you take birth control pills along with alfalfa, use an additional form of birth control such as a condom.
Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.
- Large amounts of alfalfa might have some of the same effects as estrogen. Taking alfalfa along with estrogen might change the effects of estrogen.
Some types of estrogen include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.
- Medications for diabetes (Antidiabetes drugs)
- Alfalfa might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking alfalfa along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.
- Medications that decrease the immune system (Immunosuppressants)
- Alfalfa might increase the immune system. By increasing the immune system, alfalfa might decrease the effectiveness of medications that decrease the immune system.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
- Medications that increase sensitivity to sunlight (Photosensitizing drugs)
- Some medications can increase sensitivity to sunlight. Large doses of alfalfa might also increase your sensitivity to sunlight. Taking alfalfa along with medication that increase sensitivity to sunlight could make you even more sensitive to sunlight, increasing the chances of sunburn, blistering or rashes on areas of skin exposed to sunlight. Be sure to wear sunblock and protective clothing when spending time in the sun.
Some drugs that cause photosensitivity include amitriptyline (Elavil), Ciprofloxacin (Cipro), norfloxacin (Noroxin), lomefloxacin (Maxaquin), ofloxacin (Floxin), levofloxacin (Levaquin), sparfloxacin (Zagam), gatifloxacin (Tequin), moxifloxacin (Avelox), trimethoprim/sulfamethoxazole (Septra), tetracycline, methoxsalen (8-methoxypsoralen, 8-MOP, Oxsoralen), and Trioxsalen (Trisoralen).
Are there interactions with herbs and supplements?
- Herbs and supplements that might lower blood sugar
- Alfalfa might lower blood sugar. Using alfalfa along with other herbs and supplements that might lower blood sugar might lower blood sugar too much. Herbs that might lower blood sugar include devil's claw, fenugreek, guar gum, Panax ginseng, and Siberian ginseng.
- Alfalfa might lower the body's absorption of dietary iron.
- Vitamin E
- Alfalfa might interfere with the way the body takes in and uses vitamin E.
Are there interactions with foods?
- There are no known interactions with foods.
What dose is used?
- For high cholesterol: a typical dose is 5-10 grams of the herb, or as a steeped strained tea, three times a day. 5-10 mL of a liquid extract (1:1 in 25% alcohol) three times a day has also been used.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- Mac Lean JA. Unsaponifiable substance from alfalfa for pharmaceutical and cosmetic use. Pharmaceuticals 1974;81:339.
- Malinow MR, McLaughlin P, Naito HK, and et al. Regression of atherosclerosis during cholesterol feeding in
- Ponka A, Andersson Y, Siitonen A, and et al. Salmonella in alfalfa sprouts. Lancet 1995;345:462-463.
- Kaufman W. Alfalfa seed dermatitis. JAMA 1954;155:1058-1059.
- Rubenstein AH, Levin NW, and Elliott GA. Manganese-induced hypoglycemia. Lancet 1962;1348-1351.
- 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;281:158-162. View abstract.
- 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;30:27-43. View abstract.
- Gray, A. M. and Flatt, P. R. Pancreatic and extra-pancreatic effects of the traditional anti- diabetic plant, Medicago sativa (lucerne). Br J Nutr. 1997;78:325-334. View abstract.
- 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;175:876-882. View abstract.
- Jurzysta, M. and Waller, G. R. Antifungal and hemolytic activity of aerial parts of alfalfa (Medicago) species in relation to saponin composition. Adv.Exp Med Biol 1996;404:565-574. View abstract.
- Herbert, V. and Kasdan, T. S. Alfalfa, vitamin E, and autoimmune disorders. Am J Clin Nutr 1994;60:639-640. View abstract.
- Farnsworth, N. R. Alfalfa pills and autoimmune diseases. Am J Clin Nutr. 1995;62:1026-1028. View abstract.
- 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;37:591-601. View abstract.
- Malinow, M. R., Connor, W. E., McLaughlin, P., Stafford, C., Lin, D. S., Livingston, A. L., Kohler, G. O., and McNulty, W. P. Cholesterol and bile acid balance in Macaca fascicularis. Effects of alfalfa saponins. J Clin Invest 1981;67:156-162. View abstract.
- Malinow, M. R., McLaughlin, P., and Stafford, C. Alfalfa seeds: effects on cholesterol metabolism. Experientia 5-15-1980;36:562-564. View abstract.
- Grigorashvili, G. Z. and Proidak, N. I. [Analysis of safety and nutritive value of protein isolated from alfalfa]. Vopr.Pitan. 1982;5:33-37. View abstract.
- Malinow, M. R., McNulty, W. P., Houghton, D. C., Kessler, S., Stenzel, P., Goodnight, S. H., Jr., Bardana, E. J., Jr., Palotay, J. L., McLaughlin, P., and Livingston, A. L. Lack of toxicity of alfalfa saponins in cynomolgus macaques. J Med Primatol. 1982;11:106-118. View abstract.
- Garrett, B. J., Cheeke, P. R., Miranda, C. L., Goeger, D. E., and Buhler, D. R. Consumption of poisonous plants (Senecio jacobaea, Symphytum officinale, Pteridium aquilinum, Hypericum perforatum) by rats: chronic toxicity, mineral metabolism, and hepatic drug-metabolizing enzymes. Toxicol Lett 1982;10(2-3):183-188. View abstract.
- 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;216:415-417. View abstract.
- Jackson, I. M. Abundance of immunoreactive thyrotropin-releasing hormone-like material in the alfalfa plant. Endocrinology 1981;108:344-346. View abstract.
- Elakovich, S. D. and Hampton, J. M. Analysis of coumestrol, a phytoestrogen, in alfalfa tablets sold for human consumption. J Agric.Food Chem. 1984;32:173-175. View abstract.
- Malinow, M. R. Experimental models of atherosclerosis regression. Atherosclerosis 1983;48:105-118. View abstract.
- Smith-Barbaro, P., Hanson, D., and Reddy, B. S. Carcinogen binding to various types of dietary fiber. J Natl.Cancer Inst. 1981;67:495-497. View abstract.
- Cookson, F. B. and Fedoroff, S. Quantitative relationships between administered cholesterol and alfalfa required to prevent hypercholesterolaemia in rabbits. Br J Exp.Pathol. 1968;49:348-355. View abstract.
- Malinow, M. R., McLaughlin, P., Papworth, L., Stafford, C., Kohler, G. O., Livingston, A. L., and Cheeke, P. R. Effect of alfalfa saponins on intestinal cholesterol absorption in rats. Am J Clin Nutr. 1977;30:2061-2067. View abstract.
- Barichello, A. W. and Fedoroff, S. Effect of ileal bypass and alfalfa on hypercholesterolaemia. Br J Exp.Pathol. 1971;52:81-87. View abstract.
- Shemesh, M., Lindner, H. R., and Ayalon, N. Affinity of rabbit uterine oestradiol receptor for phyto-oestrogens and its use in a competitive protein-binding radioassay for plasma coumestrol. J Reprod.Fertil. 1972;29:1-9. View abstract.
- Malinow, M. R., McLaughlin, P., Kohler, G. O., and Livingston, A. L. Prevention of elevated cholesterolemia in monkeys. Steroids 1977;29:105-110. View abstract.
- Polacheck, I., Zehavi, U., Naim, M., Levy, M., and Evron, R. Activity of compound G2 isolated from alfalfa roots against medically important yeasts. Antimicrob.Agents Chemother. 1986;30:290-294. View abstract.
- Esper, E., Barichello, A. W., Chan, E. K., Matts, J. P., and Buchwald, H. Synergistic lipid-lowering effects of alfalfa meal as an adjuvant to the partial ileal bypass operation. Surgery 1987;102:39-51. View abstract.
- Polacheck, I., Zehavi, U., Naim, M., Levy, M., and Evron, R. The susceptibility of Cryptococcus neoformans to an antimycotic agent (G2) from alfalfa. Zentralbl.Bakteriol.Mikrobiol.Hyg.[A] 1986;261:481-486. View abstract.
- Rosenthal, G. A. The biological effects and mode of action of L-canavanine, a structural analogue of L-arginine. Q.Rev.Biol 1977;52:155-178. View abstract.
- Morimoto, I. A study on immunological effects of L-canavanine. Kobe J Med Sci. 1989;35(5-6):287-298. View abstract.
- 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;55:97-108. View abstract.
- Polacheck, I., Levy, M., Guizie, M., Zehavi, U., Naim, M., and Evron, R. Mode of action of the antimycotic agent G2 isolated from alfalfa roots. Zentralbl.Bakteriol. 1991;275:504-512. View abstract.
- Vasoo, S. Drug-induced lupus: an update. Lupus 2006;15:757-761. View abstract.
- Burden and causes of foodborne disease in Australia: Annual report of the OzFoodNet network, 2005. Commun.Dis Intell. 2006;30:278-300. View abstract.
- Akaogi, J., Barker, T., Kuroda, Y., Nacionales, D. C., Yamasaki, Y., Stevens, B. R., Reeves, W. H., and Satoh, M. Role of non-protein amino acid L-canavanine in autoimmunity. Autoimmun.Rev 2006;5:429-435. View abstract.
- 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;9:474-479. View abstract.
- Kim, C., Hung, Y. C., Brackett, R. E., and Lin, C. S. Efficacy of electrolyzed oxidizing water in inactivating Salmonella on alfalfa seeds and sprouts. J.Food Prot. 2003;66:208-214. View abstract.
- Strapp, C. M., Shearer, A. E., and Joerger, R. D. Survey of retail alfalfa sprouts and mushrooms for the presence of Escherichia coil O157:H7, Salmonella, and Listeria with BAX, and evaluation of this polymerase chain reaction-based system with experimentally contaminated samples. J.Food Prot. 2003;66:182-187. View abstract.
- Thayer, D. W., Rajkowski, K. T., Boyd, G., Cooke, P. H., and Soroka, D. S. Inactivation of Escherichia coli O157:H7 and Salmonella by gamma irradiation of alfalfa seed intended for production of food sprouts. J.Food Prot. 2003;66:175-181. View abstract.
- 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;82:245-253. View abstract.
- 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;66:13-17. View abstract.
- 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;69:548-553. View abstract.
- Yanaura, S. and Sakamoto, M. [Effect of alfalfa meal on experimental hyperlipidemia]. Nippon Yakurigaku Zasshi 1975;71:387-393. View abstract.
- 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;287:581-582. View abstract.
- Stochmal, A., Piacente, S., Pizza, C., De Riccardis, F., Leitz, R., and Oleszek, W. Alfalfa (Medicago sativa L.) flavonoids. 1. Apigenin and luteolin glycosides from aerial parts. J Agric.Food Chem. 2001;49:753-758. View abstract.
- 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;115:339-345. View abstract.
- Taormina, P. J., Beuchat, L. R., and Slutsker, L. Infections associated with eating seed sprouts: an international concern. Emerg.Infect.Dis 1999;5:626-634. View abstract.
- Feingold, R. M. Should we fear "health foods"? Arch Intern Med 7-12-1999;159:1502. View abstract.
- 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;49:308-314. View abstract.
- Mackler BP, Herbert V. The effect of raw wheat bran, alfalfa meal and alpha-cellulose on iron ascorbate chelate and ferric chloride in three binding solutions. Am J Clin Nutr. 1985 Oct;42:618-28. View abstract.
- Swanston-Flatt SK, Day C, Bailey CJ, Flatt PR. Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetologia 1990;33:462-4. View abstract.
- Timbekova AE, Isaev MI, Abubakirov NK. Chemistry and biological activity of triterpenoid glycosides from Medicago sativa. Adv Exp Med Biol 1996;405:171-82. View abstract.
- Zehavi U, Polacheck I. Saponins as antimycotic agents: glycosides of medicagenic acid. Adv Exp Med Biol 1996;404:535-46. View abstract.
- Malinow MR, McLaughlin P, et al. Comparative effects of alfalfa saponins and alfalfa fiber on cholesterol absorption in rats. Am J Clin Nutr 1979;32:1810-2. View abstract.
- Story JA, LePage SL, Petro MS, et al. Interactions of alfalfa plant and sprout saponins with cholesterol in vitro and in cholesterol-fed rats. Am J Clin Nutr 1984;39:917-29. View abstract.
- Bardana EJ Jr, Malinow MR, Houghton DC, et al. Diet-induced systemic lupus erythematosus (SLE) in primates. Am J Kidney Dis 1982;1:345-52. View abstract.
- Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med 1983;308:1361. View abstract.
- Alcocer-Varela J, Iglesias A, Llorente L, Alarcon-Segovia D. Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa. Arthritis Rheum 1985;28:52-7. View abstract.
- Prete PE. The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum 1985;28:1198-200. View abstract.
- Montanaro A, Bardana EJ Jr. Dietary amino acid-induced systemic lupus erythematosus. Rheum Dis Clin North Am 1991;17:323-32. View abstract.
- Light TD, Light JA. Acute renal transplant rejection possibly related to herbal medications. Am J Transplant 2003;3:1608-9. View abstract.
- 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;65:173-9. View abstract.
- Farber JM, Carter AO, Varughese PV, et al. Listeriosis traced to the consumption of alfalfa tablets and soft cheese [Letter to the Editor]. N Engl J Med 1990;322:338. View abstract.
- Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. View abstract.
- Brown R. Potential interactions of herbal medicines with antipsychotics, antidepressants and hypnotics. Eur J Herbal Med 1997;3:25-8.
- Malinow MR, Bardana EJ Jr, Goodnight SH Jr. Pancytopenia during ingestion of alfalfa seeds. Lancet 1981;14:615. View abstract.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.