Gerson Regimen

Health Care Professional Information

Common Name

Gerson diet, Gerson therapy, Gerson method, Gerson program, Gerson treatment, Gerson Institute

Clinical Summary

Regimen developed by Max Gerson involving a strict metabolic diet, coffee enemas, and various supplements, including laetrile, which is illegal in the United States but available at clinics in Mexico and elsewhere. The diet emphasizes fresh fruit and vegetable juice, high carbohydrate and potassium, no sodium or fat, and low animal protein, and is sometimes supplemented with exogenous digestive enzymes. This regimen claims to address the cause of cancer by detoxifying the system and stimulating metabolism so that the body can heal itself (10).
Coffee enemas can cause infections, dangerous electrolyte deficiencies, and death (5). Despite proponents' claims of recovery rates as high as 70-90 percent, case reviews by the NCI and New York County Medical Society in 1947 found no evidence of anticancer effects with the Gerson diet (1). The only large, retrospective review of patient survival in the literature was conducted by the Gerson Research Organization.

The American Cancer Society (ACS) warns that the Gerson method can be very harmful (9).

Purported Uses
  • Allergies
  • Arthritis
  • Asthma
  • Atherosclerosis
  • Cancer treatment
  • Cardiovascular disease
  • Chronic fatigue syndrome
  • Detoxification
  • Diabetes
  • Hypertension
  • Infertility
  • Lou Gehrig's Disease
  • Migraine treatment
  • Multiple sclerosis
  • Peptic ulcers
  • Psoriasis
  • Tuberculosis
Constituents
  • Metabolic diet: Juice from fresh fruits and vegetables, high potassium, high carbohydrate, little animal protein, fat-free, sodium-free diet. Prohibited foods include coffee, berries, nuts, dairy, tap water, bottled, canned or processed foods, and aluminum utensils.
  • Coffee enemas
  • Additional therapies: Linseed oil, acidophilus-pepsin capsules, potassium solution, laetrile, Lugol's solution (iodine/potassium iodide), thyroid tablets, niacin, pancreatic enzymes, royal-jelly capsules, castor oil, ozone enemas, vaccines, and vitamin B12 mixed with liver.
Mechanism of Action

Gerson claims he originally developed the diet to treat his migraines, but found it a successful as a treatment for skin tuberculosis and stomach cancer (7). His therapy is based on the theory that cancer is caused by alteration of cell metabolism by toxic environmental substances and food processing, which changes the sodium and potassium content of foods. Gerson's rationale is that cancer patients have low immunity and generalized tissue damage characterized by decreased intracellular potassium to sodium (K/Na) ratios, and, when their cancer is destroyed, toxic degradation products cause coma and death. His diet increases potassium intake and minimizes sodium consumption in an effort to correct the electrolyte imbalance, repair tissue, and detoxify the liver, while coffee enemas reportedly cause dilation of bile ducts and excretion of toxic breakdown products by the liver and through the colon wall. Supplemental potassium and oxidizing thyroid enzymes are given to introduce oxidation to cancer cells and kill them. None of these claims has been substantiated by scientific research (4) (6).

This regimen has resulted in coma-inducing low levels of sodium. Case reports of deaths from repeated administration of coffee enemas indicate that the practice causes a dangerous decrease in serum electrolytes. Coffee enemas have an osmolality of 62 mOsm/kg; repeated administration increases extravascular fluid volume and may cause electrolyte imbalances and subsequent death (5).

The ease of absorption of the high volumes of raw fruit and vegetables in this diet is questionable, especially in patients with GI cancers or chemotherapy-induced mucosal damage. While elements of the Gerson diet are similar to diet recommendations made by the USDA and the American Cancer Society, metabolic diets are unsuitable for some patients with disseminated or metastatic disease, particularly of the head, neck, and gut (1).

Pharmacokinetics

No formal pharmacokinetics studies have been performed.

Warnings

The American Cancer Society warns that Gerson therapy can be very harmful.
(9)

Adverse Reactions

Common: Flu-like symptoms, loss of appetite, perspiration with foul odor, weakness, dizziness, cold sores, fever blisters, high fever, tumor pain, intestinal cramping, diarrhea, and vomiting. (The Gerson handbook claims that these adverse reactions are indicative of response) (1).
Common (metabolic diet): Nutrient deficiencies (calcium, vitamins D and B12, protein), anemia, and malabsorption may result from metabolic diets.
Reported: Campylobacterfetus sepsis caused by the liver injections was reported in 13 patients using the Gerson therapy between 1980-6; liver injections were subsequently eliminated from the regimen. Coma from low serum sodium (as low as 102 mEq/l) occurred in 5 of these patients (9).
Coffee enemas cause electrolyte imbalance, which has resulted in serious infections, dehydration, colitis, constipation, and death.
Case Reports (Coffee enemas): Case 1: Multiple seizures and hypokalemia leading to cardiorespiratory arrest, coma, and death were reported after excessive use of coffee enemas (1-4 per hour) for a number of days. Case 2: Death attributable to fluid and electrolyte imbalance causing pleural and pericardial effusions after use of coffee enemas, 4 per day for 8 weeks (5).

Herb-Drug Interactions

None known.

References
  1. Gerson Therapy. American Cancer Society's Guide to Complementary and Alternative Methods. American Cancer Society. Available at: http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Gerson_Therapy.asp?sitearea=ETO. Accessed October 5, 2012.
  2. Dwyer JT. Unproven nutritional remedies and cancer. Nutr Rev 1992;50:106-9.
  3. McCarty MF. Aldosterone and the Gerson diet: a speculation. Med Hypotheses 1981;7:591-7.
  4. Cope FW. A medical application of the Ling association-induction hypothesis: the high potassium, low sodium diet of the Gerson cancer therapy. Physiol Chem Phys 1978;10:465.
  5. Eisele JW, Reay DT. Deaths related to coffee enemas. JAMA 1980;244:1608-9.
  6. Jansson B. Geographic cancer risk and intracellular potassium/sodium ratios. Cancer Detect Prevent 1986;9:171-94.
  7. Gerson M. The cure of advanced cancer by diet therapy: a summary of 30 years of clinical experimentation. Physiol Chem Physics 1978;10:449-64.
  8. Hildenbrand GL, et al. Five-year survival rates of melanoma patients treated by diet therapy after the manner of Gerson: a retrospective review. Altern Ther Health Med 1995;1:29-37.
  9. American Cancer Society. Questionable methods of cancer management: 'Nutritional' therapies. CA: Cancer J Clin 1993;43:309-319.
  10. Gerson Institute web site. Available at http://gerson.org. Accessed October 5, 2012.
  11. Austin S, Dale EB, Dekadt S. Longterm followup of cancer patients using Contreras, Hoxsey and Gerson therapies. J Naturopathic Med 1994;5:74-6.

Consumer Information

How It Works

Bottom Line: The Gerson regimen does not treat or prevent cancer.

The Gerson regimen was developed by Max Gerson in the 1940s. It involves a strict metabolic diet that emphasizes fresh fruit and vegetable juice, high carbohydrate and potassium, no sodium or fat, and low animal protein. The diet is often supplemented with digestive enzymes, coffee enemas, and various supplements, including laetrile. This diet is based on the theory that it addresses the cause of cancer by detoxifying the body and stimulating metabolism so that the body can heal itself. These toxins, Gerson claimed, build up from environmental pollution and processed foods and eventually alter cell metabolism. However, this proposed toxin build-up has never been proven, nor has the diet's ability to remove such toxins from the body.

Coffee enemas are used in several metabolic therapies. Theoretically, coffee enemas might aid excretion from the liver and colon, but no theory has been proven. In addition, coffee enemas can be dangerous when used repeatedly, causing electrolyte imbalances in the blood and impaired nutrient absorption. Because the high levels of fruits and vegetables are eaten raw, they may not be absorbed as easily, especially in patients with GI cancers or chemotherapy-induced GI disorders.

Purported Uses

There is no scientific evidence to support use of Gerson regimen for the following:

  • To manage allergies and asthma
  • To treat arthritis
  • To treat atherosclerosis
  • To treat cancer
  • To treat heart disease
  • To treat chronic fatigue syndrome
  • To detoxify the body
  • To treat diabetes
  • To lower high blood pressure
  • To treat infertility
  • To treat Lou Gehrig's Disease
  • To treat migraine headaches
  • To treat mutiple sclerosis
  • To treat peptic ulcers
  • To treat psoriasis
  • To treat tuberculosis
Patient Warnings
  • The American Cancer Society warns that Gerson therapy can be very harmful to the body.
  • Metabolic diets like the Gerson Regimen can result in nutrient deficiencies (calcium, vitamins D and B12, protein), anemia, and malabsorption in the intestine.
Side Effects
  • Flu-like symptoms
  • Loss of appetite
  • Perspiration with foul odor
  • Weakness, dizziness
  • Cold sores, fever blisters
  • High fever
  • Tumor pain
  • Intestinal cramping, diarrhea, and vomiting
  • Coffee enemas, a regular part of the Gerson regimen, can cause electrolyte imbalance, which has resulted in serious infections, dehydration, colitis, constipation, seizures, pleural and pericardial effusions (fluid collecting in the lining around the lungs and heart), and death.
  • Coma from low sodium levels in the blood has occurred in a handful of patients.
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