Wise Mind Herbs

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Chamomile

Chamomile is one of the most ancient medicinal herbs known to mankind, with its therapeutic use dating back thousands of years. This review examines the scientific evidence for chamomile's health benefits, standardized preparations, potential adverse effects, and pharmaceutical applications based on peer-reviewed literature.

Image source and license: https://commons.wikimedia.org/wiki/File:Matricaria_chamomilla_%288824767912%29.jpg.
Modified by Peter Jorgensen.

Botanical Classification and Common Names

There are primarily two types of chamomile used medicinally:

• German chamomile (Matricaria chamomilla, also known as Matricaria recutita)
• Roman chamomile (Chamaemelum nobile, formerly Anthemis nobilis)

Common names include Hungarian chamomile, wild chamomile, scented mayweed, and pin heads (for German chamomile); and English chamomile, garden chamomile, ground apple, and whig plant (for Roman chamomile). It's important to note that plants sometimes confused with true chamomile include dog fennel (Anthemis cotula), corn chamomile (Anthemis arvensis), and dyer's chamomile (Cota tinctoria, formerly Anthemis tinctoria), which do not share the same therapeutic profile.

Active Constituents

The therapeutic effects of chamomile are primarily attributed to the following compounds:

• Flavonoids (apigenin, quercetin, patuletin, luteolin)
• Essential oils (α-bisabolol, chamazulene, farnesene, spiroethers)
• Terpenoids
• Coumarins

Evidence-Based Health Benefits

According to peer-reviewed research, chamomile has demonstrated the following therapeutic properties:

• Anti-inflammatory effects: Multiple studies have shown chamomile's ability to inhibit inflammatory pathways, particularly through the compound chamazulene and the flavonoid apigenin.
• Anxiety and stress reduction: Clinical trials suggest modest anxiolytic effects, particularly with standardized extracts.
• Sleep quality improvement: Research supports mild sedative effects that may improve sleep onset and quality.
• Gastrointestinal disorders: Studies indicate benefits for irritable bowel syndrome, indigestion, and intestinal cramping.
• Wound healing: Topical applications show enhanced wound healing and reduced inflammation.
• Menstrual pain management: Moderate evidence supports its use for primary dysmenorrhea.
• Mild antimicrobial activity: In vitro studies demonstrate activity against certain bacteria and fungi.
• Glycemic control: Emerging research suggests potential benefits for glucose metabolism in type 2 diabetes.

Conditions with Limited or Inconclusive Evidence

The following conditions have some preliminary research but require more rigorous investigation:

• Cancer (primarily in vitro studies showing apoptotic effects)
• Eczema and dermatitis
• Cardiovascular health
• Oral mucositis
• Generalized anxiety disorder (GAD)

Recommended Dosages and Standardization

Dosage forms and recommendations based on clinical studies:

• Tea preparation: 3-4g dried flower heads in 150ml hot water, steeped 5-10 minutes, up to 3-4 times daily
• Fluid extract (1:1): 1-4ml three times daily
• Standardized extract: 220-1100mg daily of extract standardized to 1.2% apigenin
• Essential oil: External use only, typically in 3-10% dilution in carrier oil
• Topical creams/ointments: Products containing 3-10% chamomile extract applied 2-3 times daily

Most clinical trials have used extracts standardized to contain 1.2% apigenin and 0.5% essential oil. The European Medicines Agency recommends standardization based on apigenin-7-glucoside (min 0.25%) and essential oil content for medicinal products.

High-Dose Studies and Knowledge Gaps

Research on doses exceeding standard therapeutic ranges is limited. Studies exploring high-dose chamomile extract (1600-2400mg daily) have been conducted primarily for generalized anxiety disorder but have not demonstrated clear dose-dependent benefits beyond the standard therapeutic range. Importantly, comprehensive toxicology studies for long-term, high-dose consumption are lacking. Most safety data comes from typical therapeutic dosing, leaving significant knowledge gaps regarding potential hormonal effects, drug interactions, and metabolic impacts of sustained high-dose use.

Adverse Effects and Contraindications

Generally recognized as safe (GRAS) by the FDA, chamomile nevertheless has some documented adverse effects:

• Allergic reactions: More common in individuals with allergies to plants in the Asteraceae/Compositae family (ragweed, chrysanthemums, marigolds, daisies)
• Drug interactions: Potential interactions with anticoagulants, sedatives, and CYP450 substrate medications
• Pregnancy considerations: Medicinal doses (beyond food amounts) not recommended during pregnancy due to potential uterine stimulant effects
• Contact dermatitis: Reported with topical use in sensitive individuals
• Drowsiness: May potentiate effects of alcohol or sedative medications

Commercial Pharmaceutical Products

Chamomile is more commonly found as an ingredient in combination products rather than as a standalone pharmaceutical. It appears in numerous regulated medical devices and cosmeceuticals for skin conditions throughout Europe and parts of Asia.

Conclusion

Chamomile has demonstrated beneficial effects for several conditions, particularly mild anxiety, sleep disturbances, and inflammatory gastrointestinal disorders. The strongest evidence supports its use as an anti-inflammatory and anxiolytic agent. However, many traditional uses lack robust clinical evidence, and standardization varies widely between preparations. More rigorous clinical trials are needed to fully establish efficacy, optimal dosing, and safety profiles, particularly for long-term use and specific medical conditions.

References

Adib-Hajbaghery, M., & Mousavi, S. N. (2017). The effects of chamomile extract on sleep quality among elderly people: A clinical trial. Complementary therapies in medicine, 35, 109-114.

Amsterdam, J. D., Li, Q. S., Xie, S. X., & Mao, J. J. (2020). Putative antidepressant effect of chamomile (Matricaria chamomilla L.) oral extract in subjects with comorbid generalized anxiety disorder and depression. The Journal of Alternative and Complementary Medicine, 26(9), 815-821.

Hajizadeh-Sharafabad, F., Varshosaz, P., Jafari-Vayghan, H., Alizadeh, M., & Maleki, V. (2020). Chamomile (Matricaria recutita L.) and diabetes mellitus, current knowledge and the way forward: A systematic review. Complementary therapies in medicine, 48, 102284.

Hieu, T. H., Dibas, M., Surya Dila, K. A., Sherif, N. A., Hashmi, M. U., Mahmoud, M., ... & Huy, N. T. (2019). Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: A systematic review and meta‐analysis of randomized trials and quasi‐randomized trials. Phytotherapy Research, 33(6), 1604-1615.

Keefe, J. R., Guo, W., Li, Q. S., Amsterdam, J. D., & Mao, J. J. (2018). An exploratory study of salivary cortisol changes during chamomile extract therapy of moderate to severe generalized anxiety disorder. Journal of psychiatric research, 96, 189-195.

Miraj, S., & Alesaeidi, S. (2016). A systematic review study of therapeutic effects of Matricaria recuitta chamomile (chamomile). Electronic physician, 8(9), 3024.

Salehi, B., Venditti, A., Sharifi-Rad, M., Kręgiel, D., Sharifi-Rad, J., Durazzo, A., ... & Martins, N. (2019). The therapeutic potential of apigenin. International journal of molecular sciences, 20(6), 1305.

Zick, S. M., Wright, B. D., Sen, A., & Arnedt, J. T. (2011). Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: a randomized placebo-controlled pilot study. BMC complementary and alternative medicine, 11, 1-8.