Aroma Siez Essential Oil by Young Living Essential Oils

Acne. Topical basil has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in healthy individuals with acne shows that applying a gel formulation consisting of basil essential oil 5% and sweet orange essential oil 3% daily for 8 weeks can reduce acne lesions when compared to baseline (76896). It is unclear if these findings are due to basil, sweet orange, or the combination.
Chronic kidney disease (CKD). Although there has been interest in using oral basil for prevention of CKD, there is insufficient reliable information about the clinical effects of basil for this purpose.
Common cold. Although there has been interest in using oral basil for the common cold, there is insufficient reliable information about the clinical effects of basil for this purpose.
Constipation. Although there has been interest in using oral basil for constipation, there is insufficient reliable information about the clinical effects of basil for this purpose.
Diarrhea. Although there has been interest in using oral basil for diarrhea, there is insufficient reliable information about the clinical effects of basil for this purpose.
Flatulence. Although there has been interest in using oral basil for flatulence, there is insufficient reliable information about the clinical effects of basil for this purpose.
Headache. Although there has been interest in using oral basil for headache, there is insufficient reliable information about the clinical effects of basil for this purpose.
Insect bite. Although there has been interest in using topical basil for insect bites, there is insufficient reliable information about the clinical effects of basil for this purpose.
Intestinal parasite infection. Although there has been interest in using oral basil for intestinal parasite infections, there is insufficient reliable information about the clinical effects of basil for this purpose.
Lactation. Although there has been interest in using oral basil to stimulate lactation, there is insufficient reliable information about the clinical effects of basil for this purpose.
Mental alertness. Inhalation of basil as aromatherapy has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A very small clinical study in patients reporting mental exhaustion with moderate burnout shows that inhalation of aromatherapy consisting of basil, peppermint, and sandy everlasting essential oils improves attention, mental alertness, and mental focus when compared with placebo. After one week, patients in the aromatherapy group improved by about 21%, while patients in the control group improved by only 11% (68534). It is unclear if these findings are due to basil, other ingredients, or the combination.
Migraine headache. It is unclear if topical basil essential oil is beneficial in patients with migraine headache. Details: A moderate sized clinical trial in adults with migraine headaches shows that applying 2%, 4%, or 6% basil essential oil to the forehead and temples every 8 hours for 12 weeks reduces the intensity of migraine headache pain and the frequency of attacks in a dose- and time-dependent manner when compared with placebo (103622).
Peptic ulcers. Although there has been interest in using oral basil for peptic ulcers, there is insufficient reliable information about the clinical effects of basil for this purpose.
Warts. Although there has been interest in using topical basil for warts, there is insufficient reliable information about the clinical effects of basil for this purpose. More evidence is needed to rate basil for these uses.

CYPRESS

There is insufficient reliable information available about the effectiveness of cypress.

LAVENDER

POSSIBLY EFFECTIVE

Anxiety. Orally, lavender seems to improve anxiety in some patients. Lavender oil aromatherapy and aromatherapy massage also seem to improve chronic and situational anxiety in some patients. Details: Guidelines from The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce state that lavender essential oil at doses of 80-160 mg daily or dried lavender flower at doses of 500-1500 mg twice daily is provisionally recommended for monotherapy or adjunctive use in the treatment of generalized anxiety disorder. Essential oil capsules and standardized dried flower formulations are preferred over tea preparations (110318). Most meta-analyses and clinical trials in patients with subthreshold anxiety, mixed anxiety and depressive disorder, generalized anxiety disorder, and mild to severe anxiety show that taking capsules containing a specific lavender oil ingredient (Silexan, Dr Willmar Schwabe GmbH & Co. KG) 80-160 mg orally daily for 6-10 weeks improves objective and subjective measures of anxiety and increases response rates and complete remission rates when compared with placebo. However, heterogeneity and small sample sizes limit the validity of these findings (58077,58080,58098,95640,97257,103061,103069,112255). Subgroup analysis of a meta-analysis of 5 clinical studies suggests that Silexan is more effective in older adults with higher somatic symptom burden and those with anxiety-related difficulties in concentration and poor memory at baseline (112255). Limited research compares Silexan to the conventional medications paroxetine and lorazepam. One clinical study shows that taking Silexan 80 mg daily for 6 weeks improves anxiety and quality of sleep similarly to low-dose lorazepam 0.5 mg in adults with generalized anxiety disorder (58077). Another clinical study in adults with generalized anxiety disorder shows that taking Silexan 80-160 mg daily for 10 weeks reduces symptom severity similar to paroxetine 20 mg daily (93004). A network meta-analysis suggests that the higher dose of Silexan (160 mg) might be more effective when compared with paroxetine 20 mg or lorazepam 0.5 mg (103069). Limited research has assessed other oral formulations of lavender. A small clinical study in postmenopausal adults with mild to moderate anxiety shows that taking a dried lavender flower powder 500 mg twice daily for 8 weeks reduces anxiety by about 6% when compared with placebo, as measured on the State-Trait Anxiety Inventory Scale (97256). The clinical significance of this improvement is not clear. Meta-analyses of clinical trials in patients with chronic or situational anxiety show that inhalation aromatherapy or aromatherapy massage using lavender oil moderately reduces anxiety when compared with control. Most often, the control group received no intervention although occasionally they received standard or routine care. In some studies, plain water or diluted lemon juice were used as controls. Most treatments with lavender aromatherapy were given as single sessions of 1-30 minutes. However, occasionally multiple sessions were used (101720,103061,109974). Most other individual clinical trials of aromatherapy with lavender, alone or in combination with bergamot, are in agreement with these findings (58103,95637,97258,99713,101722,101724,108752,109854,109981), although some research does not support the use of lavender aromatherapy for anxiety (29504,58053,97258,101724,109853). The poor quality of most of the available research makes it difficult to determine which patients, if any, are most likely to benefit.
Depression. Oral lavender, in the form of tea, tincture, powder, or a specific oil (Silexan), seems to reduce depressive symptoms in some patients. Early research also shows that lavender oil aromatherapy seems to improve symptoms of depression. Details: Guidelines from The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce state that lavender essential oil at doses of 80-160 mg daily or dried lavender flower at doses of 500-1500 mg twice daily is weakly recommended for monotherapy or adjunctive use in the treatment of major depressive disorder (110318). Essential oil capsules and standardized dried flower formulations are preferred over tea preparations. A meta-analysis of five clinical trials shows that oral lavender is moderately more beneficial than a control group for reducing symptoms of depression (109860). Most studies included in the analysis were low- to moderate-quality with variation in patient demographics. Studies in the analysis investigated the effects of oral lavender oil or powder in menopausal or postpartum patients, or in patients with major depression, and compared lavender with routine care, placebo, medication, or no intervention. Doses have included powdered lavender leaves 1-2 grams daily for 8 weeks, lavender tea made from 2 grams powder per teabag once or twice daily for 2 weeks, and a specific oral capsule containing lavender oil (Silexan, Dr. Willmar Schwabe GmbH & Co. KG) 80 mg daily for 70 days (103060,104433,109860). Other preliminary clinical research in patients with depressed mood shows that taking Silexan 80 mg daily for 6 weeks can improve depression scores by about 33% when compared to baseline (58098). Also, a small clinical study in patients with mild to moderate depression shows that drinking a tincture of lavender appears to be slightly less effective than imipramine; however, lavender might have some additive antidepressant effects when used in combination with imipramine (9792). The validity of these findings is limited by the lack of a placebo group and small study size. Lavender has also been taken in combination with other products. A small clinical study in patients with depression and anxious distress shows that taking 5 mL of a syrup containing lavender flower extract and Chinese dodder extract twice daily for 6 weeks seems to reduce depression to a similar degree as citalopram 20 mg daily (104437). It is unclear if the benefit is due to lavender, Chinese dodder, or the combination. Lavender oil aromatherapy has also been evaluated. A meta-analysis of nine clinical trials shows that lavender oil aromatherapy is moderately more beneficial than control for reducing symptoms of depression. Most studies included in the analysis were low- to moderate-quality with variation in patient demographics. Studies in the analysis investigated the effects of lavender oil aromatherapy in a variety of patient populations, and no studies were specific to patients with depression. Lavender aromatherapy was compared with no intervention, routine care, other aromatherapy oils, or distilled water (109860). However, in hospitalized patients undergoing microvascular breast reconstruction, lavender oil aromatherapy does not improve symptoms of perioperative depression when compared with coconut oil (109853). Lavender oil has also been studied in combination with other oils as aromatherapy. A small clinical study in community-dwelling older adults shows that inhalation or massage with lavender, sweet orange, and bergamot oils twice weekly for 8 weeks improves depressive symptoms in 55% to 65% of patients when compared with a control (98474). Another small clinical study in postmenopausal adults shows that a combination of aromatherapy with lavender and bergamot oils three times daily for 8 weeks along with routine care modestly improves symptoms of depression when compared with routine care alone (109981). It is unclear if any benefit is due to lavender, other ingredients, or the combination.
Dysmenorrhea. Limited clinical research suggests that lavender oil aromatherapy might reduce dysmenorrhea symptoms. Details: A clinical study in young adults with dysmenorrhea shows that applying 3 drops of lavender oil to a piece of cotton and inhaling for 30 minutes daily for the first 3 days of menstruation modestly reduces pain when compared to inhaling the scent of diluted milk (95635). Another small clinical study in patients with dysmenorrhea shows that applying 3 drops of lavender oil to the hands and inhaling for 5 minutes every 6 hours for the first 3 days of menstruation seems to reduce abdominal pain and backache when compared with inhaling the scent of sesame oil (90510). Lavender oil has also been added to abdominal massage. A clinical crossover study in young females with dysmenorrhea shows that administering a gentle abdominal massage with lavender essential oil for 15 minutes moderately reduces pain immediately after treatment when compared with a massage with petrolatum (58106). It is unclear if the benefit persists after the end of the treatment. Additionally, because all available research has been conducted in the Middle East, it is unclear if these results can be extrapolated to other geographic locations.

POSSIBLY INEFFECTIVE

Cancer-related pain. Using lavender oil for massage or as an aromatherapy diffusion does not seem to provide any additional pain relief in patients with advanced or terminal cancer. Details: Clinical research in patients with advanced or terminal cancer shows that diffusing lavender oil as aromatherapy or using lavender oil for massage does not improve pain scores when compared with control treatments without lavender oil (29504,58053).

Alopecia areata. Topical lavender oil has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in patients with alopecia areata shows that applying lavender oil in combination with essential oils from thyme, rosemary, and cedarwood daily for 7 months seems to improve hair growth in 44% of participants when compared with 15% of those using only carrier oils (5177). It is unclear if this effect is due to lavender oil, other oils, or the combination.
Atopic dermatitis (eczema). Although there is interest in using topical lavender oil for eczema, there is insufficient reliable information about the clinical effects of lavender oil for this condition.
Burns. It is unclear whether lavender oil aromatherapy is beneficial as adjunct treatment for reducing pain associated with dressing changes in children with burns. Details: Preliminary clinical research in young children with second-degree burns shows that lavender oil aromatherapy, provided as 0.5 mL dripped onto a gauze pad and placed 20 cm away from the child's nose for 15 minutes before a dressing change, modestly reduces pain severity at 1 and 30 minutes after the dressing change when compared with placebo aromatherapy with jojoba oil. Use of lavender oil aromatherapy also attenuated increases in heart and respiratory rates after the dressing change (109857).
Canker sores. Topical lavender oil might improve canker sore healing and reduce swelling and pain. Details: A clinical study shows that applying 2 drops of lavender oil to canker sores three times daily might reduce redness, swelling, and pain when compared with placebo (58099).
Colic. Two clinical studies suggest that lavender oil, applied topically during massage of the belly or inhaled as aromatherapy, might modestly reduce duration of crying in infants with colic. Details: A small clinical trial shows that using lavender oil diluted with almond oil to massage the belly of infants for 5-15 minutes beginning at the onset of colic reduces average weekly crying times by about 7 hours when compared with infants not receiving aromatherapy massages (58096). It is unclear if this effect is due to lavender oil, massage, or the combination. Another moderate-sized clinical study in infants 4-8 weeks old with colic shows that inhaling lavender oil as aromatherapy for 4-6 hours daily for 7 days reduces the duration of night crying when compared with placebo (112260).
Coronary artery bypass graft (CABG) surgery. Small clinical studies suggest that lavender aromatherapy might modestly improve sleep and reduce pain in patients who have undergone CABG surgery. Details: One small clinical study shows that placing three drops of lavender oil (Barich Essence Company) on the pillow every night for 5 nights modestly improves sleep quality, but not sleep latency, duration, or efficiency, when compared with placebo (109861). Another small clinical study shows that placing 2 drops of lavender oil on a cotton ball for overnight aromatherapy starting on the second evening after surgery modestly improves sleep quality on the second and third nights of use, but not the first night, when compared with distilled water (109856). Also, a small clinical study shows that applying 5 drops of lavender oil 20% to a gauze which is worn around the neck for 30 minutes after CABG surgery modestly reduces postoperative pain on the day of surgery and the day after surgery when compared with pre-aromatherapy pain levels. These changes were greater than those seen in patients inhaling distilled water (109850). However, one small clinical study shows that inhaling 2 drops of lavender oil 2% for 20 minutes on postoperative days 2 and 3 does not reduce mental stress when compared with placebo (93009).
Coronavirus disease 2019 (COVID-19). It is unclear if oral lavender is beneficial for olfactory dysfunction in patients with COVID-19. Details: A small preliminary clinical trial in patients with olfactory dysfunction related to COVID-19 shows that taking lavender syrup 9 mL twice daily for 3 weeks in combination with routine treatments modestly reduces symptoms when compared with routine treatments alone. However, there was no change in symptom scores or the percentage of patients with complete improvement in olfactory or taste dysfunction. The lavender syrup was made by preparing a water extract of the dried aerial parts and mixing with honey and water (109864).
Dementia. Small clinical studies suggest that diffused aromatherapy with lavender oil may modestly improve agitation symptoms in patients with dementia; however, lavender oil applied to the patient or the patient's clothes might not be beneficial. Details: Some small and heterogeneous clinical studies in patients with dementia show that applying lavender oil aromatherapy via a diffuser for either 20 minutes twice daily, 2 hours daily, or once nightly for up to 3 weeks seems to improve agitation when compared with baseline, water, or a sunflower oil placebo (16393,58052,95632). However, using aromatherapy that is applied to the person's clothes or arms does not seem to help. Small clinical studies in patients with moderate or advanced dementia show that applying lavender oil to a pad attached to a patient's shirt does not reduce agitation when compared with placebo (12213,99710). Another clinical study in nursing home residents with dementia and frequent agitated behavior shows that applying 1 mL of 30% lavender oil to each forearm does not reduce agitation or improve mood when compared with applying placebo oil (93014).
Diabetic neuropathy. It is unclear if lavender aromatherapy massage is beneficial for diabetic neuropathy. Details: Preliminary clinical research in patients with neuropathic pain related to diabetes shows that a gentle foot massage with lavender essential oil 3% in sunflower oil for 10 minutes nightly for 1 month reduces neuropathic pain and improves quality of life when compared with a placebo sunflower oil massage or routine care alone (109858).
Fall prevention. It is unclear if lavender aromatherapy prevents falls in elderly patients. Details: A clinical study in nursing home residents aged 65 years or older shows that attaching a patch with lavender oil (Aromaseal Lavender, Hakujuji Co.) onto the neckline of clothing once daily for one year seems to have a non-significant trend toward reduced fall incidence when compared with placebo (58101).
Fatigue. Small clinical studies suggest that lavender aromatherapy may modestly reduce fatigue in patients with underlying medical conditions, such as kidney failure or heart disease. The effects of lavender for fatigue in otherwise healthy adults is unclear. Details: Most small clinical studies in adults with kidney failure show that receiving aromatherapy with lavender essential oil during hemodialysis sessions for 4 weeks reduces fatigue when compared with baseline, a control group, or a placebo group (98524,109867). However, one small clinical study in these patients shows that applying lavender oil for inhalation for 10 minutes during dialysis sessions for 4 weeks does not reduce fatigue when compared with control (95642). Lavender aromatherapy has also been tried in patients hospitalized with various forms of cardiac disease. A small clinical trial shows that placing 3 drops of lavender oil on a cotton ball and inhaling for 20 minutes nightly for 7 days improves fatigue scores by 21 points, compared with a 2-point improvement in those receiving placebo (107959). The validity of these findings is limited due to the short duration of treatment.
Hypertension. Although there is interest in using lavender aromatherapy for hypertension, there is insufficient reliable information about the clinical effects of lavender for this condition.
Insect repellent. Although there is interest in using topical lavender to repel insects, there is insufficient reliable information about the clinical effects of lavender for this condition.
Insomnia. Inhalation aromatherapy or aromatherapy massage with lavender oil may improve some subjective measures of sleep, but results are conflicting and improvements appear minimal at best. Additionally, most small clinical studies suggest it does not improve sleep in hospitalized patients. Details: Lavender oil aromatherapy seems to improve sleep quality in some patients, although it is unclear which patient populations may be most likely to be benefit. A clinical study in healthy college students with self-reported sleep problems shows that wearing a patch containing lavender oil 55 mcL on the chest, in addition to practicing sleep hygiene, improves self-reported sleep quality, but not sleep quantity, when compared with wearing a placebo patch (93012). Another small clinical study in elderly patients that have trouble sleeping in nursing homes shows that placing 2 drops of lavender oil to a cotton pad on a nightstand at bedtime for 4 weeks moderately improves sleep quality and reduces fatigue when compared with control (103062). A meta-analysis of three clinical trials shows that lavender modestly improves postpartum sleep quality when compared with control, including placebo or no intervention. However, each trial used a different form of lavender, including a topical cream, a tea, and aromatherapy. Also, the individual trials included in the analysis show that only the cream and aromatherapy resulted in statistically significant improvements in sleep quality (109866). Conversely, a small clinical study in postmenopausal adults with insomnia who received sleep hygiene guidance shows that inhaling lavender oil 6% before bed nightly for 1 month does not improve sleep quality when compared with sunflower oil. The oil was inhaled from the bottle for two, two-minute sessions and then poured on a cotton ball and placed near the head while sleeping (109852). Lavender aromatherapy has also been evaluated for insomnia in patients with comorbid disease states. A clinical study in patients with insomnia and type 2 diabetes shows that lavender oil aromatherapy for 5 minutes at bedtime nightly for 4 weeks improves sleep when compared with almond oil (103065). Preliminary clinical research in adults with kidney failure shows that foot massage with lavender oil 1.5% for 3 weeks during hemodialysis modestly improves sleep quality when compared with routine care, but is no more effective than sweet orange oil (109859). Another preliminary clinical study in cancer patients shows that receiving aromatherapy as two drops of pure lavender oil applied to a cotton ball and attached to the collar for 20 minutes at bedtime for one week improves sleep when compared with baseline, but seems to be no better than using peppermint oil or a lavender oil 1% control (103063). The validity of this finding is limited because the lavender oil 1% control resulted in notable benefit and might have been an inadequate control treatment. Aromatherapy with lavender oil does not seem to improve sleep in most hospitalized patients, including patients in intermediate care units, hospitalized cardiac patients, and in patients undergoing microvascular breast reconstruction. Aromatherapy treatments have included lavender aromatherapy throughout hospitalization, placing 3 mL of lavender oil 3 feet away from the bed during sleep, and hand and lower leg massage with lavender essential oil 1.5% in sweet almond oil at bedtime (93013,101727,109853). However, studies have generally been small and did not use proper controls. Also, some small clinical studies suggest that lavender aromatherapy might have modest beneficial effects in patients undergoing coronary artery bypass graft (CABG) surgery (109856,109861).
Kidney failure. Small clinical studies suggest that lavender aromatherapy may modestly reduce fatigue and improve sleep quality in adults receiving hemodialysis. Lavender oil massage may also modestly improve symptoms of restless leg syndrome (RLS) in these patients. Details: Multiple small studies have evaluated lavender aromatherapy, provided during hemodialysis sessions, for reducing fatigue. A small clinical study shows that applying 5% lavender essential oil (Barij Essence Pharmaceutical Company) to a cotton ball on the patient's collar for inhalation for 15-20 minutes twice daily during each session for 1 month reduces fatigue by an additional 44% and 40% when compared with baseline and control, respectively (98524). Another preliminary clinical trial shows that applying lavender oil 7% in sweet almond oil to a gauze pad placed 20 cm from the patient's nose for 2 minutes improves fatigue when compared with placebo aromatherapy. By the third week of four total weeks of treatment, most patients given lavender oil aromatherapy had only mild fatigue, compared with moderate or severe fatigue in the control group (109867). Also, a small clinical trial shows that aromatherapy or aromatherapy foot massage with lavender and sweet orange oil for 10-20 minutes during each session for 2 months reduces fatigue when compared with no treatment. Aromatherapy massage seems to be more effective than aromatherapy alone (103068). However, one small clinical study shows that applying the oil for inhalation for 10 minutes during each session for 1 month does not reduce fatigue when compared with control (95642). The difference in these findings might be due to study size, lavender oil concentration, or the frequency and duration of aromatherapy sessions. Lavender aromatherapy has also been evaluated for reducing insomnia in adults on hemodialysis. A small clinical study shows that foot massage with lavender oil 1.5% for 3 weeks during hemodialysis sessions modestly improves sleep quality when compared with routine care. However, it does not seem to be more effective than using sweet orange oil (109859). Some small clinical studies in patients undergoing hemodialysis show that massaging the feet or lower legs with lavender oil reduces the severity of RLS by up to 45% when compared with routine care, massage only, or baby oil as placebo (95638,103064,109865). However, massage with lavender oil does not seem to be more beneficial than glycerin oil 2% or sweet orange oil 1.5% for reducing RLS severity (103064,109859). Doses have included 10-15 mL of 1.5% or 5% lavender oil for 10- to 45-minutes during hemodialysis sessions for 3-4 weeks (95638,103064,109859,109865).
Labor pain. Lavender aromatherapy may help to reduce pain during childbirth. Details: A meta-analysis of clinical trials in pregnant patients in Iran shows that lavender oil aromatherapy applied by various means, such as mask or massage, reduces labor pain when compared with control (104440). All available research has been conducted in Iran, so it is unclear if the benefit can be extrapolated to other geographic locations.
Lice. Topical lavender oil has only been evaluated in combination with other essential oils; its effect when used alone is unclear. Details: Clinical studies in patients with head lice shows that applying lavender oil in combination with tea tree oil reduces the number of hatched and unhatched live lice when compared with control (19188,19189). When applied with tea tree oil three times weekly, lavender oils seems to improve lice eradication when compared with two weekly treatments of pyrethrin and piperonyl butoxide (19189). It is not known if these effects are due to tea tree oil, lavender, or the combination.
Menopausal symptoms. It is unclear if lavender aromatherapy reduces menopausal symptoms such as hot flushes. Details: A meta-analysis and individual clinical studies in postmenopausal adults show that lavender aromatherapy for 4-12 weeks, alone or in combination with other essential oils, reduces menopausal symptoms such as hot flushes when compared with placebo (95634,99711,103067). However, heterogeneity and small sample sizes limit the validity of these findings. A small clinical study in postmenopausal adults shows that aromatherapy with lavender 2% oil for 20 minutes at bedtime every day for 1 month improves quality of life scores when compared to baseline (99711). Another small clinical study in menopausal adults shows that receiving aromatherapy with lavender oil and lemon oil for 5 minutes daily for 30 days seems to improve sleep and quality of life when compared with placebo (104439). However, a small clinical study in postmenopausal adults shows that a combination of lavender and bergamot oils administered via inhalation three times daily for 8 weeks with routine care does not improve sexual function when compared with routine care alone (109981).
Migraine headache. It is unclear if lavender aromatherapy improves migraine symptoms. Details: A small clinical study in patients with migraine headaches shows that rubbing 2-3 drops of lavender oil on the upper lip for inhalation might reduce headache pain and associated symptoms such as nausea and photophobia. Of 129 headaches treated with lavender oil, 92 responded completely or partially, compared with 32 of 68 headaches in the placebo group (18209).
Multiple sclerosis (MS). It is unclear if lavender aromatherapy can improve memory in patients with MS. Details: A small preliminary clinical trial in patients with MS shows that dripping 2 drops of lavender oil (Barij Essence Pharmaceutical Company) on a cotton ball for inhalation for 10 minutes twice daily for 2 weeks improves working memory by a small amount when compared with inhaling distilled water (109855).
Multiple sclerosis-related fatigue. It is unclear if oral lavender is beneficial for reducing fatigue in adults with multiple sclerosis (MS). Details: A small clinical trial in patients with MS shows that taking lavender 600 mg three times daily for 60 days improves fatigue by a large amount when compared with placebo (109851).
Neuropathic pain. Although there is interest in using topical lavender oil for neuropathic pain, there is insufficient reliable information about the clinical effects of lavender for this condition.
Osteoarthritis. It is unclear if lavender aromatherapy with massage reduces osteoarthritis pain. Details: A small clinical study in patients with osteoarthritis shows that applying 5 mL of 3% lavender oil (Barij Essence Pharmaceutical Company) to the knee through self-administered massage three times weekly for 3 weeks can reduce pain by 23% when compared to massage with placebo oil and by 36% when compared with no treatment. However, any benefits of treatment begin to wear off after treatment completion (95645).
Otitis media. Topical lavender oil has only been evaluated in combination with other essential oils; its effect when used alone is unclear. Details: A clinical study in children ages 5-18 years with otitis media and otalgia shows that administering ear drops containing lavender and other herbal extracts, alone or in combination with a topical anesthetic, improves ear pain when compared with baseline. However, it is possible that the pain is self-limited and any pain reduction is due to natural resolution (39500).
Pain (acute). Small clinical studies suggest that lavender aromatherapy may modestly reduce acute pain from needle insertion or other procedures in infants and adults. Details: Lavender has been evaluated for treating acute pain in infants and adults prior to a variety of procedures. Two small clinical studies in patients having a needle inserted for hemodialysis shows that inhaling 10% lavender essence for 5 minutes or topically applying 0.3 mL of 100% lavender oil for 5 minutes prior to needle insertion modestly reduces pain when compared with using placebo oil or water (93008,93010). A moderate-sized clinical study in adults with diabetes on insulin shows that topical lavender aromatherapy (Talya, Talya Herbal LLC) sprayed 3 times on the arm five minutes before insulin injection reduces injection-site pain when compared with placebo (112254). Lavender aromatherapy has also been used for gynecological exam pain. A clinical study shows that inhaling 10% lavender oil from a heat lamp for 10-15 minutes prior to gynecological exams reduces pain experienced during the exam up to three-fold when compared with no treatment (95639). However, not all research shows that lavender reduces acute pain. A moderate-sized clinical study in adults undergoing extracorporeal shockwave lithotripsy (ESWL) to treat kidney stones shows that inhaling 4 drops of diffused lavender oil does not reduce pain or the use of self-administered opioids when compared with standard control opioid analgesia. These results were unchanged when lavender aromatherapy was combined with music (112258). The validity of these effects is limited by a lack of blinding. Additionally, the kidney stones in the groups studied were different sizes at baseline. Lavender oil aromatherapy may also reduce pain in infants undergoing various medical procedures. One clinical study shows that aromatherapy with lavender oil (Barij Essence Pharmaceutical Company) 0.5% for one minute before vaccination modestly reduces pain and decreases crying time by about 20 seconds when compared with sweet almond oil (109869). Another small clinical study in term infants shows that being placed in an incubator with lavender essential oil scent overnight before receiving a blood draw modestly reduces overall pain scores when compared with no intervention, but seems to be no different than giving 2 mL of 30% glucose solution (103066). Another small clinical study in premature infants shows that inhaling the scent of 6 lavender oil drops on a cotton ball for 3 minutes before and 30 seconds after a heel-lancing procedure seems to reduce pain scores when compared with exposure to an unscented cotton ball (104442). Lavender oil aromatherapy may also reduce pain due to frenotomy in infants. Preliminary clinical research shows that applying a gauze pad containing one drop of lavender oil under the nose, starting 2 minutes before the frenotomy and continuing throughout the procedure, modestly reduces pain when compared with routine care, which includes swaddling, oral sucrose, and pre-frenotomy sucking. Post-frenotomy crying was also reduced by about 50%, or 10 seconds (109868). Lavender oil seems to be similarly effective to vanilla oil (109810).
Perioperative anxiety. It is unclear if lavender aromatherapy is beneficial for perioperative anxiety. Details: A moderate-sized clinical study in adults with kidney stones undergoing extracorporeal shockwave lithotripsy (ESWL) shows that inhaling 4 drops of diffused lavender oil does not reduce anxiety when compared with standard control opioid analgesia. These results were unchanged when lavender aromatherapy was combined with music (112258). The validity of these effects is limited by a lack of blinding. Additionally, the kidney stones in the groups studied were different sizes at baseline. Another large clinical study in adults shows that inhaling lavender 2% before, during, and after dental procedures reduces dental pain intensity and perioperative dental anxiety when compared with control. Inhaled lavender seems to have the greatest effect on perioperative anxiety when used in the waiting room (112250).
Postdural puncture headache. It is unclear if lavender aromatherapy improves postdural puncture headache severity. Details: A small clinical study in patients with postdural puncture headache shows that receiving lavender oil aromatherapy for 15 minutes modestly improves pain immediately after treatment when compared with placebo. However, the pain relief is not maintained at 30 minutes after treatment (104441).
Postoperative nausea and vomiting (PONV). It is unclear if lavender aromatherapy reduces PONV. Details: A small clinical study in postoperative patients shows that inhaling the scent of 2 drops of lavender oil from a cotton pad for 5 minutes improves nausea scores in 83% of people, compared with 44% of those inhaling a placebo. There was no difference in vomiting scores between groups (99712). Another small clinical study in patients after percutaneous nephrolithotomy shows that inhaling the scent of 3 drops of lavender essential oil from a gauze for 5 minutes immediately after the operation, and again 3 and 6 hours later, does not improve nausea or vomiting when compared with a control group that was not receiving aromatherapy (103872).
Postoperative pain. The evidence for the use of lavender aromatherapy for pain after various types of surgical procedures is preliminary and conflicting. Details: Some preliminary clinical research in patients post-Cesarean section shows that, when used in conjunction with standard analgesic therapy, applying 2 drops of lavender oil 2% to a face mask or applying 3 drops of lavender to a cotton ball for inhalation seems to reduce postoperative pain when compared with control (58093,101724). Additionally, preliminary clinical research in patients undergoing coronary artery bypass graft (CABG) surgery shows that applying lavender oil to a gauze which is worn around the neck may modestly reduce postoperative pain on the day of surgery and the day after surgery when compared with distilled water (109850). Also, a small clinical study in children aged 6-12 years post-tonsillectomy shows that rubbing lavender oil onto the palms and inhaling for 3 minutes every 6 hours as needed reduces the use of acetaminophen when compared with control (90513). However, aromatherapy with lavender throughout hospitalization does not seem to improve postoperative pain in patients undergoing microvascular breast reconstruction when compared with coconut oil (109853).
Postpartum complications. It is unclear if topical or inhaled lavender reduces postpartum complications such as pain and swelling. Details: Some clinical research in patients receiving an episiotomy during childbirth shows that adding lavender oil to water or sitz baths for up to 10 days might reduce episiotomy redness and discomfort when compared with using no lavender and standard treatment, such as povidone-iodine. However, findings are mixed as to whether adding lavender oil to baths helps to reduce edema and analgesic use (58085,58092,58116,58121). Lavender aromatherapy has also been studied to improve wellbeing in postpartum patients. A small clinical study in postpartum patients immediately following a natural birth shows that inhaling lavender oil from a cotton ball for 10-15 minutes in the morning, 6 hours later, and at bedtime, improves perceived pain, fatigue, distress, and mood within 1 hour of treatment and also the next morning when compared with placebo (95631).
Postpartum depression. Small clinical studies suggest that aromatherapy with lavender oil may modestly improve or prevent depressive symptoms in postpartum patients. Details: A clinical study in healthy postpartum patients shows that placing 3 drops of lavender essential oil on the palms three times daily for 4 weeks after delivery moderately reduces depressive symptoms and anxiety when compared with usual care only (95637). There is limited research on the benefits of lavender aromatherapy in patients diagnosed with postpartum depression. A small clinical trial in these patients shows that a combination of lavender and rose essential oils, administered via inhalation or aromatherapy massage using hand "M" technique for 15-minute sessions, twice weekly for 4 weeks, reduces depression scores when compared with no intervention (58103).
Pre-procedural anxiety. It is unclear if lavender aromatherapy can reduce preoperative or preprocedural anxiety; results from clinical research are generally of low-quality and benefits are modest at best. Details: A meta-analysis of four small clinical studies in patients undergoing cardiac surgery shows that lavender aromatherapy modestly reduces preoperative anxiety when compared with control (103058). However, the included studies were conducted in the Middle East, and it is unknown if these results are generalizable to other geographic areas. There is conflicting clinical evidence regarding the effect of lavender aromatherapy on anxiety prior to a dental procedure (58078,101725,103059). Small clinical studies also show mixed results as to whether lavender oil aromatherapy applied to a gauze bandage or oxygen mask improves anxiety in patients waiting for breast surgery when compared with usual care. (95641,101729). Lavender aromatherapy might reduce anxiety prior to less risky and extensive procedures such as needle injections. Small clinical studies in adults receiving botulinum toxin type A injections or children receiving dental injections show that lavender oil aromatherapy reduces heart rate and cortisol levels when compared with placebo (58089,104438). Another clinical study in preoperative patients undergoing insertion of a peripheral venous cannula shows that inhalation of 1% lavender oil (Talya Herbal Products) from a gauze pad for 5 minutes modestly reduces pain and anxiety scores and improves patient satisfaction when compared with control (95636). However, a clinical study in patients undergoing a colonoscopy or esophagogastroduodenoscopy shows that inhaling lavender oil does not reduce anxiety, although it does improve patient satisfaction, when compared with placebo (58066). Reasons for conflicting findings are unclear but may relate to the severity of anxiety, the specific outcomes measured, and cultural differences occurring in different geographic locations.
Psychological well-being. It is unclear if topical or inhaled lavender improves well-being. Details: A small clinical study in healthy females shows that adding 3 mL of a mixture containing 20% lavender oil and 80% grapeseed oil to daily baths modestly improves mood when compared with baths containing grapeseed oil alone (15534). However, lavender may not impact well-being in patients with cancer. Clinical research shows that that adding lavender oil for an aromatherapy massage in patients with advanced or terminal cancer does not improve well-being or quality of life when compared with no massage treatment or massage with inert oil (29504,58053).
Restless legs syndrome (RLS). Most preliminary clinical research suggests that lavender oil aromatherapy massage is beneficial for RLS in patients undergoing hemodialysis. Its effect in other patient populations is unclear. Details: Some small clinical studies in patients undergoing hemodialysis show that massaging the feet or lower legs with lavender oil reduces the severity of RLS by up to 45% when compared with routine care, massage only, or baby oil as placebo (95638,103064,109865). However, massage with lavender oil does not seem to be more beneficial than glycerin oil 2% or sweet orange oil 1.5% for reducing RLS severity (103064,109859). Doses have included 10-15 mL of 1.5% or 5% lavender oil for 10 to 45 minutes during hemodialysis sessions for 3-4 weeks (95638,103064,109859,109865).
Stress. Small studies suggest that inhaled lavender oil does not reduce stress in students under academic stress. Details: A meta-analysis of 21 moderate- to high-quality, small- to medium-sized studies shows that inhaling lavender oil modestly reduces stress when compared with control. Most studies included in the analysis have used lavender oil as aromatherapy; other studies have used a cream (109863). In contrast, inhaling lavender oil 3% in almond oil twice daily for 30 minutes during the exam period does not reduce academic stress or associated symptoms, including headache, blood pressure, or heart rate, in pharmacy students when compared with inhaling an odorless oil, although both were more effective than no intervention (101723). Lavender oil has also been evaluated for reducing stress for healthcare professionals. A small study in hospital nurses with work-related stress shows that inhaling lavender oil as aromatherapy for 2 hours daily for 4 weeks does not reduce job-related stress when compared with placebo or rose oil aromatherapy (112256). However, another small clinical study in healthcare professionals at an outpatient clinic shows that inhaling lavender oil through a diffuser during work shifts reduces work stress and increases job satisfaction when compared with placebo (112251).
Toothache. Although there is interest in using topical lavender oil for toothache, there is insufficient reliable information about the clinical effects of lavender oil for this purpose. More evidence is needed to rate lavender for these uses.

MARJORAM

Asthma. Preliminary clinical research in adults shows that taking marjoram oil 2 drops daily for 3 months along with conventional treatment for asthma improves some measures of lung function. Forced vital capacity (FVC) increased by 0.3 mL with marjoram compared to 0.1 mL in the control group. The forced expiratory volume in 1 second (FEV1) increased by 4.1% with marjoram compared to 2.7% with control. While these improvements were statistically significant compared to baseline, statistical analysis between groups was lacking (76944).
Dysmenorrhea. Preliminary clinical research in women aged 19-45 years with primary dysmenorrhea shows that massaging the lower abdomen with a cream containing lavender, clary sage, and marjoram essential oils (2:1:1 ratio) diluted in unscented jojoba cream to a 3% concentration, in a dose of two grams daily, starting at the end of menstruation and continuing until the beginning of the next, might decrease the level and duration of pain when compared with a placebo cream containing synthetic fragrances. The decrease in pain duration, from 2.4 days to 1.8 days in the essential oils group, was statistically significant when compared to baseline (58095). It is unclear if these effects are due to marjoram, other ingredients, or the combination.
Parkinson disease. Preliminary clinical research in patients with Parkinson disease who are stabilized on levodopa shows that drinking a tea containing 5 grams of dried marjoram leaf daily for 30 days does not lower Unified Parkinson Disease Rating Scale part III motor scores (USPDRSIII), but does decrease scores on the Non-Motor Symptoms Scale (NMSS) and the Beck Depression Inventory (BDI), when compared with placebo tea (108498).
Polycystic ovary syndrome (PCOS). Preliminary clinical research shows that drinking marjoram leaf tea 250 mL twice daily for 1 month modestly reduces levels of dehydroepiandrosterone sulfate (DHEA-S) and insulin in women with PCOS. Body weight, fasting glucose, and serum levels of follicle-stimulating hormone, luteinizing hormone, progesterone, and testosterone did not improve (95325). More information is needed to rate marjoram for these uses.

PEPPERMINT

LIKELY EFFECTIVE

Irritable bowel syndrome (IBS). Oral enteric-coated peppermint oil is conditionally recommended by the American College of Gastroenterology (ACG) for the relief of global IBS symptoms, such as abdominal pain. Details: The ACG conditionally recommends the use of peppermint for the relief of global IBS symptoms. This recommendation is based on an available meta-analysis of generally low-quality clinical research (105124). Several clinical trials and meta-analyses show that taking enteric-coated peppermint oil 1-2 capsules orally two to four times daily reduces abdominal pain, distention, flatulence, and bowel movements in patients with IBS. Each capsule provides approximately 0.2 mL of peppermint oil or 180-225 mg peppermint oil. Most trials have used specific products (Colpermin, Tillotts Pharma; Mintoil, Cadigroup; Ibgard, IM HealthScience, Tempocol) (3802,3803,4469,11778,11779,17681,17682,68467,68515,68522)(68603,68604,68605,96360,99493,109980). The most recent meta-analysis to date shows that four patients would need to take peppermint oil to prevent one patient from having persistent IBS symptoms, and seven patients would need to take peppermint oil to prevent one patient from having abdominal pain. However, the individual studies included in the analysis lasted no more than 12 weeks (109980); any long-term effects are unclear. Although most studies have shown benefit for reducing symptoms, some older studies have found no significant effect (11777,11789) or only short-term benefits (68620). Also, a well-designed study shows that taking peppermint oil capsules designed for either small intestinal release (enteric-coated) or ileocolonic release does not increase the number of people with at least a 30% decrease in abdominal pain over a period of 4 weeks, although symptoms are modestly reduced when compared with placebo (102602). Another clinical trial in patients with moderate to severe IBS shows that taking a specific enteric-coated formulation of peppermint oil (Pepogest; Nature's Way) 180 mg three times daily for 6 weeks does not further improve symptom severity when compared with placebo. However, both groups experienced a large improvement on the IBS-Severity Scoring System (IBS-SSS) and the IBS Global Improvement Scale (107955). The validity of these findings is limited due to lost data and inconsistent follow-up; additionally, adverse effects occurred more frequently in the peppermint oil group. The reasons for these negative findings are unclear but may include short treatment durations and the use of different formulations; additionally, IBS is comprised of various subtypes and symptoms that can range in severity and presentation, which may alter treatment response. Some clinical research has also evaluated a specific combination product (Atrantil, KBS Research) containing peppermint leaf, red quebracho extract, and conker tree extract. Taking this product as needed for 2 weeks seems to reduce constipation and bloating when compared to baseline in patients with constipation-predominant IBS (95429,95430). It is unclear if the effects of this product are due to peppermint, the other ingredients, or the combination.

POSSIBLY EFFECTIVE

Barium enema-related colonic spasm. Rectal peppermint, as part of barium enema preparations, seems to reduce colonic spasms during examination. Oral peppermint also seems to be beneficial. Details: Rectal use of peppermint oil, added as an ingredient in barium enema preparations, seems to relax the colon during barium enema examination and reduce the percentage of patients who experience colonic spasms by about 25% to 30% (6739,6749,12009). Adding peppermint oil to the barium enema seems to be at least as effective as using systemic scopolamine (Buscopan). Adding peppermint oil to the barium solution also does not seem to impair image quality (12009). Some clinical research also shows that taking peppermint oil orally before the start of a double-contrast barium enema examination decreases spasms and might also increase diagnostic quality (14467).
Chemotherapy-induced nausea and vomiting (CINV). Oral and inhaled peppermint seem to reduce nausea and vomiting in patients with CINV. Details: Clinical research shows that adding peppermint oil, 40 drops in 20 mL water, every 8 hours following chemotherapy treatment to treatment with standard antiemetics reduces the severity of nausea, vomiting, and anorexia by moderate to large amounts over 48 hours when compared with a plain water placebo (105123). The use of peppermint oil aromatherapy has also been investigated. Clinical research shows that adding 2 drops of peppermint oil to a cool, damp washcloth for use on the neck as aromatherapy for about 30 minutes helps relieve chemotherapy-induced nausea by a small amount when compared with a washcloth without peppermint oil (102603). Additional clinical research in patients receiving standard antiemetics after chemotherapy shows that applying one drop of peppermint oil below the nose three times daily for 5 days reduces the severity of nausea and the frequency of nausea, vomiting, and retching by a moderate to large amount when compared with the antiemetics alone. These parameters were not improved following treatment with cisplatin (105122). A meta-analysis of 3 randomized controlled trials in adults receiving chemotherapy also shows that peppermint oil aromatherapy moderately improves nausea and vomiting when compared with control. However, the results of this analysis are limited by heterogenous application methods, doses, and durations of peppermint therapy (114761). In children with acute leukemia, a small clinical study shows that aromatherapy with 2 drops of peppermint oil and 3 drops of lemon oil in 80 mL of water diffused 30 minutes prior to and 2 and 4 hours after chemotherapy once weekly for 4 weeks decreases the severity of nausea, vomiting, and retching, and improves quality of life scores when compared with diffused water or no intervention (112015). The validity of these findings is limited by the use of patient-reported outcomes. Another small clinical trial in children receiving chemotherapy for acute leukemia shows that aromatherapy with peppermint oil 2%, 0.2 mL inhaled over 3 minutes immediately prior to 3 consecutive chemotherapy sessions, added to standard care (e.g. antiemetic medications), reduces overall incidence of nausea by 40%, and improves nausea and vomiting severity scores, when compared with no additional interventions. These results were similar to those receiving Swedish massage prior to chemotherapy sessions (114759).
Dyspepsia. Oral peppermint, in combination with caraway and possibly other ingredients, seems to reduce symptoms of dyspepsia. It is unclear if oral peppermint alone is beneficial. Details: Some clinical research shows that taking specific products containing peppermint and caraway oil (Enteroplant, Dr Willmar Schwabe Pharmaceuticals; Menthacarin, Dr Willmar Schwabe GmbH & Co.) improves quality of life and reduces symptoms of dyspepsia, including feelings of fullness, pain, and mild gastrointestinal spasms (6740,6741,10075,96344,102600). A meta-analysis of three of these clinical studies shows that taking this combination product 2-3 times daily for 4 weeks modestly reduces abdominal pain when compared with placebo (110091). Taking this combination twice daily for 4 weeks also improves postprandial distress syndrome and epigastric pain syndrome, two subtypes of dyspepsia, when compared with placebo (96344). The combination of enteric-coated peppermint oil 90 mg and caraway oil 50 mg appears to be comparable to cisapride for relieving dyspepsia when taken 2-3 times daily for up to 4 weeks (6740,6741,10075). However, most trials investigating this combination are small and/or of overall low quality (102600). A specific combination product containing peppermint leaf (Iberogast, Steigerwald Arzneimittelwerk GmbH) also seems to improve symptoms of dyspepsia. The combination includes peppermint leaf plus clown's mustard plant, German chamomile, caraway, licorice, milk thistle, angelica, celandine, and lemon balm (7049). A meta-analysis of studies using this combination product shows that taking 1 mL orally three times daily over a period of 4 weeks reduces the severity of acid reflux, epigastric pain, cramping, nausea, and vomiting when compared with placebo (13089). A similar combination product containing extracts from peppermint leaf, clown's mustard plant, German chamomile flower, caraway, licorice root, and lemon balm (STW 5-II, Steigerwald Arzneimittelwerk GmbH) 1 mL taken three times daily for up to 8 weeks eliminates gastrointestinal symptoms in 40% more dyspepsia patients when compared with placebo (12724).
Endoscopy-associated adverse effects. Intraluminal peppermint seems to reduce spasticity during an endoscopy. It is unclear if oral peppermint is beneficial for reducing adverse effects related to endoscopy. Details: A meta-analysis of four clinical trials show that peppermint oil, administered orally or intraluminally, reduces the incidence of spasticity by about 41% when compared with placebo in patients undergoing endoscopy, with severe spasticity occurring at about 30% the rate of those taking placebo. However, there was no effect on subjective pain (102604). Individual clinical studies show that intraluminal peppermint oil can reduce both pain and spams in patients undergoing endoscopy (18220,68371,68395,68445,68532). However, there are limitations with this form of administration, including cost and practicality, which has led to interest in the use of oral formulations (104221). Studies evaluating oral extended-release peppermint have been conflicting. While one study shows that a specific extended-release peppermint oil product (Colpermin) 187 mg or 0.2 mL taken orally 4 hours prior to a colonoscopy reduces procedure time, pain, and spasticity (68532), a study using another specific extended-release peppermint oil (IBGard) did not show an effect on colonic spasms, procedure time, or adenoma detection rate when compared with placebo (104221). These differing outcomes may be due to timing of administration. The study that showed benefit administered the treatment 4 hours prior to endoscopy, whereas the study showing no benefit administered the treatment only 1 hour prior. This suggests that extended-release peppermint may need to be administered at least 4 hours prior to the procedure to allow for adequate colonic release (68532,102604,104221).
Nipple fissures. Topical peppermint seems to reduce cracked skin and pain in the nipples due to breastfeeding. Details: Clinical research shows that topical application of peppermint oil in gel or water reduces cracked skin and pain in the nipple area from breastfeeding when compared with using placebo, lanolin, or the expressed breast milk technique (68454,68462). Other research shows that applying peppermint oil in cream immediately after breastfeeding for 2 weeks decreases pain and trauma in the nipple area similarly to the topical application of dexpanthenol or lanolin (96365).
Pressure ulcers. Topical peppermint seems to reduce the risk of pressure ulcers. Details: Clinical research in bedridden patients shows that prophylactic application of a topical gel containing peppermint oil 0.2% three times daily for up to 14 days results in pressure injuries in about 23% of patients compared with 77% of those given a placebo gel (102605).
Tension headache. Topical peppermint seems to relieve tension headaches. Details: Clinical research shows that topical application of peppermint oil 10% relieves tension headaches when compared with placebo (3801,6190).

Abdominal pain. Although there has been interest in using oral peppermint for abdominal pain, there is insufficient reliable information about the clinical effects of peppermint for this condition.
Anxiety. It is unclear if inhaled peppermint oil is beneficial for reducing anxiety. Details: A clinical trial in patients presenting to the emergency department for an acute coronary syndrome event shows that placing 3 drops of peppermint oil on a cotton ball and inhaling for 1 hour improves anxiety and respiratory rate when compared with baseline or placebo (107958). Due to the single-dose nature of this study, the effects of repeated inhalation of peppermint oil are unclear.
Athletic performance. It is unclear if oral peppermint oil is beneficial for athletic performance. Details: Preliminary clinical research in trained adult runners shows that taking peppermint essential oil, 0.05 mL diluted in 500 mL of water, orally once 30 minutes before exercise improves running time to exhaustion by 11% when compared with placebo (112742). Another very small clinical study in elite soccer athletes shows that use of a specific peppermint essential oil (doTERRA), 1 drop rubbed into hands and inhaled with 5 deep breaths, does not improve jump performance metrics when compared with placebo (114760).
Breast cancer-related hot flashes. It is unclear if topical peppermint is beneficial for reducing hot flashes in patients with breast cancer. Details: Preliminary clinical research shows that using a spray containing a combination of peppermint and neroli hydrolat does not alleviate hot flashes in most patients receiving chemotherapy for breast cancer when compared with using a plain water spray (68481).
Cognitive function. It is unclear if inhaled peppermint oil is beneficial for improving cognitive function. Details: Preliminary clinical research shows that inhalation of peppermint oil slightly improves memory and the performance of cognitive tasks such as typing, alphabetization, and ordering, but not attention and speed of task completion, when compared with control (56954,68416,68466).
Common cold. Although there has been interest in using oral, topical, or inhaled peppermint for the common cold, there is insufficient reliable information about the clinical effects of peppermint for this condition.
Dental plaque. Topical peppermint has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research shows that rinsing the mouth for one minute with 10 mL of a specific combination product (HiOra, Himalaya Herbal Healthcare) containing peppermint oil and numerous other ingredients twice daily for two days reduces plaque index or plaque area when compared with placebo; however, it was not as effective as chlorhexidine 0.2% solution (68530). It is unclear if these effects are due to peppermint oil, other ingredients, or the combination.
Diffuse esophageal spasm. It is unclear if oral peppermint oil is beneficial for diffuse esophageal spasm. Details: A small exploratory study in adults with diffuse esophageal spasm shows that drinking a solution of peppermint oil, 5 drops in 10 mL of water, can resolve esophageal contractions when compared with baseline (13415). The validity of this finding is limited by the lack of a comparator group.
Dysmenorrhea. It is unclear if oral peppermint oil is beneficial for reducing menstrual pain. Details: Preliminary clinical research shows that taking three capsules of peppermint oil (Colpermin; Tillotts Company or Razak company) daily for 3 days, starting on the first day of menstruation, is as effective as mefenamic acid 250 mg three times daily for reducing pain, and more effective for reducing nausea and vomiting, associated with dysmenorrhea. However, mefenamic acid was more effective for reducing bleeding and analgesic use (105125).
Fatigue. It is unclear if inhaled peppermint oil improves fatigue in patients with cardiac disease. Details: A clinical trial in hospitalized patients with various forms of cardiac disease shows that placing 3 drops of peppermint oil on a cotton ball and inhaling for 20 minutes nightly for 7 days improves fatigue scores when compared with placebo. These improvements were similar to those seen with lavender oil inhalation. Fatigue scores decreased by 24 and 21 points in the peppermint and lavender groups, respectively, compared with a 2-point reduction in the placebo group (107959). The validity of these findings is limited due to the short duration of treatment.
Halitosis. Peppermint has only been evaluated in combination with other ingredients as a mouthwash; its effect when used alone is unclear. Details: Preliminary clinical research shows that rinsing the mouth with a specific combination of tea tree oil, peppermint, and lemon essential oil once for three minutes improves breath smell when compared with placebo or benzydamine hydrochloride (19177). Other preliminary clinical research in elderly adults with dementia who require oral care assistance shows that cleaning the mouth with a mixture of peppermint oil, tea tree oil, and lemon essential oils diluted to 0.5%, applied via gauze, twice daily for 7 days improves halitosis scores and oral condition scores when compared with placebo (112957).
Insomnia. It is unclear if inhaled peppermint oil is beneficial for insomnia. Details: Preliminary clinical research in cancer patients shows that receiving aromatherapy as three drops of peppermint oil applied to a cotton ball and attached to the collar for 20 minutes at bedtime for one week improves sleep when compared with baseline. However, it seems to be no better than using lavender oil aromatherapy or using a control of lavender oil 1% (103063).
Menopausal symptoms. It is unclear if inhaled peppermint oil is beneficial for menopausal symptoms. Details: Preliminary clinical research in adults with menopausal symptoms shows that receiving aromatherapy as 2 drops of peppermint oil with upper extremity massage and for 30 minutes twice weekly for 4 weeks moderately improves menopause symptom scores, including both somatic symptoms and urogenital symptoms, when compared with placebo (112745).
Migraine headache. It is unclear if intranasal or inhaled peppermint oil is beneficial for migraine headache. Details: Preliminary clinical research shows that using 1-2 doses of intranasal peppermint oil 1.5% (Poursina Company) at the start of migraine pain is as effective as intranasal lidocaine 4%, and more effective than placebo, for reducing migraine headache intensity. Approximately 42% of those using peppermint oil indicated a high level of headache reduction, compared with 42% of those using lidocaine and 5% of those using placebo. Also, pain relief was felt within 5 minutes in more patients using peppermint than placebo (105126). However, it is unclear if participants were truly blinded to the use of peppermint oil. Other preliminary clinical research in pediatric patients with migraine or other chronic headaches shows that receiving aromatherapy with peppermint oil over 10 minutes during a footbath does not improve pain or anxiety scores when compared with control (112746).
Mosquito repellent. Although there has been interest in using topical peppermint oil as a mosquito repellent, there is insufficient reliable information about the clinical effects of peppermint for this purpose.
Myalgia. Although there has been interest in using topical peppermint oil for myalgia, there is insufficient reliable information about the clinical effects of peppermint for this condition.
Oral mucositis. Topical peppermint has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Clinical research in adults undergoing stem cell transplantation shows that using an oral rinse containing peppermint oil and German chamomile three times daily, in addition to standard treatment with sodium chloride and chlorhexidine, reduces the duration and severity of mucositis and the use of narcotic analgesics when compared with placebo and standard treatment. However, this oral rinse does not reduce or delay the occurrence of mucositis or affect the duration of hospitalization (96363). Another small clinical study in adults with head and neck cancers undergoing radiation shows that rinsing with 5 mL of a polyherbal mouthwash containing peppermint oil, German chamomile, aloe vera, and honey for 1 minute 3 times daily for 6 weeks reduces oral mucositis incidence, severity, and pain when compared with chlorhexidine 0.2% and placebo (111291). Clinical research in adults receiving treatment with 5-fluorouracil shows that using an oral rinse containing peppermint, sage tea, and thyme in addition to basic oral care, starting on the first day of chemotherapy and continuing for 14 days, delays the onset of mucositis, but not the rate or severity of mucositis, when compared with basic oral care alone (96364). It is unclear if these effects are due to peppermint oil, other ingredients, or the combinations.
Osteoarthritis. Although there has been interest in using topical peppermint oil for osteoarthritis, there is insufficient reliable information about the clinical effects of peppermint for this condition.
Pain (acute). It is unclear if inhaled or topical peppermint oil is beneficial for acute pain. Details: Preliminary clinical research in cardiac patients shows that peppermint oil aromatherapy reduces pain associated with intravenous catheterization by a small amount when compared with a distilled water control (102601). Another small open-label study in adults undergoing venipuncture for dialysis shows that topical application of peppermint gel 5 mL reduces pain scores by approximately 50% when compared with no intervention. These results were similar to using a cold compress (114758). Additionally, a small open-label study in children undergoing a dental procedure, shows that topical application of peppermint oil 0.2% , moderately improves pain scores after a buccal injection when compared with lidocaine spray 15% (114757).
Postherpetic neuralgia. Although there has been interest in using topical peppermint oil for postherpetic neuralgia, there is insufficient reliable information about the clinical effects of peppermint for this condition.
Postoperative ileus. It is unclear if oral peppermint oil is beneficial for the prevention of postoperative ileus. Details: Clinical research shows that taking a specific peppermint oil product (Colpermin, Tillotts Pharma) as two capsules three times daily for 5 days after routine gynecological surgery does not prevent postoperative abdominal distension and dyspepsia when compared with placebo (68602). Conversely, a small clinical study in patients undergoing elective cesarean section shows that taking 20 drops of peppermint oil 4 hours after surgery and then hourly for a total of three doses reduces the time to first bowel sounds by around 3.3 hours, first flatulence by 4.4 hours, and first stool by 5 hours when compared with placebo (110092).
Postoperative nausea and vomiting (PONV). Some preliminary clinical studies suggest that inhaled peppermint may be beneficial for PONV. However, it is unclear if the benefit is due to aromatherapy or improved breathing patterns. Details: Some preliminary clinical research shows that using peppermint aromatherapy helps relieve postoperative nausea (3804,13415,68524,104219,104220). Inhaling peppermint oil 10% and 30% as aromatherapy reduces the severity of nausea when compared with placebo, with no significant difference between concentrations (104220). Small clinical trials show improvement in PONV within the first 4 hours after surgery. However, this effect diminishes beyond 4 hours (104219). Other preliminary clinical research shows that peppermint oil aromatherapy is no more effective for reducing postoperative nausea than inhaling isopropyl alcohol or saline (13416,68529). It is possible that any relief of postoperative nausea observed with peppermint aromatherapy results from improved breathing patterns after surgery rather than peppermint oil itself (13416,90512). One small study shows that inhaling peppermint oil while practicing controlled breathing does not appear to relieve PONV better than practicing controlled breathing alone (90512). Some preliminary clinical research shows that inhaling vapors from a mixture of peppermint, ginger, spearmint, and cardamom essential oils reduces symptoms of postoperative nausea in approximately 15% more patients when compared with inhaling ginger essential oils alone, and in approximately 43% more patients when compared with inhaling saline (89888). However, it is not clear if the effect is due to peppermint, the other oils, or the combination. In contrast, a small clinical trial in adults undergoing port catheter placement shows that application of a specific aromatherapy patch containing peppermint and lavender (Elequil Aromatabs, Beekley Medical) preoperatively does not reduce PONV rescue treatment when compared with placebo (114623). Another small clinical trial in adults with anxiety undergoing total hip or knee arthroplasty shows that application of the same patch containing peppermint and lavender every 12 hours for 6 doses does not reduce overall PONV when compared with placebo (114622).
Postoperative pain. It is unclear if inhaled peppermint oil is beneficial for postoperative pain. Details: Preliminary clinical research in adults undergoing open heart cardiac surgery shows that receiving aromatherapy with peppermint oil 10%, 0.1 mL, three times daily for 7 doses moderately improves pain scores when compared with placebo (112747). Other preliminary clinical research in adults undergoing lumbar discectomy surgery shows that receiving aromatherapy with peppermint oil 5 drops once postoperatively modestly improves pain scores and anxiety scores when compared with no intervention (112744). A small clinical trial in adults undergoing port catheter placement shows that application of a specific aromatherapy patch containing peppermint and lavender (Elequil Aromatabs, Beekley Medical) preoperatively does not improve pain scores or reduce opioid rescue treatment in the immediate post-operative period when compared with placebo (114623). Another small clinical trial in adults with anxiety undergoing total hip or knee arthroplasty shows that application of the same patch containing peppermint and lavender every 12 hours for 6 doses modestly reduceses opioid consumption on postoperative day 2, but not day 1, 7, or 30, when compared with placebo (114622). However, these changes are unlikely to be clinically relevant. In addition, it is unclear if any potential effects are due to peppermint, lavender, or the combination.
Postoperative recovery. Inhaled peppermint has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical trial in adults undergoing port catheter placement shows that application of a specific aromatherapy patch containing peppermint and lavender (Elequil Aromatabs, Beekley Medical) preoperatively does not shorten postoperative length of stay when compared with placebo (114623).
Postoperative sleep disturbance. It is unclear if inhaled peppermint oil is beneficial for postoperative sleep disturbance. Details: Preliminary clinical research in adults undergoing open heart cardiac surgery shows that receiving aromatherapy with peppermint oil 10%, 0.1 mL, three times daily for 7 doses modestly improves sleep scores when compared with placebo (112747).
Pre-procedural anxiety. It is unclear if inhaled peppermint oil is beneficial for reducing anxiety prior to a medical procedure. Details: Preliminary clinical research in cardiac patients shows that peppermint oil aromatherapy does not reduce anxiety associated with intravenous catheterization when compared with a distilled water control (102601).
Pregnancy-induced nausea and vomiting. Inhaled peppermint oil has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research shows that aromatherapy with a mixture of 5% lemon and 5% peppermint essential oils modestly reduces the intensity of nausea and vomiting on days 2-4, but not day 1, when compared with placebo aromatherapy. When nauseated, patients placed three drops of the essential oil mixture (Barij Essence Co.) onto a cotton ball held 3 cm from the nose. This action could be repeated after 5 minutes if needed (105121).
Pruritus. Some preliminary clinical studies suggest that topical peppermint oil improves itching of various etiologies. Details: Preliminary clinical research in adults with renal, hepatic, or diabetic pruritus shows that topical application of peppermint oil 5% in petrolatum twice daily for 2 weeks improves symptoms of pruritus when compared with petrolatum alone (96361). Preliminary clinical research in patients with severe or intractable pruritus secondary to burn scars shows that applying a specific product (Chongqing No.1, CQ-01, MJ Medical Gel Systems Ltd.) containing peppermint oil 3.6%, menthol 1.4%, and methyl salicylate 2.5%, covered with gauze for 24 hours, reduces the severity of pruritus for up to 7 days after application when compared with hydrogel covered with gauze or with gauze alone (96362). Preliminary clinical research in females experiencing itchy skin due to intrahepatic cholestasis of pregnancy also shows that applying peppermint oil 0.5% in sesame oil twice daily for 2 weeks reduces pruritus severity approximately 1.8-fold when compared with sesame oil alone (89478).
Small intestinal bacterial overgrowth (SIBO). Although there has been interest in using oral peppermint for SIBO, there is insufficient reliable information about the clinical effects of peppermint for this condition.
Stress. It is unclear if inhaled peppermint oil is beneficial for stress. Details: Clinical research shows that peppermint aromatherapy decreases physical and perceived levels of stress when compared with baseline (68422,68517). A small clinical study in adults undergoing a virtual reality (VR) driving scenario to test road rage shows that exposure to peppermint oil (Pure Essential Oil of Peppermint, Tisserand Aromatherapy) 5 drops via fan diffuser improves aggressive driving behavior scores but does not seem to improve self-reported stress, aggression, alertness, happiness, or calmness when compared with controls that did not receive aromatherapy during the VR session (112017).
Toothache. Although there has been interest in using topical peppermint oil for toothache, there is insufficient reliable information about the clinical effects of peppermint for this condition.
Urticaria. Although there has been interest in using topical peppermint oil for urticaria, there is insufficient reliable information about the clinical effects of peppermint for this condition. More evidence is needed to rate peppermint for these uses.

Safety view details

Below is general information about the safety of the known ingredients contained in the product Aroma Siez Essential Oil. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.

BASIL

LIKELY SAFE ...when used orally in amounts commonly found in foods. Basil has Generally Recognized as Safe (GRAS) status in the US (4912).

POSSIBLY SAFE ...when used topically in medicinal amounts. Solutions containing up to 6% basil essential oil have been used with apparent safety for up to 12 weeks (103622). There is insufficient reliable information available about the safety of basil when inhaled as aromatherapy.

POSSIBLY UNSAFE ...when used orally in medicinal amounts. Both the above ground parts and the oil of basil contain estragole, which might be hepatocarcinogenic and mutagenic (2,8,12).

CHILDREN: LIKELY SAFE
when the above ground parts are used in amounts commonly found in foods.

CHILDREN: POSSIBLY UNSAFE
when used orally in medicinal amounts due to the estragole constituent (2,8).

PREGNANCY AND LACTATION: LIKELY SAFE
when the above ground parts are used in amounts commonly found in foods.

PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used in larger amounts due to the estragole constituent of the essential oil. Estragole might have mutagenic effects (2,12).

CYPRESS

There is insufficient reliable information available about the safety of cypress.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

LAVENDER

LIKELY SAFE ...when used orally in amounts commonly found in foods. Lavender has Generally Recognized as Safe (GRAS) status for food use in the US (4912).

POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts (9792). In clinical research, a specific product containing lavender oil (Silexan, Dr Willmar Schwabe GmbH & Co. KG) has been used safely at doses of 80-160 mg daily for up to 10 weeks (58077,58080,58098,97257,112255). Powdered dried lavender flowers 500 mg twice daily has also been used with apparent safety for up to 8 weeks (97256). ...when used topically and appropriately. Lavender oil has been used safely for up to 7 months in adults (5177,109858,109865). ...when the essential oil is inhaled as a part of aromatherapy. Clinical studies have used lavender oil aromatherapy with apparent safety for up to 12 weeks (7107,12213,16393,16394,95634,103062,103063,103065,103068).

CHILDREN: POSSIBLY SAFE
when the essential oil is inhaled as a part of aromatherapy. Clinical studies have used lavender oil aromatherapy with apparent safety in single doses for up to 2 hours (109868,112260).

CHILDREN: POSSIBLY UNSAFE
when applied topically in males. Anecdotal reports suggest that applying topical products containing lavender oil to prepubertal males may result in gynecomastia in some cases (15254,95643). Products with a higher concentration of lavender oil and more frequent applications might be more likely to result in gynecomastia.

PREGNANCY AND LACTATION:
Insufficient reliable evidence available. Preliminary clinical research shows that lavender essential oil can be inhaled during labor, with no apparent adverse outcomes in the infants (95633). Although this study suggests safety, high quality assessment of safety has not been conducted.

MARJORAM

LIKELY SAFE ...when used in amounts commonly found in foods. Marjoram and its essential oil have Generally Recognized as Safe (GRAS) status in the US (4912).

POSSIBLY SAFE ...when the leaf is used orally and appropriately in tea, short-term (12,18). ...when marjoram oil is used orally and appropriately, short-term (11).

POSSIBLY UNSAFE ...when the flower, leaf, and oil are used orally, long-term. Marjoram contains arbutin, a hydroquinone glycoside (2,18). Studies in animals suggest that long-term use of hydroquinone can damage the liver and kidneys and might cause cancer (2,76395,95524). There is insufficient reliable information available about the safety of marjoram when used topically.

PREGNANCY: POSSIBLY UNSAFE
when used in medicinal amounts; marjoram has the potential for stimulating menstruation (19,95324). Avoid amounts greater than those found in foods.

LACTATION:
Insufficient reliable information available; avoid amounts greater than those found in foods.

PEPPERMINT

LIKELY SAFE ...when peppermint oil is used orally, topically, or rectally in medicinal doses. Peppermint oil has been safely used in multiple clinical trials (3801,3804,6190,6740,6741,10075,12009,13413,14467,17681)(17682,68522,96344,96360,96361,96362,96363,96364,96365,99493).

POSSIBLY SAFE ...when peppermint leaf is used orally and appropriately, short-term. There is some clinical research showing that peppermint leaf can be used safely for up to 8 weeks (12724,13413). The long-term safety of peppermint leaf in medicinal doses is unknown. ...when peppermint oil is used by inhalation as aromatherapy (7107). There is insufficient reliable information available about the safety of using intranasal peppermint oil.

CHILDREN: POSSIBLY SAFE
when used orally for medicinal purposes. Enteric-coated peppermint oil capsules have been used with apparent safety under medical supervision in children 8 years of age and older (4469).

PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (96361). There is insufficient information available about the safety of using peppermint in medicinal amounts during pregnancy or lactation; avoid using.

Interactions with Drugs view details

Below is general information about the interactions of the known ingredients contained in the product Aroma Siez Essential Oil. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.

BASIL

ANTICOAGULANT/ANTIPLATELET DRUGS

Interaction Rating = Moderate Be cautious with this combination.

Severity = High • Occurrence = Possible • Level of Evidence = D

Theoretically, basil might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.

Details

In vitro and animal studies suggest that basil oils and extracts inhibit platelet aggregation (49445,76838,76884).

ANTIHYPERTENSIVE DRUGS

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = D

Theoretically, basil might increase the risk of hypotension when taken with antihypertensive drugs.

Details

Animal research suggests that basil extract can reduce systolic and diastolic blood pressure (76893).

CYPRESS

ANTICOAGULANT/ANTIPLATELET DRUGS

Interaction Rating = Moderate Be cautious with this combination.

Severity = High • Occurrence = Possible • Level of Evidence = D

In vitro evidence shows that cypress cone extract inhibits blood coagulation in a concentration-dependent manner. In one case report, prolonged bleeding time during surgery occurred in a 52-year-old female undergoing removal of a premalignant skin lesion. Based on preoperative questioning, the patient had no relevant history of systemic disease, drug use, or allergy. Upon postoperative questioning, the patient reported taking cypress cone extract for one year prior to surgery (97898). Theoretically, taking cypress extract along with anticoagulant/antiplatelet drugs might increase the risk of bruising and bleeding in some patients. Some anticoagulant/antiplatelet drugs include aspirin; clopidogrel (Plavix); nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), and naproxen (Anaprox, Naprosyn, others); dalteparin (Fragmin); enoxaparin (Lovenox); heparin; warfarin (Coumadin); and others.

LAVENDER

CNS DEPRESSANTS

Interaction Rating = Moderate Be cautious with this combination.

Severity = High • Occurrence = Unlikely • Level of Evidence = D

Theoretically, lavender might potentiate the therapeutic effects and adverse effects of CNS depressants.

Details

Laboratory research suggests that lavender has sedative effects (7). However, clinical studies in patients taking oral lavender oil (Silexan) 160 mg for 10 weeks or taking lavender flower powder 1 gram daily for 2 months have not reported side effects of drowsiness, sedation, or sleepiness (97256,103061). There is still some concern that higher doses or different preparations of lavender might have additive effects with CNS depressant medications.

MARJORAM

ANTICHOLINERGIC DRUGS

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = D

In vitro research suggests that marjoram extract can inhibit acetylcholinesterase activity (31438,76912). Theoretically, using marjoram in medicinal amounts along with anticholinergic drugs might decrease the effectiveness of marjoram or the anticholinergic agent.

Details

Some anticholinergic drugs include atropine, benztropine (Cogentin), biperiden (Akineton), procyclidine (Kemadrin), and trihexyphenidyl (Artane).

ANTICOAGULANT/ANTIPLATELET DRUGS

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = D

In vitro research suggests that marjoram extract inhibits platelet aggregation and adhesion (76932). Theoretically, marjoram might increase the risk of bleeding when used in medicinal amounts along with antiplatelet or anticoagulant drugs.

Details

Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

CHOLINERGIC DRUGS

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = D

In vitro research suggests that marjoram extract can inhibit acetylcholinesterase activity (31438,76912). Theoretically, using marjoram in medicinal amounts along with cholinergic drugs might have additive effects and increase the risk of cholinergic side effects.

Details

Cholinergic drugs include bethanechol (Urecholine), donepezil (Aricept), echothiophate (Phospholine Iodide), edrophonium (Enlon, Reversol, Tensilon), neostigmine (Prostigmin), physostigmine (Antilirium), pyridostigmine (Mestinon, Regonol), succinylcholine (Anectine, Quelicin), and tacrine (Cognex).

PEPPERMINT

CYCLOSPORINE (Neoral, Sandimmune)

Interaction Rating = Moderate Be cautious with this combination.

Severity = High • Occurrence = Possible • Level of Evidence = D

Theoretically, peppermint oil might increase the levels and adverse effects of cyclosporine.

Details

In animal research, peppermint oil inhibits cyclosporine metabolism and increases cyclosporine levels. Inhibition of cytochrome P450 3A4 (CYP3A4) may be partially responsible for this interaction (11784). An interaction between peppermint oil and cyclosporine has not been reported in humans.

CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES

Interaction Rating = Minor Be watchful with this combination.

Severity = Mild • Occurrence = Possible • Level of Evidence = B

Theoretically, peppermint might increase the levels of CYP1A2 substrates.

Details

In vitro and animal research shows that peppermint oil and peppermint leaf inhibit CYP1A2 (12479,12734). However, in clinical research, peppermint tea did not significantly affect the metabolism of caffeine, a CYP1A2 substrate. It is possible that the 6-day duration of treatment may have been too short to identify a difference (96359).

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = D

Theoretically, peppermint might increase the levels of CYP2C19 substrates.

Details

In vitro research shows that peppermint oil inhibits CYP2C19 (12479). So far, this interaction has not been reported in humans.

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = D

Theoretically, peppermint might increase the levels of CYP2C9 substrates.

Details

In vitro research shows that peppermint oil inhibits CYP2C9 (12479). So far, this interaction has not been reported in humans.

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Interaction Rating = Moderate Be cautious with this combination.

Severity = Moderate • Occurrence = Possible • Level of Evidence = B

Theoretically, peppermint might increase the levels of CYP3A4 substrates.

Details

Clinical research in healthy volunteers shows that a single dose of peppermint oil 600 mg inhibits CYP3A4 enzymes and increases the AUC of felodipine, a CYP3A4 substrate (11783). However, in vitro research suggests that peppermint oil only inhibits CYP3A4 at very high concentrations (12479).

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Adverse Effects view details

Below is general information about the adverse effects of the known ingredients contained in the product Aroma Siez Essential Oil. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.

BASIL

General ...Topically, basil seems to be well tolerated.

Immunologic ...Allergic contact dermatitis has been reported in a 45-year old woman with occupational exposure to basil (95140).

CYPRESS

General ...Orally, cypress may cause kidney irritation (18). Airborne pollens from cypress may cause respiratory allergies (46912,46915,46925,46930,106005).

Immunologic ...Airborne cypress pollen is a common cause of allergy-related respiratory and ocular symptoms in some people (46912,46915,46925,46930,106005). A case of allergic contact dermatitis to the resin-impregnated leaves of a cypress tree has occurred in a patient with a history of cutaneous reactions to adhesive bandages, likely due to a cross-sensitivity with colophonium (106005).

Renal ...Orally, cypress may cause kidney irritation (18).

LAVENDER

General ...Orally, lavender is well tolerated in food amounts and seems to be well tolerated in larger amounts. Topically, lavender oil seems to be well tolerated.
Most Common Adverse Effects:
Orally: Breath odor, constipation, diarrhea, dyspepsia, eructation, headache, and nausea.
Topically: Allergic contact dermatitis (with lavender oil).
Serious Adverse Effects (Rare):
Topically: Cases of gynecomastia have been reported in prepubertal males using lavender oil.

Cardiovascular ...Orally, a specific lavender oil ingredient (Silexan) has been associated with palpitations (103061).

Endocrine ...Topical products containing lavender oil alone, including a product referred to as agua de violetas, or in combination with tea tree oil have been linked to at least six cases of gynecomastia when used in prepubertal males. In each case, gynecomastia resolved when the lavender oil products were discontinued. It is thought that the estrogenic and antiandrogenic activity of lavender oil and tea tree oil resulted in gynecomastia in these cases (15254,95643).

Gastrointestinal ...Orally, lavender oil, including a specific lavender oil ingredient KG), may cause gastrointestinal disturbance, including dyspepsia, diarrhea, breath odor, eructation, and nausea (58077,58080,58098,93004,103061). Tincture of lavender has been linked to cases of constipation and increased appetite; however, it is unknown if this occurred at a greater rate than with placebo (9792).

Immunologic ...Topically, use of lavender oil, such as in personal care products, might cause allergic contact dermatitis in some patients (6,101728). There have been numerous case reports of allergic contact dermatitis and eczema linked to lavender oil exposure from shampoos, lotions, fragrances, or direct application of oil to pillows (10031,58043,58109,58120,101728,112253). In one case series, only 4 out of 15 cases of allergic contact dermatitis due to lavender had positive patch tests for lavender. Oxidation products of lavender essential oils such as linalool, linalyl acetate, limonene, cineol, geraniol, eugenol, and isoeugenol may be more allergenic than un-oxidized lavender essential oil, which may result in a false negative patch test (112253).

Neurologic/CNS ...Orally, lavender flower powder, tincture of lavender containing 50% alcohol, and a specific lavender oil ingredient (Silexan) have been linked to headache (9792,103061,109860). Headache has also been reported rarely following lavender oil aromatherapy (109860).

Pulmonary/Respiratory ...In one case report, a 34-year-old Japanese female presented with complaints of dyspnea, cough, and fever 2 weeks after initiating lavender essential oil therapy via humidifier. The patient had an oxygen saturation of 88% and was diagnosed with acute eosinophilic pneumonia. Symptoms improved after a course of corticosteroids and discontinuation of aromatherapy (109979).

Renal ...In one case report, a 24-year-old male presented with shortness of breath, weakness, nausea, and decreased urine output following the intake of Spanish lavender tea twice daily for 5 days. After presenting to the hospital, the patient was diagnosed with acute kidney failure secondary to acute interstitial nephritis likely due to lavender consumption (112259).

MARJORAM

General ...Orally, marjoram and its essential oil are well tolerated in amounts commonly found in foods (4912). Marjoram leaf and marjoram oil seem to be well tolerated when used appropriately for medicinal purposes (2,11,12,18). However, marjoram flower, leaf, and oil should not be used long-term due to the arbutin content (2,76395,95524).
Topically, there are rare reports of allergic skin reactions with marjoram use (33865,58049).

Immunologic ...Possible allergic contact dermatitis in children with pre-existing childhood atopic eczema was observed in a randomized clinical trial employing extended use of essential oils, including sweet marjoram essential oil (58049). A case report describes a 38-year old woman who had an exacerbation of perioral dermatitis after eating food seasoned with marjoram. The dermatitis resolved within 3 weeks on a marjoram-free diet, but reappeared when she was rechallenged with marjoram (33865).

PEPPERMINT

General ...Orally, topically, or rectally, peppermint oil is generally well tolerated. Inhaled, peppermint oil seems to be well tolerated. Intranasally, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted. Orally, peppermint leaf seems to be well tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, anal burning, belching, diarrhea, dry mouth, heartburn, nausea, and vomiting.
Topically: Burning, dermatitis, irritation, and redness.

Dermatologic ...Topically, peppermint oil can cause skin irritation, burning, erythema, and contact dermatitis (3802,11781,31528,43338,68473,68457,68509,96361,96362). Also, a case of severe mucosal injury has been reported for a patient who misused an undiluted over the counter mouthwash that contained peppermint and arnica oil in 70% alcohol (19106).
In large amounts, peppermint oil may cause chemical burns when used topically or orally. A case of multiple burns in the oral cavity and pharynx, along with edema of the lips, tongue, uvula, and soft palate, has been reported for a 49-year-old female who ingested 40 drops of pure peppermint oil. Following treatment with intravenous steroids and antibiotics, the patient's symptoms resolved over the course of 2 weeks (68432). Also, a case of chemical burns on the skin and skin necrosis has been reported for a 35-year-old male who spilled undiluted peppermint oil on a previous skin graft (68572). Oral peppermint oil has also been associated with burning mouth syndrome and chronic mouth ulceration in people with contact sensitivity to peppermint (6743). Also, excessive consumption of mint candies containing peppermint oil has been linked to cases of stomatitis (13114).

Gastrointestinal ...Orally, peppermint oil can cause heartburn, nausea and vomiting, anal or perianal burning, abdominal pain, belching, dry mouth, diarrhea, and increased appetite (3803,6740,6741,6742,10075,11779,11789,17682,68497,68514)(68532,68544,96344,96360,102602,104219,107955). Enteric-coated capsules might help to reduce the incidence of heartburn (3802,4469,6740,11777). However, in one clinical study, a specific enteric-coated formulation of peppermint oil (Pepogest; Nature's Way) taken as 180 mg three times daily was associated with a higher rate of adverse effects when compared with placebo (48% versus 31%, respectively). Specifically, of the patients consuming this product, 11% experienced belching and 26% experienced heartburn, compared to 2% and 12%, respectively, in the placebo group (107955). A meta-analysis of eight small clinical studies in patients with irritable bowel syndrome shows that taking enteric-coated formulations of peppermint oil increases the risk of gastroesophageal reflux symptoms by 67% when compared with a control group (109980). Enteric-coated capsules can also cause anal burning in people with reduced bowel transit time (11782,11789).

Genitourinary ...Orally, a sensitive urethra has been reported rarely (102602).

Hepatic ...One case of hepatocellular liver injury has been reported following the oral use of peppermint. Symptoms included elevated liver enzymes, fatigue, jaundice, dark urine, and signs of hypersensitivity. Details on the dosage and type of peppermint consumed were unavailable (96358).

Immunologic ...One case of IgE-mediated anaphylaxis, characterized by sudden onset of lip and tongue swelling, tightness of throat, and shortness of breath, has been reported in a 69-year-old male who consumed peppermint candy (89479). An allergic reaction after use of peppermint oil in combination with caraway oil has been reported in a patient with a history of bronchial asthma (96344). It is not clear if this reaction occurred in response to the peppermint or caraway components.

Neurologic/CNS ...Orally, headache has been reported rarely (102602).

Ocular/Otic ...Orally, peppermint has been reported to cause blurry vision (3803).

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