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The Chamomile Fever Gets Sparked
As I was reading through some of my favorite weekly health newsletters and journals, I became immersed in a cross-reference frenzy on the ancient medicinal, chamomile. What ignited this PubMed connection was a fantastic summary touting the calming properties of this herb. I became mesmerized by the vast uses of this plant belonging to the family of Asteraceae/Compositae (daisy).
Chamomile’s Impressive Resume
There are many different species of chamomile, but the two most common varieties are German chamomile (Matricaria recutita) and Roman chamomile (Chamaemelum nobile). Though they share the same family and some constituents, these two varieties have differing quantities and makeups.
As a whole, chamomile preparations have been reported to have a wide variety of uses, including respiratory support, immune modulation, hormonal balance, skin health, and calming the gastrointestinal system. (1)
Memorial Sloan Kettering reports the following clinical summary on this well-known herb:
Chamomile, an aromatic annual herb, has a long history of use in traditional medicine to treat muscle spasms, menstrual disorders, insomnia, ulcers, wounds, stomach disorders, rheumatic pain, hay fever, and hemorrhoids. It is widely used in teas for its relaxing and calming effects.
In vitro and animal studies indicate that chamomile extracts have anti-inflammatory (11), antihyperglycemic (12), antigenotoxic (13), and anticancer (14).
Apigenin, a flavone present in chamomile, has strong chemopreventive effects (15). Bisabololoxide A, another constituent of chamomile, was shown to reduce the dose of 5-fluorouracil when used together against leukemic cells (19).
Preliminary data suggest modest benefits of chamomile in improving chronic insomnia (20); chamomile tea was shown to have positive effects on glycemic control in patients with diabetes(33).
Chamomile extract showed a mild to moderate effect in patients with generalized anxiety disorder (16) and may also have antidepressant effects (30).
In another controlled trial, application of a chamomile compress was shown to be effective, and superior to hydrocortisone ointment, in facilitating healing of peristomal skin lesions in patients following colostomy (21). (2)
Of The Famous German Variety
According to a 2011 review on German chamomile, the main source for production of essential oil is the flower. Many sesquiterpene derivatives (75–90%) and small amounts of monoterpenes are the constituents of this variety. (2) According to this same article, amongst the vast amounts of constituents of Matricaria recuitita, it is the a-bisbolol oxide (a monocylic sesquiterpene) and chamazulene (a sesquiterpene derivative of matricine) that are the most important. (3)
Interesting, most quality herbal preparations of German chamomile are standardized to the amazing flavonoid, apigenin, which is actually more common in Roman chamomile. (3) This may be due to the studies which have touted its amazing benefits and the explosive of research on the power of phenolics in wellness. (4-7)
The Relaxation Response Of Chamomile
Several trials have studied the effect of chamomile and mood. This study based its conclusions on a standardized formulation with 1.2% apigenin and reported:
This is the first, controlled clinical trial of chamomile extract for GAD. The results suggest that chamomile may have modest anxiolytic activity in patients with mild to moderate GAD. Future studies are needed to replicate these observations. (8)
According to a 2013 article from Green Med Info:
Recent clinical and laboratory research has determined that chamomile is not only relaxing, but it can significantly decrease anxiety and even fight depression. The most recent study, from the UK’s University of Nottingham Medical School, found that chamomile significantly relaxed blood vessels and smooth muscle fibers. This effect was indicated specifically with the application of three of chamomile’s central constituents, apigenin, luteolin and bisabolol – all hydroxylates.
Three years later, the University of Pennsylvania researchers undertook another review of the data in this study to determine whether or not treatment with chamomile for the clinically anxious and clinically depressed could be considered “clinically meaningful.” This of course enables medical peers to gauge whether or not chamomile could be used as a prescriptive treatment for diagnosed patients. (9)
When referencing the first article that was discussed in Green Med Info, I found it was an in vitro study on pig arteries with an aim to determine the actions of apigenin, luteolin, and bisabolol on blood vessels. The results concluded that apigenin and luteolin affected the vascular dilator nitric oxide and that all three compounds caused relaxation by influencing calcium influx. (10)
The second study noted from Green Med Info consisted of 57 subjects using chamomile extract or placebo in a randomized, double-blind, placebo-controlled trial. They concluded, “Chamomile may have clinically meaningful antidepressant activity that occurs in addition to its previously observed anxiolytic activity.” (11)
Essential Oils & Mood: What About chamazulene!?
Many studies have used the herbal formulation with standardized apigenin and have shown considerable effect. However, what would happen if these studies added the synergy of essential oils which contain more than one plant secondary metabolite and therefore can modulate and balance many more biochemical pathways at once?
For example, what effects on mood and relaxation will occur with all the constituents of a combination of essential oils, such as lavender, roman chamomile, and neroli are present? This study with 56 patients in a percutaneous coronary intervention ICU reported that it would cause positive effects on anxiety, sleep, and diastolic blood pressure:
Participants received 10 times treatment before PCI, and the same essential oils were inhaled another 10 times after PCI. Outcome measures patients’ state anxiety, sleeping quality, and BP. An aromatherapy group showed significantly low anxiety (t = 5.99, P < .001) and improving sleep quality (t = -3.65, P = .001) compared with conventional nursing intervention. The systolic BP of both groups did not show a significant difference by time or in a group-by-time interaction; however, a significant difference was observed between groups (F = 4.63, P = .036). The diastolic BP did not show any significant difference by time or by a group-by-time interaction; however, a significant difference was observed between groups (F = 6.93, P = .011). In conclusion, the aromatherapy effectively reduced the anxiety levels and increased the sleep quality of PCI patients admitted to the ICU. Aromatherapy may be used as an independent nursing intervention for reducing the anxiety levels and improving the sleep quality of PCI patients. (12)
Many other studies have also demonstrated the effect of “aromatherapy” on emotional health. I have also previously discussed the power of essential oils on mood and how the sense of smell modulates our nervous system and stress response.
In the case of chamomile, we’ve been only getting part of the story. I think researchers would be amazed if they combined the herbal preparations with the intact essential oil. Specifically, I am a little confused as to why the sesquiterpene derivatives are being ignored? Poor chamazulene!
Why was it put in the corner? (I’m sure it could fire up the dance floor with Patrick Swazi and I’m willing to stand up for it!)
The flavonoid apigenin does do so many cool things that chamzulene and chamomile’s other constituents have become overlooked. But check out what happens with a little bit of synergism…
One review in Medical Hypothesis believes that the combination of the essential oil containing chazulene, bisabolol, along with the flavonoid apigenin, could be a new treatment for migraine headache sufferers. The researchers discussed how this merger could have amazing mechanisms of actions, as evidenced by their abstract below that appears to be an alphabet of biochemical soup. The Cliff’s Notes version is there are many pathways that would be affected that modulate inflammatory signals and assist with oxidative stress:
Migraine is a chronic recurring headache for which no complete treatment has been found yet. Therefore, finding new treatment approaches and medicines is important. In this review, we consider the probable mechanism of action of a traditional and ethnic formulary of chamomile extract in sesame oil as a new topical medication for migraine pain relief. Chamomile oil is prepared in Traditional Persian Medicine by boiling aqueous extract of chamomile in sesame oil. To optimize the procedure, we can use a Clevenger-type apparatus to extract the essential oil and add it to the end product. The preparation includes both essential oils (chamazulene and bisabolol oxide) and polyphenols (a flavonoid such as apigenin and its derivatives). It probably possesses pain relief effects for migraines because of the following properties: (1) chamazulene and apigenin, which inhibit iNOS expression in activated macrophages and can lead to the prohibition of NO release and synthesis; (2) chamomile flavonoids, which have a strong inhibitory effect on endogenous prostaglandin E2 (PGE2) levels in RAW 264.7 macrophages and can play the role of selective COX-2 inhibitor; (3) chamomile polyphenols, which possess anti-inflammatory effects due to the inhibition of pro-inflammatory biomarkers in THP1 macrophages and which can reduce inflammation in neurovascular units (NVU) at the site of migraine pain; (4) chamomile, which has neuroprotective effects because of reduced NO levels; (5) sesamine in sesame oil, which possesses an anti-inflammatory effect. These effects are supported by main pathophysiological theories of migraine such as neural and sensitization theories. Chamomile oil is a traditional formulation still used in Iran as an ethno-medicine. Because of the mentioned mechanisms of action, it can be hypothesized that chamomile oil is a novel medicine for the relief of migraine pain. (13)
Therefore, the power of apigenin in standardized herbals is not to be ignored! (14-16) However, in support of the hypothesis above, this in vitro study reported on combining it with chamomile’s other constituents provided additional benefits, including modulating the neuro-hormonal pathways (pituitary and adrenal response):
Several constituents of chamomile, including apigenin 7-O-glucoside, luteolin, terpene compounds, chamazulene, and -alpha-bisabolol, patuletin, quercetin, myricetin, and rutin have been studied with respect to their anti-inflammatory activities. Of these, chamazulene, alpha-bisabolol, and apigenin have been shown to possess the highest anti-inflammatory activity against pro-inflammatory agents (McKay and Blumberg, 2006). The anti-inflammatory effects of azulenes may be related to an influence on the pituitary and adrenal glands, through increased cortisone release and reduced histamine production (Rekka et al., 1996). Apigenin 7-O-glucoside application has been shown to inhibit skin inflammation caused by application of xanthine-oxidase and cumene hydroperoxide in rats (Fuchs and Milbradt, 1993). In light of accumulated investigative evidence, we speculated that chamomile may contain constituents that interfere with the actions of COX-2. To investigate this hypothesis, we used LPS-activated murine RAW 264.7 macrophages as a cell model, since they express high levels of COX-2 and are the most relevant model for our studies. (14) (blood emphasis mine)
Why I’m An Essential Oil Doc
Along with my love of supplements, whole foods, herbs, and nutraceuticals, my consulting practice is not complete without my BFFs, essential oils. I found using them with my clients speeds up results due to their ability to enhance absorption and assimilation. They also aid in calming and nervous system relaxation, which helps prevent new stressors from hindering progress.
Although some may believe it’s just the smell of an oil or scent that causes a response, my findings show this isn’t true. An oil that’s cut or adulterated but smells pretty could produce negative effects from the inhaled chemicals. Therefore, this proves it is not just the smell or perception of an odor that calms the nervous system when using genuine essential oils! It’s all the constituents which can affect cellular signaling pathways (such as modulating glutathione), whether they are inhaled, rubbed on, or taken orally.
A healthy diet and lifestyle complimented with herbs and supplements are important for filling nutrient gaps and modulating essential biochemical pathways. However, I’ve seen that synergizing these effects with essential oils causes these nutrients and biochemical signaling pathways to be enhanced and complemented with profound results…not to mention the power of diffusing!
The Soothing Results Of Safety
Chamomile has a good safety profile (2,4, 17-18). There has only been one case of a drug interaction of chamomile with the drug warfarin; however, the case was with a woman who drank 4-5 cups of chamomile tea a day and used an unreported form of “chamomile lotion.” (18)
In this report, it wasn’t established that the quality of the products and potential tainting of them was ruled out. Furthermore, there was no fatality when the drug level was regulated.
For kicks and giggles, let’s do a comparison to properly prescribed anticoagulant medications. According to the Journal of American College of Cardiology, there were 827 bleeding events related to warfarin and 44 bleeding-related fatalities in one year (2011-2012):
Bleeding-related fatalities increased during the reported period for dabigatran compared to a stable number of reports with warfarin (Figure 1). Dabigatran was the primary or secondary agent in 4,270 bleeding events with 638 bleeding-related fatalities. In comparison, warfarin had 827 bleeding events with 44 bleeding-related fatalities. We estimated a lower bound of 88 bleeding-related fatalities per 100,000 dabigatran treated patients. Because of under-reporting bias these estimates represent a lower bound on the population bleeding mortality rates. (19)
Still, I’m not saying to take anything with impunity! This is especially true for anyone on blood thinning medication. They should always monitor their levels with a physician with any new implementation.
Furthermore, depending on the chemotype (composition of plant secondary metabolites) and the distillation technique used to extract what is deemed the most therapeutic constituents, therapeutic properties of the oils will vary. This is why, beyond assuring if a company uses GC/MS analysis of constituents present and/or uses European standardizations, you will want to verify what other types of testing they use for purity and assessment of quality, especially if propriety blends are being trademarked. This is why I use the company I use.
Interested in a summary on how to safely use some of the most essential oils in less than 7 minutes? Watch the video below:
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Disclaimer: This information is applicable ONLY for therapeutic, Grade A essential oils. This information DOES NOT apply to essential oils that have not been AFNOR and ISO standardized or tested for purity. There is no quality control in the United States and oils labeled as “100% pure” need only contain 5% of the actual oil. The rest of the bottle can be filled with fillers and sometimes toxic ingredients that can irritate the skin.
This information is for information purposes only and is not intended to diagnose, treat, or prescribe for any illness.
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(2) Memorial Sloan-Kettering Cancer Center. Chamomile (German). Mskcc.org. July 7, 2011. http://www.mskcc.org/cancer-care/herb/chamomile-german
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(4) Essential Science Publishing. Chamomile (German). Essential Oils Desk Reference (3rd ed.). USA. 2004.
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(6) Srivastava JK1, Gupta S. Antiproliferative and apoptotic effects of chamomile extract in various human cancer cells. J Agric Food Chem. 2007 Nov 14;55(23):9470-8. Epub 2007 Oct 17.
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(8) Amsterdam JD, Li Y, Soeller I, Rockwell K, Mao JJ, Shults J. A Randomized, double-bling, placebo-controlled trial of oral Matricaria Recutitta (chamomile) extract therapy of generalized anxiety disorder. Journal of clinical psychopharmacology. 2009;29(4):378-382. doi:10.1097/JCP.0b013e3181ac935c.
(9) Adams, C. Chamomile Proven to Fight Anxiety and Clinical Depression. Green Med Info. August 13, 2013.
(10) Roberts RE, Allen S, Chang AP, Henderson H, Hobson GC, Karania B, Morgan KN, Pek AS, Raghvani K, Shee CY, Shikotra J, Street E, Abbas Z, Ellis K, Heer JK, Alexander SP. Distinct mechanisms of relaxation to bioactive components from chamomile species in porcine isolated blood vessels. Toxicol Appl Pharmacol. 2013 Jul 8.
(11) Amsterdam JD, Shults J, Soeller I, Mao JJ, Rockwell K, Newberg AB. Chamomile (Matricaria recutita) May Have Antidepressant Activity in Anxious Depressed Humans – An Exploratory Study. Alternative therapies in health and medicine. 2012;18(5):44-49.
(12) Cho MY, Min ES, Hur MH, Lee MS. Effects of aromatherapy on the anxiety, vital signs, and sleep quality of percutaneous coronary intervention patients in intensive care units. Evid Based Complement Alternat Med. 2013;2013:381381.
(13) Zargaran A, Borhani-Haghighi A, Faridi P, Daneshamouz S, Kordafshari G5, Mohagheghzadeh A. Potential effect and mechanism of action of topical chamomile (Matricaria chammomila L.) oil on migraine headache: A medical hypothesis. Med Hypotheses. 2014 Nov;83(5):566-9. doi: 10.1016/j.mehy.2014.08.023. Epub 2014 Sep 6.
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(15) Chandrashekhar VM, Halagali KS, Nidavani RB, Shalavadi MH, Biradar BS, Biswas D, Muchchandi IS. Anti-allergic activity of German chamomile (Matricaria recutita L.) in mast cell mediated allergy model. J Ethnopharmacol. 2011 Sep 1;137(1):336-40. doi: 10.1016/j.jep.2011.05.029. Epub 2011 May 31.
(16) Cemek 1, Ka?a S, Sim?ek N, Büyükokuro?lu ME, Konuk M.Antihyperglycemic and antioxidative potential of Matricaria chamomilla L. in streptozotocin-induced diabetic rats. J Nat Med. 2008 Jul;62(3):284-93. doi: 10.1007/s11418-008-0228-1. Epub 2008 Feb 13.
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(18) Jacob SE1, Hsu JW. Reactions to Aquaphor: is bisabolol the culprit? Pediatr Dermatol. 2010 Jan-Feb;27(1):103-4. doi: 10.1111/j.1525-1470.2009.01064.x.
(19) McConeghy K, Bress, A, Wing C. Reports of Bleeding-related fatalities with Dabigatran and Warafarin: An anaylsis using the Fodd and Drug Administration adverse events reporting systems. J Am Coll Cardiol. 2013;61(10_S):. doi:10.1016/S0735-1097(13)60319-8
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