Chamomile(Matricaria recutita, Chamaemelum nobile)

Chamomile(Matricaria recutita, Chamaemelum nobile)

Background

Chamomile has been used medicinally for thousands of years, and is widely used in Europe. It is a popular treatment for numerous ailments, including sleep disorders, anxiety, digestion/intestinal conditions, skin infections/inflammation (including eczema), wound healing, infantile colic, teething pains, and diaper rash. In the United States, chamomile is best known as an ingredient in herbal tea preparations advertised for mild sedating effects.

German chamomile ( Matricaria recutita ) and Roman chamomile ( Chamaemelum nobile ) are the two major types of chamomile used for health conditions. They are believed to have similar effects on the body, although German chamomile may be slightly stronger. Most research has used German chamomile, which is more commonly used everywhere except for England, where Roman chamomile is more common.

Although chamomile is widely used, there is not enough reliable research in humans to support its use for any condition. Despite its reputation as a gentle medicinal plant, there are many reports of allergic reactions in people after eating or coming into contact with chamomile preparations, including life-threatening anaphylaxis.

Synonyms

Anthemis arvensis , Anthemis cotula , Anthemis nobile, Anthemis nobilis , Asteraceae ( Compositae ) family, baboonig, babuna, babunah, babunah camomile, babunj, bunga kamil, camamila, camomile, camamilla, camomilla, Camomille Allemande, camomile sauvage, Campomilla, Chamaemelum nobile L. , chamomillae ramane flos, chamomille commune, chamomile flowers, Chamomilla, chamomilla recutita, classic chamomile, common chamomile, double chamomile, Echte Kamille, English chamomile, feldkamille, Flores Anthemidis, fleur de camomile, fleurs de petite camomille, flos chamomillae, garden chamomile, German chamomile, Grosse Kamille, Grote Kamille, ground apple, Hungarian chamomile, Kamille, Kamillen, kamitsure, kamiture, Kleine, kleme kamille, lawn chamomile, low chamomile, manzanilla, manzanilla chiquita, manzilla comun, manzanilla dulce, matricaire, Matricaria chamomilla, Matricaria recutita , Matricaria suaveolens , matricariae flos, matricariae flowers, may-then, Nervine, pin heads, rauschert, Romaine, Roman chamomile, romaine manzanilla, Romische Kamille, single chamomile, sweet chamomile, sweet false chamomile, sweet feverfew, true chamomile, whig-plant, wild chamomile.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidenceGrade*Sleep aid / sedation
Traditionally, chamomile preparations such as tea and essential oil aromatherapy have been used for insomnia and sedation (calming effects). Small, poor-quality studies report mild hypnotic effects of chamomile aromatherapy and possible sedative properties of tea, although there are no well-designed human trials in these areas. Better research is needed before a recommendation can be made.

C

Gastrointestinal conditions
Chamomile is used traditionally for numerous gastrointestinal conditions, including digestion disorders, "spasm" or colic, upset stomach, flatulence (gas), ulcers, and gastrointestinal irritation. However, there is no reliable human research in any of these areas. In large doses, chamomile may cause vomiting.

C

Skin conditions (eczema / radiation damage / wound healing)
Laboratory and animal studies report anti-inflammatory properties of chamomile. Individual human studies suggest that chamomile ointment may work as well as hydrocortisone cream for eczema, that chamomile may improve wound healing, but that chamomile cream may not work as well as almond oil for skin damage after radiation therapy. Relief of inflammation and itching has been observed in clinical trials. These studies have not been well designed or reported, and better research is needed before a firm conclusion can be reached.

C

Quality of life in cancer patients
A small amount of research suggests that massage using chamomile essential oil may improve anxiety and quality of life in cancer patients. However, this evidence is not high quality. It is not clear if this approach is superior to massage alone without essential oils. Additional study is needed before a firm conclusion can be reached.

C

Mucositis from cancer treatment (mouth ulcers/irritation)
Poor-quality studies have used chamomile mouthwash for the prevention or treatment of mouth mucositis caused by radiation therapy or cancer chemotherapy. Results are conflicting, and it remains unclear if chamomile is helpful in this situation.

C

Common cold
One study reports that inhaling steam with chamomile extract improves common cold symptoms. Better research is necessary before a recommendation can be made.

C

Diarrhea in children
One study reports that chamomile with apple pectin may reduce the length of time that children experience diarrhea. However, neither the design nor the results are well reported, and it is not clear if benefits might be due to chamomile or to pectin.

C

Hemorrhagic cystitis (bladder irritation with bleeding)
One poor-quality study reports that the combination of chamomile baths plus chamomile bladder washes and antibiotics is superior to antibiotics alone for hemorrhagic cystitis. Additional research is necessary before a conclusion can be reached. Hemorrhagic cystitis is a potentially serious condition for which medical attention should be sought.

C

Hemorrhoids
One poor quality study reports that chamomile ointment may improve hemorrhoids. Better evidence is needed before a recommendation can be made.

C

Vaginitis (inflammation of the vagina)
Vaginitis may involve itching, discharge, or pain with urination. A small study reports that chamomile douche may improve symptoms of vaginitis with few side effects. Since vaginitis can be caused by infection (including sexually transmitted diseases), poor hygiene, or nutritional deficiencies, medical attention should be sought by people with this condition. Better research is needed before a conclusion can be drawn regarding the role of chamomile in the management of vaginitis.

C

Post-operative sore throat/hoarseness due to intubation
A human trial compared chamomile extract spray with normal saline spray (control), administered before placement of a breathing tube (endotracheal tube), to determine effects on post-operative sore throat and hoarseness. Chamomile was found not to prevent post-operative sore throat and hoarseness any more than normal saline.

D

* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Abdominal bloating, abrasions, abscesses, acne, anorexia, anti-inflammatory, antibacterial, antifungal, antioxidant, anxiety, arthritis, back pain, bedsores, blocked tear ducts, burns, cancer, carpal tunnel syndrome, chickenpox, contact dermatitis, constipation, convulsions, delirium tremens (DTs), diaper rash, diaphoretic, diuretic, (increasing urination), dysmenorrhea, ear infections, eye infections, fever, fistula healing, frostbite, fungal infections, gas, gingivitis, gum irritation, hay fever, heartburn, heat rash, hives, impetigo, infantile colic, insect bites, irritable bowel syndrome, liver disorders, malaria, mastitis (breast inflammation), menstrual disorders, morning sickness, motion sickness, nausea, neuralgia (nerve pain), parasites/worms, poison ivy, psoriasis, restlessness, sciatica, sea sickness, seizure disorder, sinusitis, skin infections, teething pain (mouth rinse), uterine disorders.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients.

Most American chamomile products are not standardized to any particular constituent. Many German chamomile products, such as Kamillosan®, which contains 20mg chamomile essential oil per 100 grams of cream, are standardized to a minimum value of chamazulene and alpha-bisobolol. Tablets and capsules of chamomile may be standardized to contain 1.2% apigenin and 0.5% essential oil per dose. Examples of standardized chamomile preparations include Nutritional Dynamics German Chamomile® (400mg chamomile flower per capsule, standardized to 1.25% apigenin and 0.5% essential oil), Nature's way® German chamomile (125mg extract standardized to 1.25% apigenin), and Nature's way® German Chamomile (350mg chamomile flower per capsule, standardized to essential oil).

Adults (18 years and older)

Tea/infusion : Traditional doses include 150 milliliters of boiling water over 2 to 4 grams of fresh flower heads, steeped for 10 minutes, taken by mouth 3 times daily. One to 4 cups of chamomile tea taken daily (from tea bags) has also been used.

Liquid extract/tincture : As a liquid extract (1:1 in 45% alcohol), 1 to 4 milliliters taken by mouth 3 times daily has been used. As a tincture (1:5 in alcohol), 15 milliliters taken 3 to 4 times per day has been used.

Capsules/tablets : 400 to 1,600 milligrams taken by mouth daily in divided doses has been used.

Skin use : There are no standard doses for chamomile used on the skin. Some natural medicine publications have recommended paste, plaster, or ointment containing 3% to 10% chamomile flower heads.

Douche : There is no standard or well-studied dose for chamomile used as a douche. Some natural medicine publications have recommended a preparation containing 3% to 10% chamomile.

Mouth-rinse/gargle : 1% fluid extract or 5% tincture has been used.

Bath : 5 grams of chamomile per liter (1/4 gallon) of water or 0.8 grams of alcoholic extract per liter of water has been used.

Children (younger that 18 years)

There is not enough reliable scientific data available to recommend the safe use of chamomile products in children. Some natural medicine textbooks recommend that the dose of chamomile tea for children should be half of the adult dose.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

There are multiple reports of serious allergic reactions to chamomile taken by mouth or as an enema, including anaphylaxis, throat swelling, and shortness of breath. Skin allergic reactions have been frequently reported, including dermatitis and eczema. Chamomile eyewash can cause allergic conjunctivitis (pink eye).

People with allergies to other plants in the Asteraceae ( Compositae ) family should avoid chamomile. Examples include: aster, chrysanthemum, mugwort, ragweed and ragwort. Cross-reactions may occur with celery, chrysanthemum, feverfew, tansy, and birch pollen. Individuals with allergies to these plants should avoid chamomile.

Side Effects

Impurities (adulterants) in chamomile products are common and may cause adverse effects.

Chamomile in various forms may cause drowsiness or sedation. Use caution when driving or operating heavy machinery. In large doses, chamomile can cause vomiting. Due to its coumarin content, chamomile may theoretically increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. A poor-quality study reports slight increases in blood pressure from chamomile, but this is not enough evidence to make a firm conclusion.

Pregnancy and Breastfeeding

In theory, chamomile may act as a uterine stimulant or lead to abortion. It therefore should be avoided during pregnancy. There is not enough scientific data to recommend the safe use of chamomile while breastfeeding.

References

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January 01, 2004