Wheatgrass Juice Put to the Test

In an editorial that accompanied a landmark study showing an extract of the spice turmeric could be used to fight ulcerative colitis, the authors congratulated the researchers on performing the largest study ever on complementary or alternative medicine approaches to treat inflammatory bowel disease. But that’s not saying much.

Two of the only other high quality trials tested aloe vera gel and wheat grass juice. No significant improvements in clinical remission rates or endoscopy findings on aloe vera were observed,. (And I would recommend against internal aloe use–see my aloe vera videos here). However the wheat grass findings were impressive, as I discuss in my video Wheatgrass Juice for Ulcerative Colitis. “The use of wheat grass…juice for treatment of various gastrointestinal and other conditions had been suggested by its proponents for more than 30 years, but was never clinically assessed in a controlled trial”…until now.

Wrote the researchers: “The use of wheat grass juice in the treatment of [ulcerative colitis] UC was brought to our attention by several patients with UC who attributed improvement to regular use of the extract.” So, in a pilot study, the researchers gave 100 cc of wheatgrass juice, which is between a third and a half cup, daily to ten patients for two weeks. “Eight patients described clinical improvement, one had no change, and one got worse.” Why had I never heard of this study? Because it was never published. They thought they were really onto something, so they wanted to do it right. Therefore, the “randomized, double-blind, placebo-controlled trial was designed to examine the effects of wheat grass juice in patients with active distal U[lcerative]C[olitis].”

The study found that treatment with wheatgrass juice was associated with reductions in overall disease activity and the severity of rectal bleeding. Ninety percent of the wheatgrass patients improved, and none got worse. The researchers concluded that wheatgrass juice appeared effective and safe as a single or added treatment of active lower ulcerative colitis.

No answer is available at present as to the site of wheatgrass juice action. Does the active substance get absorbed into the body and have some kind of general anti-inflammatory effect, or does it act locally right in the colon? How would you figure that out? Well, you could juice in the opposite direction (i.e. wheatgrass enemas).

A study like this raises so many questions. How would wheatgrass juice perform head-to-head against other treatments? Does it have any role in preventing attacks, or does it only work when you already have one? Should we be giving it to people with Crohn’s disease, too? What’s the best dose? It’s been over ten years since the publication of this study, yet nothing has been published since. How sad. Yes, no one’s going to make a million dollars selling wheat berries, but what about the wheatgrass juicer companies? I wish they’d pony up some research dollars.

Until then,  the researchers “believe that wheat grass juice offers a genuine therapeutic advantage in the disabling disease of UC.” That is, if you can stand the taste.


The turmeric video I mentioned is Striking with the Root: Turmeric Curcumin and Ulcerative Colitis.

I think the only other video  I’ve mentioned wheatgrass is How Much Broccoli Is Too Much? and that was really just for comic relief. This is one of the topics I get lots of questions about, but there just wasn’t any good science…until now! Please never hesitate to contact me with topics you’d like us to cover.

For more on ulcerative colitis and inflammatory bowel disease, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Turmeric Curcumin Put to the Test for Inflammatory Bowel Disease

My video Striking with the Root: Turmeric Curcumin and Ulcerative Colitis tells the story how this amazing discovery was made, and how curcumin stacks up against pharmacological interventions.

Despite evidence going back 40 years that the turmeric spice component curcumin possesses significant anti-inflammatory activity, it wasn’t until 2005 that it was first tested on inflammatory bowel disease. Why did it take so long? Well, who’s going to fund such a study? Big Curry? Even without corporate backing, individual physicians from New York decided to ask the next five patients with ulcerative colitis who walked through their office doors to start curcumin supplements.

“Ulcerative colitis (UC) is a debilitating, chronic, relapsing-remitting [i.e., it comes and goes] IBD [inflammatory bowel disease] that afflicts millions of individuals throughout the world and produces symptoms that impair quality of life and ability to function.” As with most diseases, we have a bunch of drugs to treat people, but sometimes these medications can add to disease complications, most commonly nausea, vomiting, headaches, rash, fever, and inflammation of the liver, pancreas, and kidneys, as well as potentially wiping out our immune system and causing infertility. Most ulcerative colitis patients need to be on drugs every day for the rest of their lives, so we need something safe to keep the disease under control.

So how did those five patients do on the spice extract? Overall, all five subjects improved by the end of the study, and four of the five were able to decrease or eliminate their medications. They had “more formed stools, less frequent bowel movements, and less abdominal pain and cramping. One subject reported decreased muscle soreness, commonly felt after his exercise routine.” This, however, was what’s called an open-label study, meaning the patients knew they were taking something so some of the improvement may have just been the placebo effect. In 2013, another small open-label pilot study found encouraging results in a pediatric population, but what was needed was a larger scale, double-blind, placebo-controlled trial.

And, researchers obliged. They took a bunch of people with quiescent ulcerative colitis and gave them either turmeric curcumin along with their typical anti-inflammatory drugs, or a placebo and their drugs. In the placebo group, 8 out of 39 patients relapsed, meaning their disease flared back up. In the curcumin group, however, only 2 out of 43 relapsed, significantly fewer. And, relapse or not, clinically, the placebo group got worse, while the curcumin group got better. Endoscopically, which is objectively visualizing the inside of their colons, doctors saw the same thing: trends towards worse or better.

The results were stunning: a 5 percent relapse rate in the curcumin group compared with a 20 percent relapse rate in the conventional care group. It was such a dramatic difference that the researchers wondered if it was some kind of fluke. Even though patients were randomized to each group, perhaps the curcumin group just ended up being much healthier through some chance coincidence, so maybe it was some freak occurrence rather than curcumin that accounted for the results? So, the researchers extended the study for another six months but put everyone on the placebo to ensure the initial findings were not some aberration. The curcumin was stopped to see if that group would then start relapsing, too—and that’s exactly what happened. Suddenly, they became just as bad as the original placebo group.

The researchers concluded: “Curcumin seems to be a promising and safe medication for maintaining remission in patients with quiescent ulcerative colitis.” Indeed, no side effects were reported at all. So, “Curry for the cure?” asked an accompanying editorial in the journal of the Crohn’s and Colitis Foundation of America. “Can curcumin be added to our list of options with respect to maintaining remission in ulcerative colitis? What is noteworthy about this trial is the fact that not only did the authors demonstrate a statistically significant decrease in relapse at 6 months, but a statistically significant improvement in the endoscopic index as well. Equally telling is the fact that upon withdrawal of curcumin the relapse rate quickly paralleled that of patients treated initially with placebo, implying that curcumin was, in fact, exerting some important biologic effect.”

Similarly, a Cochrane review concluded in 2013 that curcumin may be a safe and effective adjunct therapy. Cochrane reviews take all the best studies meeting strict quality criteria and compile all the best science together, which is normally a gargantuan undertaking. Not so in this case, however, as there is really just that one good study.


Turmeric is one of the most popular trending topics, and I encourage you to check out the most popular turmeric videos, including:

For more on ulcerative colitis and inflammatory bowel disease, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Splenda Side-Effects

On April Fool’s Day, 1998, the Food and Drug Administration approved the artificial sweetener sucralose, aka 1,6-dichloro-1,6-dideoxy-beta-D-fructofuranosyl-4- chloro-4-deoxy-alpha-D-galactopyranoside. But, despite its scary name, the worst it seemed to do was just be a rare migraine trigger in susceptible individuals, to which the manufacturer of sucralose replied that you have to weigh whatever risk there may be against its broader health benefits, “helping to mitigate the health risks associated with the national epidemic of obesity.”

As I discuss in my video Effect of Sucralose (Splenda) on the Microbiome, the hope was to offer a harmless sugar substitute to provide a sweet taste without the calories or spikes in blood sugar. However, that’s not how it appears to have turned out: Population studies have tied consumption of artificial sweeteners, mainly in diet sodas, with increased risk of developing obesity, metabolic syndrome, and type 2 diabetes. But, an association is not causation. You’ve got to put it to the test.

Indeed, if you give obese individuals the amount of sucralose found in a can of diet soda, for example, they get a significantly higher blood sugar spike in response to a sugar challenge, requiring significantly more insulin—20 percent higher insulin levels in the blood—suggesting sucralose causes insulin resistance. This may help explain the links between artificial sweetener consumption and the development of diabetes, heart disease, and stroke. So, sucralose is not some inert substance. It affects the blood sugar response. But how?

The Splenda company emphasizes that sucralose is hardly even absorbed into the body and, as such, stays in the digestive tract to be quickly eliminated from the body. But the fact that it’s not absorbed in the small intestine means it makes it down to the large intestine and may affect our gut flora. Studies have been done on artificial sweeteners and the gut bacteria of rats going back years, but there hadn’t been any human studies until fairly recently. Researchers tested saccharin, sucralose, and aspartame, the artificial sweeteners in Sweet & Low, Splenda, and NutraSweet, respectively, and found that non-caloric artificial sweeteners induce glucose intolerance by altering the microbes in our gut. The human studies were limited, but, after a few days on saccharin, for example, some people got exaggerated blood sugar responses tied to changes over just one week to the type of bacteria they had in their gut.

Acesulfame K, another common artificial sweetener, also was found subsequently to be associated with changes in gut bacteria. So, all this time, artificial sweeteners were meant to stave off chronic diseases but may actually be contributing to the problem due to microbial alterations. Some in the scientific community were surprised that “even minor concentrations of a sweetener [in this case, aspartame] are sufficient to cause substantial changes in gut inhabitants…” Others were less surprised. Each molecule of aspartame is, after all, metabolized into formaldehyde. That may explain why some people who are allergic to formaldehyde have such bad reactions to the stuff. “Therefore, it is not unexpected that very small amounts of the sweetener can modify bacterial communities…” However, the reports about the safety of aspartame are mixed. “All of the studies funded by the industry vouch for its safety, whereas 92% of independently funded studies report that aspartame can cause adverse health effects.”

That should tell you something.

“Undoubtedly, consumers of these food additives, which are otherwise perceived as safe, are unaware that these substances may influence their gut bacteria. This may be of particular importance to patients with diseases correlated with modifications of the gut [bacteria], such as irritable bowel syndrome and inflammatory bowel diseases” (IBDs) like ulcerative colitis and Crohn’s disease. People may not realize artificial sweeteners may be affecting their gut.

Might the effect be large enough to be actually see changes in the incidence of inflammatory bowel disease? Let’s look at Canada, the first country to approve the use of sucralose. Their rates of IBD did seem to double after the approval of sucralose. What about in the United States? After decades of relatively stable rates of ulcerative colitis and Crohn’s disease, rates did appear to start going up. In China, after the approval of sucralose, IBD rates rose 12-fold. Again, these could just be total flukes, but such correlations were also found on two other continents as well. Indeed, the more graphs you see showing this rise in rates of IBD after sucralose’s approval in different countries, the harder it is to dismiss a possible connection.

The good news, though, is that after stopping artificial sweeteners, the original balance of gut bacteria may be restored within weeks. Now, of course, the negative consequences of artificial sweeteners should not be interpreted to suggest that we should all go back to sugar and high fructose corn syrup. For optimal health, it is recommended that we all try to cut down on both.


Can’t get enough of artificial sweeteners? Check out:

Erythritol May Be a Sweet Antioxidant, but there are some caveats for it and other nontoxic, low-calorie sweeteners. See:

Does it really matter if our gut flora get disrupted? You’re in for a surprise. See:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: