Are You Up-To-Date on Sage Research?

Modern Research

Note: Some of the studies mentioned below address S. lavandulifolia (lavandulaefolia), which is now recognized as a subspecies of S. officinalis, e.g., Salvia officinalis subsp. lavandulifolia (Vahl) Gams.22 (Unless specified otherwise, the species studied was S. officinalis.)

Based on sage’s traditional use as an aid to memory, preliminary pharmacological investigations were conducted into its bioactivity (S. officinalis and S. lavandulifolia) that led to more detailed in vitro studies which investigated the chemical constituents that might be responsible for aiding failing memory.11 Results suggested that cyclic monoterpenes 1,8-cineole and alpha-pinene, as well as camphor, were responsible for the cholinesterase inhibition witnessed. Additionally, 1,8-cineole, alpha- and beta-pinene appeared partially responsible for the antioxidant effect of sage. Because Alzheimer’s Disease (AD) is thought to be due, in part, to inflammation and damage caused by pro-oxidant compounds that act on the brain cells, and since cholinesterase inhibitors are a standard treatment for AD patients, clinical studies on sage were needed to determine if it might be an appropriate treatment for AD patients.

A 2010 clinical study investigated the effect of the essential oils of S. officinalis and other species on cognition and mood in 135 healthy adults (45 in each group of S. officinalis, S. lavandulifolia, [5 drops of each essential oil in 5 ml water, NHR Organic Essential Oils, Brighton, UK] and no aroma). 23 The S. officinalis group performed significantly better than the S. lavandulifolia and control groups on the quality of memory, specifically long-term or secondary memory with no impact on working memory performance. The authors state that they would not have predicted the non-significant difference between the S. lavandulifolia and no aroma based on previous research, but that one possible explanation could be the lack of standardization of the sage preparations. The S. officinalis findings compared favorably with those reported earlier following oral administration of sage in healthy young participants.

A randomized, placebo-controlled, double-blind, balanced, 5-period crossover study in 2008 investigated the acute effects on cognitive performance of a standardized extract of sage (either 167 or 333 mg of a 70% dried ethanolic extract, Essential Nutrition, Brough, East Yorkshire, UK) in healthy adults (n=20) between 65-90 years of age.24 The study found that administration of a standardized sage extract can improve cognitive function in healthy older people. Specifically, the authors saw dose-specific improvement in secondary memory performance for the 333 mg dose. Results corresponded to those found in earlier studies on younger populations and suggested that further investigations were warranted in larger numbers, other populations, and with different dosing regimens.

In a 2006, a double-blind, placebo-controlled, crossover study, 30 healthy participants received—on 3 separate days, 7 days apart—either 600 mg or 300 mg dried sage leaf or placebo.25 Mood was assessed predose and at 1 and 4 hours post-dose, with each mood assessment being done before and after 20 minute performance of the Defined Intensity Stress Simulator (DISS) computerized multitasking battery. Improved ratings of mood in the absence of the stressor (pre-DISS) occurred with both doses, with the 300 mg dose reducing anxiety and the 600 mg dose leading to alertness, calmness, and contentedness. Reduced anxiety disappeared upon performance of the DISS. Results corresponded to those in other dose-dependent studies, and the authors suggested that further research was warranted into the potential use of sage in treating AD and natural aging, and the mechanisms responsible for the beneficial effects.

A 2005 placebo-controlled, double-blind, balanced, crossover study investigated the effect of S. lavandulifolia on mood and cognition in healthy young volunteers (n=24, 16 female, 8 male, 18-37 years old).26 Single doses of placebo, 25 ml, and 50 ml of a standardized essential oil (Baldwins, London, UK) were given 4 times, 7 days apart. Participants were tested pre-dose and at 1, 2.5, 4, and 6 hours after dosing. Results showed consistent improvement for both doses on speed of memory, alertness, calmness, and contentedness.

In a 4-month, parallel group, placebo-controlled clinical trial in 2003 where 42 patients with mild to moderate AD were randomized to placebo or fixed dose of S. officinalis extract (1:1 in 45% alcohol, Institute of Medicinal Plants, Halejerd, Iran), the patients taking the sage extract showed a significantly better outcome on cognitive functions than placebo.27 Additionally, agitation appeared to remain more frequent in the placebo group.

Human clinical studies on other aspects of sage have also been conducted. In 2009, a trial assessed the relative efficacy of a sage/ echinacea (SE) spray and a chlorhexidine/lidocaine (CL) spray in the treatment of acute sore throat.28 The SE treatment was a little better at reducing sore throat symptoms than the CL treatment during the first 3 days (63.8% vs. 57.8% at 3 days). No differences were noticed in secondary parameters and both were well-tolerated.

A 2007 prospective, randomized, double-blind, placebo-controlled study investigated the anti-inflammatory effects of a sage extract using the ultraviolet erythema test.29 Test areas on the backs of 40 healthy volunteers were irradiated with the minimal erythema dose, then treated with 2% w/w of a commercially available sage extract (Flavex GmbH; Rehlingen, Germany), a 1% hydrocortisone control, 0.1% betamethasone control, placebo ointment, or no treatment. The sage extract significantly reduced the UV-induced erythema compared to placebo, and to a similar extent as the hydrocortisone.

A clinical study from 2001 has documented the benefits of a sage-rhubarb cream to decrease the duration of external lip eruptions caused by Herpes simplex (H. labialis).30 The same study showed that the sage-rhubarb cream was also effective at relieving the pain and swelling that patients experience with herpetic flares.

http://cms.herbalgram.org/herbalgram/issue89/herbpro.html

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