When you were young and causing problems, maybe your grandma would yell that you were going to give her an ulcer!

Probably because in the early 20th century, when your grandma was young, ulcers were one of the top  ten causes of death in the US. And today, they’re not!

One of the pioneering doctors  in that story was Garnett Cheney from Stanford, who had a bizarre idea to feed his ulcer patients a lot of green cabbage. What’s even more bizarre is that it worked. [INTRO] In Cheney’s time, the  prevailing medical wisdom was that peptic ulcers happened because  of too much acid in the stomach, usually because of a bad diet or stress. Which would mean that a certain cabbage vendor in Avatar the Last Airbender,  would probably have an ulcer from the stress of constantly  getting their cart knocked over.

But today, we know that the idea of  stress causing ulcers is not true. It’s just where your grandma’s saying comes from. Since we didn’t know what actually  caused ulcers back in her day, we also didn’t know how to properly treat them.

It would usually go like this: a patient would get diagnosed with an ulcer and  admitted to the hospital. The doctors would tell them to stay  in bed, give them some antacids and painkillers, and feed them bland  food, even by hospital standards. Everyone would wait around, for weeks by the way, for the ulcer to clear up or  get bad enough for surgery.

Not an ideal way to treat a top killer. And maybe that’s part of why it was so deadly. This was what the Cabbage Crusader himself, Garnett Cheney, was trying to fix.

His big idea, based on his own  earlier work in guinea pigs, was to offer his ulcer patients green  cabbage juice as a supplement to the usual treatment of bedrest,  boring food, and soothing medicines. In the guinea pig study,  those furry little guys were given ulcers and then treated with cabbage juice. As little as 5 milliliters of juice was enough to completely prevent ulcers in the rodents!  And if the juice could prevent ulcers  from developing in guinea pigs, maybe it could help treat  the same disease in humans.

So Cheney prescribed 13 human  patients about 1 liter of freshly pressed green cabbage  juice per day… delicious. Just imagine a doctor in a hospital asking for 1,000 cc’s of cabbage juice, STAT! It might sound ridiculous,  but it was an amazing success!

Cheney’s patients healed up in 7 to 10 days, compared to the 30 to 40 day stints typical of ulcer patients at the time. That means the cabbage drinkers got out of the hospital 4 or 5 times faster  than those on standard therapies. So the Avatar cabbage vendor just needed to eat his own wares, and his ulcers  would handle themselves!

Cheney’s simple green cabbage  therapy must have seemed like a miracle cure to doctors dealing with what must have felt like an intractable epidemic. And any good miracle cure needs a cool name. Since Cheney’s cabbage juice seemed to have an unidentified compound in  it with anti-Ulcer effects, he named that compound “vitamin U.” Eventually, scientists tracked  down the identity of “Vitamin U” based on hints like the fact that cabbage juice only worked when it was fresh and uncooked.

In the end, Vitamin U was a modified amino acid called S-Methylmethionine. It’s found in raw egg yolks, milk, butter, and yes green vegetables like cabbage. And it’s protected chickens, guinea pigs, and humans from ulcers over decades of research.

But chemically identifying  Vitamin U wasn’t as big a step forward in understanding how  it works as you might expect. Because unlike its parent compound, methionine, we don’t know much about  S-Methylmethionine, at least in humans. We know that methionine is  an amino acid that helps build proteins and regulate  metabolism and gene expression.

But S-Methylmethionine is more mysterious. Based on what it does in plants,  researchers think it may do a few things, like help you store  methionine or move sulfur around. In other words, we don’t know why it’s apparently therapeutic for ulcers.

It should be an anti-bacterial,  since the vast majority of peptic ulcers are caused by a bacterial infection. But that idea didn’t become mainstream for decades after Cheney’s study. In the 1980s, there was an infamous  future Nobel Prize recipient who was so convinced H. pylori  caused ulcers that he drank a concoction of the bacteria to prove it.

Since he won the Nobel prize, you  can guess how that turned out. He survived, but you still  don’t want to try this at home. Ulcers are brutal.

First, H. pylori burrows into  the lining of your GI tract, secreting toxins and proteins  that weaken the protective mucous barrier between stomach acid and cells. Once the barrier is destroyed,  your own stomach acid eats away at… well, you, causing the wounds  that we call peptic ulcers. Today, we primarily treat ulcers with  antibiotics to kill off the bacteria.

Plus a drug called a proton  pump inhibitor that makes you temporarily make less stomach  acid so your GI tract can heal. These drugs are really good at getting rid of H. pylori and clearing ulcers. And they’ve been the standard  treatment since the 90s.

So the discovery of H. pylori fundamentally changed how to approach ulcers, and interest in potential alternative therapies,  like Vitamin U, fell off. But the real ones on Team Cabbage need to know why this random  early treatment still works. One idea is that the key may  not be what S-methylmethione does to bacteria, but how it  manages the inflammatory damage that they cause.

And to test that,  researchers gave mice diabetes. Like ulcers, diabetes causes inflammation, which leads to a lot of the complications of diabetes, like kidney damage. So in a 2026 study, researchers  gave mice diabetes and then gave them a dietary  supplement of S-methylmethionine.

And their kidneys didn’t have the kind of damage that you’d expect from diabetic mice. Basically, there’s a cellular  signalling pathway that can cause damaging levels of inflammation  in response to stress, whether it’s related to diabetes  or an H. pylori infection. And S-Methylmethionine indirectly  shuts down that pathway.

So that could be how Vitamin U treats ulcers. Or maybe it stimulates a change in blood flow to help your immune response and healing. Or maybe it’s not even the  Vitamin U that matters the most, but another of the nearly 60  compounds found in the magic green juice, including some with anti-microbial, anti-inflammatory, and antioxidant properties.

So people are still researching what makes cabbages a great ulcer treatment. …Even when we know that drugs  can handle the situation. And that’s because it still stacks up pretty well against our more modern options. A 2011 Brazilian study tested  cabbage juice as a treatment for ulcers caused by too much  aspirin, which also damages the stomach’s barrier but through a  different mechanism than H. pylori.

Rats with ulcers were given either cabbage juice or a proton pump inhibitor known as omeprazole. And the rats given cabbage  juice recovered just as well as those treated with the drug, showing  clear signs of healing like a thickened stomach lining and  reduced inflammation within days. The authors were so impressed  that they said cabbage juice should at least be considered  in the management of gastric disorders, and may even be superior in some cases.

But, even though cabbage is  cheap and abundant in many parts of the world and works as an ulcer  treatment in many animal studies and some small but mighty human  trials, proton pump inhibitors like omeprazole are still the gold  standard treatment for peptic ulcers. Unlike cabbage juice, they  have been tested over and over again in clinical trials. Omeprazole,  for example, appears in over 1,000 clinical trials in the National  Library of Medicine’s database.

S-Methylmethionine doesn’t show up once. Clinical trials are how we really test if something works and that it's safe. It's how we make sure that the  effect that we see in rats or in, say, 13 patients treated for ulcers in the 1940s, is real and not caused by random chance or something else that we  didn’t notice at the time.   Without this kind of heavy  duty scientific backing, green cabbage juice is a  quirky drink that sounds good and is probably fine as a  supplement, but not ready to replace approved pharmaceutical treatments.

It was probably just a case of bad timing. The reason cabbage juice  effectively treated ulcers was still a mystery when  H. pylori got its big break and attention shifted to the  clear cause-and-effect story. Or it could have come down to a cultural preference for drug innovation.

This doesn’t mean that green cabbage  juice’s story is over, though. There’s still interest in finding  applications for S-methylmethionine or synthetic compounds inspired  by its chemical structure. We’ve already covered one of  these – the diabetic mice that avoided kidney damage when  dosed with S-Methylmethionine.

A separate study, also on mice,  showed that diets supplemented with S-Methylmethionine improve glucose metabolism and limit the weight gain caused by a fatty diet, both of which may have  implications for not just diabetes, but other common public  health concerns like obesity. And synthetic compounds,  inspired by S-Methylmethionine, are currently being tested as a  potential treatment for MRSA infections and as an additive to cosmetics  to protect from UV radiation. So there may be even more reasons  to love those cabbages and eat… or I guess, drink, your vegetables!

Over the years, the humble cabbage has earned at least little respect from  the scientific community. …which is more respect than the  cabbage vendor in Avatar gets. [OUTRO]