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Alfalfa (Medicago sativa L.) : Safety, Interactions
(Page 2 of 2) 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.
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