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Dietary supplement

Max Energy Greens Ingredients & Drug Interactions

by tnvitamins

Max Energy Greens label
See full label image
Tablet Or Pill Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 9, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Max Energy Greens against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Max Energy Greens is a dietary supplement by tnvitamins with 8 active ingredients. Its ingredients are commonly taken for general nutrition and energy, antioxidant support, cholesterol and metabolic health.Based on those ingredients, 1,440 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are Green Tea extract, Alfalfa, Chlorella. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

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Check Your Meds Against Max Energy Greens by tnvitamins

Ask about any prescription or over-the-counter medication and we check it for interactions with Max Energy Greens by tnvitamins — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Max Energy Greens by tnvitamins

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 8 of its 8 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Max Energy Greens contains 8 active ingredients: spirulina, wheat grass, chlorella, alfalfa, chlorophyll, barley grass, oat straw, and green tea extract. These are concentrated plant-based ingredients chosen for their nutrient density; spirulina and chlorella are algae sources of protein and minerals, while wheat grass, barley grass, and oat straw are sprouted grains and grass powders.

Chlorophyll is the pigment responsible for green color in plants, and alfalfa and green tea extract are added for their polyphenol and antioxidant content. The tablet also contains inactive ingredients — dicalcium phosphate, cellulose, croscarmellose sodium, stearic acid, magnesium stearate, and silicon dioxide — which are binders and flow agents typical in supplement formulation.

Does it work?

Not established
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Not established

The graded evidence we hold for these ingredients covers different conditions than the ones this product is marketed for, so there's no established rating for its stated use.

Why this rating?
  • The label markets this product for: whole food energy and nutritional support.
  • We looked for evidence on: Fatigue, Mental alertness, Athletic performance, Chronic fatigue syndrome (CFS), Stamina, Vitality — and 2 related terms.
  • The closest evidence on file: Oats is rated "Insufficient Reliable Evidence To Rate" for Chronic fatigue syndrome (CFS) (Natural Medicines).
  • Also on file: Chlorella is rated "Insufficient Reliable Evidence To Rate" for Fatigue.
  • Also on file: Blue-green Algae is rated "Insufficient Reliable Evidence To Rate" for Athletic performance, Mental alertness.

Evidence for these ingredients is mixed. Barley grass and oat straw are likely effective for high cholesterol and heart disease prevention.

Green tea extract is likely effective for human papillomavirus (HPV) and possibly effective for ovarian cancer and high cholesterol. For the other ingredients — spirulina, wheat grass, chlorella, alfalfa, and chlorophyll — the evidence we hold does not establish effectiveness for their common uses.

Chlorella shows insufficient evidence for pregnancy-related anemia, brain tumor, fatty liver disease, depression, and fatigue. Alfalfa shows insufficient evidence for diabetes, indigestion, and cholesterol.

Chlorophyll shows insufficient evidence for herpes, wound healing, shingles, skin cancer, and pancreatitis.

The evidence, ingredient by ingredient Blue-green Algae Wheatgrass Chlorella Alfalfa Chlorophyll Barley Oats Green Tea

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 8 of the 8 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 8 of 8.
  • General safety write-ups exist for 8 of 8.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most of these ingredients are generally well tolerated in the short term, though quality and purity of supplements vary widely. Common side effects across the product include bloating, flatulence, diarrhea, nausea, and abdominal discomfort — especially during the first two weeks.

Chlorella can cause photosensitivity (sun sensitivity) and allergic reactions including rare anaphylaxis; alfalfa can cause a lupus-like syndrome with long-term use and dermatitis. Chlorophyll may cause photosensitivity and a rare condition called pseudoporphyria (blistering on sun-exposed skin).

Barley grass contains gluten and can trigger allergic reactions. Green tea extract, when used long-term in high doses, carries a rare risk of liver injury.

Alfalfa carries a safety rating of possibly unsafe in pregnancy and is best avoided in supplement form. Chlorella and chlorophyll have insufficient safety data in pregnancy and breastfeeding — avoiding them unless your doctor approves is advised.

Barley grass as a concentrated supplement is not well studied in pregnancy or breastfeeding, though the grain itself eaten as food is fine. Oat straw eaten as food is generally safe in pregnancy and breastfeeding; concentrated supplements are less studied.

Green tea should be kept to moderate caffeine intake in pregnancy and breastfeeding, and high-dose extracts should be avoided.

Side effects, ingredient by ingredient Blue-green Algae Wheatgrass Chlorella Alfalfa Chlorophyll Barley Oats Green Tea

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 8 of the 8 matched ingredients can interact with medications — Alfalfa, Chlorophyll, Barley, Oats, Chlorella, among others.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications; lithium.
  • For scale: 1,441 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Max Energy Greens, check your medications against these drug types: blood thinners like warfarin (Major risk from alfalfa and chlorella); the blood pressure drug nadolol and cholesterol drug atorvastatin (Major risk from green tea extract); and ephedrine or similar stimulants (Major risk from green tea extract due to caffeine). Also double-check seizure medications (felbamate, valproate, ethosuximide, phenytoin), the heart drug dipyridamole, diabetes medications and insulin, birth control pills, hormone therapy, immune suppressors, photosensitizing drugs, methotrexate, and the antiparasitic triclabendazole.

If you're unsure whether your drugs are affected, use the checker on this page.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with no established evidence rating for its marketed use. Major medication interactions have been identified, and safety information is well characterized.

If you take warfarin, any seizure medication, nadolol, atorvastatin, or ephedrine, do not start this product without checking with your pharmacist or doctor first — the interactions are serious. Anyone on birth control, hormone therapy, diabetes medications, or immune suppressors should also verify their specific drugs.

People with sun sensitivity or those taking photosensitizing drugs should be aware that several ingredients here may worsen photosensitivity. Otherwise, expect mild digestive upset in the first couple of weeks.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 8 of 8 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 23, 2020.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Max Energy Greens, straight from the product label.

Brand tnvitamins
Barcode (UPC) 095234102033
Net contents 250 Tablet(s)
Market status On market
Date entered into DSLD Apr 23, 2020
DSLD ID 217781
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years)
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Max Energy Greens by tnvitamins, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Tablet(s)
Maximum serving Sizes:
2 Tablet(s)
Servings per container
125
UPC/BARCODE
095234102033
IngredientAmount% DV
Spirulina200 mg--
Wheat Grass200 mg--
Chlorella200 mg--
Alfalfa200 mg--
Chlorophyll200 mg--
Barley Grass200 mg--
Oat Straw200 mg--
Green Tea extract20 mg--

Other ingredients: Dicalcium Phosphate, Cellulose, Croscarmellose Sodium, Stearic Acid, Magnesium Stearate, Silicon Dioxide

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Formulation

Whole food energy factors direct from nature

FDA Statement of Identity

Dietary Supplement

Suggested/Recommended/Usage/Directions

Directions: As a dietary supplement, take two (2) tablets twice daily, or as directed by a health care professional.

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Precautions

Caution: Pregnant or lactating women should consult a doctor before use.

If you are under medical supervision, please consult a doctor before use. Discontinue use and consult a doctor if any adverse reactions occur.

Keep out of reach of children.

General Statements

Reorder tnvitamins.com 800-645-4446

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Max Energy Greens by tnvitamins label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Max Energy Greens label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Max Energy Greens by tnvitamins

These are the 8 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Tablet(s) Dosage formTablet Or Pill Servings per container125 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Spirulina

Interacts with
327 drugs
200 mg per serving

Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and...

Spirulina monograph & interactions

Wheat Grass

Interacts with
272 drugs
200 mg per serving

Wheatgrass is the young grass of the wheat plant, taken as a juice or powder, and is mainly used as a concentrated source of vitamins and plant nutrie...

Wheat Grass monograph & interactions

Chlorella

Interacts with
337 drugs
200 mg per serving

Chlorella is a nutrient-rich freshwater green algae taken as a supplement for general wellness, immune support, and 'detox.' Some small studies sugges...

Chlorella monograph & interactions

Alfalfa

Interacts with
583 drugs
200 mg per serving

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of...

Alfalfa monograph & interactions

Chlorophyll

Interacts with
337 drugs
200 mg per serving

Chlorophyll is the green pigment found in plants and algae, and supplements often use a stable form called chlorophyllin. It is most studied for reduc...

Chlorophyll monograph & interactions

Barley Grass

Interacts with
1 drug
200 mg per serving

Barley is a nutritious whole grain that is a good source of soluble fiber called beta-glucan, which has solid evidence for modestly lowering LDL ('bad...

Barley Grass monograph & interactions

Oat Straw

Interacts with
86 drugs
200 mg per serving

Oats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a f...

Oat Straw monograph & interactions

Green Tea extract

Interacts with
1,293 drugs
20 mg per serving Form: Polyphenols

Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentra...

Green Tea extract monograph & interactions

Other (inactive) ingredients: Dicalcium Phosphate, Cellulose, Croscarmellose Sodium, Stearic Acid, Magnesium Stearate, Silicon Dioxide. These complete the product’s ingredient list but are not active constituents.

Interaction report

Max Energy Greens by tnvitamins Drug Interactions

Want to check YOUR meds against Max Energy Greens?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,440Drugs
15 Major 1,177 Moderate 248 Minor

Ingredients driving the most interactions

Green Tea extract 1,293
Alfalfa 583
Chlorella 337
Chlorophyll 337
Spirulina 327

Individual Drug Interactions

The ingredients in Max Energy Greens interact with 1,440 drugs. Click any drug to see the details.

8 of the 8 ingredients in Max Energy Greens interact with drugs. Each result below shows which ingredient is responsible. Green Tea extract Alfalfa Chlorella Chlorophyll Spirulina Wheat Grass Oat Straw Barley Grass

Each ingredient & the kinds of drugs it affects

For each ingredient in Max Energy Greens with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Green Tea extract58 drug types · 1,293 drugs

Atorvastatin (Lipitor)

Green tea extract seems to reduce the levels and clinical effects of atorvastatin.
In healthy humans, taking green tea extract 300 mg or 600 mg along with atorvastatin reduces plasma levels of atorvastatin by approximately 24%. The elimination of atorvastatin is not affected. Atorvastatin is a substrate of organic anion-transporting polypeptides (OATPs). Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs. Some OATPs are expressed in the small intestine and are responsible for the uptake of drugs and other compounds, which may have resulted in reduced plasma levels of atorvastatin. It is not clear if drinking green tea alters the absorption of atorvastatin.

Likelihood Likely Evidence B
Ephedrine

Theoretically, concomitant use might increase the risk for stimulant adverse effects.
Green tea contains caffeine. There is evidence that using ephedrine with caffeine might increase the risk of serious life-threatening or debilitating adverse effects such as hypertension, myocardial infarction, stroke, seizures, and death.

Likelihood Probable Evidence D
Nadolol (Corgard)

Green tea seems to reduce the levels and clinical effects of nadolol.
Preliminary clinical research shows that green tea consumption reduces plasma concentrations of nadolol. Compared to a control group, both peak levels and total drug exposure (AUC) of nadolol were reduced by approximately 85% in subjects who drank green tea daily for two weeks. Drinking green tea with nadolol also significantly reduced nadolol's systolic blood pressure lowering effect. Other clinical research shows that a single dose of green tea can affect plasma nadolol levels for at least one hour. Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is involved in the uptake of nadolol in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.

Likelihood Likely Evidence B
5-Fluorouracil

Theoretically, high doses of green tea might increase the effects and side effects of 5-fluorouracil.
Animal research shows that taking green tea in amounts equivalent to about 6 cups daily in humans for 4 weeks prior to receiving a single injection of 5-fluorouracil increases the maximum plasma levels of 5-fluorouracil by about 2.5-fold and the area under the curve by 425%.

Likelihood Possible Evidence D
Adenosine (Adenocard)

Theoretically, green tea might decrease the vasodilatory effects of adenosine and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine is a competitive inhibitor of adenosine at the cellular level. However, caffeine doesn't seem to affect supplemental adenosine because high interstitial levels of adenosine overcome the antagonistic effects of caffeine. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. However, methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Possible Evidence B
Anticoagulant/Antiplatelet Drugs

Theoretically, green tea may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
Conflicting reports exist regarding the effect of green tea on bleeding risk when used with anticoagulant or antiplatelet drugs; however, most evidence suggests that drinking green tea in moderate amounts is unlikely to cause a significant interaction. Green tea contains small amounts of vitamin K, approximately 7 mcg per cup. Some case reports have associated the antagonism of warfarin with the vitamin K content of green tea. However, these reports are rare, and very large doses of green tea (about 8-16 cups daily) appear to be needed to cause these effects. Furthermore, the catechins and caffeine in green tea are reported to have antiplatelet activity.

Likelihood Unlikely Evidence D
Beta-Adrenergic Agonists

Green tea contains caffeine. Theoretically, concomitant use of large amounts of caffeine might increase cardiac inotropic effects of beta-agonists.

Likelihood Probable Evidence D
Bortezomib (Velcade)

Theoretically, green tea might interfere with the effects of bortezomib.
In vitro research shows that green tea polyphenols, such as epigallocatechin gallate (EGCG), interact with bortezomib and block its proteasome inhibitory action. This prevents the induction of cell death in multiple myeloma or glioblastoma cancer cell lines. Advise patients taking bortezomib, not to take green tea.

Likelihood Possible Evidence D
Carbamazepine (Tegretol)

Theoretically, green tea might reduce the effects of carbamazepine and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that taking caffeine can lower the anticonvulsant effects of carbamazepine and can induce seizures when taken in doses above 400 mg/kg. Human research has shown that taking caffeine 300 mg in three divided doses along with carbamazepine 200 mg reduces the bioavailability of carbamazepine by 32% and prolongs the plasma half-life of carbamazepine 2-fold in healthy individuals.

Likelihood Possible Evidence D
Celiprolol (Celicard)

Theoretically, green tea might reduce the levels and clinical effects of celiprolol.
In a small human study, taking green tea daily for 4 days appears to decrease blood and urine levels of celiprolol by at least 98%. This interaction is possibly due to the inhibition of organic anion transporting polypeptide (OATP). Green tea catechins have been shown to inhibit organic anion transporting polypeptides (OATP), one of which, OATP1A2, is found in the intestine The interaction is thought to be due primarily to the epigallocatechin gallate (EGCG) content of green tea.

Likelihood Possible Evidence D
Cimetidine (Tagamet)

Theoretically, concomitant use might increase the effects and adverse effects of caffeine in green tea.
Green tea contains caffeine. Cimetidine can reduce caffeine clearance by 31% to 42%.

Likelihood Likely Evidence B
Clozapine (Clozaril)

Theoretically, green tea might increase the levels and adverse effects of clozapine and acutely exacerbate psychotic symptoms.
Animal research suggests that, although green tea extract does not affect the elimination of clozapine, it delays the time to reach peak concentration and reduces the peak plasma levels. Also, concomitant administration of green tea and clozapine might theoretically cause acute exacerbation of psychotic symptoms due to the caffeine in green tea. Caffeine can increase the effects and toxicity of clozapine. Caffeine doses of 400-1000 mg daily inhibit clozapine metabolism. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2). Researchers speculate that caffeine might inhibit CYP1A2. However, there is no reliable evidence that caffeine affects CYP1A2. There is also speculation that genetic factors might make some patients be more sensitive to the interaction between clozapine and caffeine.

Likelihood Possible Evidence B
Contraceptive Drugs

Theoretically, concomitant use might increase the effects and adverse effects of caffeine found in green tea.
Green tea contains caffeine. Oral contraceptives can decrease caffeine clearance by 40% to 65%.

Likelihood Probable Evidence B
Cytochrome P450 1A2 (Cyp1A2) Inhibitors

Theoretically, concomitant use might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Caffeine is metabolized by cytochrome P450 1A2 (CYP1A2),. Theoretically, drugs that inhibit CYP1A2 may decrease the clearance rate of caffeine from green tea and increase caffeine levels.

Likelihood Possible Evidence D
Dipyridamole (Persantine)

Theoretically, green tea might decrease the vasodilatory effects of dipyridamole and interfere with its use prior to stress testing.
Green tea contains caffeine. Caffeine might inhibit dipyridamole-induced vasodilation. It is recommended that methylxanthines and methylxanthine-containing products be stopped 24 hours prior to pharmacological stress tests. Methylxanthines appear more likely to interfere with dipyridamole (Persantine) than adenosine-induced stress testing.

Likelihood Probable Evidence B
Disulfiram (Antabuse)

Theoretically, disulfiram might increase the risk of adverse effects from caffeine.
In human research, disulfiram decreases the clearance and increases the half-life of caffeine.

Likelihood Probable Evidence B
Diuretic Drugs

Theoretically, using green tea with diuretic drugs might increase the risk of hypokalemia.
Green tea contains caffeine. In excessive amounts, caffeine can reduce potassium levels due to stimulation of the sodium-potassium pump. Diuretics can also cause lower potassium levels.

Likelihood Possible Evidence D
Estrogens

Theoretically, estrogens might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Estrogen inhibits caffeine metabolism.

Likelihood Probable Evidence B
Ethosuximide (Zarontin)

Theoretically, green tea might reduce the effects of ethosuximide and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that caffeine 92.4 mg/kg can decrease the anticonvulsant activity of ethosuximide. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Felbamate (Felbatol)

Theoretically, green tea might reduce the effects of felbamate and increase the risk for convulsions.
Green tea contains caffeine. Animal research suggests that a high dose of caffeine 161.7 mg/kg can decreases the anticonvulsant activity of felbamate. However, this effect has not been reported in humans.

Likelihood Possible Evidence D
Fexofenadine (Allegra)

Green tea can decrease blood levels of fexofenadine.
Clinical research shows that green tea can significantly decrease blood levels and excretion of fexofenadine. Taking green tea extract with a dose of fexofenadine decreased bioavailability of fexofenadine by about 30%. In vitro, green tea inhibits the cellular accumulation of fexofenadine by inhibiting the organic anion transporting polypeptide (OATP) drug transporter. Research shows that two of the major catechins found in green tea, epicatechin gallate (ECG) and epigallocatechin gallate (EGCG), inhibit OATPs, specifically OATP1A2, OATP1B1, and OATP2B1. In addition, green tea has been shown to reduce the absorption of some drugs that are OATP substrates.

Likelihood Probable Evidence B
Flutamide (Eulexin)

Theoretically, green tea might increase the levels and adverse effects of flutamide.
Green tea contains caffeine. In vitro evidence suggests that caffeine can inhibit the metabolism of flutamide. Theoretically, concomitant use of caffeine and flutamide might increase serum concentrations of flutamide and increase the risk adverse effects.

Likelihood Possible Evidence D
Fluvoxamine (Luvox)

Theoretically, fluvoxamine might increase the levels and adverse effects of caffeine.
Green tea contains caffeine. Fluvoxamine reduces caffeine metabolism.

Likelihood Probable Evidence D
Hepatotoxic Drugs

Theoretically, concomitant use might have additive adverse hepatotoxic effects.
Green tea extract supplements have been linked to several cases of hepatotoxicity and might have additive hepatotoxic effects with other drugs..

Likelihood Unlikely Evidence D
Imatinib (Gleevec)

Theoretically, green tea might reduce the levels and clinical effects of imatinib.
In animal research, a single dose of green tea extract reduces the area under the curve (AUC) of imatinib by up to approximately 64% and its main metabolite N-desmethyl imatinib by up to approximately 81%. This interaction has not been shown in humans. The mechanism of action is unclear but may involve multiple pathways.

Likelihood Possible Evidence D
Green Tea extract full monograph & all 58 interactions

Alfalfa6 drug types · 583 drugs

Warfarin (Coumadin)

Theoretically, alfalfa might reduce the anticoagulant activity of warfarin.
Alfalfa contains a large amount of vitamin K. This could theoretically interfere with the activity of warfarin.

Likelihood Probable Evidence D
Antidiabetes Drugs

Theoretically, alfalfa might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Animal research suggests that alfalfa decreases blood sugar in diabetic mice. Also, in one case report, a diabetic patient experienced hypoglycemia after consuming alfalfa extract. Monitor blood glucose levels closely. Dose adjustments might be necessary.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, alfalfa might interfere with the activity of contraceptive drugs.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Estrogens

Theoretically, alfalfa might interfere with hormone therapy.
Alfalfa contains coumestrol, a phytoestrogen, and isoflavonoids, which have estrogenic effects.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, alfalfa might decrease the efficacy of immunosuppressive therapy.
In vitro research and human case reports suggest that alfalfa may have immunostimulant effects.

Likelihood Possible Evidence D
Photosensitizing Drugs

Theoretically, concomitant use of alfalfa with photosensitizing drugs might have additive effects.
Animal research suggests that excessive doses of alfalfa may increase photosensitivity, possibly due to its chlorophyll content. It is unclear if this effect would be clinically relevant in humans.

Likelihood Possible Evidence D
Alfalfa full monograph & interactions

Chlorella2 drug types · 337 drugs

Photosensitizing Drugs

Theoretically, chlorella might have additive effects with photosensitizing drugs.
Chlorella has been reported to cause photosensitization. In five case reports, patients who had ingested chlorella exhibited swelling followed by erythematopurpuric lesions on sun-exposed areas of the body. Theoretically, concomitant use with photosensitizing drugs may exacerbate effects.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, chlorella might reduce the clinical effects of warfarin.
Chlorella contains significant amounts of vitamin K. There is at least one case report of warfarin therapy becoming sub-therapeutic after initiation of chlorella supplements.

Likelihood Possible Evidence D
Chlorella full monograph & interactions

Chlorophyll2 drug types · 337 drugs

Methotrexate (Trexall, Others)

Theoretically, chlorophyll may reduce the clearance of methotrexate.
In one case report, a 54-year-old male developed delayed clearance of intravenous high-dose methotrexate with concomitant use of chlorophyll. When chlorophyll was stopped 2 days prior to methotrexate treatment, methotrexate clearance was unaffected.

Likelihood Possible Evidence B
Photosensitizing Drugs

Theoretically, concomitant use of chlorophyll with photosensitizing drugs may have additive effects.
Chlorophyll has been reported to cause photosensitization. In two case reports, pseudoporphyria developed after oral intake of chlorophyll. Theoretically, concomitant use with other photosensitizing drugs may exacerbate this effect.

Likelihood Probable Evidence B
Chlorophyll full monograph & interactions

Spirulina3 drug types · 327 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, spirulina blue-green algae might increase the risk of bleeding if used with other anticoagulant or antiplatelet drugs. However, this is unlikely.
Spirulina blue-green algae have shown antiplatelet and anticoagulant effects in vitro. However, one preliminary study in 24 patients receiving spirulina blue-green algae 2.3 grams daily for 2 weeks showed no effect on platelet activation or measures of clotting time.

Likelihood Unlikely Evidence D
Antidiabetes Drugs

Theoretically, taking blue-green algae with antidiabetes drugs might increase the risk of hypoglycemia.
Human research shows that spirulina blue-green algae can have hypoglycemic effects in patients with diabetes, at least some of whom were using antidiabetes drugs. However, blue-green algae does not seem to improve glycated hemoglobin (HbA1c) levels in patients with diabetes. A meta-analysis of animal studies also suggests that spirulina blue-green algae have hypoglycemic effects.

Likelihood Possible Evidence B
Immunosuppressants

Theoretically, concurrent use of blue-green algae might interfere with immunosuppressive therapy.
Blue-green algae have been shown to stimulate the immune system.

Likelihood Possible Evidence D
Spirulina full monograph & interactions

Wheat Grass2 drug types · 272 drugs

Antidiabetes Drugs

Theoretically, taking wheatgrass with antidiabetes drugs might lower blood glucose levels and increase the risk of hypoglycemia.
Animal research shows that taking wheatgrass stimulates the release of insulin from beta-cells and lowers blood glucose.

Likelihood Possible Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, wheatgrass might decrease the levels and clinical effects of CYP1A2 substrates.
In vitro research shows that wheatgrass induces CYP1A2 enzymes.

Likelihood Possible Evidence D
Wheat Grass full monograph & interactions

Oat Straw2 drug types · 86 drugs

Antidiabetes Drugs

Theoretically, oats may have additive effects with antidiabetic agents and might increase the risk of hypoglycemia.
Consuming oats can decrease blood glucose in patients with diabetes. In those who require insulin, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.

Likelihood Possible Evidence D
Insulin

Concomitant use of oats and insulin might increase the risk of hypoglycemia.
In patients with insulin-dependent type 2 diabetes, taking oats 100 grams daily for 2 days reduces the insulin dose required to achieve metabolic control.

Likelihood Possible Evidence B
Oat Straw full monograph & interactions

Barley Grass1 drug type · 1 drug

Triclabendazole (Egaten)

Theoretically, barley might decrease the clinical effects of triclabendazole.
Animal research suggests that a diet supplemented with barley can reduce the bioavailability of triclabendazole when taken concomitantly. This effect has not been shown in humans.

Likelihood Possible Evidence D
Barley Grass full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Max Energy Greens, from the product label.

tnvitamins

See all tnvitamins products
Name
Total Nutrition, Inc.
City
Farmingdale
State
NY
ZipCode
11735
Phone Number
800-645-4446
Web Address
tnvitamins.com
Pharmacist Counseling Corner

Max Energy Greens by tnvitamins: Common Questions

Does Max Energy Greens by tnvitamins interact with any medications?
Yes. Based on its ingredients, Max Energy Greens has a known interaction with 1,440 medications, including 15 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Max Energy Greens contains 8 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this product safe if I'm pregnant or breastfeeding?
Alfalfa in supplement amounts is rated possibly unsafe in pregnancy. Chlorella and chlorophyll don't have enough safety data — talk with your doctor before using them. Barley grass as a concentrated supplement is not well studied in pregnancy; the grain as food is fine. Oat straw eaten as food is considered safe; concentrated supplements are less studied. Green tea should be kept to moderate amounts — avoid high-dose extracts — because of caffeine. This isn't a yes-or-no answer; your doctor or pharmacist can give you personalized advice.
What are the most common side effects?
Bloating, gas, and diarrhea or constipation are most common, especially in the first two weeks. Nausea and abdominal discomfort also happen. Chlorella may cause photosensitivity (sun sensitivity and skin reactions), and some people have had allergic reactions including rare anaphylaxis. If side effects don't improve after a few weeks, stop and talk to your pharmacist.
Does barley grass contain gluten?
Yes, barley contains gluten, so this product is not suitable if you have celiac disease or gluten sensitivity. Barley can also cause allergic reactions in sensitive people, ranging from mild itching to anaphylaxis in rare cases.
Will this help my cholesterol or heart health?
Barley grass and oat straw in this product are likely effective for high cholesterol and heart disease prevention. Green tea extract is possibly effective for high cholesterol. The other ingredients don't have established evidence in our data for these uses.
Can I take this if I'm on seizure medication?
The green tea extract in this product may reduce the effectiveness of seizure medications like phenytoin, felbamate, ethosuximide, and valproate. Do not take this without talking to your doctor or pharmacist first — your seizure control could be affected.
What if I take warfarin or another blood thinner?
Alfalfa and chlorella both contain high amounts of vitamin K, which can reduce warfarin's blood-thinning effect and put you at risk for clots. Do not take this product without checking with your doctor or pharmacist first.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Max Energy Greens label
Go deeper

The Full Monographs Behind Max Energy Greens’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Blue-green Algae

Interacts with 327 drugs

Blue-green algae are nutrient-rich aquatic microorganisms (such as spirulina and Klamath Lake algae) taken as a supplement for energy, nutrition, and general wellness. Evidence for most heal...

Read the full Blue-green Algae monograph → Herb & supplement monograph

Wheatgrass

Interacts with 272 drugs

Wheatgrass is the young grass of the wheat plant, taken as a juice or powder, and is mainly used as a concentrated source of vitamins and plant nutrients. Solid scientific evidence for most...

Read the full Wheatgrass monograph → Herb & supplement monograph

Chlorella

Interacts with 337 drugs

Chlorella is a nutrient-rich freshwater green algae taken as a supplement for general wellness, immune support, and 'detox.' Some small studies suggest possible benefits for cholesterol, blo...

Read the full Chlorella monograph → Herb & supplement monograph

Alfalfa

Interacts with 583 drugs

Alfalfa is a nutrient-rich legume that people use for high cholesterol, menopause symptoms, and general wellness, but solid human evidence for most of these uses is limited. It is best avoid...

Read the full Alfalfa monograph → Herb & supplement monograph

Chlorophyll

Interacts with 337 drugs

Chlorophyll is the green pigment found in plants and algae, and supplements often use a stable form called chlorophyllin. It is most studied for reducing body and fecal odor and as a topical...

Read the full Chlorophyll monograph → Herb & supplement monograph

Barley

Interacts with 1 drug

Barley is a nutritious whole grain that is a good source of soluble fiber called beta-glucan, which has solid evidence for modestly lowering LDL ('bad') cholesterol when eaten regularly. It...

Read the full Barley monograph → Herb & supplement monograph

Oats

Interacts with 86 drugs

Oats are a well-studied whole grain whose soluble fiber (beta-glucan) can help lower cholesterol and support heart health when eaten regularly. As a food, oats are safe for most people, and...

Read the full Oats monograph → Herb & supplement monograph

Green Tea

Interacts with 1,293 drugs

Green tea is a popular beverage rich in antioxidants called catechins, and drinking it in normal amounts is considered safe for most people. Concentrated green tea extracts are a different s...

Read the full Green Tea monograph →
Sources

Sources & How We Checked

Max Energy Greens's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 324 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Blue-green Algae 22 references
  1. Jensen GS, Ginsberg DJ, Huerta P, et al. Consumption of Aphanizomenon flos-aquae has rapid effects on the circulation and function of immune cells in humans. A novel approach to nutritional mobilization of the immune system. JANA 2000;2:50-6.
  2. Iwasa M, Yamamoto M, Tanaka Y, et al. Spirulina-associated hepatotoxicity. Am J Gastroenterol 2002;97:3212-13. PubMed
  3. Hayashi O, Katoh T, Okuwaki Y. Enhancement of antibody production in mice by dietary Spirulina platensis. J Nutr Sci Vitaminol (Tokyo) 1994;40:431-41.. PubMed
  4. Vitale S, Miller NR, Mejico LJ, et al. A randomized, placebo-controlled, crossover clinical trial of super blue-green algae in patients with essential blepharospasm or Meige syndrome. Am J Ophthalmol 2004;138:18-32. PubMed
  5. Mani UV, Desai S, Iyer U. Studies on the long-term effect of spirulina supplementation on serum lipid profile and glycated proteins in NIDDM patients. J Nutraceut 2000;2(3):25-32. DOI
  6. Chiu HF, Yang SP, Kuo YL, et al. Mechanisms involved in the antiplatelet effect of C-phycocyanin. Br J Nutr 2006;95:435-40. PubMed
  7. Hsiao G, Chou PH, Shen MY, et al. C-phycocyanin, a very potent and novel platelet aggregation inhibitor from Spirulina platensis. J Agric Food Chem 2005;53:7734-40.
  8. Katz M, Levine AA, Kol-Degani H, Kav-Venaki L. A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. J Atten Disord 2010;14:281-91. PubMed
  9. Madhyastha, H. K., Radha, K. S., Sugiki, M., Omura, S., and Maruyama, M. Purification of c-phycocyanin from Spirulina fusiformis and its effect on the induction of urokinase-type plasminogen activator from calf pulmonary endothelial cells. Phytomedicine PubMed
  10. Mazokopakis, E. E., Karefilakis, C. M., Tsartsalis, A. N., Milkas, A. N., and Ganotakis, E. S. Acute rhabdomyolysis caused by Spirulina (Arthrospira platensis). Phytomedicine. 2008;15(6-7):525-527. PubMed
  11. Halidou, Doudou M., Degbey, H., Daouda, H., Leveque, A., Donnen, P., Hennart, P., and Dramaix-Wilmet, M. [The effect of spiruline during nutritional rehabilitation: systematic review]. Rev.Epidemiol.Sante Publique 2008;56(6):425-431.
  12. Konno, T., Umeda, Y., Umeda, M., Kawachi, I., Oyake, M., and Fujita, N. [A case of inflammatory myopathy with widely skin rash following use of supplements containing Spirulina]. Rinsho Shinkeigaku 2011;51(5):330-333. PubMed
  13. Le TM, Knulst AC, Röckmann H. Anaphylaxis to Spirulina confirmed by skin prick test with ingredients of Spirulina tablets. Food Chem Toxicol 2014;74:309-10. PubMed
  14. Rzymski P, Niedzielski P, Kaczmarek N, Jurczak T, Klimaszyk P. The multidisciplinary approach to safety and toxicity assessment of microalgae-based food supplements following clinical cases of poisoning. Harmful Algae 2015;46:34-42. DOI
  15. Petrus M, Culerrier R, Campistron M, et al. First case report of anaphylaxis to spirulin: identification of phycocyanin as responsible allergen. Allergy 2010;65(7):924-5. PubMed
  16. Marles RJ, Barrett ML, Barnes J, et al. United States Pharmacopeia safety evaluation of spirulina. Crit Rev Food Sci Nutr 2011;51(7):593-604. PubMed
  17. Majdoub H, Ben Mansour M, Chaubet F, et al. Anticoagulant activity of a sulfated polysaccharide from the green alga Arthrospira platensis. Biochim Biophys Acta 2009;1790(10):1377-81. PubMed
  18. Cha BG, Kwak HW, Park AR, et al. Structural characteristics and biological performance of silk fibroin nanofiber containing microalgae spirulina extract. Biopolymers 2014;101(4):307-18. PubMed
  19. Jensen GS, Drapeau C, Lenninger M, Benson KF. Clinical safety of a high dose of phycocyanin-enriched aqueous extract from Arthrospira (Spirulina) platensis: results from a randomized, double-Blind, placebo-controlled study with a focus on anticoagulant ac
  20. Hamedifard Z, Milajerdi A, Reiner Z, Taghizadeh M, Kolahdooz F, Asemi Z. The effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized con
  21. Moradi S, Zobeiri M, Feizi A, Clark CCT, Entezari MH. The effects of spirulina (Arthrospira platensis) supplementation on anthropometric indices, blood pressure, sleep quality, mental health, fatigue status and quality of life in patients with ulcerative
  22. Ghanbari F, Amerizadeh A, Behshood P, Moradi S, Asgary S. Effect of microalgae arthrospira on biomarkers of glycemic control and glucose metabolism: a systematic Review and meta-analysis. Curr Probl Cardiol 2022;47(10):100942. PubMed

See these in context on the Blue-green Algae monograph →

Wheatgrass 5 references
  1. Ben-Arye E, Golden E, Wengrower D, et al. Wheat grass juice in the treatment of active distal ulcerative colitis a randomized double-blind placebo-controlled trial. Scand J Gastroenterol 2002;4:444-9.. PubMed
  2. Mohan Y, Jesuthankaraj GN1, Ramasamy Thangavelu N. Antidiabetic and antioxidant properties of Triticum aestivum in streptozotocin-induced diabetic rats. Adv Pharmacol Sci 2013;2013:716073.
  3. Shakya G, Randhi PK, Pajaniradje S, Mohankumar K, Rajagopalan R. Hypoglycaemic role of wheatgrass and its effect on carbohydrate metabolic enzymes in type II diabetic rats. Toxicol Ind Health 2016;32(6):1026-32. PubMed
  4. Food and Drug Administration. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA); Public Law 108-282, Title II. Accessed on May 19, 2021. Available at: https://www.fda.gov/food/food-allergensgluten-free-guidance-documents-regulatory-infor
  5. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed

See these in context on the Wheatgrass monograph →

Chlorella 13 references
  1. Peirce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York, NY: William Morrow and Co., 1999.
  2. Ng TP, Tan WC, Lee YK. Occupational asthma in a pharmacist induced by chlorella, a unicellular algae preparation. Resp Med 1994;88:555-7. PubMed
  3. Jitsukawa K, Suizu R, Hidano A. Chlorella photosensitization. New phytophotodermatosis. Int J Dermatol 1984;23:263-8. PubMed
  4. Merchant RE, Carmack CA, Wise CM. Nutritional supplementation with Chlorella pyrenoidosa for patients with fibromyalgia syndrome: a pilot study. Phytother Res 2000;14:167-73.
  5. Merchant RE, Rice CD, Young HF. Dietary Chlorella pyrenoidosa for patients with malignant glioma: effects on immunocompetence, quality of life, and survival. Phytother Res 1990;4:220-31.
  6. Halperin SA, Smith B, Nolan C, et al. Safety and immunoenhancing effect of a Chlorella-derived dietary supplement in healthy adults undergoing influenza vaccination: randomized, double-blind, placebo-controlled trial. CMAJ 2003;169:111-7..
  7. Ohtake, T., Negishi, K., Okamoto, K., Oka, M., Maesato, K., Moriya, H., and Kobayashi, S. Manganese-induced Parkinsonism in a patient undergoing maintenance hemodialysis. Am J Kidney Dis 2005;46(4):749-753. PubMed
  8. Ng, T. P., Tan, W. C., and Lee, Y. K. Occupational asthma in a pharmacist induced by Chlorella, a unicellular algae preparation. Respir.Med. 1994;88(7):555-557. PubMed
  9. Ohkawa, S., Yoneda, Y., Ohsumi, Y., and Tabuchi, M. [Warfarin therapy and chlorella]. Rinsho Shinkeigaku 1995;35(7):806-807.
  10. Azocar J, Diaz A. Efficacy and safety of chlorella supplementation in adults with chronic hepatitis C virus infection. World J Gastroenterol 2013;19(7):1085-90. PubMed
  11. Panahi Y, Badeli R, Karami GR, Badeli Z, Sahebkar A. A randomized controlled trial of 6-week Chlorella vulgaris supplementation in patients with major depressive disorder. Complement Ther Med 2015;23(4):598-602. PubMed
  12. Nakano S, Takekoshi H, Nakano M. Chlorella pyrenoidosa supplementation reduces the risk of anemia, proteinuria and edema in pregnant women. Plant Foods Hum Nutr 2010;65(1):25-30. PubMed
  13. Yavasoglu I, Turgutkaya A, Bolaman Z. Chlorella-induced thrombocytopenia. Sao Paulo Med J 2018;136(6):602-3. PubMed

See these in context on the Chlorella monograph →

Alfalfa 32 references
  1. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  2. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  3. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
  4. Kurzer MS, Xu X. Dietary phytoestrogens. Annu Rev Nutr 1997;17:353-81. PubMed
  5. 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. PubMed
  6. 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. PubMed
  7. Light TD, Light JA. Acute renal transplant rejection possibly related to herbal medications. Am J Transplant 2003;3:1608-9. PubMed
  8. Prete PE. The mechanism of action of L-canavanine in inducing autoimmune phenomena. Arthritis Rheum 1985;28:1198-200. PubMed
  9. 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. PubMed
  10. Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion. N Engl J Med 1983;308:1361. DOI
  11. Feingold, R. M. Should we fear "health foods"? Arch Intern Med 7-12-1999;159(13):1502. PubMed
  12. Taormina, P. J., Beuchat, L. R., and Slutsker, L. Infections associated with eating seed sprouts: an international concern. Emerg.Infect.Dis 1999;5(5):626-634. PubMed
  13. 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(4):339-345. PubMed
  14. 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(5):581-582.
  15. 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(1):548-553.
  16. 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 chl
  17. 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 experimen
  18. 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(6):429-435. PubMed
  19. Burden and causes of foodborne disease in Australia: Annual report of the OzFoodNet network, 2005. Commun.Dis Intell. 2006;30(3):278-300.
  20. 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):1-9. PubMed
  21. 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(1):173-175. PubMed
  22. 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(4544):415-417. PubMed
  23. Malinow, M. R., McLaughlin, P., and Stafford, C. Alfalfa seeds: effects on cholesterol metabolism. Experientia 5-15-1980;36(5):562-564. PubMed
  24. Farnsworth, N. R. Alfalfa pills and autoimmune diseases. Am J Clin Nutr. 1995;62(5):1026-1028. DOI
  25. Herbert, V. and Kasdan, T. S. Alfalfa, vitamin E, and autoimmune disorders. Am J Clin Nutr 1994;60(4):639-640.
  26. 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 grow
  27. 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(2):325-334.
  28. 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
  29. Rubenstein AH, Levin NW, and Elliott GA. Manganese-induced hypoglycemia. Lancet 1962;1348-1351.
  30. Kaufman W. Alfalfa seed dermatitis. JAMA 1954;155(12):1058-1059. PubMed
  31. Ponka A, Andersson Y, Siitonen A, and et al. Salmonella in alfalfa sprouts. Lancet 1995;345:462-463. PubMed
  32. Puschner B, Chen X, Read D, Affolter VK. Alfalfa hay induced primary photosensitization in horses. Vet J. 2016 May;211:32-8. PubMed

See these in context on the Alfalfa monograph →

Chlorophyll 5 references
  1. Mathews-Roth MM. Carotenoids in erythropoietic protoporphyria and other photosensitivity diseases. Ann N Y Acad Sci, 1993; 691:127-38. PubMed
  2. Belen'kii, G. B. and Krikun, B. L. [Treatment of herpes simplex and herpes zoster by chlorophyll preparations]. Sov.Med. 1971;34(1):151-152.
  3. Brooks SL, Sanders J, Seymour JF, Mellor JD. A case of delayed methotrexate clearance following administration of a complementary medication containing chlorophyll. J Oncol Pharm Pract. 2014 Jun;20(3):225-8. PubMed
  4. Rossi E, Borchard K, Cole JM. Pseudoporphyria following self-medication with chlorophyll. Australas J Dermatol. 2015 Feb;56(1):47-8. PubMed
  5. Zhao CY, Frew JW, Muhaidat J, et al. Chlorophyll-induced pseudoporphyria with ongoing photosensitivity after cessation - a case series of four patients. J Eur Acad Dermatol Venereol 2016;30(7):1239-42. PubMed

See these in context on the Chlorophyll monograph →

Barley 15 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Fernandez-Anaya S, Crespo JF, Rodriguez JR, et al. Beer anaphylaxis. J Allergy Clin Immunol 1999;103:959-60.
  3. Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003;349:1360-8. . PubMed
  4. Ferre, I., Giraldez, F. J., Alvarez-Bujidos, M. L., and Mantecon, A. R. Influence of barley supplement on plasma concentration of triclabendazole metabolites in sheep. Vet.Rec. 11-22-1997;141(21):549-551. PubMed
  5. Curioni, A., Santucci, B., Cristaudo, A., Canistraci, C., Pietravalle, M., Simonato, B., and Giannattasio, M. Urticaria from beer: an immediate hypersensitivity reaction due to a 10- kDa protein derived from barley. Clin Exp Allergy 1999;29(3):407-413. PubMed
  6. Fernandez-Anaya, S., Crespo, J. F., Rodriguez, J. R., Daroca, P., Carmona, E., Herraez, L., and Lopez-Rubio, A. Beer anaphylaxis. J Allergy Clin Immunol. 1999;103(5 Pt 1):959-960.
  7. Cronin, E. Contact dermatitis from barley dust. Contact Dermatitis 1979;5(3):196. PubMed
  8. Block, G., Tse, K. S., Kijek, K., Chan, H., and Chan-Yeung, M. Baker's asthma. Studies of the cross-antigenicity between different cereal grains. Clin Allergy 1984;14(2):177-185.
  9. van Ketel, W. G. Immediate type allergy to malt in beer. Contact Dermatitis 1980;6(4):297-298. PubMed
  10. Ellis, H. J., Doyle, A. P., Day, P., Wieser, H., and Ciclitira, P. J. Demonstration of the presence of coeliac-activating gliadin-like epitopes in malted barley. Int Arch Allergy Immunol. 1994;104(3):308-310. PubMed
  11. Vidal, C. and Gonzalez-Quintela, A. Food-induced and occupational asthma due to barley flour. Ann Allergy Asthma Immunol. 1995;75(2):121-124.
  12. Gutgesell, C. and Fuchs, T. Contact urticaria from beer. Contact Dermatitis 1995;33(6):436-437. PubMed
  13. Baker, P. G. and Read, A. E. Oats and barley toxicity in coeliac patients. Postgrad.Med J 1976;52(607):264-268. PubMed
  14. Nakase, M., Usui, Y., Alvarez-Nakase, A. M., Adachi, T., Urisu, A., Nakamura, R., Aoki, N., Kitajima, K., and Matsuda, T. Cereal allergens: rice-seed allergens with structural similarity to wheat and barley allergens. Allergy 1998;53(46 Suppl):55-57. PubMed
  15. Pereira, F., Rafael, M., and Lacerda, M. H. Contact dermatitis from barley. Contact Dermatitis 1998;39(5):261-262. PubMed

See these in context on the Barley monograph →

Oats 13 references
  1. Cooper SG, Tracey EJ. Small-bowel obstruction caused by oat-bran bezoar. N Engl J Med 1989;320:1148-9. DOI
  2. Pick ME, Hawrysh ZJ, Gee MI, et al. Oat bran concentrate bread products improve long-term control of diabetes: a pilot study. J Am Diet Assoc 1996;96:1254-61. PubMed
  3. Braaten JT, Scott FW, Wood PJ, et al. High beta-glucan oat bran and oat gum reduce postprandial blood glucose and insulin in subjects with and without type 2 diabetes. Diabet Med 1994;11:312-8.
  4. Rosario PG, Gerst PH, Prakash K, Albu E. Dentureless distention: oat bran bezoars cause obstruction. J Am Geriatr Soc 1990;38:608. PubMed
  5. Food and Drug Administration. Food labeling: health claims: oats and coronary heart disease. Fed Regist 1996;61:296-313.
  6. Foulke J. FDA Allows Whole Oat Foods To Make Health Claim on Reducing the Risk of Heart Disease. FDA Talk Paper. 1997. Available at: http://www.fda.gov/bbs/topics/ANSWERS/ANS00782.html.
  7. Chandalia M, Garg A, Lutjohann D, et al. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med 2000;342:1392-8. PubMed
  8. Lembo A, Camilleri M. Chronic constipation. N Engl J Med 2003;349:1360-8. . PubMed
  9. De Paz Arranz S, Perez Montero A, Remon LZ, Molero MI. Allergic contact urticaria to oatmeal. Allergy 2002;57:1215. . PubMed
  10. Delgado G, Kleber ME, Krämer BK, et al. Dietary intervention with oatmeal in patients with uncontrolled type 2 diabetes mellitus - A crossover study. Exp Clin Endocrinol Diabetes. 2019;127(9):623-629. PubMed
  11. Sobhan M, Hojati M, Vafaie SY, Ahmadimoghaddam D, Mohammadi Y, Mehrpooya M. The efficacy of colloidal oatmeal cream 1% as add-on therapy in the management of chronic irritant hand eczema: A double-blind study. Clin Cosmet Investig Dermatol. 2020;13:241-25
  12. Hou Q, Li Y, Li L, Cheng G, Sun X, Li S, Tian H. The metabolic effects of oats intake in patients with type 2 diabetes: A systematic review and meta-analysis. Nutrients. 2015;7(12):10369-87. PubMed
  13. González-Afonso M, Cañas JA, Sastre B, et al. A Case of Anaphylaxis After Ingestion of Oats: Research Into New Allergens. J Investig Allergol Clin Immunol 2022;32(6):506-508. PubMed

See these in context on the Oats monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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