Immediate and Lasting Effects of the dōTERRA AromaTouch Technique®, a Topical Essential Oil Application Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial

Abstract

Objectives: To explore the immediate and lasting benefits of the essential oils used in the dōTERRA AromaTouch Technique®, an essential oil application method similar to a full-body aromatherapy massage, on stress, immune secretions, inflammatory signaling, and anxiety in healthy volunteers.

Design: Pilot trial.Location: dōTERRA International corporate campus (Pleasant Grove, UT)Subjects: Healthy volunteers (n=18).Interventions: Half of the subjects (n=9) received the technique twice per week for three weeks. Control groups consisted of the other healthy individuals (n=9) who received the same massage-like technique with fractionated coconut oil instead of the essential oils.Outcome

Measures: Salivary levels of cortisol (μg/dL), TNF-α (pg/mL), IL-6 (pg/mL), IL-1β (pg/mL), IL-8 (ng/mL), and C-reactive protein (ng/mL) as well as the secretory rate of immunoglobulin A (μg/min), heart rate (beats/minute), blood pressure (mm Hg), and Spielberger state anxiety scores. Baseline measurements were taken immediately before the first session. Additional measurements were taken immediately after the first session and after receiving bi-weekly sessions for a 3-week period.

Results: Both groups experienced decreases in heart rate, mean arterial pressure, diastolic blood pressure, state anxiety scores, and salivary levels of cortisol immediately after the first session. The essential oil group also showed significantly decreased levels of C-reactive protein in the saliva immediately after the technique. After three weeks of regularly receiving the technique, subjects in the essential oil group had significantly lower salivary levels of C-reactive protein and three of the four inflammatory cytokines tested.

Conclusions: Because of the experimental design, many outcomes of the technique can be attributed specifically to the activity of the essential oils. The essential oils used in the AromaTouch Technique may be effective for enhancing the relaxation associated with a massage-like procedure involving physical touch. The oils in the technique may also be solely responsible for a major inhibitory effect on inflammatory signaling. Validation of this result warrants further investigation in a trial with a larger sample size.

Full text

Citation: Bahr T, Rodriguez D, Allred K. Immediate and Lasting Effects of the doTERRA AromaTouch Technique, a Topical Essential Oil Application
Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial. J Integrative Med Ther. 2018;5(1): 7.
J Integrative Med Ther
May 2018 Vol.:5, Issue:1
© All rights are reserved by Bahr7, et al.
Immediate and Lasting Effects
of the d
ō
TERRA AromaTouch
Technique®, a Topical Essential
Oil Application Procedure, on
Autonomic Function and Salivary
Biomarkers: A Pilot Trial
Autonomic Nervous System; CRP: C-Reactive Protein; SSAI:
Spielberger State Anxiety Inventory; sIgA: Secretory IgA
Introduction
Aromatherapy, the inhalation or topical use of essential oils
[EOs] for therapeutic benet, and massage have been investigated
separately and in combination with positive results on various
patient populations. ese results are largely due to the relaxing
eects of EOs on the autonomic nervous system [ANS] and their anti-
inammatory properties. ere is evidence that EOs and their aromas
decrease heart rate and blood pressure in both healthy individuals
and individuals with heart rate variability, anxiety, or chronic stress
[1,2]. Other research suggests that aromatherapy massage may help
reduce psychological and endocrine measures of stress in pregnant
women and breast cancer patients, and that it may promote immune
function in healthy individuals [3-5].
We propose that massage-like techniques involving the topical
application of EOs might have positive eects on autonomic balance
and immune function in healthy individuals, both immediately
and over an extended period of time. In this study, we evaluate the
dōTERRA AromaTouch Technique® [ATT] specically. e ATT is
a method of applying EOs by physical touch similar to a massage.
It was developed by dōTERRA, a private company that sells EOs, to
promote relaxation, stress relief, immune function, and overall well-
being. is is the rst study to examine the benets of the ATT. To
our knowledge, this is also the rst study to investigate the benets of
regularly receiving aromatherapy massage for an extended period of
time in healthy volunteers.
e outcome measures in this study are associated with dierent
measures of health and wellness, such as autonomic function and
endocrine markers of stress, immune secretions, inammatory
biosignals, and psychological anxiety. Cortisol, for instance, is easily
measurable in several dierent body uids as a parameter of acute,
chronic, and diurnal stress levels [6]. High levels of salivary cortisol
have been shown to be associated with emotional stress and are
believed to be a part of the mechanism linking chronic stress and
infection risk [7]. e ease of collecting salivary cortisol has made it a
novel alternative to more complex stress biomarker assessments [8,9].
Tyler Bahr*, Damian Rodriguez and Kathryn Allred
dōTERRA International, LLC, USA
*Address for Correspondence
Tyler Bahr, dōTERRA International, LLC, 389 S 1300 W,
Pleasant Grove, UT 84062, USA, Email: tbahr@doterra.com
Submission: 27 April, 2018
Accepted: 30 May, 2018
Published: 08 June, 2018
Copyright: © 2018 Bahr T, et al. This is an open access article
distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
Research Article
Open Access
Journal of
Integrative
Medicine &
Therapy
Avens Publishing Group
Invi ting Innovations
Avens Publishing Group
Invi ting Innovations
Keywords: AromaTouch Technique; Essential oils; dōTERRA; Aro-
matherapy massage; Anti-inflammatory activity; pro-inflammatory cy-
tokines; C-reactive protein
Abstract
Objectives: To explore the immediate and lasting benets of
the essential oils used in the dōTERRA AromaTouch Technique®, an
essential oil application method similar to a full-body aromatherapy
massage, on stress, immune secretions, inammatory signaling, and
anxiety in healthy volunteers.
Design: Pilot trial.
Location: dōTERRA International corporate campus (Pleasant
Grove, UT)
Subjects: Healthy volunteers (n=18).
Interventions: Half of the subjects (n=9) received the technique
twice per week for three weeks. Control groups consisted of the
other healthy individuals (n=9) who received the same massage-like
technique with fractionated coconut oil instead of the essential oils.
Outcome Measures: Salivary levels of cortisol (µg/dL), TNF-α (pg/
mL), IL-6 (pg/mL), IL-1β (pg/mL), IL-8 (ng/mL), and C-reactive
protein (ng/mL) as well as the secretory rate of immunoglobulin A
(µg/min), heart rate (beats/minute), blood pressure (mm Hg), and
Spielberger state anxiety scores. Baseline measurements were taken
immediately before the rst session. Additional measurements were
taken immediately after the rst session and after receiving bi-weekly
sessions for a 3-week period.
Results: Both groups experienced decreases in heart rate, mean
arterial pressure, diastolic blood pressure, state anxiety scores, and
salivary levels of cortisol immediately after the rst session. The essential
oil group also showed signicantly decreased levels of C-reactive
protein in the saliva immediately after the technique. After three
weeks of regularly receiving the technique, subjects in the essential oil
group had signicantly lower salivary levels of C-reactive protein and
three of the four inammatory cytokines tested.
Conclusions: Because of the experimental design, many outcomes
of the technique can be attributed specically to the activity of the
essential oils. The essential oils used in the AromaTouch Technique may
be effective for enhancing the relaxation associated with a massage-
like procedure involving physical touch. The oils in the technique may
also be solely responsible for a major inhibitory effect on inammatory
signaling. Validation of this result warrants further investigation in a trial
with a larger sample size.
Abbreviations
EO(s): Essential oil(s); ATT: AromaTouch Technique®; FCO:
Fractionated Coconut Oil; SYS: Systolic; DIA: Diastolic; BP: Blood
Pressure; HR: Heart Rate; MAP: Mean Arterial Pressure; ANS:

Citation: Bahr T, Rodriguez D, Allred K. Immediate and Lasting Effects of the doTERRA AromaTouch Technique, a Topical Essential Oil Application
Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial. J Integrative Med Ther. 2018;5(1): 7.
J Integrative Med Ther 5(1): 7 (2018) Page - 02
ISSN: 2378-1343
Salivary cortisol levels are unaected by salivary ow rate or salivary
enzymes, and several studies consistently report high correlations
between serum and saliva cortisol, indicating that salivary cortisol
levels reliably estimate serum cortisol levels [10-13]. Several previous
studies have investigated the inuence of EO inhalation on salivary
cortisol levels, with generally positive results [14-17]. If these eects
are from pharmacology (rather than just psychology of aroma
sensation) the topical application of oils should have similar (or more
pronounced) benets. Cortisol levels are also reduced by the pressure
receptor stimulation induced by massage so the combination of
aromatherapy and massage should theoretically have additive eects
on reduction of cortisol levels [18].
e salivary glands and their immune secretions are also under
autonomic control. Chronic activation of stress pathways decreases
salivary secretion of IgA, an antibody protein commonly recognized
as the immune system’s initial defense mechanism against microbial
colonization [19]. IgA is particularly key in warding o bacterial and
viral infections, and it is not only secreted in the saliva, but also in the
tears and in the mucous membranes of the respiratory and digestive
tracts [19,20]. Studies have shown that aromatherapy massage
can promote other measures of immune function, such as serum
antibody levels, lymphocyte levels, and a reduction in salivary cortisol
levels [3,21,22]. Congruent with these results is the hypothesis that
aromatherapy massage may have positive effects on salivary
secretory immunoglobulin A [sIgA] levels. BP and HR are also
regulated by the ANS, and when elevated they are associated with
many disorders and conditions related to stress [23-30]. We
expect that aromatherapy massage will have inhibitory effects on
these parameters.
Commonly used to assess inflammation in the body, CRP is
a positive acute-phase protein; high levels in serum are indicative
of inflammation in the body. Although the relationship between
salivary and serum CRP levels is not fully understood, salivary CRP is
considered an accurate predictor of serum CRP levels symptomatic of
systemic inflammation [31]. Results from human and animal research
suggest that treatment with EOs may be associated with decreased
levels of CRP [32,33].
The four cytokines chosen for analysis in this study were tumor
necrosis factor α (TNF-α), interleukin 6 (IL-6), interleukin 1β
(IL-1β) , and interleukin 8 (IL-8, which are all common markers of
inflammation. Generally, cytokines are known for their salivary
levels to correlate reasonably well with serum levels [34,35]. A great
deal of research suggests that EOs have potent anti-inflammatory
properties, and many EOs and their chemical constituents have been
specifically documented for their ability to inhibit inflammatory
cytokine production [36-38]. Among the EOs with cytokine-
inhibitory properties are melaleuca oil and its constituents
terpinene-4-ol and α-terpineol, lavender oil, and orange oil’s
primary constituent limonene, which are all applied topically to
AromaTouch Technique recipients [38-41].
Materials and Methods
Study design
This pilot study used a randomized, single blind, placebo-
controlled design. One-half of the subjects were given the ATT with
EOs while the other half were given the ATT with the fractionated
coconut oil [FCO] placebo. Participants were not informed about
which treatment was being received. Participants were treated twice
per week for three weeks, with at least two days but no more than four
days between each treatment. A total of six treatments were delivered.
Data was collected within 5 minutes of treatment completion after the
first ATT to evaluate the immediate effects of the technique, and
then exactly 24 hours after the final ATT to evaluate lasting
effects. A schematic diagram of the experimental design is shown in
Figure 1.
Participants
Participants were selected from a group of employees who
volunteered to participate in the study. An online screening tool was
used to screen potential subjects to ensure their compliance with the
study criteria. To decrease the risk of subjects experiencing negative
skin reactions, all subjects were required to be between 25-50 years
of age, already acquainted with EOs, and self-reported as never
having experienced an allergic skin reaction to EOs. To prevent
interference with the results, individuals who anticipated life events
that might possibly affect the variables measured in this study
during the 1 month period of evaluation were excluded
Figure 1: Experimental design.
After obtaining research approval from the institutional review board, 18
qualied subjects were recruited using a yer which directed them to an online
screening tool. Before the study began, subjects were randomly assigned
to the intervention group or the control group. The intervention
treatment consisted of the AromaTouch Technique (ATT) with essential
oils, while the control treatment was the same except with inactive
coconut oil instead of the essential oils. Before beginning the study,
participants were given a washout period (not shown) of 1 week to
discontinue all use of essential oils or essential oil-containing products.
Immediately before the first session on day 1, the baseline values of all
outcome measures were recorded. After the first session, the same values
were measured and recorded. Comparison of this data to baseline provided
insights regarding the immediate effects of the technique with or without the
essential oils. After 5 more sessions at a rate of 2 per week, the final
measurements were recorded on day 22 (24 hours after the final session) to
provide insights regarding the lasting effects of regularly receiving the
technique with or without the essential oils.

Citation: Bahr T, Rodriguez D, Allred K. Immediate and Lasting Effects of the doTERRA AromaTouch Technique, a Topical Essential Oil Application
Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial. J Integrative Med Ther. 2018;5(1): 7.
J Integrative Med Ther 5(1): 7 (2018) Page - 03
ISSN: 2378-1343
from the study. Individuals taking prescription or over-the-counter
drugs were also excluded from the study. e subjects’ names were
written on paper, drawn at random, and placed into two groups
representing the treatment and placebo groups.
For a washout period of one week prior to the study and then
for the remainder of the study, subjects refrained from taking any
medications, using any EOs, or any EO-containing products.
Subjects were advised to avoid strenuous exercise, alcohol, tobacco,
over-the-counter medications, and certain foods and drinks before
saliva sampling according to the instructions provided by the saliva
collection kit manufacturer (Salimetrics, State College, PA).
One subject in the intervention group dropped out of the study
prior to its completion because she did not wish to refrain from using
other EO products any longer. Her data was still used to evaluate the
short-term benets of the ATT. us n=9 for all data for all groups
except in the long-term data for the EO group, which was reduced
to n=8.
e AromaTouch Technique®
e AromaTouch Technique is an EO application method
involving physical touch similar to a massage. e individual
administering the ATT applies 3-5 drops (0.15-0.25 mL) of an EO
directly to the spine and then rubs the oil into the skin on the back
of the recipient. Sometimes the oil is applied to the hands of the
administrator and then rubbed on the soles of the feet of the recipient
rather than the back. is process is repeated once for eight specic
oils and oil blends. Note that the oils and blends used in this technique
are known to be safe for topical use, and have been recommended as
safe for topical use by dōTERRA’s product safety department. Topical
application of these oils is thought to increase the magnitude of
benet by direct absorption into the skin. e oils and blends used in
the technique and their primary chemical components, determined
by gas chromatography, are given below:
1. dōTERRA Balance® blend: linalool (30%), bornyl acetate
(19%), α-pinene (16%)
2. Lavender EO: linalool (30%), linalyl acetate (37%)
3. Melaleuca EO: terpinen-4-ol (43%), γ-terpinene (19%)
4. dōTERRA On Guard® blend: limonene (44%), eugenol (36%)
5. dōTERRA AromaTouch® blend: menthol (14%), linalool
(13%), limonene (12%), α-pinene (11%)
6. dōTERRA Deep Blue® blend: methyl salicylate (32%),
menthol (12%)
7. Wild orange EO: limonene (95%)
8. Peppermint EO: menthone (36%), menthol (30%)
The total amount of EO applied to the skin during this procedure
is 24-40 drops (1.2-2.0 mL), since 3-5 drops (0.15-0.25 mL) are used
for each of the eight EOs in the technique. e full ATT usually lasts
about 45 minutes. e method of administration of this technique
for controls was completely identical to the process outlined above,
except with FCO replacing each EO.
Testing procedures
All measurements including cardiovascular parameters, anxiety
inventory, and saliva samples were taken before the first ATT for
each participant. These measurements were then repeated
immediately after its completion. A final round of measurements
was taken exactly 24 hours after the final ATT. Note that the final
measurements were taken at the exact same time of day as the first
set of measurements, controlling for diurnal cortisol fluctuation.
Because subjects were lying face down during the entire ATT,
they were quite literally blind to their surroundings. However, to
prevent subjects from using their sense of smell to determine
which group they had been placed in, the administration room was
intentionally filled with the scent of EOs during each step of the
technique. The administrator accomplished this by placing a drop of
EO on the floor rather than on the back or feet of the recipient just
before applying the FCO. The administrator also used other
techniques, such as setting down different bottles at different times
to reinforce the illusion that they were using different EOs rather
than the coconut oil placebo. This was done to replicate the
sounds and smells that would be experienced if the individuals
were receiving the technique with EOs.
For both groups, the technique was given in the same room
which had dimensions 10 ftx12 ftx10 ft. The same music was played
during every session for members of both groups. The music was of
the spa style and can be accessed at the following URL:
https://www.youtube. com/watch?v=VP-5GNJSw4g.
The lights in the room were dimmed to the same brightness, and
the same two therapists delivered the technique. Recipients received
their techniques from one of two trained therapists on the first
session of the week, and then from the other therapist on the second
session of the week.
Cardiovascular measurements
Systolic [SYS] and diastolic [DIA] blood pressure [BP] and heart
rate [HR] were measured using the Omron 10 model BP786N digital
cuff. The cuff was used on the left arm for all participants. Data was
recorded using the average of three consecutive measurements.
Mean Arterial Pressure [MAP] was calculated according to the
formula MAP =[(2xDIA)+SYS]/3.
Saliva biomarker analysis
Whole saliva samples were collected with Saliva Bio’s 2 mL
cryovials and the Saliva Collection Aid (exclusively from Salimetrics,
State College, PA), a collection device specifically designed to
improve volume collection and increase participant compliance, and
validated for use with all analytes used in this study. Drool time and
sample volume were recorded immediately after sample collection.
Samples were promptly placed on dry ice and placed in storage at -20
°C. After all samples had been collected, they were shipped overnight
on dry ice to SalivaBio Lab (Carlsbad, CA, USA) for analysis. All
samples were tested for cortisol, secretory immunoglobulin A [sIgA],
C-reactive protein [CRP], and a panel of four cytokines: IL-1β, IL-6,
IL-8, and TNF-α.
Spielberger state anxiety inventory
Anxiety scores were evaluated using the Spielberger State-Trait
Anxiety Inventory. Only the state anxiety questions were used in this
study; trait anxiety questions were omitted. The Spielberger State

Citation: Bahr T, Rodriguez D, Allred K. Immediate and Lasting Effects of the doTERRA AromaTouch Technique, a Topical Essential Oil Application
Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial. J Integrative Med Ther. 2018;5(1): 7.
J Integrative Med Ther 5(1): 7 (2018) Page - 04
ISSN: 2378-1343
Anxiety Inventory [SSAI] questions were incorporated into an online
questionnaire that subjects completed using a tablet device.
Statistical analysis
Differences between groups after treatment were analyzed
using one-way ANCOVA, which bears the most statistical power in
direct comparison to other clinically relevant statistical
methods [42]. Adjusted means were obtained using baseline data as
the concomitant (covariate) variable. Statistical significance of the
differences between group means after treatment w as determined
using the F-test. Confidence intervals w ere computed using the
mean-square error for dataset. The analysis w as performed using
the computational tool “One-Way ANCOVA for 2 Independent
Samples” provided by Vassar Stats, a free web-based statistical
computation service.
Results
Immediate effects of the technique
The effect of the ATT with EOs was clearly different from the
ATT with FCO alone, and many of the differences were statistically
significant, although difficult to generalize due to the small
sample size (Table 1). After adjusting for baseline
differences, subjects given the ATT with EOs experienced a -12.2%
decrease in HR of -8.9±1.44 beats/minute) on average after the
ATT, compared to controls treated with coconut oil only whose
HR decreased by only about -2.5% (about -1.8±1.44 beats/minute)
on average. The difference in percent decrease between
groups was markedly statistically significant, with a p-value of
0.0002. SYS BP, DIA BP, and MAP each decreased slightly in the
EO group but increased slightly in the FCO placebo group after
the A TT. None of these measures achieved statistical significance.
Cortisol levels decreased about -26.8% (-68±46 ng/dL) on
average following the ATT with EOs, but only decreased by -21.7%
(-55±46 ng/dL) in the placebo group, although the difference was
not statistically significant. Salivary CRP was also lower in the group
treated with EOs, with a decrease of -32.9% (-5.45±3.3 ng/mL) that
was statistically significant, with a p-value of 0.048 (Table 1). No
meaningful differences in salivary sIgA secretion or cytokine levels
were observed between groups immediately after the first session.
Scores on the SSAI also decreased in both groups after the ATT.
Subjects in the EO group experienced a percent change of -33.8%
(-13.21±2.06 points), on average, while subjects in the FCO group
experienced a percent change of only -24.3% (-9.51±2.06 points).
This difference between groups did not reach statistical significance.
Lasting effects from regularly receiving the technique
The quantitative differences in the various inflammatory
biomarkers between the intervention and placebo groups were
pronounced (Table 2). Three of the four cytokine levels measured,
TNF-α, IL-1β, and IL-8, showed remarkable decrease in the ATT
with EOs group, with percent changes of -64.4%, -63.5%, and
-59.7%, respectively. The differences between the EOs and FCO
groups’ average levels of these cytokines 24 hours after the final
treatment achieved statistical significance, with p-values of 0.005,
0.006, and 0.001, respectively. The difference in salivary IL-6 was a
noteworthy -73.1% which approached statistical significance with a
p-value of 0.07. The difference in salivary CRP between groups was
also marked and significant. Subjects in the EO group exhibited a
-71.1% decrease in CRP levels, while CRP levels of those in the
FCO group actually increased by a negligible amount. Again,
the difference between groups reached statistical significance,
Table 1: Immediate effects of the AromaTouch Technique with or without essential oils.
The following variables were measured immediately before and immediately following the first session: Heart Rate (HR), Mean Arterial Pressure (MAP), Systolic Blood
Pressure (SYS BP), Diastolic Blood Pressure (DIA BP), Anxiety Scores, and Salivary levels of Cortisol, Secretory Immunoglobulin A (sIgA), C-Reactive Protein (CRP),
Tumor Necrosis Factor alpha (TNF-α), Interleukin 6 (IL-6), Interleukin 1 β (IL-1β), and Interleukin 8 (IL-8). Adjusted group means post-treatment were calculated using
one-way ANCOVA with the baseline data as the covariate to correct for baseline differences between groups. The data collected immediately before the rst session was
used as the baseline. Differences were calculated using the change from the pre-treatment combined group mean, and percent differences were calculated by dividing
the difference by the pre-treatment combined group mean. Mean changes in each variable are given with their respective 95% condence intervals. P-values comparing
the two post-treatment adjusted group means to one another were calculated using the F-test. 95% condence intervals for t he post-treatment m eans were calculated
using the mean square error (MSE) and an alpha value of 0.05. Note that because ANCOVA assumes equal variances in both groups, the condence interval for post-
treatment data is the same for the treatment and control groups. Asterisks (*) emphasize p-values with statistical signicance. Obelisks (†) indicate a p-value associated
with a difference that would likely reach statistical signicance given a larger sample size.
Pre-Treatment
(Combined
Group Mean)
Post-Treatment
(Adjusted Group
Means)
Difference From Baseline (Post-
Pre)
Difference Between
Group Means Signicance and Spread
Dependent
Variable Units BL (n=18) EOs (n=9) FCO (n=9) EOs - BL % FCO -
BL % EOs-FCO % P-value
Mean
Square
Error
95% CONF
(+/-)
HR beats/min 72.7 63.8 70.9 -8.9 -12.2 -1.8 -2.5 -7.1 -9.8 0.0002* 9.65 1.44
MAP mm Hg 93.3 90.2 94.7 -3.1 -3.3 1.4 1.5 -4.5 -4.8 0.08† 22.42 2.19
DIA BP mm Hg 80.6 79.2 81.8 -1.4 -1.7 1.2 1.5 -2.6 -3.2 0.2 15.89 1.84
SYS BP mm Hg 118.8 112.6 120.2 -6.2 -5.2 1.4 1.2 -7.6 -6.4 0.19 125.2 5.17
Anxiety
Score N/A 39.1 25.9 29.6 -13.21 -33.8 -9.51 -24.3 -3.7 -9.5 0.11† 19.92 2.06
Cortisol µg/dL 0.254 0.186 0.199 -0.068 -26.8 -0.055 -21.7 -0.013 -5.1 0.7 0.01 0.046
sIgA µg/min 1.31 1.19 1.15 -0.116 -8.9 -0.156 -11.9 0.04 3.1 0.8 0.192 0.203
CRP ng/mL 16.6 11.1 18.4 -5.45 -32.9 1.81 10.9 -7.26 -43.8 0.048* 51.1 3.3
TNF-α pg/mL 3.41 5.7 4.59 2.29 67.2 1.18 34.6 1.11 32.6 0.18 2.63 0.749
IL-6 pg/mL 7 7.81 6.53 0.81 11.6 -0.47 -6.7 1.28 18.3 0.52 15.2 1.8
IL-1βpg/mL 148 198 198 50 33.5 50 33.5 0 0 1 5590 34.5
IL-8 ng/mL 0.926 1.802 1.45 0.876 94.6 0.523 56.5 0.353 38.1 0.25 0.37 0.281

Citation: Bahr T, Rodriguez D, Allred K. Immediate and Lasting Effects of the doTERRA AromaTouch Technique, a Topical Essential Oil Application
Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial. J Integrative Med Ther. 2018;5(1): 7.
J Integrative Med Ther 5(1): 7 (2018) Page - 05
ISSN: 2378-1343
with a p-value of 0.05. These results suggest a lasting beneficial
impact of the ATT on inflammation, as demonstrated by the
statistically significant difference between groups in four of the five
measured inflammatory biosignals. The ATT with EOs group
showed an overall decrease in HR, MAP, DIA BP, and SYS BP, while
the ATT with FCO showing a decrease in only MAP, DIA BP, and
SYS BP. Indeed, the ATT and FCO group actually saw an increase
in HR (Table 2). While the decrease in these parameters was more
pronounced in the treatment group, the difference between groups
did not achieve statistical significance.
In both groups, scores on the SSAI once again decreased. Subjects
in the intervention group experienced a percent change of -27.6±3.14,
whereas the control group experienced a point change of -19.7±3.14,
a dierence that was not statistically signicant (Table 2). However,
this assessment would likely achieve statistical signicance with a
larger sample size. We did not observe any signicant dierences
in sIgA secretion or cortisol levels between groups or compared to
baseline aer the three weeks.
Discussion
Our results in healthy volunteers suggest that aromatherapy
massage and techniques like the ATT should be investigated for their
potential to help reduce HR, BP, and MAP in individuals with acute
or chronic anxiety. e menthol content in peppermint oil, Deep
Blue® blend, and the AromaTouch® blend may explain these eects, at
least in part. Menthol has been identied as a calcium channel blocker
that acts on both smooth and cardiac muscle [43,44]. Its action on
L-type calcium channels suggests the same mechanism as the calcium
channel blocker nifedipine, which is used clinically to reduce heart
rate and blood pressure [43,44].
Although a subjective measure, the psychological perception of
stress or relaxation is an important outcome of the ATT from a
patient’s perspective. We found that perceived anxiety decreased
considerably after receiving the ATT with EOs and was significantly
greater than the decrease in anxiety experienced by individuals
receiving the touch procedure with the inactive FCO. The
pharmacology of certain EO constituent compounds may be linked
with these effects. Lavender oil is known to block N-type, P/Q-type,
and T-type voltage-dependent calcium channels similarly to the
anxiolytic drug pregabalin, and it has been recommended for clinical
use in patients suffering from anxiety [45]. Its constituents linalool
and linalyl acetate are also known for their ability to potentiate
GABAA currents in electrophysiology experiments and have
demonstrated anxiolytic and sedative effects in animal models
[46,47]. The main compound in melaleuca oil, terpinene-4-ol, also
potentiates GABAergic neurotransmission and may have similar
effects [48]. α-pinene, found in both the Balance® and AromaTouch®
blends, is a partial GABAA agonist with direct interaction at the
benzodiazepine site [49]. Bornyl acetate, a compound found in the
AromaTouch blend, is also documented for anxiolytic effects, which
are described as being specifically mediated by altering autonomic
nervous system activity [50].
Perhaps the most significant finding in this study was the lasting
effects of the EOs on inflammatory biomarkers. CRP and cytokine
levels were significantly reduced in the EOs group but not the FCO
group, suggesting that the effects were due to the activity of the EOs
specifically and not the touch procedure. Furthermore, the
reduction in these biomarkers was considerable. Each was
reduced two- to three-fold compared to either baseline or FCO
controls. These results suggest that regular topical application of
Table 2: Lasting effects of the AromaTouch Technique with or without essential oils.
The following variables were measured immediately before the first session and 24 hours following the final session (3 weeks later): Heart Rate (HR), Mean Arterial
Pressure (MAP), Systolic Blood Pressure (SYS BP), Diastolic Blood Pressure (DIA BP), Anxiety Scores, and Salivary levels of Cortisol, Secretory Immunoglobulin A
(sIgA), C-Reactive Protein (CRP), Tumor Necrosis Factor alpha (TNF-α), Interleukin 6 (IL-6), Interleukin 1 β (IL-1β), and Interleukin 8 (IL-8). Adjusted group means post-
treatment were calculated using one-way ANCOVA with the baseline data as the covariate to correct for baseline differences between groups. The data collected
immediately before the rst session was used as the baseline. Differences were calculated using the change from the pre-treatment combined group mean, and percent
differences were calculated by dividing the difference by the pre-treatment combined group mean. Mean changes in each variable are given with their respective 95%
condence intervals. P-values comparing the two post-treatment adjusted group means were calculated using the F-test. 95% condence intervals for the post-treatment
means were calculated using the mean square error (MSE) and an alpha value of 0.05. Note that because ANCOVA assumes equal variances in both groups, the
condence interval for p ost-treatment data i s the s ame for t he treatment and control groups. Asterisks (*) e mphasize p-values w ith statistical s ignicance. Obelisks (†)
indicate a p-value associated with a difference that would likely reach statistical signicance given a larger sample size.
Pre-Treatment
(Combined
Group Average)
Post-Treatment
(Adjusted Group
Averages)
Difference From Baseline (Post-
Pre)
Difference
Between
Group Means
Signicance and Spread
Dependent
Variable Units BL (n=17) EOs
(n=8)
FCO
(n=9) Eos-BL % FCO-BL % Eos-
FCO % P-value Mean
Square Error
95% CONF
(+/-)
HR beats/min 72.9 70.2 68.3 -2.7 -3.7 -4.6 -6.3 1.9 2.6 0.56 45.3 3.199
MAP mm Hg 93.5 90 92 -3.5 -3.7 -1.5 -1.6 -2 -2.1 0.26 11 1.577
DIA BP mm Hg 80.8 78.2 79.9 -2.6 -3.2 -0.9 -1.1 -1.7 -2.1 0.18 6.17 1.181
SYS BP mm Hg 119 114 116 -5 -4.2 -3 -2.5 -2 -1.7 0.5 40 3.007
Anxiety Score N/A 39.5 28.6 31.7 -10.9 -27.6 -7.8 -19.7 -3.1 -7.8 0.38 43.5 3.135
Cortisol µg/dL 0.241 0.266 0.237 0.025 10.4 -0.004 -1.7 0.029 12 0.45 0.01 0.048
sIgA µg/min 1.37 0.856 1.64 -0.514 -37.5 0.27 19.7 -0.784 -57.2 0.19 1.31 0.544
CRP ng/mL 17.5 5.05 18.7 -12.5 -71.1 1.2 6.9 -13.7 -78 0.05* 178 6.342
TNF-α pg/mL 3.48 1.24 3.73 -2.24 -64.4 0.25 7.2 -2.49 -71.6 0.005* 2.3 0.721
IL-6 pg/mL 7.22 1.94 6.61 -5.28 -73.1 -0.61 -8.4 -4.67 -64.7 0.07† 19 2.072
IL-1βpg/mL 153 55.8 128 -97.2 -63.5 -25 -16.3 -72.2 -47.2 0.006* 2090 21.732
IL-8 ng/mL 0.926 0.373 0.958 -0.553 -59.7 0.032 3.5 -0.585 -63.2 0.001* 0.08 0.134

Citation: Bahr T, Rodriguez D, Allred K. Immediate and Lasting Effects of the doTERRA AromaTouch Technique, a Topical Essential Oil Application
Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial. J Integrative Med Ther. 2018;5(1): 7.
J Integrative Med Ther 5(1): 7 (2018) Page - 06
ISSN: 2378-1343
EOs in a massage-like touch procedure may bear considerable
implications for patients with inflammatory disorders.
Conclusion
It is well-known that the moderate pressure touch associated with
massage can have positive eects on anxiety and stress. e current
study design made it possible to control for the eects of the touch
procedure and determine the extent to which the EOs aected patients
receiving the ATT. e EOs used in the ATT robustly enhanced the
relaxing eects of the touch procedure as measured immediately aer
the technique’s administration. Our ndings suggest that the ATT,
which employs both physical touch and EOs, should be considered
for practitioners or patients seeking to manage acute stress or anxiety
as a complementary or alternative therapy.
Our data also suggests that the EOs are responsible for
additional benets not associated with the touch procedure. Regular
administration of the technique with EOs may have positive eects
on systemic inammation by reducing endogenous inammatory
signals. Future research in patients with inammatory disorders
should be conducted to further explore the benets of the ATT with
EOs in this context.
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Citation: Bahr T, Rodriguez D, Allred K. Immediate and Lasting Effects of the doTERRA AromaTouch Technique, a Topical Essential Oil Application
Procedure, on Autonomic Function and Salivary Biomarkers: A Pilot Trial. J Integrative Med Ther. 2018;5(1): 7.
J Integrative Med Ther 5(1): 7 (2018) Page - 07
ISSN: 2378-1343
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This study was funded by dōTERRA Intl. (Pleasant Grove, UT, USA) and
the saliva analysis was conducted at SalivaBio Lab (Carlsbad, CA, USA).
Questionnaires and surveys were built and administered by SurveyMonkey.
com, a paid web survey service. T. Bahr interpreted the data, performed
the statistical analysis, and wrote the paper. D. Rodriguez and K. Allred
participated in the writing of the paper. We acknowledge Jordan Hanks,
Shane Beck, Alex Agle, Hillary Slaughter, and Emily Miller for their help in
collecting data and/or administering the AromaTouch Techniques. We also
acknowledge Baylee Van Camp and Lindsey Humes for assisting with
scheduling and correspondence.
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