Chamomile: Clinical Applications
Welcome to the blog series Herb of the Month!
This week, we will be exploring the many benefits and clinical applications of the hardy, daisy-like plant known as Chamomile. It’s had deep roots in history throughout the ages as an herbal remedy for many different ailments. Chamomile essential oil and extracts have been reported to have over 120 chemical constituents identified (the active ingredients of the herb). The most important compounds found were chamazulene, apigenin, luteolin, beta-carotene, and bisabolol. Additionally, it’s rich in vitamin C, calcium, copper, zinc, and iron. Chamomile preparations are known to have antioxidant, antibacterial, antimicrobial, antiviral, antifungal, antiparasitic, insecticidal, diuretic, anti-inflammatory, antispasmodic, anti-ulcer, sedative, anxiolytic, antidepressant, antihypertensive, gastroprotective effects. Because of this herb’s versatile roles, Chamomile can be used alone or even combined with other herbs and dietary supplements to help bring out the synergistic and potent medicinal qualities.
Health Benefits of Chamomile
Women’s Health
Chamomile’s generic name, Matricaria, comes from the Latin word matrix which means womb. This is because it was used historically to treat disorders of the female reproductive system. In a review entitled “A systematic review of the efficacy of alternative medicine in the treatment of nausea and vomiting of pregnancy,” written by Fahimeh Khorasani et al and published in 2020 in the Journal of Obstetrics and Gynaecology aimed to review the efficacy of herbal medicines such as Chamomile on nausea and vomiting in pregnancy (NVP). They found that herbal medicines such as Chamomile, Elettaria, and Lemon provided a safe and effective alternative for treating pregnant women with mild to moderate NVP.
Another recent study entitled “The Effect of Chamomile on Pain and Menstrual Bleeding in Primary Dysmenorrhea: A Systematic Review,” written by Azin Niazi and Maryam Moradi and published in the International Journal of Community Based Nursing & Midwifery in 2021, aimed to systematically review the clinical trials to determine the effect of Chamomile on pain and menstrual bleeding in primary dysmenorrhea. Primary dysmenorrhea is characterized by pain during menstruation. It’s a common symptom found among females in their reproductive age, caused by increased production of prostaglandin in the endometrium. After examining 7 clinical trials (with a sample size of 1,033), they found that Chamomile was considered an effective treatment for primary dysmenorrhea and reducing menstrual bleeding. Similarly, another study entitled “Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial,” written by N Saghafi et al and published in 2018 in the Journal of Obstetrics and Gynaecology aimed to study the effectiveness of chamomile on pain control of cyclic mastalgia. Breast pain (mastalgia) is often a chief complaint reported by many women. Oftentimes it begins in the luteal phase(the second half of the menstrual cycle – starting after ovulation and ending the first day of your period). All the participants in the trial were asked to take drops three times a day each time having five drops for two consecutive months. They found significant decline is mastalgia after two months, indicating that Chamomile is a safe, well-tolerated and effective treatment for women experiencing mild to moderate mastalgia.
Hot flashes are a common symptom of the menopausal transition. It can be very uncomfortable for many women and last for many years. It’s one of many challenging symptoms to navigate during perimenopause. In a study entitled “The immediate effect of natural plant extract, Angelica sinensis and Matricaria chamomilla (Climex) for the treatment of hot flushes during menopause. A preliminary report” written by C Kupfersztain et al in 2003 and published in the international journal Clinical and Experimental Obstetrics & Gynecology, they aimed to assess the efficiency of a medicinal herb extract preparation (Female Ginseng and Chamomile) called Climex for the treatment of menopausal symptoms. In this experiment, 55 postmenopausal women were divided randomly into two groups, one to receive Climex (5 chewable tablets daily between meals) and the other group to receive a placebo. They found that treatment with Climex seemed to be effective for menopausal symptoms without apparent major adverse effects.
Mental Health
Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. However, current treatments can have limited efficacy and significant side effects. In a 2016 study written by Jun J Mao et al, published in the Phyomedicine journal, and entitled, “Long-term Chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial,” they sought out a long-term evaluation of Chamomile use for prevention of GAD symptom relapse. During the first phase of the trial, participants received 12 weeks of open-label therapy with Chamomile pharmaceutical grade extract (500mg capsule 3x daily). During phase two, treatment responders were randomized into two different groups- 26 weeks of continuation chamomile therapy or placebo in a double-blinded, placebo substitution design. They found that long-term chamomile was safe and significantly reduced moderate-to-severe GAD symptoms, but did not significantly reduce the rate of relapse. In another study entitled “Short-term open-label chamomile (Matricaria chamomilla L.) therapy of moderate to severe generalized anxiety disorder” written by John R Keefe et al and published in the 2016 Phytomedicine journal, they hypothesized that treatment with chamomile extract would result in a significant reduction in GAD severity ratings. Participants diagnosed with moderate to severe GAD received open-label treatment with pharmaceutical-grade Chamomile extract 1500mg/day for up to 8 weeks. They found that Chamomile extract produced a clinically meaningful reduction in GAD symptoms over 8 weeks, with a response rate comparable to those observed during conventional anxiolytic drug therapy and a favorable adverse event profile.
It’s important to note that about 60% of people diagnosed with anxiety will also present with symptoms of depression, and vice versa. Although conventional antidepressant drug therapies have simplified this comorbid treatment of anxiety and depression, a large population still goes untreated. Many of those going untreated prefer to seek out alternative medicine remedies for their symptoms. In this recent 2020 study entitled “Putative Antidepressant Effect of Chamomile ( Matricaria chamomilla L.) Oral Extract in Subjects with Comorbid Generalized Anxiety Disorder and Depression,” written by Jay D Amsterdam et al and published in The Journal of Alternative and Complementary Medicine, they examined the assumed antidepressant effect of Chamomile extract in subjects with GAD with or without comorbid depression. 179 participants received initial therapy with open-label Chamomile extract 1500 mg daily for 8 weeks. They found that Chamomile may produce clinically meaningful antidepressant effects in addition to its anxiolytic activity in subjects with GAD and comorbid depression.
Sleep Health
Sleep is one of the most important, basic human needs. When there’s any disruption in its natural course, it can significantly impact how we function in our day to day life. There are various ways to deal with sleep disorders, but the return to herbal and natural drugs has been a more emphasized approach over the last decades. The 2011 study entitled, “Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: A randomized placebo-controlled pilot study,” written by Suzanna M Zick et al and published in the BMC Complementary Medicine and Therapies Journal examined the preliminary efficacy and safety of chamomile for improving subjective sleep and daytime symptoms in patients with chronic insomnia. Participants were randomized into two different groups: 270mg of Chamomile twice daily or placebo for 28 days. They concluded there was a possibility that Chamomile extract could provide modest and mixed clinical benefit, at the doses evaluated, to patients with chronic primary insomnia. More studies are needed to investigate these conditions.
Another study entitled “Investigation effect of oral chamomilla on sleep quality in elderly people in Isfahan: A randomized control trial” written by Mehrdad Abdullahzadeh et al in the 2017 Journal of Education and Health Promotion aimed to determine the effect of Chamomile extract on the sleep quality in elderly people admitted to nursing homes. They had 80 participants split into a test group and a control group, however at the end of the study there were only 77 participants that were able to finish the control trial. The test group received 400mg oral capsules of Chamomile 2x daily. The control group did not receive anything. They found that 4 weeks of consuming Chamomile extract was significantly effective in improving sleep quality.
Additional Health Benefits of Chamomile
Wound Healing & Skin Health
Wound healing involves a complex response to tissue injury achieved through four overlapping phases: hemostasis, inflammation, proliferation, and remodeling. The concept of using certain herbs in wound dressing is a prehistoric tradition that is still highly preferred by the general population. In a recent 2021 study entitled, “Polyherbal combination for wound healing: Matricaria chamomilla L. and Punica granatum L.” written by Somayeh Niknam et al and published in the DARU Journal of Pharmaceutical Sciences, they evaluated the individual and combined wound healing activity of methanol extracts of Pomegranate and Chamomile flowers. They found that extracts containing phytoconstituents with anti-inflammatory, antioxidant, and antimicrobial properties can promote high speed, uncomplicated wound healing. While the methanol fraction of Chamomile and Pomegranate both exhibited an acceleration in wound enclosures individually, combining them into one formulation had better wound healing properties.
Another study entitled “Effect of German chamomile oil application on alleviating atopic dermatitis-like immune alterations in mice” written by Soon-Hee Lee et al and published in 2010 in the Journal of Veterinary Science assessed the effectiveness of German Chamomile oil in relieving atopic dermatitis in mice by applying it to their skin. They found that markers associated with allergy were significantly lower in the mice that received chamomile oil compared to those that didn’t.
Joint Pain & Dysfunction
Chamomile has been shown to have antioxidant and anti-inflammatory properties. Because of this, it’s one of the oldest and most widely used medicinal plants in the world. However, did you know it can potentially help your muscle and joint pain? A study entitled “Efficacy and safety of topical Matricaria chamomilla L. (chamomile) oil for knee osteoarthritis: A randomized controlled clinical trial” written by Ruhollah Shoara et al in 2015 and published in the Complementary Therapies in Clinical Practice Journal assessed the efficacy and safety of topical Chamomile oil in participants with knee osteoarthritis. The participants were asked to apply the oil 3x a day for three weeks. They found that when compared to participants who didn’t use this treatment, Chamomile essential oil significantly reduced the need for pain relief medication.
Another study entitled “Efficacy of topical chamomile oil for mild and moderate carpal tunnel syndrome: A randomized double-blind placebo-controlled clinical trial” written by Mohammad Hashem Hashempur et al in 2017 and published in the Complementary Therapies in Clinical Practice Journal evaluated the efficacy of topical Chamomile oil in participants with mild and moderate carpal tunnel syndrome (CTS). They found that after four weeks, symptom severity scores in the Chamomile treatment group were significantly lower than the placebo group. Researchers believe it could be an effective non-invasive treatment for mild to moderate CTS.
Final Recommendations
Here are Nancy’s Chamomile recommendations from Fullscript:
Some Precautions with Chamomile Use:
Pregnancy – Caution is advised in using Chamomile during pregnancy in the first trimester. The first trimester should not exceed 500 mg of chamomile tea a day (that’s two cups of strong tea) but that’s being overly cautious. All foods and herbs should be scrutinized and monitored during the first trimester, however, if there is nausea then chamomile is excellent during the first trimester to gently reduce nausea. Rare individuals may have an allergic response to chamomile.
Ragweed allergies – Chamomile is a relative of ragweed and can cause allergy symptoms in individuals with ragweed allergies. While extremely rare, very large doses of chamomile may cause nausea and vomiting. Even more rarely, rashes may occur especially around the mouth.
Blood thinners – Chamomile also contains coumarin, so care should be taken to avoid potential drug interactions, especially prescription blood thinners.
A typical suggested serving of Chamomile is 250mg (1 strong cup of tea) a day, but can be 500mg of chamomile daily for mild worry and digestive upset. However, there is no “one size fits all” when it comes to recommending Chamomile. Because of this, Nancy recommends Booking a 15 Minute Discovery call if you’re interested in taking this wonderful herb. It’s important to consult with a registered clinical herbalist or natural health practitioner trained in clinical herbalism for more resistant and deeper set health issues. They will be able to give a more tailored suggested serving and daily frequency based on your age, gender, body weight, and any present medical conditions.
Remember to join us each month as we explore the history, personality, clinical application, and more of Nancy’s favorite plants. Get a snippet of the properties and practical uses of these herbs and how they supported the health of our ancestors as well as how they can support us in our present day.
Other Resources:
Science Direct | Greenjeeva | Herbalgram | NAMI | iHerb|
Welcome to the blog series Herb of the Month!
This week, we will be exploring the many benefits and clinical applications of the hardy, daisy-like plant known as Chamomile. It’s had deep roots in history throughout the ages as an herbal remedy for many different ailments. Chamomile essential oil and extracts have been reported to have over 120 chemical constituents identified (the active ingredients of the herb). The most important compounds found were chamazulene, apigenin, luteolin, beta-carotene, and bisabolol. Additionally, it’s rich in vitamin C, calcium, copper, zinc, and iron. Chamomile preparations are known to have antioxidant, antibacterial, antimicrobial, antiviral, antifungal, antiparasitic, insecticidal, diuretic, anti-inflammatory, antispasmodic, anti-ulcer, sedative, anxiolytic, antidepressant, antihypertensive, gastroprotective effects. Because of this herb’s versatile roles, Chamomile can be used alone or even combined with other herbs and dietary supplements to help bring out the synergistic and potent medicinal qualities.
Health Benefits of Chamomile
Women’s Health
Chamomile’s generic name, Matricaria, comes from the Latin word matrix which means womb. This is because it was used historically to treat disorders of the female reproductive system. In a review entitled “A systematic review of the efficacy of alternative medicine in the treatment of nausea and vomiting of pregnancy,” written by Fahimeh Khorasani et al and published in 2020 in the Journal of Obstetrics and Gynaecology aimed to review the efficacy of herbal medicines such as Chamomile on nausea and vomiting in pregnancy (NVP). They found that herbal medicines such as Chamomile, Elettaria, and Lemon provided a safe and effective alternative for treating pregnant women with mild to moderate NVP.
Another recent study entitled “The Effect of Chamomile on Pain and Menstrual Bleeding in Primary Dysmenorrhea: A Systematic Review,” written by Azin Niazi and Maryam Moradi and published in the International Journal of Community Based Nursing & Midwifery in 2021, aimed to systematically review the clinical trials to determine the effect of Chamomile on pain and menstrual bleeding in primary dysmenorrhea. Primary dysmenorrhea is characterized by pain during menstruation. It’s a common symptom found among females in their reproductive age, caused by increased production of prostaglandin in the endometrium. After examining 7 clinical trials (with a sample size of 1,033), they found that Chamomile was considered an effective treatment for primary dysmenorrhea and reducing menstrual bleeding. Similarly, another study entitled “Effectiveness of Matricaria chamomilla (chamomile) extract on pain control of cyclic mastalgia: a double-blind randomised controlled trial,” written by N Saghafi et al and published in 2018 in the Journal of Obstetrics and Gynaecology aimed to study the effectiveness of chamomile on pain control of cyclic mastalgia. Breast pain (mastalgia) is often a chief complaint reported by many women. Oftentimes it begins in the luteal phase(the second half of the menstrual cycle – starting after ovulation and ending the first day of your period). All the participants in the trial were asked to take drops three times a day each time having five drops for two consecutive months. They found significant decline is mastalgia after two months, indicating that Chamomile is a safe, well-tolerated and effective treatment for women experiencing mild to moderate mastalgia.
Hot flashes are a common symptom of the menopausal transition. It can be very uncomfortable for many women and last for many years. It’s one of many challenging symptoms to navigate during perimenopause. In a study entitled “The immediate effect of natural plant extract, Angelica sinensis and Matricaria chamomilla (Climex) for the treatment of hot flushes during menopause. A preliminary report” written by C Kupfersztain et al in 2003 and published in the international journal Clinical and Experimental Obstetrics & Gynecology, they aimed to assess the efficiency of a medicinal herb extract preparation (Female Ginseng and Chamomile) called Climex for the treatment of menopausal symptoms. In this experiment, 55 postmenopausal women were divided randomly into two groups, one to receive Climex (5 chewable tablets daily between meals) and the other group to receive a placebo. They found that treatment with Climex seemed to be effective for menopausal symptoms without apparent major adverse effects.
Mental Health
Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. However, current treatments can have limited efficacy and significant side effects. In a 2016 study written by Jun J Mao et al, published in the Phyomedicine journal, and entitled, “Long-term Chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial,” they sought out a long-term evaluation of Chamomile use for prevention of GAD symptom relapse. During the first phase of the trial, participants received 12 weeks of open-label therapy with Chamomile pharmaceutical grade extract (500mg capsule 3x daily). During phase two, treatment responders were randomized into two different groups- 26 weeks of continuation chamomile therapy or placebo in a double-blinded, placebo substitution design. They found that long-term chamomile was safe and significantly reduced moderate-to-severe GAD symptoms, but did not significantly reduce the rate of relapse. In another study entitled “Short-term open-label chamomile (Matricaria chamomilla L.) therapy of moderate to severe generalized anxiety disorder” written by John R Keefe et al and published in the 2016 Phytomedicine journal, they hypothesized that treatment with chamomile extract would result in a significant reduction in GAD severity ratings. Participants diagnosed with moderate to severe GAD received open-label treatment with pharmaceutical-grade Chamomile extract 1500mg/day for up to 8 weeks. They found that Chamomile extract produced a clinically meaningful reduction in GAD symptoms over 8 weeks, with a response rate comparable to those observed during conventional anxiolytic drug therapy and a favorable adverse event profile.
It’s important to note that about 60% of people diagnosed with anxiety will also present with symptoms of depression, and vice versa. Although conventional antidepressant drug therapies have simplified this comorbid treatment of anxiety and depression, a large population still goes untreated. Many of those going untreated prefer to seek out alternative medicine remedies for their symptoms. In this recent 2020 study entitled “Putative Antidepressant Effect of Chamomile ( Matricaria chamomilla L.) Oral Extract in Subjects with Comorbid Generalized Anxiety Disorder and Depression,” written by Jay D Amsterdam et al and published in The Journal of Alternative and Complementary Medicine, they examined the assumed antidepressant effect of Chamomile extract in subjects with GAD with or without comorbid depression. 179 participants received initial therapy with open-label Chamomile extract 1500 mg daily for 8 weeks. They found that Chamomile may produce clinically meaningful antidepressant effects in addition to its anxiolytic activity in subjects with GAD and comorbid depression.
Sleep Health
Sleep is one of the most important, basic human needs. When there’s any disruption in its natural course, it can significantly impact how we function in our day to day life. There are various ways to deal with sleep disorders, but the return to herbal and natural drugs has been a more emphasized approach over the last decades. The 2011 study entitled, “Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: A randomized placebo-controlled pilot study,” written by Suzanna M Zick et al and published in the BMC Complementary Medicine and Therapies Journal examined the preliminary efficacy and safety of chamomile for improving subjective sleep and daytime symptoms in patients with chronic insomnia. Participants were randomized into two different groups: 270mg of Chamomile twice daily or placebo for 28 days. They concluded there was a possibility that Chamomile extract could provide modest and mixed clinical benefit, at the doses evaluated, to patients with chronic primary insomnia. More studies are needed to investigate these conditions.
Another study entitled “Investigation effect of oral chamomilla on sleep quality in elderly people in Isfahan: A randomized control trial” written by Mehrdad Abdullahzadeh et al in the 2017 Journal of Education and Health Promotion aimed to determine the effect of Chamomile extract on the sleep quality in elderly people admitted to nursing homes. They had 80 participants split into a test group and a control group, however at the end of the study there were only 77 participants that were able to finish the control trial. The test group received 400mg oral capsules of Chamomile 2x daily. The control group did not receive anything. They found that 4 weeks of consuming Chamomile extract was significantly effective in improving sleep quality.
Additional Health
Benefits of Chamomile
Wound Healing
Wound healing involves a complex response to tissue injury achieved through four overlapping phases: hemostasis, inflammation, proliferation, and remodeling. The concept of using certain herbs in wound dressing is a prehistoric tradition that is still highly preferred by the general population. In a recent 2021 study entitled, “Polyherbal combination for wound healing: Matricaria chamomilla L. and Punica granatum L.” written by Somayeh Niknam et al and published in the DARU Journal of Pharmaceutical Sciences, they evaluated the individual and combined wound healing activity of methanol extracts of Pomegranate and Chamomile flowers. They found that extracts containing phytoconstituents with anti-inflammatory, antioxidant, and antimicrobial properties can promote high speed, uncomplicated wound healing. While the methanol fraction of Chamomile and Pomegranate both exhibited an acceleration in wound enclosures individually, combining them into one formulation had better wound healing properties.
Another study entitled “Effect of German chamomile oil application on alleviating atopic dermatitis-like immune alterations in mice” written by Soon-Hee Lee et al and published in 2010 in the Journal of Veterinary Science assessed the effectiveness of German Chamomile oil in relieving atopic dermatitis in mice by applying it to their skin. They found that markers associated with allergy were significantly lower in the mice that received chamomile oil compared to those that didn’t.
Joint Pain & Dysfunction
Chamomile has been shown to have antioxidant and anti-inflammatory properties. Because of this, it’s one of the oldest and most widely used medicinal plants in the world. However, did you know it can potentially help your muscle and joint pain? A study entitled “Efficacy and safety of topical Matricaria chamomilla L. (chamomile) oil for knee osteoarthritis: A randomized controlled clinical trial” written by Ruhollah Shoara et al in 2015 and published in the Complementary Therapies in Clinical Practice Journal assessed the efficacy and safety of topical Chamomile oil in participants with knee osteoarthritis. The participants were asked to apply the oil 3x a day for three weeks. They found that when compared to participants who didn’t use this treatment, Chamomile essential oil significantly reduced the need for pain relief medication.
Another study entitled “Efficacy of topical chamomile oil for mild and moderate carpal tunnel syndrome: A randomized double-blind placebo-controlled clinical trial” written by Mohammad Hashem Hashempur et al in 2017 and published in the Complementary Therapies in Clinical Practice Journal evaluated the efficacy of topical Chamomile oil in participants with mild and moderate carpal tunnel syndrome (CTS). They found that after four weeks, symptom severity scores in the Chamomile treatment group were significantly lower than the placebo group. Researchers believe it could be an effective non-invasive treatment for mild to moderate CTS.
Final Recommendations
Here are Nancy’s Chamomile recommendations from Fullscript:
Some Precautions with Chamomile Use:
Pregnancy – Caution is advised in using Chamomile during pregnancy in the first trimester. The first trimester should not exceed 500 mg of chamomile tea a day (that’s two cups of strong tea) but that’s being overly cautious. All foods and herbs should be scrutinized and monitored during the first trimester, however, if there is nausea then chamomile is excellent during the first trimester to gently reduce nausea. Rare individuals may have an allergic response to chamomile.
Ragweed allergies – Chamomile is a relative of ragweed and can cause allergy symptoms in individuals with ragweed allergies. While extremely rare, very large doses of chamomile may cause nausea and vomiting. Even more rarely, rashes may occur especially around the mouth.
Blood thinners – Chamomile also contains coumarin, so care should be taken to avoid potential drug interactions, especially prescription blood thinners.
A typical suggested serving of Chamomile is 250mg (1 strong cup of tea) a day, but can be 500mg of chamomile daily for mild worry and digestive upset. However, there is no “one size fits all” when it comes to recommending Chamomile. Because of this, Nancy recommends Booking a 15 Minute Discovery call if you’re interested in taking this wonderful herb.
It’s important to consult with a registered clinical herbalist or natural health practitioner trained in clinical herbalism for more resistant and deeper set health issues. They will be able to give a more tailored suggested serving and daily frequency based on your age, gender, body weight, and any present medical conditions.
Remember to join us each month as we explore the history, personality, clinical application, and more of Nancy’s favorite plants. Get a snippet of the properties and practical uses of these herbs and how they supported the health of our ancestors as well as how they can support us in our present day.
Other Resources: