How It Works
Bottom Line: Fermented wheat germ extract has been shown to improve quality of life in some cancer patients.
Fermented wheat germ extract (WGE) was developed by Mate Hidvegi, a Hungarian chemist, in the 1990s. It should not be confused with wheat germ oil. WGE is used as a dietary supplement by cancer patients in Hungary to improve quality of life. Laboratory studies show that WGE may have anticancer properties. Results from some clinical trials suggest WGE improves quality of life in some cancer patients. This product is associated with some adverse effects. Patients should consult their physicians before taking any supplements.
Purported Uses
Cancer Treatment
WGE was shown to improve quality of life in cancer patients but more data is needed to establish its use.
Autoimmune Diseases
Studies done in mice showed that WGE is beneficial but human data is lacking.
Immunostimulation
Data from in vitro and observational studies indicate that WGE has immunomodulatory effects.
Research Evidence
Cancer Treatment:
This study was done to determine the benefits of WGE for patients with colorectal cancer. Sixty-six patients were given WGE (9g once daily) along with cancer treatments whereas 104 patients received only cancer treatments. Results showed WGE had improved overall survival compared to those in control group.
Another study involved twenty-two children with different cancers. Eleven of them were given 12g/m2/day of WGE during cancer treatments whereas eleven others received only cancer treatments. Researchers found the overall white blood cell and lymphocyte counts were close to normal values in the WGE group compared to those in the control group.
Warnings
WGE should be taken under medical supervision only. Patients with hormonal-sensitive cancers should use it with caution. Diabetics should be careful because of the carbohydrate content of WGE.
Do Not Take If
You are pregnant or nursing
You had an organ or tissue transplant
You have bleeding, ulcers of the stomach and intestine, or severe absorption problem
You have sensitivity to gluten
You are fructose intolerant
Side Effects
Mild and infrequent side effects may include diarrhea, nausea, flatulence, soft stool, constipation, dizziness. Long term use of WGE may result in increased body weight.
Common Name
Fermented Wheat germ extract, MSC (Code Name)
Brand Name
Avemar
Clinical Summary
Fermented wheat germ extract (WGE) was developed by Mate Hidvegi, a Hungarian chemist, in the 1990s. It should not be confused with wheat germ oil. WGE is used as a dietary supplement by cancer patients in Hungary to improve quality of life. Results from in vitro studies show that WGE has anticancer (1) (2) (12) , antimetastatic (3), and immunomodulatory (2) (4) effects. It was also shown to increase estrogen receptor (ER) activity in vitro. However, when used along with tamoxifen, an ER antagonist, it enhanced efficacy of tamoxifen in ER positive breast cancer cells (5). The antitumor effect of WGE is comparable to other endocrine treatments in animal model (11). WGE also increased production of tumor necrosis factor and cytokines that are responsible for tumor cell death (6). Data from pilot studies implicates a beneficial role for WGE in patients with colorectal cancer (7) and in reducing treatment associated febrile neutropenia in pediatric cancer patients (8). Because it potentiates estrogen receptor activity, patients with hormonal sensitive cancers should use WGE with caution. Reported mild side effects include diarrhea, nausea, flatulence, soft stool, constipation, and dizziness. Long term use of WGE may result in increased body weight (10).
Purported uses
- Autoimmune diseases
- Cancer treatment
- Immunomodulation
Constituents
Wheat germ
Mechanism of Action
Although the exact mechanism of action is not clear, WGE was shown to increase TNF and cytokine production in vitro by activating certain metabolic pathways
(6) involved in tumor cell death. WGE also regulates tumor cell proliferation by inhibiting glycolysis and pentose cycle enzymes and induces apoptosis through caspase-3-mediated poly (ADP ribose) polymerase cleavage
(4).
Warnings
WGE should be taken under medical supervision only. Diabetics should use this product with caution because of the high carbohydrate content.
(10)
Contraindications
Pregnant and nursing women
Patients with organ or tissue transplants
Patients with bleeding gastric or duodenal ulcers, enteritis/colitis, malabsorption syndrome.
Patients with sensitivity to gluten and those with fructose intolerance.
(10)
Adverse Reactions
Mild and infrequent side effects may include diarrhea, nausea, flatulence, soft stool, constipation, dizziness. Long term use of WGE may result in increased body weight.
(10) WGE may have estrogen receptor activity. Patients with hormonal-sensitive cancers should consult with a physician before using WGE.
Herb-Drug Interactions
WGE should be taken at least two hours before or after consuming vitamin C.
(10)
Literature Summary and Critique
Jakab F, et al. A medical nutriment has supportive value in the treatment of colorectal cancer. British Journal of Cancer 2003; 89:465-469.
This study was done to determine if WGE supplementation was beneficial for patients with colorectal cancer. Sixty-six patients were given WGE (9g once daily) in addition to anticancer treatments and 104 patients received only anticancer treatments. Data analysis revealed that patients who took WGE had fewer disease progression-related events compared to the control group. There was also an improvement in overall survival of patients on WGE. But more trials are needed with equal number of patients in the experimental and control groups.
Garami M, et al. Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. J Pediatr Hematol Oncol 2004; 26(10): 631-635.
Twenty-two pediatric patients with different malignant tumors participated in this study. Eleven patients were given 12g/m2/day of WGE during cancer treatments and eleven patients received only cancer treatments. Researchers found that there was no recognizable progression of disease during the follow-up period. But there was a significant difference in the frequency of febrile neutropenic events between the two groups. The overall white blood cell and lymphocyte counts during such events were close to normal values in the WGE group compared to those in the control group. Since this is a pilot study, randomized controlled trials are warranted with larger sample size to verify these effects.
References
- Zalatnai A, Lapis K, Szende B et al. Wheat germ extract inhibits experimental colon carcinogenesis in F-344 rats. Carcinogenesis 2001; 22(10):1649-1652.
- Jakab F, Mayer A, Hoffmann A, Hidvegi M. First clinical data of a natural immunomodulator in colorectal cancer. Hepatogastroenterology 2000; 47(32):393-395.
- Hidvegi M, Raso E, Tomoskozi-Farkas R, Paku S, Lapis K, Szende B. Effect of Avemar and Avemar + vitamin C on tumor growth and metastasis in experimental animals. Anticancer Res 1998; 18(4A):2353-2358.
- Comin-Anduix B, Boros LG, Marin S et al. Fermented wheat germ extract inhibits glycolysis/pentose cycle enzymes and induces apoptosis through poly(ADP-ribose) polymerase activation in Jurkat T-cell leukemia tumor cells. J Biol Chem 2002; 277(48):46408-46414.
- Marcsek Z, Kocsis Z, Jakab M, Szende B, Tompa A. The efficacy of tamoxifen in estrogen receptor-positive breast cancer cells is enhanced by a medical nutriment. Cancer Biother Radiopharm 2004; 19(6):746-753.
- Telekes A, Kiss-Toth E, Nagy T et al. Synergistic effect of avemar on proinflammatory cytokine production and ras-mediated cell activation. Ann N Y Acad Sci 2005; 1051:515-528.
- Jakab F, Shoenfeld Y, Balogh A et al. A medical nutriment has supportive value in the treatment of colorectal cancer. Br J Cancer 2003; 89(3):465-469.
- Garami M, Schuler D, Babosa M et al. Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. J Pediatr Hematol Oncol 2004; 26(10):631-635.
- Boros LG, Nichelatti M, Shoenfeld Y. Fermented Wheat Germ Extract (Avemar) in the Treatment of Cancer and Autoimmune Diseases. Ann N Y Acad Sci 2005; 1051:529-542.
- http://www.avemar.com (Last accessed on December 12, 2005).
- Tejeda M, D. Gaál, I. Szûcs, et al. Avemar inhibits the growth of mouse and human xenograft mammary carcinomas comparable to endocrine treatments. ASCO Annual Meeting 2007. Abstract No: 21132.
- Saiko P, Ozsvar-Kozma M, Madlener S, et al. Avemar, a nontoxic fermented wheat germ extract, induces apoptosis and inhibits ribonucleotide reductase in human HL-60 promyelocytic leukemia cells. Cancer Lett. 2007 Jun 8;250(2):323-8.
