Does Clary Sage Oil Have Health Benefits? A Scientist Explains

Clary sage (Salvia sclarea L. Lamiaceae) is an aromatic plant which is  cultivated in Europe and North America (1).

The list of anecdotal benefits of clary sage is extremely long and includes being used as an antidepressant, anti-convulsive, anti-septic, anti-spasmodic, astringent, antibacterial, uterine tonic nervine and for sore throat, muscular pain, low estrogen, PMS, menstrual cramps, varicose veins, nervous fatigue, muscle cramps, acne and dandruff.

It is even listed as one of the top 13 garden plants for witchcraft.(2).

So the obvious question is whether we are dealing with a scientifically proven medicinal plant, witchcraft or just more blogger fiction?

What Is Clary Sage?

Clary sage is a biennial plant (meaning it has a two year biological cycle) that grows to about four feet and produces purple-blue colored flowers. As a flowering plant, clary sage produces a wide range of low molecular weight volatile agents that gives it a characteristic scent.

Linalool and linalyl acetate are the key isolates from the flowers of the plant , while sesquiterpenes are found in the leaves (1). In nature, the plant volatile linalool, has diverse functions including attracting pollinators and herbivores (3).  Clary sage also contains sclariol which is structurally related to oestrogen.

Clary sage is used as a medicinal herb, aromatherapy oil and in the cosmaceutical, food, alcohol and cigarette industries. The largest grower of clary sage worldwide is the US based tobacco industry as clary sage derived sclariol is used to flavor cigarettes.

Is There Any Research?

There are 112 publications relating to clary sage including 4 human clinical trials. To put this into context there are over 2000 studies on lavender oil which includes over 200 clinical trials.

Clary sage is definitely the poor cousin when it comes to research here.

Does Clary Sage Relieve Menstrual Discomfort?

Clary sage is widely recommended as a remedy for menstrual discomfort.

There are no clinical studies looking at clary sage as monotherapy for menstrual discomfort. There are two relevant studies relating to clary sage (as part of a combination oil blend) and menses.

The first study comes from a school of nursing in Korea and looked at the effect of aromatherapy on dysmenorrhea in 67 college students with known dysmenorrhea (4). The students were randomized to one of three groups: a control group, a placebo group or an aromatherapy treatment arm.

An aromatherapy oil mixture of two drops of lavender (Lavandula officialis), one drop of clary sage (Salvia sclarae) plus one drop of rose (Rosa centifolia) in 5cc of almond oil (as the carrier oil) was massaged to the lower abdomen. The placebo group had almond oil without the essential oils applied topically to the lower abdomen. Results of the study showed a significant decrease in menstrual cramps in the aromatherapy treatment arm.

A second randomized double-blind study was conducted in 48 patients in Taiwan and compared essential oil to a synthetic fragrance for dysmenorrhea (5). The essential oil used was a blend of lavender (Lavandula officialis), clary sage (Salvia sclavae) and marjoram (Origanum majorana) in a 2:1:1 ratio in an unscented cream. The cream was applied topically to the lower abdomen. This study also showed a statistically significant decrease in dysmenorrhea in the aromatherapy treatment arm.

Summary: There is no information on the use of clary sage as a single oil to help relieve the symptoms of dysmenorrhea. There are 2 small studies suggesting that essential oil blends which include clary sage can help relieve dysmenorrhea. Further research is needed to help clarify this issue.

Does It Support Hormonal Balance?

Clary sage is frequently advertised as a remedy for ‘balancing hormones’.There are three published studies which look at clary sage for ‘balancing hormones’.

The first study was a non-randomized study which classified 22 menopausal woman as normal or as having a tendency towards depression. Inhalation of clary sage resulted in a statistically significant reduction in cortisol levels and an increase in 5HT levels in the group that had a tendency towards depression (5).

Clary sage contains the rarely found di-terpene, sclariol. The chemical structure of sclariol resembles estrogen leading to speculation that it may bind to the same receptors as oestrogen and exert a pro-oestrogenic effect (much like the controversy over soy).

The second study evaluated the effect of ten essential in peri-menopausal women and found no benefit of clary sage on salivary oestrogen concentration (6)

A third study showed that clary sage reduced stress induced by a forced swim test in mice and that this anti-stress effect could be blocked by antidepressant therapy (7).

These studies are interesting but far from conclusive.

Summary: There is no conclusive scientific data to support claims that clary sage helps balance hormones.

Does It Reduce Cholesterol?

There are no studies looking at the effect of clary sage on dyslipidemia.

There are not even any laboratory based studies evaluating this as a hypothesis.

Summary: There is absolutely no data to support clary sage as a cholesterol lowering agent.

Does It Improve Circulation?

A number of bloggers have claimed that there is proof that clary sage helps with circulation. I completely disagree. There are no studies or laboratory experiments looking at clary sage for improving circulation. As doctors, we use the term circulation to refer to blood supply. The study that bloggers have used to support the circulation claim is a study from Taiwan looking at 34 women with urinary incontinence who were undergoing urodynamic testing (8).

The women were randomized to inhale either lavender, clary sage or almond oil (control). The study found that systolic and diastolic blood pressure decreased in the clary sage arm of the study. The study team interpret this information (along with reductions in respiratory rate and cortisol levels) to conclude that clary sage may help relax people who are undergoing urodynamic testing. I agree with the researchers conclusions.

However somehow the blogosphere has interpreted this as evidence to support the fact that clary sage helps circulation. Seriously? They must be joking!

  1. The study showed a decrease in blood pressure.
  2. The decrease was non-statistically significant.
  3. The research team in Taiwan did not draw this conclusion.

I am beginning to think that there should be an environmental style tax applied to bloggers who pollute the web with trash. Maybe a double tax for bloggers who make stuff up and then use their own fiction as a hyperlink in their other blog posts (knowing full well that most people read the blogs on their phone on-the-go and tend to assume that hyperlinks go to a reputable reference).

Summary: Claims that clary sage helps circulation are false and misleading.

Does It Help Insomnia?

A study in Taiwan looked at a range of interventions to improve quality of life in career women (9). A total of career 132 women were randomly allocated to one of four interventions: (1) placebo (distilled water), (2) lavender essential oil (Lavandula angustifolia), (3) blended essential oil (1:1:1 ratio of L. angustifolia, Salvia sclarea, and Origanum majorana), and (4) acupressure massage groups for a 4-week treatment.

A non-stastically significant improvement in quality of life and sleep was noted in the group of women in the blended oil intervention group.

Summary: There are no studies supporting the claim that clary sage can help with insomnia.

Does It Relieve Stress?

Aromatherapy of essential oils is generally believed to help reduce stress (10). There are no studies looking at the specific effects of clary sage as a stress reducing agent apart from the study mentioned above which looked at women undergoing urodynamic studies showed that clary sage may have helped reduced the stress of the procedure (8).

There is a single study which found that clary sage had benefits in reducing stress which was induced by immobilisation in rats  (11).

A study in dominant and submissive mice showed that mice who received clary sage enriched feed showed a significant reduction of dominant and anxiety like behaviour as compared to mice who received sunflower oil treated feed (12). Fifty shades of clary sage!

Summary: There are no convincing studies to support an anti-stress role for clary sage.

Does It Fight Leukemia?

There are no clinical trials looking at clary sage for leukaemia. There is a single laboratory based study which evaluated the effect of clary sage root extract in leukemia cell lines in vitro (13). The study showed that the some extracts from the clary sage root were able to kill leukaemia cell lines.

However this is a laboratory test-tube based study and is very far removed from real life clinical practice.

Summary: There is no clinical evidence to support the use of clary sage for leukemia.

Does It Kill Bacteria & Infections?

There is growing interest in the potential of essential oils to treat antibiotic resistant bacteria (14). There are many studies which have shown that essential oils have real potential as anti- infective agents. As an example, one study looked at the antibacterial properties of clary sage in vitro (15).

The researchers used a colony counting method which counts the number of colonies of a bacteria that can grow in the presence of an antibiotic or essential oil.

The less colonies, the more effective the agent. The study looked at a range of bacteria including E coli, Pseudomonas, Klebsiella, Staph aureus. Clary sage was effective at reducing the colony count of all bacterial species. The mode of action of clary sage was damage to the cell wall. The authors concluded that the study was an ‘experimental basis’ for the practical application of using clary sage as a natural antibiotic.

Summary: There are numerous studies in vitro which suggest that clary sage may be a potential candidate as an antibacterial agent. However rigorous clinical trials are now needed to evaluate the safety and efficacy of using clary sage in humans. We are very far from being able to use clary sage as an antibiotic in clinical practice.

Does It Promote Skin Health?

There are no published studies, case reports or review articles linking clary sage to skin health. The study that is used in other blogs to support the role of clary sage in skin health was actually a study looking at the anti-bacterial effects of clary sage against different types of staphylococcal infections (16).

The study showed that clary sage inhibited the growth of staphylococcus. Staphylococcus can cause skin and soft tissue infections. However (technically) treating a skin infection is different to promoting skin health.

Summary: There is no clinical basis to support claims that clary sage helps promote skin health.

Does It Aid Digestion?

There is nothing in the medical or scientific literature to support the use of clary sage as a digestion aid.

Summary: There is nothing to support claims that clary sage helps aid digestion.

Is Clary Sage Safe?

There are no case reports of side effects or toxicity of clary sage.

Clary sage contains sclariol which has been shown to enhance the anti-cancer effect of some chemotherapy agents (18). Therefore clary sage should be avoided in people who are on chemotherapy to avoid excessive chemotherapy related toxicity.

Clinicians who use clary sage report that it is noted for inducing euphoria and that excessive use can be stupefying. It is generally recommended that it should not be combined with alcohol and may potentiate hypnotic drugs especially chloral hydrate and hexobarbitone.

Conclusion

It might be easier to prove that clary sage is beneficial in witchcraft than to use the current scientific evidence to prove that it has benefits as a medicinal plant.

References

1. Diversity of essential oil glands of clary sage (Salvia sclarea L., Lamiaceae). Schmiderer C, Grassi P, Novak J, Weber M, Franz C. Plant Biol (Stuttg). 2008 Jul;10(4):433-40. doi: 10.1111/j.1438-8677.2008.00053.x.

2. The Witching Herbs: 13 Essential Plants and Herbs for Your Magical Garden by Harold Roth http://a.co/bYQgldW www.amazon.com/Witching-Herbs-Essential-Plants-Magical/dp/1578635993/ref=sr_1_6?ie=UTF8&qid=1503399405&sr=8-6&keywords=clary+sage+book www.amazon.com/Witching-Herbs-Essential-Plants-Magical

3. More lessons from linalool: insights gained from a ubiquitous floral volatile. Raguso RA. Curr Opin Plant Biol. 2016 Aug;32:31-6. doi: 10.1016/j.pbi.2016.05.007. Epub 2016 Jun 7. Review.

4. Effect of aromatherapy on symptoms of dysmenorrhea in college students: A randomized placebo-controlled clinical trial. Han SH, Hur MH, Buckle J, Choi J, Lee MS. J Altern Complement Med. 2006 Jul-Aug;12(6):535-41.

5. Pain relief assessment by aromatic essential oil massage on outpatients with primary dysmenorrhea: a randomized, double-blind clinical trial. Ou MC, Hsu TF, Lai AC, Lin YT, Lin CC. J Obstet Gynaecol Res. 2012 May;38(5):817-22. doi: 10.1111/j.1447-0756.2011.01802.x. Epub 2012 Mar 22.

5. Effects of essential oil exposure on salivary estrogen concentration in perimenopausal women. Shinohara K, Doi H, Kumagai C, Sawano E, Tarumi W. Neuro Endocrinol Lett. 2017 Jan;37(8):567-572. PMID: 28326753

6. Changes in 5-hydroxytryptamine and cortisol plasma levels in menopausal women after inhalation of clary sage oil. Lee KB, Cho E, Kang YS. Phytother Res. 2014 Nov;28(11):1599-605. doi: 10.1002/ptr.5163. Epub 2014 May 7. Erratum in: Phytother Res. 2014 Dec;28(12):1897 PMID: 24802524

7. Antidepressant-like effect of Salvia sclarea is explained by modulation of dopamine activities in rats. Seol GH, Shim HS, Kim PJ, Moon HK, Lee KH, Shim I, Suh SH, Min SS. J Ethnopharmacol. 2010 Jul 6;130(1):187-90. doi: 10.1016/j.jep.2010.04.035. Epub 2010 May 2

8. Randomized controlled trial for Salvia sclarea or Lavandula angustifolia: differential effects on blood pressure in female patients with urinary incontinence undergoing urodynamic examination.Seol GH, Lee YH, Kang P, You JH, Park M, Min SS. J Altern Complement Med. 2013 Jul;19(7):664-70. doi: 10.1089/acm.2012.0148. Epub 2013 Jan 29.

9. Comparisons for Effectiveness of Aromatherapy and Acupressure Massage on Quality of Life in Career Women: A Randomized Controlled Trial. Kao YH, Huang YC, Chung UL, Hsu WN, Tang YT, Liao YH. J Altern Complement Med. 2017 Jun;23(6):451-460. doi: 10.1089/acm.2016.0403. Epub 2017 May 15.

10. Essential oils and ‘aromatherapy’: their modern role in healing. Lis-Balchin M. J R Soc Health. 1997 Oct;117(5):324-9. Review.

11. Effects of Salvia sclarea on chronic immobilization stress induced endothelial dysfunction in rats. Yang HJ, Kim KY, Kang P, Lee HS, Seol GH. BMC Complement Altern Med. 2014 Oct 14;14:396. doi: 10.1186/1472-6882-14-396.

12. Chronic food administration of Salvia sclarea oil reduces animals’ anxious and dominant behavior. Gross M, Nesher E, Tikhonov T, Raz O, Pinhasov A. J Med Food. 2013 Mar;16(3):216-22. doi: 10.1089/jmf.2012.0137. Epub 2013 Feb 27.

13. Cytotoxic and proapoptotic activity of diterpenoids from in vitro cultivated Salvia sclarea roots. Studies on the leukemia cell lines.Rózalski M, Kuźma L, Krajewska U, Wysokińska H.Z Naturforsch C. 2006 Jul-Aug;61(7-8):483-8.

14. Antibacterial and antifungal properties of essential oils. Kalemba D, Kunicka A. Curr Med Chem. 2003 May;10(10):813-29. Review

15. Antimicrobial activity and mechanisms of Salvia sclarea essential oil. Cui H, Zhang X, Zhou H, Zhao C, Lin L. Bot Stud. 2015 Dec;56(1):16. doi: 10.1186/s40529-015-0096-4. Epub 2015 Jun 19.

16. The effect of clary sage oil on staphylococci responsible for wound infections. Sienkiewicz M, Głowacka A, Poznańska-Kurowska K, Kaszuba A, Urbaniak A, Kowalczyk E. Postepy Dermatol Alergol. 2015 Feb;32(1):21-6. doi: 10.5114/pdia.2014.40957. Epub 2015 Feb 3.

17. Labd-14-ene-8,13-diol (sclareol) induces cell cycle arrest and apoptosis in human breast cancer cells and enhances the activity of anticancer drugs. Dimas K, Papadaki M, Tsimplouli C, Hatziantoniou S, Alevizopoulos K, Pantazis P, Demetzos C. Biomed Pharmacother. 2006 Apr;60(3):127-33. Epub 2006 Feb 21.

Summary
Does Clary Sage Oil Have Health Benefits? A Scientist Explains
Article Name
Does Clary Sage Oil Have Health Benefits? A Scientist Explains
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Healthy But Smart

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