Sage

Botanical Description & Habitat

(click image to enlarge) Salvia officinalis Family Labiatae

Common names Garden sage Meadow sage Scarlet sage True sage

Sage Products Sage Herbal Capsules Sage Tea Sage Essential Oils Sage Body Care Sage Hair Care Sage Fragrances Sage Smudge Sticks

Description
The woody root produces a square, pubescent, gray stem reaching two feet in height. The leaves are soft, gray-green, oblong-lanceolate, with lightly toothed margins. The flowers are blue or white and purple, and grow in whorls at the top of the stems. They appear in terminal racemes and bloom during June and July.

Habitat
Native of southern Europe and is widely cultivated in gardens as a kitchen spice. It is a perennial plant thriving in warm, dry soil, or in poor soil with sufficient light.

Medicinal parts
Leaves, fresh or dried, gathered before flowering in May.
whole herb, fresh or dried, gathered just after flowering, in August.

 

Historical Properties & Uses

The Latin word salvia means to heal.

Sage is a popular home remedy. The herb has been recommended for almost every illness or problem by one herbalist or another. Perhaps the most frequently cited effects of sage are its antihydrotic (antiperspiration), antibiotic, astringent, antispasmodic, and hypoglycemic properties. Each of these effects has received some experimental support. The antihydrotic action is often used to stop night sweats experienced during tuberculosis. Sage's spasmolytic quality is useful to quiet nervousness, remedy digestive disturbances, and treat respiratory problems.

Sage is commonly used to remedy leukorrhea, amenorrhea, and dysmenorrhea. While these effects have been observed experimentally, and estrogenic properties have been discovered, it is unclear if there is a direct connection between them; the herb's mechanism of action requires more investigation.

Sage has moderate but extensive bacteriostatic, antifungal, and antiviral properties. Often used as a mouthwash or gargle to treat inflammations and irritations of the mouth and throat. This effect is due to the herb's high content of volatile oils and tannins. Its hypotensive property may also contribute to this action. Sage is often used to dry up the milk of nursing mothers, but this action has not been verified experimentally.

Sage leaf is an approved herb by the German Commisssion E for internal and external use.

Internally it is used for dyspepsia and excessive perspiration (sweating).

Externally it is applied to the inflamed mucous membranes of the nose and throat.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
 

Method of Action

Active Principles Of Sage
The chief therapeutic, biologically active component of sage is its essential oil (1-2.5%), which contains mainly cineol, borneol, and alpha- and beta-thujone. Sage leaf contains appreciable amounts of tannic acid (3-8%), resins (5-6%) with oleic, ursonic, and ursolic acids, as well as bitter substances (1.3-1.8%) with cornsole and cornsolic acid. Fumaric, chlorogenic, caffeic and nicotinic acids, nicotinamide, flavones, flavone glycosides, and estrogenic substances are also present.

It has antioxidative properties.

General Pharmacology And Antibacterial Properties Of Sage
Essential oil of sage is reported to have astringent, anti-inflammatory, bacteriostatic, and antiperspiration action. In addition to the essential oil, still-unidentified components have marked antimicrobial action. In vitro experiments indicate aqueous extracts from sage leaves strongly inhibit the development of dysenteric bacteria, E. coli, B. paracoli, Enterobacter aerogenes, and Enterococcus, while moderately inhibiting the development of Staph. aureus, alpha-hemolytic streptococci, and some other pathogenic microorganisms. Bitter substances isolated from sage leaf have bacteriostatic action against S. aureus, E. coli, and Epidermophyton, at dilutions as great as 1:10000.

Sage contains the same condensed tannin (consisting of trimers of caffeic acid) as found in lemon balm and peppermint. This tannin has potent inhibitory action against Newcastle Disease virus and herpes simplex virus. Incubated at 37 degrees C. for seven days with the H37Rv strain of mycobacterium tuberculosis, sage leaf extract produced inhibition at concentrations lower than 1:80 but higher than 1:40. This makes it one of the weakest among those plants having such activity, but demonstrates the presence of the property nonetheless.

Sage has potent antiperspiring action
The rare ability of sage tea to partially or totally inhibit perspiration in humans has been known for several hundred years. There is little responsible disagreement about this effect. Most herbalists have witnessed it first hand, and research has confirmed sage's ability to eliminate the perspiring response. Sage infusions have a strong therapeutic effect on nocturnal perspiration (night sweats) in cases of neuroses and tuberculosis. The effect seems to reach its peak 2-3 hours after ingesting the tea or tincture, and then gradually subsides. The response is attributed to some component of the volatile oil, but the exact active principle is unknown. Experimental pylocarpine-induced hyperhydrosis is almost completely suppressed by sage.

Sage has estrogenic action
The estrogenic activity of sage has been demonstrated experimentally, and a team of investigators has shown the herb has strong effects in cases of oligomenorrhea and amenorrhea. The herb's estrogenic substance is thought to constitute 1-2% of the dried plant, but it is doubtful this effect has anything to do with the common practice of using sage to dry up the milk of nursing mothers.

Sage has hypoglycemic properties
Sage's hypoglycemic property has been investigated sporadically; tests show it has strong activity in humans suffering from diabetes, especially if taken on an empty stomach. The herb has achieved drug status in some eastern European countries as a hypoglycemic agent of merit.

Sage has spasmolytic effect on smooth muscle
The essential oil of sage has spasmolytic action against acetylcholine-induced contractions of isolated rat intestine, which are immediately suppressed by sage tincture and emulgated oil. However, water extracts, and especially infusions, manifest very slight effect. In a series of experiments carried out on segments of isolated guinea ileum, sage extract inhibited the spasmodic effects of acetylcholine, histamine, serotonin, and barium chloride by 70-85%. This spasmolytic effect was of long duration. The total flavonoid fraction has demonstrated a spasmolytic effect, though weaker than the total extract. In yet another study, the spasmolytic property of sage was established against many convulsant drugs, including acetylcholine, histamine, serotonin, anaphylatoxin. Preparations used included isolated cuts of rabbit and guinea-pig intestine, isolated guinea pig lungs, cat lungs "in situ," and whole animals under conditions of anaphylactic shock. The smooth muscle spasmolytic effect is myotropic, resembling that of papaverine.

Effect Of Sage On Blood Pressure
Sage extracts applied in the femoral vein of male cats in a dose of 0.2 mg/kg, or intraduodenally through chronically implanted canuli at a dose of 0.5 ml/kg, produced moderate but prolonged hypotension (30 and 15% respectively, after three hours,as compared to controls).
 

Drug Interactions & Precautions

Possible Interactions
Sage should be used with caution in conjunction with CNS-depressants or stimulants.

The hypotensive effect of this herb may be potentiated by anorectic drugs, such as fenfluramine, whose effects are mediated by brainstem 5HT. Additive effects may occur between the hypotensive property of sage and that of dopamine receptor agonists, such as bromocriptine mesylate. The antituberculous activity of the herb may also potentiate the adverse effects of other antituberculous drugs, especially ethionamide.

The tannin in sage may potentiate the antibiotic activity of echinacea. The tannin in sage tea may be inactivated by the addition of milk or cream.

The presence of estrogen-like substances in sage may increase the production of procoagulant factors which, in turn, may inhibit the anticoagulant action of heparin or coumarin. The estrogenic constituents of this plant may also potentiate oral antidiabetics, folic acid antagonists, and some corticosteroids.

Conversely, the presence of estrogen in the herb can inhibit antihypercholesterolemics by inducing hyperlipemia. It can also inhibit the activity of most parenteral medications by reducing the rate of spreading. However, the estrogenic activity of sage may be inhibited by meprobamate and phenobarbital.

Due to the presence of estrogenic substance, oxytocin may augment the neural conductivity and contractility of uterine smooth muscle. The estrogen in sage may also raise blood glucose levels enough to alter insulin requirements in diabetics.

Topical application of sage, in conjunction with the acne product tretinoin (retinoic acid, vitamin A acid), may adversely affect the skin.

Comments
The hypotensive property of this herb may be additive with the CNS depressant activity of the analgesic nalbuphine HCl. The same is true of the analgesic propoxyphene HCl.

To minimize central nervous system depression and possible synergism, it would be wise to avoid using this herb with procarbazine antineoplastic drugs.

In the absence of other hard data, it may still be assumed observable interactions may occur between the many central nervous system drugs and the psychoactive principles in sage.

There is evidence to show combined use of bactericidal and bacteriostatic agents will lower the effectiveness of the bacteriostatic agent. However, how this finding applies to herbal antibiotics is not known.
 

Safety Factors & Toxicity

Although sage contains more thujones that the leading thujone intoxicator, wormwood, sage is considered nontoxic.

One study demonstrated toxicity in sage, and attributed it to the herb's thujone content. However, the same study failed to find any of the effects of sage documented by other investigators. Were that the only study finding negative properties in sage, it could easily be written off as mistake; however, another comprehensive screening test also failed to find many of its otherwise well-substantiated properties, including antibiotic, hypoglycemic, and antispasmodic effects.

These studies may have been cases of misidentification, since the several varieties of sage demonstrate differing levels of potency; if such is not the case, however, a very confusing picture of sage activity emerges.

Sage leaf has approval status by the German Commission E.

References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

 

Preparation & Administration

This herb has approval status by the German Commission E.

Recommended daily dosages in Germany are as follows:

Internal:

4 - 6 g of the herb.
0.1 - 0.3 g of essential oil.
2.5 - 7.5 g of tincture.
1.5 - 3 g fluid extract.

For gargles or rinses:

2.5 g of herb in 100 ml of water.
2 - 3 drops of essential oil in 100 ml of water.
5 g of alcoholic extract in 1 glass of water.

External:

Undiluted alcohol extract.


References:

Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.

Note: This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.


 

References

Aizenman, B., et.al. 1982. Salvin, an antibiotic from salvia officinalis. Mikrobiol. Zhurnal, 44(3).

Albert-Puleo, M. 1980. Fennel and anise as estrogenic agents. Journal of Ethnopharmacology, 2. pp. 337-344.

Am Hospital Formulary Service. Am Soc of Hosp Pharm. Wash, D.C.

Bergeret, Cl. & Tetau, M. La Phytotherapie Renovee, Paris, Maloine S.A., 1972, 304 pages.

Bhakuni, D.S., M.L. Dhar, et.al. Screening of indian plants for biological activity. Part II. Indian Journal Of Experimental Biology. 7(10), 250-262, 1969.

Boehme, H. & K. Hartke. Deutsche Arzneibuch, 7th ed. Stuttgart, Wissenschftliche Verlagsgeselschaft, 1970, p. 1619.

Bressler, R., M.D. Bogdonoff & G.J. Subak-Sharpe. 1981. The Physicians Drug Manual. Doubleday & Co, Inc. Garden City, NY.

Braun, H. Heilpflanzen-lexikon Fuer Aerzte Und Apotheker. Stuttgart, G. Fischer Verlag, 1974, p. 253.

Brieskorn, C., U. Leiner & K. Thiele. Constituents of salvia officinalis. X. Isolation and properties of the bitter substance from sage leaves. Deutsche Apotheker Zeitung, 98, 651-653, 1958.

Brieskorn, Ch. Active ingredients of salvia officinales. Bactericidal activity of oil of sage. Arch Pharm., 283, 33-35, 1950.

Clark, T.H., A.H. Conney & B.P. Harpole, et.al. 1967. Drug interactions that can affect your patients. Patient Care, 1(11). pp.33-71.

Committee on Pharmocopaeia of the Am Institute of Homeopathy, The Homeopathic Pharmacopaeia of the United States. 8th ed., Vol 1. Otis Clapp and Son, Agents, Boston, l981.

Costello, C.H. & C.L. Butler. 1950. The estrogenic and uterine-stimulating activity of asclepias tuberosa. A preliminary investigation. J of the Am Pharm Assoc, 39. pp. 233-237.

Delia, B. Una nuova droga ipoglicemmizante, la salvia. Clin Med Ital., 69, 315-338, 1938.

Drug package insert (FDA approved official brochure) and other labeling based on sponsored clinical investigations and New Drug Application data.

Facts and Comparisons. The Lawrence Review of Natural Products. Aug, 1992.

Fischer, G. Heilkroeuter Und Arzneipflanzen, 5Th Edtion, Heidelberg, K.F. Haug Verlag, 1978, p. 327.

Fitzpatrick, F.K. Plant substances active against mycobacterium tuberculosis. Antibiotics And Chemotherapy, 4(5), 528-536, 1954.

Goodman, L.S. & A. Gilman. 1975. Pharm Basis of Thera. Macmillan, NY.

Hansten, P.D. 1979. Drug Interactions, 4th ed. Lea & Febiger, Phila.

Hermann, E.C., Jr. & L.S. Kucera. Antiviral substances in plants of the mint family (labiatae). III. Peppermint (mentha piperita) and other mint plants. Proceedings Of The Society For Experimental Biology And Medicine. 124, 874-878, 1967.

Hoppe, H.A. Drogenkunde, 2nd Vol., 8th edition, Berlin, New York, Walter de Gruyter, p. 366.

Kastrup, E.K., ed. 1981. Drug Facts and Comparisons, 1982 edition. Facts and Comparisions Division, J.P. Lippincott Co, Phila (St. Louis).

Kovaleva, H.G. Lechenii Rasteniami. Moscow, Medichina, 1971.

List, P. & L. Hoerhammer. 1969-1976. Hagers Hanbuch der Pharmazeutischen Praxis, vols. 2-5. Springer-Verlag, Berlin.

Martin, E.W. 1978. Drug Interactions Index, 1978/79. J.B. Lippincott Company, Philadelphia.

Maruzzella, J.C. & N.A. Sircurella. Antibacterial activity of essential oil vapors. J Of The Am Pharm Assoc. 49(11), 692-694, 1960.

Maruzzela, J.C. & M.B. Lichtenstein. The in vitro antibacterial activity of oils. J. Of The Am. Pharm. Ass. 45(6), 378-381, 1956.

Morrelli, H.F. & K.L. Melmon. 1968. The clinician's approach to drug interactions. California Medicine, 109(11). pp. 380-389.

Mowrey, Daniel B., Ph.D. Exper. Psych., Brigham Young University. Director of Nebo Institute of Herbal Sciences. Director of Behavior Change Agent Training Institute. Director of Research, Nova Corp.

Nelson, D.H., et.al. 1963. Potentiation of the biologic effect of administered cortisol by estrogen treatment. Journal of Clin Endocrinology and Metabolism, 23(3). pp. 261-265.

Perrot, E. & R. Paris. Les Plantes Medicinales. Paris, Presses Universitaires De France, 1974, 320 pages.

Petkov, V., M. Penova, K. Paparkova & S. Jekov. Screening studies on the antimicrobial action of plants growing in Bulgaria. Proceedings Of The Postgrad Med Institute, 16(2), 11-13, 1969.

Scientific Committee, British Herbal Pharmocopaeia, British Herbal Med Assoc, Lane House, Cowling, Na Keighley, West Yorks, Bd Bd220lx, l983

Shipochliev, T. Pharmacological study of several essential oils. I. Effect on the smooth muscle. Vet. Med. (Prague), 13(8-9), 63-69, 1968.

Spangler, A.S., et.al. 1969. Enhancement of the antiinflammatory action of hydrocortisone by esrtogen. J of Clin Endoc, 29(5). p.650-655.

Stuart, D.M. 1968. Drug metabolism Part 2. Drug interactions. PharmIndex, 10(10). pp. 4-16.

Todorov, S., S. Philianos, et.al. Experimental pharmacological study of three species from genus salvia. Acta Physiologica Et Pharmacologica Bulgarica,(sophia), 10(2), 1984.

Turova, A.D. Medicinal Plants Of The Ussr And Their Use. Moscow, Medizina, 1947, P. 424.

Vincent, D. & G. Segonzac. 1953. Comptes Rendus des Seances de la Societe de Biologie et de ses Filiales, 147. pp. 1776-1779.

Weiss, R.F. Lehrbuck Der Phytotherapie, Stuttgart, Hippokrates Verlag, 1960, p.408.
 

Essential Oil

See Sage Essence under Aromatherapy

See Clary Sage Essence under Aromatherapy