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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Non-Standardized Food Allergenic Extract [EPC]
Alfalfa (Medicago sativa) is a botanical agent primarily classified as a Non-Standardized Food Allergenic Extract [EPC]. It is used in allergen immunotherapy and as a nutritional source of vitamins and minerals.
Name
Alfalfa
Raw Name
ALFALFA
Category
Non-Standardized Food Allergenic Extract [EPC]
Drug Count
32
Variant Count
40
Last Verified
February 17, 2026
About Alfalfa
Alfalfa (Medicago sativa) is a botanical agent primarily classified as a Non-Standardized Food Allergenic Extract [EPC]. It is used in allergen immunotherapy and as a nutritional source of vitamins and minerals.
Detailed information about Alfalfa
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Alfalfa.
Alfalfa has a long history of use in traditional medicine, but its modern clinical relevance is defined by its nutrient density and its role in immunology. It is often referred to as the "father of all foods" due to its deep root system, which absorbs a vast array of minerals from the soil. In the context of FDA-regulated products, Alfalfa extracts are utilized in diagnostic testing and therapeutic hyposensitization for allergic rhinitis or asthma triggered by environmental or food-based allergens. The FDA has historically permitted the use of non-standardized allergenic extracts under specific regulatory pathways, acknowledging their utility in specialized allergy practices.
At the molecular level, Alfalfa’s mechanism of action is multifaceted, depending on the form of administration. As an Allergenic Extract, it works through immunological desensensitization. When administered in small, escalating doses, the extract modulates the immune system's response by shifting the T-cell profile from a Th2-dominated (allergic) response to a Th1-dominated response. This process increases the production of regulatory T-cells and IgG4 "blocking antibodies," which compete with IgE for allergen binding, thereby reducing the release of histamine and other inflammatory mediators from mast cells and basophils.
From a metabolic perspective, Alfalfa contains high concentrations of saponins. These compounds are known to interfere with the absorption of cholesterol in the small intestine. Saponins bind with bile acids and cholesterol, forming insoluble complexes that are excreted rather than reabsorbed. Furthermore, Alfalfa acts as a Calcium Chelating Activity [MoA] agent and exhibits Ammonium Ion Binding Activity [MoA], which may play a role in its traditional use for metabolic detoxification. The presence of L-canavanine, an amino acid analogue, also contributes to its pharmacological profile, although this specific compound is associated with significant safety concerns regarding autoimmune activation.
The absorption of Alfalfa-derived compounds varies significantly by chemical class. The water-soluble vitamins (such as Vitamin C) are readily absorbed via active transport in the small intestine. However, the complex saponins and fibers have low systemic bioavailability, as they primarily exert their effects within the gastrointestinal lumen. When used as an allergenic extract (subcutaneous injection), the proteins are slowly absorbed into the lymphatic system to interact with immune cells.
Once absorbed, the micro-nutrients in Alfalfa are distributed widely throughout the body. Trace minerals like copper and manganese are transported via specific carrier proteins (e.g., ceruloplasmin). There is no significant evidence that Alfalfa’s primary allergenic proteins cross the blood-brain barrier in therapeutic concentrations.
Alfalfa contains various phytoestrogens, such as coumestrol, which undergo hepatic metabolism. These compounds are typically conjugated with glucuronic acid or sulfate in the liver to facilitate excretion. The amino acid L-canavanine is metabolized similarly to arginine, which allows it to be mistakenly incorporated into proteins, a key factor in its toxicity profile.
The primary route of elimination for Alfalfa’s water-soluble components and metabolites is renal (urine). Insoluble fibers and saponin-cholesterol complexes are eliminated via the feces. The half-life of specific allergenic proteins in the systemic circulation is relatively short, though the immunological effects (memory T-cell changes) can persist for years.
Alfalfa is utilized in several clinical contexts:
Alfalfa is available in several pharmaceutical and over-the-counter preparations:
> Important: Only your healthcare provider can determine if Alfalfa is right for your specific condition. The use of allergenic extracts must be supervised by a qualified allergist.
Dosage for Alfalfa varies significantly based on the intended use and the specific preparation. Because many Alfalfa products are non-standardized, it is critical to follow the labeling of the specific product prescribed.
For desensitization, the dosage is highly individualized. It typically begins with a Build-up Phase:
Alfalfa is generally not recommended for use in infants or young children without strict medical supervision.
Patients with significant renal impairment should use Alfalfa with caution. The high mineral content (especially potassium and magnesium) may accumulate in patients with a GFR (Glomerular Filtration Rate) below 30 mL/min. No specific dose-reduction formulas exist, but close monitoring of serum electrolytes is required.
No specific adjustments are documented for mild hepatic impairment. However, in cases of severe liver failure, the metabolism of phytoestrogens may be reduced, potentially leading to increased systemic levels of estrogen-like compounds.
Elderly patients should start at the lower end of the dosing range. This population is at higher risk for interactions with medications like Warfarin (Coumadin) due to Alfalfa's high Vitamin K content.
If you miss a dose of an Alfalfa supplement, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular schedule. Do not double the dose to catch up.
For missed immunotherapy injections, contact your allergist immediately. If the interval between doses becomes too long, the dose may need to be reduced to prevent an adverse reaction upon resumption.
Signs of Alfalfa overdose (particularly from concentrated supplements) may include:
In the event of an overdose, contact a Poison Control Center or seek emergency medical attention. For immunotherapy, an overdose can trigger systemic anaphylaxis, requiring immediate administration of epinephrine.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
Most patients taking Alfalfa supplements or undergoing immunotherapy may experience mild reactions. These commonly include:
> Warning: Stop taking Alfalfa and call your doctor immediately if you experience any of these.
Prolonged use of high-dose Alfalfa (especially the seeds) can lead to chronic immunological stimulation. The most significant long-term risk is the development of antinuclear antibodies (ANA), which can precede clinical autoimmune disease. Additionally, the high Vitamin K content can lead to chronic alterations in coagulation parameters for patients on anticoagulant therapy.
No FDA black box warnings currently exist for Alfalfa as a dietary supplement or non-standardized allergenic extract. However, clinical literature strongly warns against its use in patients with a history of Systemic Lupus Erythematosus (SLE).
Report any unusual symptoms to your healthcare provider. Monitoring for autoimmune markers may be necessary during long-term therapy.
Alfalfa is not a benign herb; it contains potent bioactive compounds that can significantly alter immune function and blood chemistry. Patients must be aware that "natural" does not equate to "safe" in all contexts. The most critical safety concern involves its potential to trigger or worsen autoimmune conditions.
No FDA black box warnings for Alfalfa. However, the FDA regulates Alfalfa allergenic extracts with strict requirements for administration in settings equipped to handle life-threatening allergic reactions.
As a Non-Standardized Plant Allergenic Extract [EPC], Alfalfa carries an inherent risk of anaphylaxis. Patients with known sensitivities to legumes (such as peas, beans, or peanuts) may exhibit cross-reactivity. Any sign of hives, throat tightening, or wheezing requires immediate cessation of use.
Alfalfa contains L-canavanine, a non-protein amino acid. Clinical studies have demonstrated that L-canavanine can reactivate Systemic Lupus Erythematosus (SLE) in patients whose disease was in remission. It may also induce SLE-like symptoms in healthy individuals when consumed in large quantities. Patients with a family history of autoimmune disease should exercise extreme caution.
Alfalfa contains phytoestrogens, specifically coumestrol. These compounds can bind to estrogen receptors. Patients with hormone-sensitive conditions (e.g., breast cancer, uterine cancer, endometriosis, or uterine fibroids) should avoid Alfalfa as it may mimic or interfere with endogenous estrogen.
Due to its high Vitamin K content, Alfalfa can promote blood clotting. This is a major precaution for patients with a history of thromboembolic events (blood clots) or those taking anticoagulants.
If your healthcare provider prescribes Alfalfa for long-term use, the following monitoring may be required:
Alfalfa generally does not cause drowsiness or cognitive impairment. However, if an individual experiences a systemic reaction to an allergenic extract, they should not drive until cleared by a medical professional.
There are no direct contraindications between Alfalfa and moderate alcohol use. However, alcohol can exacerbate the gastrointestinal side effects of Alfalfa, such as diarrhea or nausea.
Alfalfa supplements do not typically require a tapering period. However, if being used for its desensitizing effects in immunotherapy, stopping suddenly will result in a loss of immunological tolerance, and the patient will return to their baseline level of allergy sensitivity.
> Important: Discuss all your medical conditions with your healthcare provider before starting Alfalfa.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Alfalfa must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis by a physician:
Patients allergic to the following substances may also be allergic to Alfalfa:
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Alfalfa.
Alfalfa is categorized as Pregnancy Category C (or equivalent in some jurisdictions). There is evidence from animal studies and traditional use that Alfalfa may have uterine-stimulating effects. Furthermore, the phytoestrogenic content (coumestrol) could potentially interfere with the delicate hormonal balance required to maintain a healthy pregnancy. While Alfalfa is a source of Vitamin K (often needed in pregnancy), it is safer to obtain this through standardized prenatal vitamins. Use during pregnancy is generally discouraged unless specifically directed by an obstetrician.
It is not known if the complex saponins or L-canavanine from Alfalfa pass into human breast milk. However, phytoestrogens are known to enter breast milk and could theoretically affect the nursing infant. Due to the lack of safety data, nursing mothers should avoid Alfalfa supplements.
Alfalfa is not FDA-approved for general nutritional use in children. In the context of Allergen Immunotherapy, it is used in children as young as 5 years old, provided the administration is performed by an allergist. There are concerns that the L-canavanine content could affect the developing immune system of children, potentially increasing the risk of autoimmune disorders later in life.
Elderly patients are more likely to be on complex medication regimens. The most significant risk in the geriatric population is the interaction with anticoagulants and the potential for Alfalfa to cause gastrointestinal malabsorption of other essential medications. Additionally, the mild diuretic effect of Alfalfa may contribute to dehydration in elderly patients who already have a reduced thirst mechanism.
In patients with chronic kidney disease (CKD), the kidneys' ability to excrete minerals like potassium and phosphorus is diminished. Alfalfa is rich in these minerals. Therefore, patients with CKD Stage 3 or higher (GFR < 60 mL/min) should avoid Alfalfa to prevent hyperkalemia or mineral-bone disorder complications.
Patients with Child-Pugh Class B or C hepatic impairment may have difficulty metabolizing the coumarins and phytoestrogens found in Alfalfa. This can lead to an increased risk of bleeding or hormonal imbalances. Monitoring of liver enzymes and coagulation factors is mandatory if Alfalfa is used in this population.
> Important: Special populations require individualized medical assessment.
Alfalfa’s pharmacology is driven by its diverse chemical constituents:
| Parameter | Value |
|---|---|
| Bioavailability | Low for saponins (<5%); High for Vitamin C (>70%) |
| Protein Binding | Variable (Phytoestrogens >90% to albumin) |
| Half-life | 4-6 hours (Metabolites) |
| Tmax | 1-2 hours (Oral water-soluble components) |
| Metabolism | Hepatic (Glucuronidation/Sulfation) |
| Excretion | Renal 60%, Fecal 40% |
Alfalfa is classified as a Non-Standardized Food Allergenic Extract [EPC]. It is related to other plant extracts like Timothy Grass or Ragweed used in allergy medicine, and to nutritional agents like Vitamin K (Phytonadione).
Medications containing this ingredient
Alfalfa
Universaltox
Sleepology
Ohm Tonic Syrup
Para-bn
Tox-chord
Bestmade Natural Products Bm228
Endocrinpath
D01
Vivacity
A03
Bestmade Natural Products Bm41
+ 1 more drugs
Common questions about Alfalfa
Alfalfa is primarily used in two ways: as a nutritional supplement and as an allergenic extract for immunotherapy. In clinical settings, healthcare providers use Alfalfa extracts to help desensitize patients who have severe allergies to the plant's proteins. As a supplement, it is often taken for its high content of Vitamin K, Vitamin C, and minerals. Some people also use it off-label to help lower high cholesterol levels, as the saponins in the plant can bind to cholesterol in the digestive tract. However, it should only be used under medical supervision due to its potential effects on the immune system.
The most common side effects of Alfalfa include gastrointestinal issues such as bloating, gas, and diarrhea. These symptoms are usually mild and occur because of the high fiber and saponin content in the plant. If you are receiving Alfalfa as an injection for allergies, you may also experience redness, itching, or swelling at the site of the shot. Some people also report increased sensitivity to sunlight, which can lead to sunburns more easily. Always report any side effects to your doctor, especially if they persist or become bothersome.
There is no known direct chemical interaction between Alfalfa and alcohol that would cause a dangerous reaction. However, both Alfalfa and alcohol can irritate the gastrointestinal lining, so combining them might increase the likelihood of stomach upset or diarrhea. Additionally, if you are taking Alfalfa for a specific medical condition like high cholesterol or allergies, alcohol consumption might interfere with your overall treatment goals. It is always best to discuss your alcohol intake with your healthcare provider to ensure it does not complicate your therapy. Moderation is key if your doctor says it is safe for you to drink.
Alfalfa is generally not recommended during pregnancy. It contains compounds called phytoestrogens, which can mimic the hormone estrogen and potentially disrupt the hormonal balance necessary for a healthy pregnancy. There is also some evidence that Alfalfa might act as a uterine stimulant, which could increase the risk of complications. While Alfalfa is rich in nutrients, it is safer to rely on standardized prenatal vitamins that do not contain these bioactive botanical compounds. If you are pregnant or planning to become pregnant, consult your obstetrician before using any Alfalfa products.
The time it takes for Alfalfa to show results depends on what it is being used for. If you are taking it to help lower cholesterol, it typically takes 4 to 8 weeks of consistent daily use to see changes in blood tests. For those undergoing allergen immunotherapy, the process is much slower, often taking 6 months to a year to notice a significant reduction in allergy symptoms. Nutritional benefits, such as improved Vitamin K levels, may be seen within a few weeks. Because it is a botanical agent, its effects are often gradual rather than immediate.
If you are taking Alfalfa as a dietary supplement, you can generally stop taking it suddenly without experiencing withdrawal symptoms. However, if you are using Alfalfa extracts as part of an allergen immunotherapy program, stopping suddenly is not recommended. Stopping your allergy shots will cause your immune system to lose the tolerance it has built up, and your allergy symptoms will likely return. If you wish to discontinue immunotherapy, your doctor will provide a schedule to ensure it is done safely. Always consult your healthcare provider before making changes to a prescribed treatment plan.
If you miss a dose of an Alfalfa supplement, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular routine; do not take two doses at once. If you miss an appointment for an Alfalfa allergy injection, contact your allergist's office immediately. Missing an immunotherapy dose may require your doctor to adjust your next dose downward to prevent an adverse reaction. Consistency is very important for the effectiveness of both supplements and immunotherapy.
There is no clinical evidence to suggest that Alfalfa causes weight gain. In fact, because of its high fiber content and its ability to interfere with the absorption of certain fats and sugars in the gut, some people use it as part of a weight management plan. However, Alfalfa is not an FDA-approved weight loss drug. If you notice unexpected weight gain while taking Alfalfa, it is likely due to another factor or a potential side effect like fluid retention, which should be discussed with your doctor. Maintaining a balanced diet and exercise remains the most effective way to manage weight.
Alfalfa has several significant drug interactions that you must be aware of. Most importantly, it should not be taken with Warfarin (Coumadin) because its high Vitamin K content can make the blood thinner less effective, increasing the risk of clots. It may also interact with birth control pills, hormone replacement therapy, and medications that suppress the immune system. Because Alfalfa can lower blood sugar, it might also interact with diabetes medications. Always provide your doctor with a full list of all medications and supplements you are taking before starting Alfalfa.
Alfalfa is a natural botanical substance and is not a patented drug, so it is widely available in many generic forms. You can find it as a generic dietary supplement in health food stores and pharmacies in various forms like tablets, capsules, and teas. For medical use, Alfalfa allergenic extracts are produced by several different laboratories, but they are generally referred to by their common name rather than a brand name. When buying supplements, look for products that have been verified by third-party organizations to ensure quality and purity.