Kidney Coach

Couch Grass & Kidney Disease

Couch grass (Elymus repens)

If you are part of our Kidney Disease Solution community then you will no doubt have read in our book about the amazing effects of Nanna’s Tea. The tea is an integral part of our kidney healing program. We have had thousands of testimonials over the years about the program, but something that stands out the most is how amazing people feel after drinking what we called Nanna’s Kidney Tea. So today I want to talk about one of the key ingredients in this tea – Couch Grass.

Couch grass known scientifically as both Agropyron repens or Elymus repens and is considered by gardeners as an annoying weed, Couch Grass has long been valued by herbalists for its mucilage-rich rhizome (root). Couch Grass has been used in herbal medicine since classical Greek times where it was recommended by Dioscorides for “stone in the bladder”. One of its other common names is dog grass which comes from the fact that sick dogs will dig up the root and eat it. Culpepper said “…watch the dogs when they are sick and they will quickly lead you to it.

In Greece, according to ethnobotanical tradition, Couch Grass is used not only in urinary tract disorders (cystitis, kidney stones, prostate enlargement) but also in gastrointestinal problems (gallstones), in arthritis and rheumatism, and to reduce increased cholesterol levels (Hanlidou et al. 2004). In Bulgaria and Italy, couch grass rhizomes are traditionally used as diuretic and laxatives (Leporatti & Ivancheva 2003). They are also used as a diuretic by ethnic Albanian communities living in the Vulture area in Southern Italy (Pieroni et al. 2002). In Bosnia and Herzegovina, traditional use of couch grass as a diuretic and in rheumatic complaint is described (Redžić 2007). Couch Grass root has also been, dried, and ground into flour to make bread or thick soup in famine conditions were used in Poland until the mid-20th century and might have been used to make beer until the 18th century (Łuczaj & Szymański 2007, Łuczaj 2008). The pulverized root of Couch Grass was used in order to reduce the irritable condition of the bladder and to promote urination (Ballabh et al. 2008). 

Active Substances:

  • Tristine
  • Inositol
  • Mannitol
  • Essential oil – agropyrin
  • Vitamin A
  • Vitamin B’s
  • Vanillin
  • Saponins
  • Potassium
  • Iron
  • 5-hydroxyindole-3-acetic acid
  • 5-hydroxytryptophan
  • Beta-carotene
  • Coumarins
  • Rutin

Therapeutic Actions of Couch Grass:

  • Anti-bacterial
  • Anti – Microbial
  • Diuretic
  • Demulcent
  • Emollient
  • Aperient
  • Catarrh
  • Anti-inflammatory
  • Laxative
  • Urinary antiseptic
  • Nutritive
  • Anti-cholesterol
  • Antibiotic

Therapeutic Indications:

  • Inflammation and infection of the urinary tract including:
    • Cystitis and urethritis
    • Prophylactic for kidney gravel
    • Involuntary nocturnal enuresis
  • Benign prostatic hyperplasia, prostatitis
  • Gout
  • Rheumatism
  • Jaundice
  • Bronchitis
  • Worm infestations in children
  • Kidney Stones
  • Renal colic
  • Strengthen urinary sphincters
  • Soothes the injured membrane of the urinary tract
  • Pain and straining of urination
  • Passage of scanty, bloody urine
  • Lack of free secretion from the kidneys
  • Incontinence, dribbling
  • Kidney disease
  • Albuminuria, glomerulonephritis; frequent and scanty urination, burning and scaling in the urinary tract, heavy dull aching pains in the regions of the kidneys
  • Nephritis

couch grass - kidney disease and gout

Bladder Infections – Cystitis

Since Couch Grass has actions as both an antimicrobial and antibacterial agent it makes sense that Couch Grass could be useful in conditions such as cystitis which is a bacterial infection of the bladder, usually from an overgrowth of E.Coli. Studies have shown that Couch Grass reduces the bacterial invasion into the bladder and stops bacterial from adhering to the bladder wall. This action means a reduction in the bacterial load in the bladder leading to a potential decrease in infective organisms. This in part may be due to Couch Grasses’ mannitol content, mannitol is often used to prevent bladder infections for people who suffer from the chronic condition.

Kidney Stones

The demulcent properties of couch grass make it an excellent choice in helping alleviate the pain associated with kidney stones. Couch grass also helps to increase the excretion of oxalate acid, the chemical associated with an increased risk of kidney stone formation. Couch Grass’s ability to help clear oxalate acid was found in a 5 month clinic study to reduce the number of kidney stones in patients who already had a stone build-up and prevent further stone formation.


Couch Grass is a natural diuretic, meaning it helps to clear excess fluid build-up from the body. Couch grass is rich in a sapinon-based diuretic called mannitol that works via an osmotic diuretic mechanism, which basically means that Couch Grass has the ability to inhibit water reabsorption in the proximal convoluted tubule and the thin descending loop of Henle and collecting duct, regions of the kidney that are highly permeable to water.


Gout is caused by an inefficient excretion of uric acid by the kidneys, leading to elevated levels inside the blood. In healthy individuals, uric acid is kept in balance by the kidneys.  

In an individual with gout, however, uric acid builds up over time, causing an imbalance in this system and eventually an accumulation of “monosodium urate” crystals inside the joints.

This can build up over many years, and will eventually trigger an immune response, causing pain, inflammation, redness, swelling, and all of the various side effects of gout.

Due to Couch Grass’s ability to act as a diuretic, it is able to increase urine output by inhibiting the reabsorption of water and sodium inside the kidneys, which helps to clear excess amounts of uric acid from building up. Couch Grass also helps to clear oxalates, making it a good potential remedy for those who are prone to suffering from gout.


Couch Grass has the ability to work as an anti-inflammatory agent against acute and chronic inflammation in the kidneys. The hallmark process that underpins chronic kidney disease. By reducing the inflammatory process Couch Grass has the potential effect of slowing down the progression of kidney disease as well as being useful in kidney conditions where inflammation is the primary driver of damage to the nephrons.  

In Germany, the Commission E supports using couch grass with copious fluid intake to treat inflammatory diseases of the urinary tract and for preventing kidney gravel – Blumenthal M et al, editors: The complete German Commission E monographs: therapeutic guide to herbal medicines, Austin, 1998, American Botanical Council.


Cholesterol-Lowering Ability

Couch Grass root contains inositol, which is a compound that can prevent the accumulation of fat and cholesterol in the liver. Many studies have found that inositol can help to prevent fatty liver disease, especially if used in conjunction with choline.

Other Uses

Couch Grass is also often used for chronic respiratory infections, such as bronchitis due to its antimicrobial and demulcent actions. 

It is also useful for men with enlarged prostates due to its therapeutic actions as an anti-inflammatory and urinary antiseptic. In an open clinical trial in 99 patients with micturition disorders (12 female and 87 male), a 20% ethanol fluid extract of Agropyron repens was administered for 28-31 days. The complaints of urge incontinence, dysuria, nocturia, and tenesmus due to adenoma of prostate, prostatitis, and cystitis were significantly reduced in 44.4-100% of patients. Laboratory markers of inflammation (protein, epithelia, leucocytes, and erythrocytes in urine) were also normalized. As a result, 96% of patients estimated results as ‘good’ or ‘very good’. Adverse effects were not recorded (Barsom 1981).


  • None known

Contraindications and Precautions

  • Prolonged use may lead to loss of potassium due to its diuretic action.
  • Avoid if you have a known allergy or hypersensitivity to any constituent of couch grass, or to other members of the Poaceae/Gramineae family.
  • Caution is advised in patients who have edema (swelling) caused by heart or kidney disease

Drug Interactions

None known, however, I advise caution if you are already taking diuretics. Please consult with your health care provider.


Liquid extract 1:1 in 25% alcohol: 20 to 170mL weekly

Dried root (as a herbal tea): 1.5 – 3gs per day

Final Notes

As always we recommend that you speak to your health care professional before adding any new herbal remedy or nutritional supplement. 

Couch grass is best taken as a herbal tea made from the dried root, as that has a far greater affinity for the kidneys than a pill, tablet, or herbal tincture.

We hope you have enjoyed reading about the amazing benefits of Couch Grass and that you now have a greater understanding of why it makes up one of the four herbs in our Nanna’s Kidney Tea.

If you have found this information useful don’t forget to share the content or head over to our Facebook page and leave us a comment.

Until next time! 

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