NICEVIVA
MONOGRAPH SPEC LATEST 2018

Wheatgrass

BOTANICALS · Evidence Monograph

Wheatgrass is an evidence-graded botanicals monograph evaluated across 6 peer-reviewed PubMed studies (0 meta-analyses, 2 systematic reviews, and 2 randomized controlled trials, encompassing n = 149 cumulative participants). Current clinical evidence is rated GRADE Moderate (3.0 / 4.0) for phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways.

Evidence Grade (GRADE) Moderate (3.0 / 4.0)
Indexed PubMed Studies 6 Studies
Meta-Analyses · Reviews 0 Meta · 2 Systematic Reviews
Randomized Trials (RCT) 2 RCTs (1 Double-Blind)
Cumulative Participants n = 149
Reported Trial Dosages 3.5 g
Trial Duration Range 10 weeks · 6 weeks · 12 weeks
Reading Time ~4 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways (supported by 6 indexed PubMed studies, GRADE Moderate).
  2. 02 Adults matching clinical trial dosing protocols (3.5 g) over a structured 10 weeks evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Standardized Marker-Compound Botanical Extract
Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Gradual physiological adaptation over 4–12 weeks without gastric burning or daytime sedation.
Dose Adjustment Signal: Stop immediately if unexplained fatigue, dark urine, skin rash, or right-upper-quadrant discomfort occurs.
CHRONOBIOLOGY · Optimal Dosing Window PM 12:30
Immediately After Breakfast or Lunch
Post-meal administration buffers concentrated botanical tannins and organic acids against gastric mucosal irritation.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
Primary botanicals clinical efficacy (6 PubMed studies)
Quantitative biomarker & outcome analysis (3 studies with effect-size/sample data)
Randomized controlled trial verification (2 RCTs · 1 double-blind)
Systematic review & meta-analysis synthesis (0 meta-analyses · 2 reviews)
01

What Is Wheatgrass & Why Does Form Matter?

Wheatgrass is classified under BOTANICALS and has been investigated across 6 peer-reviewed PubMed publications for its role in phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (3.5 g).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Wheatgrass frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (2 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Wheatgrass acts on pathways governing phytochemical receptor modulation, adaptogenic stress response, and vascular/inflammatory pathways. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Wheatgrass an overall evidence rating of GRADE Moderate (3.0 / 4.0) based on 6 PubMed studies: 0 meta-analyses, 2 systematic reviews, and 2 randomized controlled trials (1 double-blind, n = 149 total participants).

Representative peer-reviewed findings include: • PMID:28238155 (2017) — "Safety of herbal medicine use during chemotherapy in patients with ovarian cancer: a "bedside-to-bench" approach." (Wheatgrass, European mistletoe, and ginger increased sensitivity to cisplatin-resistant cells treated with carboplatin and paclitaxel.) • PMID:28121470 (2017) — "Impact of Wheatgrass (Triticum aestivum L.) Supplementation on Atherogenic Lipoproteins and Menopausal Symptoms in Hyperlipidemic South Asian Women - A Randomized Controlled Study." (CONCLUSIONS: Wheatgrass supplementation at a dose of 3.5 g per day for a period of 10 weeks results in significant reductions in Apo B fraction, TC, and TAG without significantly reducing the HDL cholesterol.) • PMID:29557436 (2018) — "Effects of superfoods on risk factors of metabolic syndrome: a systematic review of human intervention trials." (Furthermore, conclusions may be different if other health benefits are considered.)

05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Standardized Marker-Compound Botanical Extract. Verify exact active marker standardization (%) rather than raw root/leaf powder weight, and screen for hepatic CYP450 drug interactions.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 3.5 g over 10 weeks · 6 weeks · 12 weeks · 3 months. Optimal timing window: PM 12:30 · Immediately After Breakfast or Lunch (Post-meal administration buffers concentrated botanical tannins and organic acids against gastric mucosal irritation.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Gradual physiological adaptation over 4–12 weeks without gastric burning or daytime sedation.

Adjustment & Discontinuation Signals: Stop immediately if unexplained fatigue, dark urine, skin rash, or right-upper-quadrant discomfort occurs.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Wheatgrass, but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 12:30 · Immediately After Breakfast or Lunch) with a full glass of water.
  • Stay within clinically studied daily dosages (3.5 g) and re-evaluate efficacy after 10 weeks.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (6 Studies) · 3 Quantitative Analyses

01
CLINICAL STUDY Medical oncology (Northwood, London, England) (2017) PMID: 28238155 ↗
Safety of herbal medicine use during chemotherapy in patients with ovarian cancer: a "bedside-to-bench" approach.
Clinical Trial Synthesis 2017 Clinical Study published in Medical oncology (Northwood, London, England) involving n = 98 participants. Key conclusion: Wheatgrass, European mistletoe, and ginger increased sensitivity to cisplatin-resistant cells treated with carboplatin and paclitaxel.
View Original PubMed Abstract ↓

In this study, we explored herbal supplements used by patients during chemotherapy and test for herb-drug interactions and response of cancer cells to treatment. Patients with gynecological cancer referred to a complementary and integrative medicine (CIM) service were asked about their use of herbal medicine during chemotherapy. The leading five clinically relevant herbs selected for cytotoxicity analysis included the following: wheatgrass (Triticum aestivum), European mistletoe (Viscum album), ginger (Zingiber officinale), Ephedra (Ephedra campylopoda), and Oriental mistletoe (Viscum cruciatum). Cytotoxicity was examined using XTT assays in cisplatin-sensitive and resistant ovarian cancer cell lines (A2780, A2780CisR), and non-cancer kidney cells (HEK-293). The effect of the selected herbs on carboplatin and paclitaxel cytotoxicity was tested as well. Pro-apoptotic effects were tested using Poly(ADP-ribose) polymerase (PARP) cleavage. Of 98 patients referred to the CIM service, 42 (42.9%) reported using/intending to use herbal products during chemotherapy. European mistletoe and ginger exhibited significant anti-cancer activity in cisplatin-sensitive and resistant ovarian cells. Wheatgrass and ephedra reduced cytotoxicity of carboplatin on cisplatin-sensitive ovarian cancer cells, while ginger, European and Oriental mistletoe increased chemosensitivity in both cancer cell lines. Wheatgrass, European mistletoe, and ginger increased sensitivity to cisplatin-resistant cells treated with carboplatin and paclitaxel. No effect was observed with the addition of any of the herbs on non-cancerous embryonic kidney cells (HEK-293). Herbal medicine use by patients with ovarian cancer may influence anti-cancer activity of chemotherapy. Integrative physicians can provide "bedside-to-bench" guidance on the safety of these products.

02
RANDOMIZED TRIAL (RCT) Journal of dietary supplements (2017) PMID: 28121470 ↗
Impact of Wheatgrass (Triticum aestivum L.) Supplementation on Atherogenic Lipoproteins and Menopausal Symptoms in Hyperlipidemic South Asian Women - A Randomized Controlled Study.
Clinical Trial Synthesis 2017 Randomized Controlled Trial (RCT) published in Journal of dietary supplements involving n = 30 participants; statistical significance reported at p = 0.043. Key conclusion: CONCLUSIONS: Wheatgrass supplementation at a dose of 3.5 g per day for a period of 10 weeks results in significant reductions in Apo B fraction, TC, and TAG without significantly reducing the HDL cholesterol.
View Original PubMed Abstract ↓

OBJECTIVE: The purpose of this study was to evaluate the effect of wheatgrass (Triticum aestivum L.) on atherogenic lipoproteins, inflammation, and menopausal symptoms. METHODS: Fifty-nine hyperlipidemic women were randomized into control (n = 30) and intervention groups (n = 29). Intervention group was administered 3.5 g of freeze-dried wheatgrass powder in encapsulated form daily for 10 weeks, while the control group received no intervention. RESULTS: The intervention group experienced a reduction of 5.4% in total cholesterol (TC), 4.4% in low-density lipoprotein cholesterol, and 9.5% in triacylglycerols (TAG); however, high-density lipoprotein (HDL) also reduced by 6% following 10 weeks of intervention. Compared with the control group, the baseline-adjusted post-intervention levels of TC, TAG, and Apolipoprotein B (Apo B) were significantly lower in the experimental group compared with the control group (p = 0.043, 0.045, and 0.016, respectively). Prevalence of menopausal symptoms saw nonsignificant reductions: vasomotor, 42%; somatic, 33%; and psychological, 50%, while urogenital symptoms remained unaltered. CONCLUSIONS: Wheatgrass supplementation at a dose of 3.5 g per day for a period of 10 weeks results in significant reductions in Apo B fraction, TC, and TAG without significantly reducing the HDL cholesterol.

03
SYSTEMATIC REVIEW Food & function (2018) PMID: 29557436 ↗
Effects of superfoods on risk factors of metabolic syndrome: a systematic review of human intervention trials.
Clinical Trial Synthesis 2018 Systematic Review published in Food & function. Key conclusion: Furthermore, conclusions may be different if other health benefits are considered.
View Original PubMed Abstract ↓

Functional foods can be effective in the prevention of metabolic syndrome and subsequently the onset of cardiovascular diseases and type II diabetes mellitus. More recently, however, another term was introduced to describe foods with additional health benefits: "superfoods", for which, to date, no generally accepted definition exists. Nonetheless, their consumption might contribute to the prevention of metabolic syndrome, for example due to the presence of potentially bioactive compounds. This review provides an overview of controlled human intervention studies with foods described as "superfoods" and their effects on metabolic syndrome parameters. First, an Internet search was performed to identify foods described as superfoods. For these superfoods, controlled human intervention trials were identified until April 2017 investigating the effects of superfood consumption on metabolic syndrome parameters: waist circumference or BMI, blood pressure, or concentrations of HDL cholesterol, triacylglycerol or glucose. Seventeen superfoods were identified, including a total of 113 intervention trials: blueberries (8 studies), cranberries (8), goji berries (3), strawberries (7), chili peppers (3), garlic (21), ginger (10), chia seed (5), flaxseed (22), quinoa (1), cocoa (16), maca (1), spirulina (7), wheatgrass (1), acai berries (0), hemp seed (0) and bee pollen (0). Overall, only limited evidence was found for the effects of the foods described as superfoods on metabolic syndrome parameters, since results were not consistent or the number of controlled intervention trials was limited. The inconsistencies might have been related to intervention-related factors, such as duration or dose. Furthermore, conclusions may be different if other health benefits are considered.

04
SYSTEMATIC REVIEW Journal of Crohn's & colitis (2015) PMID: 25518050 ↗
Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.
Clinical Trial Synthesis 2015 Systematic Review published in Journal of Crohn's & colitis. Key conclusion: CONCLUSIONS: Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.
View Original PubMed Abstract ↓

OBJECTIVE: We performed a systematic review for Complementary and Alternative Medicine [CAM] as defined by the National Institute of Health in Inflammatory Bowel Disease [IBD], ie Crohn's disease [CD] and ulcerative colitis [UC], with the exception of dietary and nutritional supplements, and manipulative therapies. METHODS: A computerized search of databases [Cochrane Library, Pubmed/Medline, PsychINFO, and Scopus] through March 2014 was performed. We screened the reference sections of original studies and systematic reviews in English language for CAM in IBD, CD and UC. Randomized controlled trials [RCT] and controlled trials [CT] were referred and assessed using the Cochrane risk of bias tool. RESULTS: A total of: 26 RCT and 3 CT for herbal medicine, eg aloe-vera gel, andrographis paniculata, artemisia absinthium, barley foodstuff, boswellia serrata, cannabis, curcumin, evening primrose oil, Myrrhinil intest®, plantago ovata, silymarin, sophora, tormentil, wheatgrass-juice and wormwood; 1 RCT for trichuris suis ovata; 7 RCT for mind/body interventions such as lifestyle modification, hypnotherapy, relaxation training and mindfulness; and 2 RCT in acupuncture; were found. Risk of bias was quite heterogeneous. Best evidence was found for herbal therapy, ie plantago ovata and curcumin in UC maintenance therapy, wormwood in CD, mind/body therapy and self-intervention in UC, and acupuncture in UC and CD. CONCLUSIONS: Complementary and alternative therapies might be effective for the treatment of inflammatory bowel diseases; however, given the low number of trials and the heterogeneous methodological quality of trials, further in-depth research is necessary.

05
RANDOMIZED TRIAL (RCT) Complementary therapies in medicine (2006) PMID: 16473748 ↗
The effect of topical wheatgrass cream on chronic plantar fasciitis: a randomized, double-blind, placebo-controlled trial.
Clinical Trial Synthesis 2006 Randomized Controlled Trial (RCT) published in Complementary therapies in medicine. Key conclusion: CONCLUSIONS: The topical application of wheatgrass cream is no more effective than a placebo cream for the treatment of chronic plantar fasciitis.
View Original PubMed Abstract ↓

OBJECTIVES: To investigate the efficacy of a topical wheatgrass cream for improving pain and function in patients with chronic plantar fasciitis. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Eighty participants with chronic plantar fasciitis were randomly assigned to a treatment group (wheatgrass cream) or a control group (placebo cream). All participants applied a cream twice daily for 6 weeks. Follow up was conducted at 6 and 12 weeks. MAIN OUTCOME MEASURES: Visual Analogue Scale (VAS) for daily first-step pain and the Foot Health Status Questionnaire (FHSQ) for overall foot function. Secondary measures of foot posture, calf muscle strength and range of ankle dorsiflexion were also assessed. RESULTS: No significant differences were found between groups with respect to main outcomes of first-step pain or foot function at any time. Both groups improved significantly from baseline to 6 weeks, and these improvements were maintained at 12 weeks. CONCLUSIONS: The topical application of wheatgrass cream is no more effective than a placebo cream for the treatment of chronic plantar fasciitis.

06
CLINICAL STUDY European journal of clinical nutrition (1993) PMID: 8269890 ↗
Effect of a strict vegan diet on energy and nutrient intakes by Finnish rheumatoid patients.
Clinical Trial Synthesis 1993 Randomized Controlled Trial (RCT) published in European journal of clinical nutrition involving n = 21 participants. Key conclusion: In spite of the increased energy intake, the group on the vegan diet lost 9% of their body weight during the intervention period, indicating a low availability of energy from the vegan diet.
View Original PubMed Abstract ↓

Dietary intake data of 43 Finnish rheumatoid arthritis patients were collected using 7-day food records. The subjects were randomized into a control and a vegan diet groups, consisting of 22 and 21 subjects, respectively. The subjects in the vegan diet group received an uncooked vegan diet ('living food') for 3 months, and they were tutored daily by a living-food expert. The subjects in the control group continued their usual diets and received no tutoring. Adherence to the strict vegan diet was assessed on the basis of urinary sodium excretion and by the information on consumption of specific food items (wheatgrass juice and the rejuvelac drink). The use of these drinks was variable, and some boiled vegetables were consumed occasionally. However, only one of the subjects in the vegan diet group lacked a clear decrease in urinary sodium excretion. Rheumatoid patients had lower than recommended intakes of iron, zinc and niacin, and their energy intake was low compared to mean daily energy intake of the healthy Finnish females of the same age. Shifting to the uncooked vegan diet significantly increased the intakes of energy and many nutrients. In spite of the increased energy intake, the group on the vegan diet lost 9% of their body weight during the intervention period, indicating a low availability of energy from the vegan diet.

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