Sage: benefits, dosage, contraindications
Scientific name(s)
Salvia officinalis
Family or group:
Plants
Indications
Scoring methodology
EFSA approval.
Alzheimer's disease ✪✪✪✪✪
Oral administration of extracts from common sage and Spanish sage appears to improve cognitive functions in patients with mild to moderate Alzheimer's disease when used for periods of up to 4 months. Formulations used: - Spanish sage essential oil (Salvia lavandulifolia) containing borneol, camphene, camphor, 1,8-cineole and a-terpineol: 50 μL. - Hydroalcoholic extract: the Salvia officinalis extract was prepared at a 1:1 ratio in 45% alcohol. In other words, 1 kg of dried herb (leaf) per 1 L of alcohol.
Posologie
Oral: leaf
50 microliters
essential oil, hydroalcoholic extract
Cognitive performance ✪✪✪✪✪
Clinical research conducted on healthy adults shows that taking a single dose of Spanish sage essential oil of 25 to 50 μL before cognitive testing improves attention and alertness compared with placebo. Other clinical research conducted on healthy older adults shows that taking a single 333 mg dose of common sage extract improves attention accuracy compared with placebo. When used in aromatherapy, common sage or Spanish sage essential oil improves alertness. However, neither species improves the speed or accuracy of attention.
Posologie
Oral: leaf
333 mg
essential oil, dry extract
An Extract of Salvia (Sage) With Anticholinesterase Properties Improves Memory and Attention in Healthy Older Volunteers
Differential Effects of the Aromas of Salvia Species on Memory and Mood
Positive Modulation of Mood and Cognitive Performance Following Administration of Acute Doses of Salvia Lavandulaefolia Essential Oil to Healthy Young Volunteers
Memory ✪✪✪✪✪
Clinical research conducted on healthy older adults shows that taking a single 333 mg dose of common sage extract improves secondary memory compared to placebo. nnSingle doses of Spanish sage essential oil of 25-50 mcL appear to improve memory in young adults in a dose-dependent manner. The essential oils of common sage appear to be more effective than Spanish sage. Neither species improves memory speed or working memory when used in aromatherapy.nn
Posologie
By mouth: leaf
333 mg
essential oil, dry extract
Monoterpenoid Extract of Sage (Salvia Lavandulaefolia) With Cholinesterase Inhibiting Properties Improves Cognitive Performance and Mood in Healthy Adults
An Extract of Salvia (Sage) With Anticholinesterase Properties Improves Memory and Attention in Healthy Older Volunteers
Differential Effects of the Aromas of Salvia Species on Memory and Mood
Positive Modulation of Mood and Cognitive Performance Following Administration of Acute Doses of Salvia Lavandulaefolia Essential Oil to Healthy Young Volunteers
Emotional balance ✪✪✪✪✪
In a clinical study conducted in young, healthy individuals, mood was consistently improved, with increases in self-rated "vigilance", "calm" and "satisfaction" after the 50 µL dose. These results provide further evidence that Salvia is capable of modulating mood and cognition in healthy young adults.
Posologie
Oral: leaf
25 - 50 microliters
essential oil
Differential Effects of the Aromas of Salvia Species on Memory and Mood
Positive Modulation of Mood and Cognitive Performance Following Administration of Acute Doses of Salvia Lavandulaefolia Essential Oil to Healthy Young Volunteers
Dyslipidemia ✪✪✪✪✪
Clinical research in adults with hypercholesterolemia shows that taking a common sage leaf extract (500 mg), standardized to 2.16% quercetin, three times daily for 2 months reduces total cholesterol and triglyceride levels and increases high-density lipoprotein (HDL) cholesterol levels compared with placebo. In addition, preliminary clinical research in adults with type 2 diabetes and hypercholesterolemia shows that taking a common sage leaf extract at 500 mg three times daily for three months reduces total cholesterol by 17%, LDL cholesterol by 36% and triglycerides by 56%, and increases HDL cholesterol by 28% compared with placebo.
Posologie
Oral: leaf
500 - 1500 mg
dry extract
Improved Glycemic Control and Lipid Profile in Hyperlipidemic Type 2 Diabetic Patients Consuming Salvia Officinalis L. Leaf Extract: A Randomized Placebo. Controlled Clinical Trial
Menopause ✪✪✪✪✪
Open-label preliminary studies conducted in postmenopausal women show that taking a specific thujone-free common sage extract at 280 mg per day for 56 days reduces the daily frequency of hot flushes by 40% and decreases their intensity compared with baseline. The validity of these results is limited by the absence of a control group.
Posologie
Oral: leaf
280 mg
dry extract
Herpes ✪✪✪✪✪
Clinical research shows that topical application of a cream containing either sage alone or sage with rhubarb heals herpes labialis lesions in 7.6 days or 6.7 days, respectively, compared with a healing time of 6.3 days with the acyclovir cream. The combination of sage and rhubarb also improves healing time and reduces pain compared with sage alone.
Posologie
Topical: leaf
cream
Synergies
Pharyngitis ✪✪✪✪✪
Clinical research conducted on patients with acute viral pharyngitis shows that inhalation of three puffs of a specific spray containing a 15% extract of common sage reduces throat pain intensity within 2 hours compared with placebo. nnOther preliminary clinical research on patients suffering from sore throats due to acute pharyngitis or tonsillitis shows that the application of a combined spray product containing common sage and echinacea every 2 hours, up to 10 times per day, for 5 consecutive days improves symptoms as effectively as a chlorhexidine-lidocaine spray.nn
Posologie
Oral use: leaf
Spray
Synergies
Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial
Digestive disorders ✪✪✪✪✪
The EMA recognizes the use of sage as a traditional herbal medicinal product for the relief of mild dyspeptic disorders such as heartburn and bloating.nn
Posologie
Oral use: leaf
320 mg
dry extract
Sweating ✪✪✪✪✪
The EMA recognizes the use of sage as a traditional herbal medicinal product for the relief of excessive sweating. nn
Posologie
Oral and topical: leaf
80 - 160 mg
dry extract
Stomatitis ✪✪✪✪✪
The EMA recommends the use of sage as a traditional herbal medicinal product for the relief of inflammations in the mouth or throat. ESCOP recognizes the use of sage (Salvia officinalis) in the treatment of inflammations and infections of the mouth and throat such as stomatitis, gingivitis or pharyngitis, and to relieve excessive sweating, in a treatment of two to four weeks.
Posologie
Oral use: leaf
250 mg
gel
Dermatoses ✪✪✪✪✪
The EMA recognizes the use of sage as a traditional herbal medicinal product for the relief of minor skin inflammations.
Posologie
Topical use: leaf
2.5 g
lotion
Properties
Hormonal metabolism
Sage stimulates the prolactin response (the lactation hormone) and the thyroid-stimulating hormone (TSH) in response to thyrotropin-releasing hormone (TRH) in postmenopausal women. However, it does not affect the levels of other hormones such as estradiol (a sex hormone), luteinizing hormone (LH), or follicle-stimulating hormone (FSH).
Usages associés
Neurological
Sage's potential to improve memory and cognitive performance has been attributed to its anticholinesterase activity. It may potentially increase levels of acetylcholine, a neurotransmitter involved in memory and learning processes. Linalool and alpha-terpineol, 1,8-cineole, alpha-pinene, and caryophyllene oxide have anticholinesterase activity.
Usages associés
Antibacterial
Sage extracts and their constituents have shown antibacterial activity against various species of Staphylococcus, vancomycin-resistant enterococci, Escherichia coli, Salmonella typhi, Salmonella enteritidis, and Shigella sonnei. It has been shown that sage carnosol potentiates the antimicrobial activity of aminoglycosides against vancomycin-resistant enterococci. Sage has also been shown to inhibit the growth of Helicobacter pylori and Campylobacter jejuni in vitro. However, the evidence regarding the antibacterial effects of sage on oral bacteria is mixed.
Antioxidant
Thanks to its constituents: rosmarinic acid, carvacrol, luteolin, carnosic acid, alpha- and beta-pinene, and 1,8-cineole, sage has demonstrated antioxidant effects in vitro.
Anti-inflammatory
In vitro and animal studies have shown that sage has anti-inflammatory properties. Ursolic acid from sage contributes to these effects. Sage acts by inhibiting the synthesis of nitric oxide, and some of its components, such as alpha-pinene and geraniol, reduce inflammation in adipose leukocytes. Other constituents, such as carnosic acid and carnosol, inhibit 5-lipoxygenase, thereby attenuating inflammatory responses.
Usages associés
Estrogenic activity
Dose-dependent estrogen activity has been demonstrated in an ethanolic extract (which appeared to be concentrated in the water-soluble fraction) of the species S. lavandulaefolia. The essential oil and its constituent, the monoterpenoid geraniol (< 1% of the essential oil), also showed estrogenic activity. The potential estrogenic activity of essential oil extracts and components of S. lavandulaefolia requires further research.
Hepatoprotective
Animal studies show that consumption of sage may increase liver glutathione-S-transferase activity and protect against lipid peroxidation and glutathione depletion. Other animal studies show that sage extract may protect the liver against acute damage induced by azathioprine (a drug).
Safe dosage
Adults aged 18 years and over: 280 mg - 320 mg (dry extract)
- Dry extract: 320 mg per day to be taken in 3 to 4 doses. - Infusion (tea): 1 to 2.5 g of the comminuted herbal substance in 150 ml of boiling water, infused 3 times per day. - Liquid extract (DER 1:3.5-5): 0.5 ml in water 3 times per day. - Liquid extract (DER 1:4-6): 0.43 ml 3 times per day - Tincture: 2-3 ml 3 times per day - Liquid extract (DER 1:1): 250 mg gel containing 20% liquid extract for oromucosal use. Apply to affected areas and gently massage up to 5 times per day. Warning : thujone is thought to be neurotoxic, which is why chemotypes with a low thujone content should be preferred.
Interactions
Médicaments
Benzodiazepines: moderate interaction
Products containing common sage may interact with certain medications prescribed for anxiety and sleep disorders (benzodiazepines), as well as certain medications for psychiatric disorders (neuroleptics) and for epilepsy. People taking these types of treatments should consult their physician before using sage for therapeutic purposes.
Anticonvulsants: moderate interaction
Products containing common sage may interact with certain medications prescribed for anxiety and sleep disorders (benzodiazepines), as well as certain medications for psychiatric disorders (neuroleptics) and for epilepsy. People taking these types of treatments should consult their physician before using sage for therapeutic purposes.
Anticholinergics: moderate interaction
In vitro evidence suggests that common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) may inhibit acetylcholinesterase and could increase acetylcholine levels. Theoretically, simultaneous use of anticholinergic medications and common sage (Salvia officinalis) or Spanish sage (Salvia lavandulaefolia) could reduce the effectiveness of either the sage or the anticholinergic agent.
Estrogens: weak interaction
In vitro evidence suggests that geraniol, a constituent of Spanish sage (Salvia lavandulaefolia), exerts estrogenic activity. Theoretically, excessive doses of sage could interfere with hormone therapy because of geraniol's estrogenic effects.
Central nervous system depressants: weak interaction
Some constituents of sage have depressant effects on the central nervous system. Theoretically, concomitant use of sedative medications could lead to additive effects and side effects.
Anticholinesterase agents: moderate interaction
Simultaneous use of common sage (Salvia officinalis) or Spanish sage (Salvia lavandulaefolia) with other acetylcholinesterase inhibitors could have additive effects and increase the risk of cholinergic side effects. Acetylcholinesterase inhibitors and cholinergic medications include donepezil, for example.
Precautions
Children up to 18 years: avoid
Insufficient data.
Contraindications
Pregnancy: contraindicated
Sage has been reported to have abortifacient properties. Its use during pregnancy is therefore not recommended.
Breastfeeding: contraindicated
Sage is thought to possibly reduce lactation.
Epilepsy: contraindicated
Sage (Salvia officinalis) contains significant amounts of thujone, a convulsant. Avoid using sage in quantities greater than those found in food.
Hormone-sensitive conditions: contraindicated
Spanish sage (Salvia lavandulaefolia) appears to have estrogenic effects. Women with hormone-sensitive disorders should avoid excessive use of Spanish sage. These conditions include breast, uterine and ovarian cancer, as well as endometriosis and uterine fibroids.
