Sage

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Sage

Uses

Sage
© Steven Foster
Botanical names:
Salvia officinalis

Parts Used & Where Grown

Sage is a silvery-green shrub with very fragrant leaves. The most commonly cultivated species of sage originally came from the area around the Mediterranean but now also grows in North America. The leaves of this common kitchen herb are used in medicine as well as in cooking.1

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

This supplement has been used in connection with the following health conditions:


Used for Amount Why
Alzheimer’s Disease
 60 drops daily of a 1:1 tincture 2 stars   Sage appears to have an effect on acetylcholine, one of the chemical messengers (neurotransmitters) in the brain and supplementing with sage has resulted in a significant improvement in cognitive function.

2 stars  Alzheimer’s Disease

60 drops daily of a 1:1 tincture

In a double-blind study of people with Alzheimer’s disease, supplementing with sage for four months resulted in a significant improvement in cognitive function, compared with a placebo.4 The amount of sage used was 60 drops per day of a 1:1 tincture. Although it is not known for sure how sage improves cognitive function, it appears to have an effect on acetylcholine, one of the chemical messengers (neurotransmitters) in the brain.

Used for Amount Why
Gingivitis
(Caraway, Chamomile, Clove Oil, Echinacea, Menthol, Myrrh, Peppermint)
 0.5 ml in half a glass of water three times per day swished slowly in the mouth before spitting out 2 stars   A mouthwash containing sage oil, peppermint oil, menthol, chamomile tincture, expressed juice from echinacea, myrrh tincture, clove oil, and caraway oil has been used successfully to treat gingivitis.

2 stars  Gingivitis

0.5 ml in half a glass of water three times per day swished slowly in the mouth before spitting out

A mouthwash combination that includes sage oil, peppermint oil, menthol, chamomile tincture, expressed juice from echinacea, myrrh tincture, clove oil, and caraway oil has been used successfully to treat gingivitis.5 In cases of acute gum inflammation, 0.5 ml of the herbal mixture in half a glass of water three times daily is recommended by some herbalists. This herbal preparation should be swished slowly in the mouth before spitting out. To prevent recurrences, slightly less of the mixture can be used less frequently.

A toothpaste containing sage oil, peppermint oil, chamomile tincture, expressed juice from Echinacea purpurea, myrrh tincture, and rhatany tincture has been used to accompany this mouthwash in managing gingivitis.6

Of the many herbs listed above, chamomile, echinacea, and myrrh should be priorities. These three herbs can provide anti-inflammatory and antimicrobial actions critical to successfully treating gingivitis.

Used for Amount Why
Indigestion, Heartburn, and Low Stomach Acidity
 4 to 6 grams daily of dried leaf or equivalent, for indigestion 2 stars   Sage is a gas-relieving herb that may be helpful in calming an upset stomach.

2 stars  Indigestion, Heartburn, and Low Stomach Acidity

4 to 6 grams daily of dried leaf or equivalent, for indigestion

Carminatives (also called aromatic digestive tonics or aromatic bitters) may be used to relieve symptoms of indigestion, particularly when there is excessive gas. It is believed that carminative agents work, at least in part, by relieving spasms in the intestinal tract.7

There are numerous carminative herbs, including European angelica root (Angelica archangelica), anise, Basil, cardamom, cinnamon, cloves, coriander, dill, ginger, oregano, rosemary, sage, lavender, and thyme.8 Many of these are common kitchen herbs and thus are readily available for making tea to calm an upset stomach. Rosemary is sometimes used to treat indigestion in the elderly by European herbal practitioners.9 The German Commission E monograph suggests a daily intake of 4–6 grams of sage leaf.10 Pennyroyal is no longer recommended for use in people with indigestion, however, due to potential side effects.

Used for Amount Why
Menopause
(Alfalfa)
 4 to 6 grams daily of dried herb or equivalent 2 stars   Supplementing with sage leaf and alfalfa extract completely eliminated hot flushes and night sweats in 20 of 30 women in one study.

2 stars  Menopause

4 to 6 grams daily of dried herb or equivalent

Sage may reduce excessive perspiration due to menopausal hot flashes during the day or at night.11 It is believed this is because sage directly decreases production of sweat. In a preliminary study, supplementation with a product containing extracts of the leaves of sage and alfalfa resulted in complete elimination of hot flushes and night sweats in 20 of 30 women, with varying degrees of improvement in the other ten cases.12

Used for Amount Why
Common Cold and Sore Throat
 Refer to label instructions 1 star   Sage tea may be gargled to soothe a sore throat.

1 star  Common Cold and Sore Throat

Red raspberry , blackberry, and blueberry leaves contain astringent tannins that are helpful for soothing sore throats.13 Sage tea may be gargled to soothe a sore throat. All of these remedies are used traditionally, but they are currently not supported by modern research.

Used for Amount Why
Halitosis
 Consult a qualified healthcare practitioner 1 star   Volatile oils made from sage have antibacterial properties and may be effective in mouthwash or toothpaste form.

1 star  Halitosis

Consult a qualified healthcare practitioner

The potent effects of some commercial mouthwashes may be due to the inclusion of thymol (from thyme) and eukalyptol (from eucalyptus)—volatile oils that have proven activity against bacteria. One report showed bacterial counts plummet in as little as 30 seconds following a mouthrinse with the commercial mouthwash Listerine™, which contains thymol and eukalyptol.14 Thymol alone has been shown in research to inhibit the growth of bacteria found in the mouth.15 , 16 Because of their antibacterial properties, other volatile oils made from tea tree,17 clove, caraway, peppermint, and sage,18 as well as the herbs myrrh19 and bloodroot,20 might be considered in a mouthwash or toothpaste. Due to potential allergic reactions and potential side effects if some of these oils are swallowed, it is best to consult with a qualified healthcare professional before pursuing self-treatment with volatile oils that are not in approved over-the-counter products for halitosis.

Used for Amount Why
Infection
 Refer to label instructions 1 star   Sage is an herb that directly attack microbes.

1 star  Infection

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Used for Amount Why
Menopause
 Refer to label instructions 1 star   Sage may reduce excessive perspiration due to menopausal hot flashes during the day or at night. It is believed this is because sage directly decreases sweat production.

1 star  Menopause

Sage may reduce excessive perspiration due to menopausal hot flashes during the day or at night.21 It is believed this is because sage directly decreases production of sweat. In a preliminary study, supplementation with a product containing extracts of the leaves of sage and alfalfa resulted in complete elimination of hot flushes and night sweats in 20 of 30 women, with varying degrees of improvement in the other ten cases.22

Used for Amount Why
Pregnancy and Postpartum Support
 Refer to label instructions 1 star   Sage has traditionally been used to dry up milk production when a woman no longer wishes to breast-feed.

1 star  Pregnancy and Postpartum Support

Sage has traditionally been used to dry up milk production when a woman no longer wishes to breast-feed.23 It should not be taken during pregnancy.

Traditional Use (May Not Be Supported by Scientific Studies)

Sage has one of the longest histories of use of any culinary or medicinal herb. It was used by herbalists externally to treat sprains, swelling, ulcers, and bleeding.2 Internally, a tea made from sage leaves has had a long history of use to treat sore throats and coughs—often used as a gargle. It was also used by herbalists for rheumatism, excessive menstrual bleeding, and to dry up a mother’s milk when nursing was stopped. It was particularly noted for strengthening the nervous system, improving memory, and sharpening the senses.3 Sage was officially listed in the United States Pharmacopoeia from 1840 to 1900.

How It Works

Botanical names:
Salvia officinalis

How It Works

The volatile oil of sage contains the constituents alpha- and beta-thujone, camphor, and cineole.24 It also contains rosmarinic acid, tannins, and flavonoids. In modern European herbal medicine, a gargle of sage tea is commonly recommended to treat sore throat, inflammations in the mouth, and gingivitis (inflammation of the gums).25 Test tube studies have found that sage oil has antibacterial, antifungal, and antiviral activity which may partially explain the effectiveness of sage for these indications.26

Sage is also approved in Germany for mild gastrointestinal upset and excessive sweating.27 An unpublished, preliminary German study with people suffering from excessive perspiration found that either a dry leaf extract or an infusion of the leaf reduced sweating by as much as 50%.28 A report from the United Kingdom indicates that herbalists there employ sage to treat symptoms of menopause such as hot flashes.29

How to Use It

For treatment of sore throats, inflammation in the mouth, or gingivitis, 3 grams of the chopped leaf can be added to 150 ml of boiling water and strained after 10 minutes.30 This is then used as a mouthwash or gargle several times daily. Alternatively, one may use 5 ml of fluid extract (1:1) diluted in one glass of water, several times daily. For internal use, the same tea preparation described above may be taken three times per day.

Interactions

Botanical names:
Salvia officinalis

Interactions with Supplements, Foods, & Other Compounds

At the time of writing, there were no well-known interactions with this supplement.

Interactions with Medicines

At the time of writing, there were no well-known drug interactions with this supplement.

Side Effects

Botanical names:
Salvia officinalis

Side Effects

Concern has been expressed about the internal use of sage due to the presence of thujone.31 Even when consumed in small amounts for long periods of time, thujone may cause increased heart rate and mental confusion. Very high amounts (several times greater than one receives if taking sage as instructed above), may lead to convulsions. If one takes sage internally, it is best to limit use to the recommended amounts and to periods of no more than one to two weeks. Extracts of sage made with alcohol are likely to be higher in thujone than those made with water. Sage oil should never be consumed without being first diluted in water. Sage should not be used internally during pregnancy. These concerns do not extend to the use of sage as a gargle or mouth rinse. Sage should be avoided when fever is present.

References

1. Blumenthal M, Goldberg A, Brinkman J (eds). Herbal Medicine: The Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications, 2000, 330–4.

2. Foster S. 101 Medicinal Herbs. Loveland, CO: Interweave Press, 1998, 176–7.

3. Foster S, Tyler VE. Tyler’s Honest Herbal. New York: Haworth Press, 1999, 327–9.

4. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003;28:53–9.

5. Serfaty R, Itic J. Comparative trial with natural herbal mouthwash versus chlorhexidine in gingivitis. J Clin Dentistry 1988;1:A34.

6. Yamnkell S, Emling RC. Two-month evaluation of Parodontax dentifrice. J Clin Dentistry 1988;1:A41.

7. Forster HB, Niklas H, Lutz S. Antispasmodic effects of some medicinal plants. Planta Med 1980;40:303–19.

8. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 425–6.

9. Weiss RF. Herbal Medicine. Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988, 185–6.

10. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 198.

11. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 420–1 [review].

12. De Leo V, Lanzetta D, Cazzavacca R, Morgante G. [Treatment of neurovegetative menopausal symptoms with a phytotherapeutic agent] [Article in Italian] Minerva Ginecol 1998;50:207–11.

13. Schilcher H. Phytotherapy in Paediatrics. Stuttgart, Germany: Medpharm Scientific Publishers, 1997, 126–7.

14. Kato T, Iijima H, Ishihara K, et al. Antibacterial effects of Listerine on oral bacteria. Bull Tokyo Dent Coll 1990;31:301–7.

15. Cosentino S, Tuberoso CI, Pisano B, et al. In-vitro antimicrobial activity and chemical composition of Sardinian Thymus essential oils. Lett Appl Microbiol 1999;29:130–5.

16. Petersson LG, Edwardsson S, Arends J. Antimicrobial effect of a dental varnish, in vitro. Swed Dent J 1992;16:183–9.

17. Cox SD, Mann CM, Markham JL, et al. The mode of antimicrobial action of the essential oil of Melaleuca alternifolia (tea tree oil). J Appl Microbiol 2000;88:170–5.

18. Serfaty R, Itic J. Comparative trial with natural herbal mouthwash versus chlorhexidine in gingivitis. J Clin Dent 1988;1:A34–7.

19. Dolara P, Corte B, Ghelardini C, et al. Local anaesthetic, antibacterial and antifungal properties of sesquiterpenes from myrrh. Planta Med 2000;66:356–8.

20. Hannah JJ, Johnson JD, Kuftinec MM. Long-term clinical evaluation of toothpaste and oral rinse containing sanguinaria extract in controlling plaque, gingival inflammation, and sulcular bleeding during orthodontic treatment. Am J Orthod Dentofacial Orthop 1989;96:199–207.

21. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 420–1 [review].

22. De Leo V, Lanzetta D, Cazzavacca R, Morgante G. [Treatment of neurovegetative menopausal symptoms with a phytotherapeutic agent] [Article in Italian] Minerva Ginecol 1998;50:207–11.

23. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd., 1988, 229–30.

24. Wichtl M. Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press, 1994, 440–3.

25. ESCOP 1996. Salviae folium (Sage leaf). Monographs on the Medicinal Use of Plant Drugs. Exeter, UK: European Scientific Cooperative on Phytotherapy, 1997.

26. ESCOP 1996. Salviae folium (Sage leaf). Monographs on the Medicinal Use of Plant Drugs. Exeter, UK: European Scientific Cooperative on Phytotherapy, 1997.

27. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 198.

28. ESCOP 1996. Salviae folium (Sage leaf). Monographs on the Medicinal Use of Plant Drugs. Exeter, UK: European Scientific Cooperative on Phytotherapy, 1997.

29. Beatty C, Denham A. Review of practice: Preliminary data collection for clinical audit. Eur J Herbal Med 1998;4:32–4.

30. Wichtl M. Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press, 1994, 440–3.

31. Foster S, Tyler VE. Tyler’s Honest Herbal. New York: Haworth Press, 1999, 327–9.

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