

Generic Name: Nasturtium
Agrião, Berro, Berro de Agua, Brassicacae, Brunnendresenkraut, Brunnenkresse, Cochleria officinalis, Crescione Di Fonte, Cresson au Poulet, Cresson D'eau, Cresson de Fontaine, Garden cress, GlucosinolatesIsothiocyanates (ITCs), Herba nasturtii Aquatici, Herbe aux Chantes, Indian Cress, Mizu-Garashi, Nasilord, Nasturii herba, Nasturtium officinale, Nasturtium officinale R. Br., Oranda-Garashi, Phenethyl isothiocyanate (PEITC) (PEITC-NAC), Rorripa, Rorripa nasturtium aquaticum, scurvy grass, scrubby grass, Selada-Air, Spoonwort, Tall Nasturtium, Tropaeolaceae, Tropaeolum majus, Wasserkresse, waterkres.
Watercress originates from the eastern Mediterranean and adjoining areas of Asia. It is cultivated commercially for its small, pungent leaves that may be used as a salad green or garnish. Greek, Persian and Roman civilizations ate watercress for its health-related properties. The Greeks believed watercress was beneficial to the brain. Applied externally, it has a reputation as an effective hair tonic, helping to promote the growth of thick hair.
Watercress is a member of the Brassicaceae family, which includes cabbage, broccoli, cauliflower, Brussels sprouts, kale, mustard greens, collard greens, bok choy and turnips. These plants contain specific indoles (aromatic organic compounds) that activate enzymes in the body; these enzymes then deactivate and dispose of excess estrogen. Heavy cooking destroys indoles and is not recommended for medicinal purposes.
Watercress also contains phenethyl isothiocyanate (PEITC), which is a dietary compound present in cruciferous vegetables that has cancer-preventive properties.
Watercress was formerly used as a domestic remedy against scurvy. The species Cochlearia officianalis is commonly referred to as scurvy grass; sailors would consume this plant to prevent scurvy from developing. Although this plant is referred to as watercress, scurvy grass has flowers with a strong fragrance and taste.
There is no proven safe or effective dose for watercress. 4-6 grams dried herb has been used, as has 20-30 grams fresh herb or 60-150 grams as a juice/tea.
There is no proven safe or effective dose for watercress, and use in children is not recommended.
Avoid in individuals with a known allergy or hypersensitivity to watercress, or members of the Brassicaceae family, which includes cabbage, broccoli, cauliflower, Brussels sprouts, kale, mustard greens, collard greens, bok choy and turnips. True Nasturtium officinale is known to cause contact dermatitis. Watercress may cause breathing problems or tightness in the throat or chest in allergic individuals.
Watercress is generally well tolerated; however some adverse effects have been reported. Use caution when gathering watercress from the wild due to the risk of plant infestation with liver fluke parasites.
Watercress may cause hives, rash, itching or swollen skin. True Nasturtium officinale is known to cause contact dermatitis. Watercress may also cause breathing problems or tightness in the throat or chest in allergic individuals.
Large amounts of watercress may cause gastrointestinal irritation. Although not well studied, excessive or prolonged use of watercress may cause kidney damage. Use cautiously in patients with gastric or duodenal ulcers or kidney disease.
Watercress is not recommended in pregnant or breastfeeding women due to a lack of scientific available evidence. Although not well-studied, watercress may be unsafe when used in pregnancy due to its possible abortifacient (abortion inducing) effects. Watercress may also stimulate menstruation.
Consumption of watercress decreases the levels of oxidative metabolites of acetaminophen. Use cautiously in patients taking acetaminophen (Tylenol®), and consult with a qualified healthcare professional, including a pharmacist, before combining therapies.
Watercress contains a high vitamin K content, and may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Concomitant use with chlorazoxazone (Parafon Forte©, Paraflex©) may alter the effects due to reduced metabolism and elimination. Caution is advised.
Early evidence suggests watercress may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Watercress contains a high vitamin K content, and may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Watercress may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Chi Dam, PharmD (Northeastern University); Nicole Giese, MS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University), Adam McLean, MPharm (University of Nottingham); Erica Seamon, PharmD (Nova Southeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Chris Tonelli, MA (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration); Shannon Welch, PharmD (Northeastern University); Catherine Ulbricht, PharmD (Massachusetts General Hospital).
Carrada-Bravo T. [Fascioliasis: diagnosis, epidemiology and treatment]. Rev Gastroenterol Mex 2003;68(2):135-142.
Chiao JW, Wu H, Ramaswamy G, et al. Ingestion of an isothiocyanate metabolite from cruciferous vegetables inhibits growth of human prostate cancer cell xenografts by apoptosis and cell cycle arrest. Carcinogenesis 2004;25(8):1403-1408.
Christmann M, Henrich R, Mayer G, et al. [Infection with fasciola hepatica causing elevated liver-enzyme results and eosinophilia - serologic and endoscopic diagnosis and therapy]. Z Gastroenterol 2002;40(9):801-806.
Conaway CC, Yang YM, Chung FL. Isothiocyanates as cancer chemopreventive agents: their biological activities and metabolism in rodents and humans. Curr Drug Metab 2002;3(3):233-255.
Cosme A, Ojeda E, Poch M, et al. Sonographic findings of hepatic lesions in human fascioliasis. J Clin Ultrasound 2003;31(7):358-363.
Dobrucali A, Yigitbasi R, Erzin Y, et al. Fasciola hepatica infestation as a very rare cause of extrahepatic cholestasis. World J Gastroenterol 2004;10(20):3076-3077.
Dreyfuss G, Vignoles P, Abrous M, et al. Unusual snail species involved in the transmission of Fasciola hepatica in watercress beds in central France. Parasite 2002;9(2):113-120.
Dreyfuss G, Vignoles P, Rondelaud D. Fasciola hepatica: epidemiological surveillance of natural watercress beds in central France. Parasitol Res 2005;95(4):278-282.
Hu R, Kim BR, Chen C, et al. The roles of JNK and apoptotic signaling pathways in PEITC-mediated responses in human HT-29 colon adenocarcinoma cells. Carcinogenesis 2003;24(8):1361-1367.
Ji Y, Morris ME. Determination of phenethyl isothiocyanate in human plasma and urine by ammonia derivatization and liquid chromatography-tandem mass spectrometry. Anal Biochem 2003;323(1):39-47.
Martinez-Bebert K, Rodriguez-Baez R, Pila-Perez R, et al. [Hepatic hematoma caused by fascioliasis]. Gac Med Mex 2002;138(3):271-274.
Robinson B, Duwig C, Bolan N, et al. Uptake of arsenic by New Zealand watercress (Lepidium sativum). Sci Total Environ 2003;301(1-3):67-73.
Rondelaud D, Hourdin P, Vignoles P, et al. The contamination of wild watercress with Fasciola hepatica in central France depends on the ability of several lymnaeid snails to migrate upstream towards the beds. Parasitol Res 2005;95(5):305-309.
Rose P, Huang Q, Ong CN, et al. Broccoli and watercress suppress matrix metalloproteinase-9 activity and invasiveness of human MDA-MB-231 breast cancer cells. Toxicol Appl Pharmacol 2005;
Yilmaz H, Godekmerdan A. Human fasciolosis in Van province, Turkey. Acta Trop 2004;92(2):161-162.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.


