The Gerson diet, also known as Gerson therapy, is a dietary regimen promoted as an alternative treatment for cancer and other chronic diseases. Developed by Dr. Max Gerson in the early 20th century, it is based on the idea that cancer develops due to changes in cell metabolism caused by the accumulation of toxic substances in the body. The therapy aims to restore health by repairing the liver, removing toxins, and boosting the immune system through a combination of diet, supplements, and detoxification methods.
History of the Gerson Therapy
Dr. Max B. Gerson (1881-1959) initially used the therapy to treat his migraine headaches. In the 1930s, it became known as a treatment for tuberculosis (TB). Later, the Gerson therapy was used to treat other conditions, including cancer. After Gerson's death, his daughter Charlotte Gerson (March 25, 1922 - February 10, 2019) continued to promote the therapy, founding the "Gerson Institute" in 1977.
Theoretical Basis of the Gerson Therapy
The Gerson therapy is based on the belief that cancer is the result of a deteriorating metabolism from an impaired liver function. Dr. Gerson said the disease process makes more toxins and the liver becomes overworked. According to Dr. Gerson, people with cancer also have too much sodium and too little potassium in the cells in their bodies, which causes tissue damage and weakened organs.
The goal of the Gerson therapy is to restore the body to health by repairing the liver and returning the metabolism to its normal state. According to Dr. Gerson, this can be done by removing toxins from the body and building up the immune system with diet and supplements. The therapy promotes the idea that cancer is caused by alteration of cell metabolism by processed food and toxic environmental substances which alter its sodium and potassium content. It also emphasizes limiting sodium and increasing potassium intake to detoxify the liver. Coffee enemas are said to cause excretion of toxic breakdown products by the liver and through the colon wall.
The regimen was 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.
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Key Components of the Gerson Therapy
The Gerson therapy is divided into three key components: diet, supplementation, and detoxification.
Diet
The Gerson therapy diet is entirely vegetarian and extremely low in sodium, fats, and proteins, as Dr. Gerson believed that this type of diet helps treat diseases. The diet is naturally high in vitamins, minerals, enzymes, micro-nutrients, and extremely low in sodium, fats, and proteins. The Gerson diet relies heavily on fruits and vegetables and provides very poor variety.
Anyone on this diet is asked to consume approximately 15-20 pounds (7-9 kg) of organic produce per day. This is said to help “flood the body with nutrients.” Most of that produce is used to make raw juices. Dieters are asked to drink up to one 8-ounce (240-ml) glass of raw juice per hour - up to 13 times per day. Juices must be freshly made from organic fruits and vegetables and be taken once every hour. Juice must be made using a Gerson-recommended two-step juicer that first grinds the vegetables into a pulp, then extracts the juice by squeezing it under high pressure.
It is also essential to eat a large portion of cooked food at every meal. Food is slow-cooked for easy digestion, which allows for easier assimilation of nutrients throughout the body. Both cooked and raw foods are encouraged.
Supplementation
Because the diet is loaded with nutrients, its supplements are not meant to provide more nutrients. Instead, they’re intended to support your cells’ metabolic processes.
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Taking a number of supplements, including:
- Potassium
- Lugol's Solution (potassium iodide, iodine, and water)
- Coenzyme Q10 injected with vitamin B12. (The original regimen used crude liver extract instead of coenzyme Q10.)
- Vitamins A, C, and B3 (niacin)
- Flaxseed oil
- Pancreatic enzymes
- Pepsin (a stomach enzyme)
- A thyroid hormone supplement
Potassium supplements are a key part of the Gerson therapy. Dr. Gerson believed that diseased cells contained too much sodium and too little potassium. Once his participants started the Gerson therapy diet - which is high in potassium and low in sodium - their cells would reportedly shrink, which Gerson believed to be a sign of recovery. Supplemental potassium and oxidizing thyroid enzymes are given to introduce oxidation to cancer cells and kill them.
The original protocol also included raw calf's liver taken orally, but this practice was discontinued in the 1980s after ten patients were hospitalized (five of them comatose) from January 1979 to March 1981 in San Diego, California, area hospitals due to infection with the rare bacterium Campylobacter fetus.
Detoxification
According to the Gerson Institute, the combined effect of the diet and supplements releases toxins from your body’s tissues. Thus, your liver - which is the main organ that processes toxins - would be working harder than usual. To support your liver, the Gerson therapy incorporates coffee enemas that allegedly widen your liver’s bile duct so that it easily releases toxins.
The bile duct is a small tube that helps carry bile - a fluid that helps break down fatty acids and many waste products - from your liver to your intestines. However, no scientific studies indicate that coffee enemas can widen your bile duct. What’s more, evidence is lacking that this therapy causes toxins to be released from your cells at all.
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Taking coffee or chamomile enemas regularly to remove toxins from the body. The enemas are said to widen the bile ducts of the liver so toxins can be released. According to Dr. Gerson, the liver is further overworked as the treatment regimen breaks down cancer cells and rids the body of toxins.
Gerson Diet Food List
The Gerson therapy mandates an organic, plant-based diet. Foods in the Gerson therapy should be prepared without salt, spices, or oils, and without using aluminum cookware or utensils.
Here are foods you may be encouraged to consume:
- Fruits: all fresh fruits except berries and pineapple, which harbor aromatic acids
- Dried fruits (stewed or pre-soaked only): peaches, dates, figs, apricots, prunes, and raisins - all unsulphured
- Vegetables: all except mushrooms, hot peppers, carrot greens, radish greens, mustard greens, and raw spinach (cooked spinach is fine)
- Lentils: allowed only at certain times if you’re in good health
- Grains: rye bread (unsalted, non-fat), brown rice (if prescribed), and oatmeal
- Dairy: only non-fat, plain, organic yogurt - and only after six weeks
- Spices (in small amounts): allspice, anise, bay leaves, coriander, dill, fennel, mace, marjoram, rosemary, sage, saffron, sorrel, summer savory, thyme, and tarragon
- Condiments: vinegar - either wine or apple cider
- Fats: flaxseed oil - only if prescribed
- Beverages: freshly pressed juices (as prescribed), caffeine-free herbal teas
In addition to the above foods, certain items are permitted occasionally:
- Bananas: typically half a banana per week
- Breads: only whole wheat rye (unsalted, non-fat) - generally 1-2 slices per day
- Quinoa: usually once a week
- Yams and sweet potatoes: typically once a week (regular potatoes are unrestricted)
- Popcorn: air-popped, usually as a holiday treat only - a few times per year
- Sweeteners: maple syrup (grade A dark color - formerly grade B), honey, brown sugar, or unrefined blackstrap molasses - 1-2 teaspoons (15-30 ml) of any per day, maximum
The Gerson therapy bans foods that are high in protein, sodium, and fat. Additionally, you cannot eat foods with certain compounds that the Institute claims interfere with the healing process. Spices and fruit - such as pineapples and berries - are often prohibited because they contain aromatic acids, a plant compound. Dr. Gerson believed that aromatic acids interfered with the healing process. However, this is currently determined on a case-by-case basis.
Staple Foods in the Gerson Therapy
Practitioners of Gerson therapy believe that cancer is caused by an accumulation of toxic substances in the body. They recommend a special diet including high carbohydrate and potassium intake, no sodium or fat, low animal protein, supplementation with exogenous digestive enzymes, and coffee enemas aimed at detoxifying the body and stimulating metabolism.
The Gerson diet is all organic and predominantly plant-based with a strong emphasis on generous, high-quality nutrition. It is naturally high in vitamins, minerals, enzymes, micro-nutrients, and extremely low in sodium, fats, and proteins.
Rolled Oats: One half-cup of raw rolled oats contains: 180 calories, 3.0 g fat, 7.0 g protein, 20 mg calcium, and 1.8 mg iron. High in dietary fiber, protein, potassium, manganese and molybdenum. For serious gluten intolerance or celiac disease, obtain a brand tested to be free of gluten or substitute with millet.
Potatoes: One large potato contains: 284 calories, 7.5 g protein, 4.5 g carbohydrate, .33 g fat, 1600 mg potassium, 22 mg sodium, 85 mg magnesium, 44.8 mg calcium, 72.7 mg Vitamin C, and trace amounts of B vitamins. The highly-colored potato varieties are rich in antioxidants, anthocyanins and carotenoids which are associated with a lower incidence of chronic diseases such as cardiovascular disease, atherosclerosis, rheumatoid arthritis and cancer.
Cooked Vegetables: Choose from a variety of cooked vegetables, especially the cruciferous variety to get the important phytonutrients. The cruciferous include broccoli, cauliflower, kale, collard greens, Brussel sprouts, bok choy, cabbage, arugula and watercress. A number of studies have shown that the bioactive components of cruciferous vegetables have anti-cancer effects. Other vegetable choices include beets, asparagus, artichoke, green beam, squash and carrots.
Hippocrates Soup: This soup is a staple of the Gerson Therapy. A minimum of 8oz. should be consumed at lunch and dinner. It is alkalinizing, detoxifying, and good for the kidneys. It is also high in antioxidants and essential vitamins and minerals, including potassium and vitamin K.
Watercress: This is used in the green juice. It belongs to the cruciferous vegetable family, contains a good amount of calcium, phosphorus and potassium, and is high in glucosinolates, which are sulfur containing compounds beneficial in inducing detoxification. Watercress also contains PEITC (Phenethylisothiocyanate), a form of glucosinolate which is thought to have chemoprotective properties. It is also a plant easily infested with parasites, so wash carefully!
Carrot Juice: An eight ounce glass of juice made from approximately 1 lb. of carrots contains: 2.85 g protein, 100 mg calcium, 1.3 mg iron, 975 mg potassium, 2545 mcg vitamin A, 18 mg vitamin C and small amounts of B vitamins. While carrots lose some vitamins and minerals in the cooking process, the amount of falcarinol is increased, although it is still available in raw carrots. Carrots contain a compound called falcarinol which is a natural pesticide. It protects the roots from fungal disease. A team of researchers from the University of Newcastle in England and Denmark found this natural pesticide reduced the risk of cancer developing in rats by one third. Research has confirmed that this substance has more anti-cancer properties than beta-carotene.
Swiss Chard: This is an ingredient in the Gerson green juice. Swiss chard is a good source of vitamin C, vitamin K, vitamin A, and the minerals calcium, magnesium, zinc and manganese, as well as antioxidant phytonutrients, including the carotenoids lutein and zeaxanthin and the flavanoid quercitin. These phytonutrients provide excellent anti-oxidant and anti-inflammatory benefits. The unique flavanoid phytonutrients offer special benefits for blood sugar control. Swiss chard inhibits activity of an enzyme called alpha-glucosidase which is used to break down carbohydrates into simple sugars. It also stabilizes blood sugar levels due to its high fiber content.
Red Cabbage: This is an ingredient in the Gerson green juice. Red cabbage contains a good amount of vitamin C. Its antioxidant and anti-inflammatory nutrients include beta-carotene, glucosinolates, anthocyanins and glutamine. One of the glucosinolates called sinigrin has received special attention in cancer prevention research, especially in respect to bladder, colon and prostate cancer. The glutamine content helps heal stomach ulcers and inflammation as well as regulates any bacterial populations of Helicobacter pylori inside the stomach.
Apples: They are in the juices and can also be eaten raw or in apple sauce. Apples contain many phytonutriends and antioxidant nutrients, as well as fiber. Quercetin and other flavonoids inhibit carbohydrate digesting enzymes like alpha-amylase and alphaglucosidase. When these enzymes are inhibited, fewer carbohydrates are broken down into simple sugars, which keep the blood sugar in balance. Apples have antioxidant benefits that lower the risk of asthma and the risk of lung, colon and breast cancer. Other anti-inflammatory benefits are found to reduce blood levels of C-reactive protein, mainly from the quercetin. Apples also decrease the oxidation of cell membrane fats, helping to prevent atherosclerosis.
Scientific Evidence and Studies
Most of the published information on the use of the Gerson therapy reports on retrospective studies (reviews of past cases). Dr. Gerson published case histories (detailed reports of the diagnosis, treatment, and follow-up of individual patients) of 50 of his patients. He treated several different types of cancer in his practice. The reports include Dr. Gerson's notes, with some X-rays of the patients over time. the cases of a total of 60 patients treated by Dr. Gerson. The NCI found that the available information did not prove the regimen had benefit.
The following studies of the Gerson therapy were published:
- In 1983-1984, a retrospective study of 38 patients treated with the Gerson therapy was done. Medical records were not available to the authors of the study; information came from patient interviews. These case reviews did not provide information that supports the usefulness of the Gerson therapy for treating cancer.
- In 1990, a study of a diet regimen similar to the Gerson therapy was done in Austria. The patients received standard treatment along with the special diet. The authors of the study reported that the diet appeared to help patients live longer than usual and have fewer side effects. The authors said it needed further study.
- In 1995, the Gerson Research Organization did a retrospective study of their melanoma patients who were treated with the Gerson therapy. The study reported that patients who had stage III or stage IV melanoma lived longer than usual for patients with these stages of melanoma. There have been no clinical trials that support the findings of this retrospective study.
- A case review of 6 patients with metastatic cancer who used the Gerson therapy reported that the regimen helped patients in some ways, both physically and psychologically. Based on these results, the reviewers recommended that clinical trials of the Gerson therapy be conducted.
Older research into the efficacy of the Gerson therapy found little evidence to support the claims that the therapy can help treat cancer. The National Cancer Institute (NCI) also states that there is limited scientific evidence to support the claims from the Gerson Institute on the treatment of cancer through the Gerson therapy. They also note that the FDA has not approved the Gerson therapy for the treatment of cancer or any other condition.
The NCI recommends that you speak with a healthcare professional about nutritional needs during cancer treatment.
The National Cancer Institute was unable to find any evidence that Gerson's claims were accurate. The NCI found that no in vivo animal studies had been conducted. Attempts to independently check the results of the therapy have been negative.
In 1947, the National Cancer Institute reviewed 10 claimed cures submitted by Gerson; however, all of the patients were receiving standard anticancer treatment simultaneously, making it impossible to determine what effect, if any, was due to Gerson's therapy. In 1959, the National Cancer Institute (NCI) again reviewed cases of patients treated by Gerson. The NCI found that the available information did not prove the regimen had benefit.
A review of the Gerson therapy by Memorial Sloan-Kettering Cancer Center concluded: "If proponents of such therapies wish them to be evaluated scientifically and considered valid adjuvant treatments, they must provide extensive records (more than simple survival rates) and conduct controlled, prospective studies as evidence".
The American Cancer Society reported that "[t]here is no reliable scientific evidence that Gerson therapy is effective in treating cancer, and the principles behind it are not widely accepted by the medical community. It is not approved for use in the United States."
Potential Benefits of the Gerson Therapy
Although no comprehensive studies exist on the health attributes of the Gerson therapy, it may provide some benefits - largely thanks to its nutrient-rich, plant-based diet.
Here are some potential benefits of the Gerson therapy:
- Higher in many nutrients: Plant-based diets tend to provide more fiber, antioxidants, vitamins, and minerals than typical Western diets high in processed foods.
- May reduce your risk of heart disease: Diets high in fruits, vegetables, and fiber have been associated with a lower risk of heart disease.
- May improve kidney function: Plant-based diets may protect against kidney disease and kidney stones.
- May help relieve constipation: The Gerson therapy and other plant-based diets are high in fiber, which may help relieve constipation and keep your digestive system healthy.
While there is no scientific evidence to support this, the Gerson Institute states that they have had success in treating the following conditions: breast cancer, ovarian cancer, rheumatoid arthritis (RA), lymphoma, melanoma, infertility, and systemic lupus erythematosus (SLE).
Risks and Side Effects
The Gerson therapy has several serious risks and downsides.
Adverse reactions to the Gerson regimen include:
- Flu-like symptoms
- Foul odor with perspiration
- Loss of appetite
- Fever
- Tumor pain
- Cold sores or fever blisters
- Dizziness or weakness
- Diarrhea, vomiting, or intestinal cramping
The Gerson therapy can lead to several significant health problems. Continued use of enemas may weaken the colon's normal function, causing or worsening constipation and colitis. Coffee enemas can also lead to electrolyte imbalance, which has resulted in serious infections, dehydration, colitis, constipation, and death. This imbalance can cause serious issues like dehydration, infections, and seizures. Coffee enemas have contributed to the deaths of at least three people in the United States.
Reports of three deaths that may be related to coffee enemas have been published. Campylobacter fetus 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. A case report of 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. 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. 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.
The strict dietary recommendations can cause severe nutritional deficiencies, and excessive use of coffee enemas can cause sepsis, dangerous electrolyte deficiencies, and death.
Regulatory Status
The Gerson therapy has not been approved by the FDA for use as a treatment for cancer or any other disease.