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Chamomile: A herbal medicine of the past with a bright future (Review)

Authors:

Abstract

Chamomile is one of the most ancient medicinal herbs known to mankind. It is a member of Asteraceae/Compositae family and represented by two common varieties viz. German Chamomile (Chamomilla recutita) and Roman Chamomile (Chamaemelum nobile). The dried flowers of chamomile contain many terpenoids and flavonoids contributing to its medicinal properties. Chamomile preparations are commonly used for many human ailments such as hay fever, inflammation, muscle spasms, menstrual disorders, insomnia, ulcers, wounds, gastrointestinal disorders, rheumatic pain, and hemorrhoids. Essential oils of chamomile are used extensively in cosmetics and aromatherapy. Many different preparations of chamomile have been developed, the most popular of which is in the form of herbal tea consumed more than one million cups per day. In this review we describe the use of chamomile in traditional medicine with regard to evaluating its curative and preventive properties, highlight recent findings for its development as a therapeutic agent promoting human health.
Chamomile: A herbal medicine of the past with bright future
Janmejai K Srivastava1,2,*, Eswar Shankar1,2, and Sanjay Gupta1,2,3
1Department of Urology & Nutrition, Case Western Reserve University, Cleveland, Ohio 44106
2Department of Urology & Nutrition, University Hospitals Case Medical Center, Cleveland, Ohio
44106
3Department of Urology & Nutrition, Case Comprehensive Cancer Center, Cleveland, Ohio 44106
Abstract
Chamomile is one of the most ancient medicinal herbs known to mankind. It is a member of
Asteraceae/Compositae family and represented by two common varieties viz. German Chamomile
(Chamomilla recutita) and Roman Chamomile (Chamaemelum nobile). The dried flowers of
chamomile contain many terpenoids and flavonoids contributing to its medicinal properties.
Chamomile preparations are commonly used for many human ailments such as hay fever,
inflammation, muscle spasms, menstrual disorders, insomnia, ulcers, wounds, gastrointestinal
disorders, rheumatic pain, and hemorrhoids. Essential oils of chamomile are used extensively in
cosmetics and aromatherapy. Many different preparations of chamomile have been developed, the
most popular of which is in the form of herbal tea consumed more than one million cups per day.
In this review we describe the use of chamomile in traditional medicine with regard to evaluating
its curative and preventive properties, highlight recent findings for its development as a
therapeutic agent promoting human health.
Keywords
chamomile; dietary agents; flavonoids; polyphenols; human health
1. INTRODUCTION
The interplay of plants and human health has been documented for thousands of years (1–3).
Herbs have been integral to both traditional and non-traditional forms of medicine dating
back at least 5000 years (2,4–6). The enduring popularity of herbal medicines may be
explained by the tendency of herbs to work slowly, usually with minimal toxic side effects.
One of the most common herbs used for medicinal purposes is chamomile whose
standardized tea and herbal extracts are prepared from dried flowers of Matricaria species.
Chamomile is one of the oldest, most widely used and well documented medicinal plants in
the world and has been recommended for a variety of healing applications (7). Chamomile is
a native of the old World and is a member of the daisy family (Asteraceae or Compositae).
The hollow, bright gold cones of the flowers are packed with disc or tubular florets and are
ringed with about fifteen white ray or ligulate florets, widely represented by two known
varieties viz. German chamomile (Matricaria chamomilla) and Roman chamomile
(Chamaemelum nobile) (8) . In this review we will discuss the use and possible merits of
Correspondence to: Sanjay Gupta, Ph.D., Department of Urology, Case Western Reserve University, 10900 Euclid Avenue,
Cleveland, Ohio 44106, Phone: (216) 368 6162; Fax: (216) 368 0213; sanjay.gupta@case.edu.
*Current address: Amity Institute of Biotechnology (Mango Orchard Campus), Amity University, Lucknow Campus, Viraj Khand
5, Gomti Nagar, Lucknow, India
NIH Public Access
Author Manuscript
Mol Med Report. Author manuscript; available in PMC 2011 February 1.
Published in final edited form as:
Mol Med Report
. 2010 November 1; 3(6): 895–901. doi:10.3892/mmr.2010.377.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
chamomile, examining its historical use and recent scientific and clinical evaluations of its
potential use in the management of various human ailments.
2. BIOACTIVE CONSTITUENTS OF CHAMOMILE
Different classes of bioactive constituents are present in chamomile, which have been
isolated and used as medicinal preparations and cosmetics (9). The plant contains 0.24%–
1.9% volatile oil, composed of a variety of separate oils. When exposed to steam distillation,
the oil ranges in color from brilliant blue to deep green when fresh but turns to dark yellow
after storage. Despite fading, the oil does not lose its potency. Approximately 120 secondary
metabolites have been identified in chamomile, including 28 terpenoids and 36 flavonoids
(10,11). The principal components of the essential oil extracted from the German chamomile
flowers are the terpenoids α-bisabolol and its oxide azulenes including chamazulene and
acetylene derivatives. Chamazulene and bisabolol are very unstable and are best preserved
in an alcoholic tincture. The essential oil of Roman chamomile contains less chamazulene
and is mainly constituted from esters of angelic acid and tiglic acid. It also contains
farnesene and α-pinene. Roman chamomile contains up to 0.6% of sesquiterpene lactones of
the germacranolide type, mainly nobilin and 3-epinobilin. Both α-bisabolol, bisabolol oxides
A and B and chamazulene or azulenesse, farnesene and spiro-ether quiterpene lactones,
glycosides, hydroxycoumarins, flavanoids (apigenin, luteolin, patuletin, and quercetin),
coumarins (herniarin and umbelliferone), terpenoids, and mucilage are considered to be the
major bio-active ingredients (12,13). Other major constituents of the flowers include several
phenolic compounds, primarily the flavonoids apigenin, quercetin, patuletin as glucosides
and various acetylated derivatives. Among flavonoids, apigenin is the most promising
compound. It is present in very small quantities as free apigenin, but predominantly exists in
the form of various glycosides (14–18).
3. HEALTHCARE PREPRATIONS OF CHAMOMILE
Chamomile is known to be used in various forms of its preparations. Dry powder of
chamomile flower is recommended and used by many people for traditionally established
health problems. Medicinal ingredients are normally extracted from the dry flowers of
chamomile by using water, ethanol or methanol as solvents and corresponding extracts are
known as aqueous, ethanolic (alcoholic) and/or methanolic extracts. Optimum chamomile
extracts contain about 50 percent alcohol. Normally standardized extracts contain 1.2% of
apigenin which is one of the most effective bioactive agents. Aqueous extracts, such as in
the form of tea, contain quite low concentrations of free apigenin but include high levels of
apigenin-7-O-glucoside. Oral infusion of chamomile is recommended by the German
Commission E (19,20).Chamomile tea is one of the world’s most popular herbal teas and
about a million cups are consumed every day. Tea bags of chamomile are also available in
the market, containing chamomile flower powder, either pure or blended with other popular
medicinal herbs. Chamomile tincture may also be prepared as one part chamomile flower in
four parts of water having 12% grain alcohol, which is used to correct summer diarrhea in
children and also used with purgatives to prevent cramping. Chamomile flowers are
extensively used alone, or combined with crushed poppy-heads, as a poultice or hot foment
for inflammatory pain or congestive neuralgia, and in cases of external swelling, such as
facial swelling associated with underlying infection or abscess. Chamomile whole plant is
used for making herb beers, and also for a lotion, for external application in toothache,
earache, neuralgia and in cases of external swelling (20). It is also known to be used as bath
additive, recommended for soothing ano-genital inflammation (21). The tea infusion is used
as a wash or gargle for inflammation of the mucous membranes of the mouth and throat
(22,23). Inhalation of the vaporized essential oils derived from chamomile flowers is
recommended to relieve anxiety, general depression. Chamomile oil is a popular ingredient
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of aromatherapy and hair care (24,25). Roman chamomile is widely used in cosmetic
preparations and in soothing and softening effect on the skin (26,27).
4. TRADITIONAL USE OF CHAMOMILE
Traditionally, chamomile has been used for centuries as an anti-inflammatory, antioxidant,
mild astringent and healing medicine (28). As a traditional medicine, it is used to treat
wounds, ulcers, eczema, gout, skin irritations, bruises, burns, canker sores, neuralgia,
sciatica, rheumatic pain, hemorrhoids, mastitis and other ailments (29,30). Externally,
chamomile has been used to treat diaper rash, cracked nipples, chicken pox, ear and eye
infections, disorders of the eyes including blocked tear ducts, conjunctivitis, nasal
inflammation and poison ivy (31,32). Chamomile is widely used to treat inflammations of
the skin and mucous membranes, and for various bacterial infections of the skin, oral cavity
and gums, and respiratory tract. Chamomile in the form of an aqueous extract has been
frequently used as a mild sedative to calm nerves and reduce anxiety, to treat hysteria,
nightmares, insomnia and other sleep problems (33). Chamomile has been valued as a
digestive relaxant and has been used to treat various gastrointestinal disturbances including
flatulence, indigestion, diarrhea, anorexia, motion sickness, nausea, and vomiting (34,35).
Chamomile has also been used to treat colic, croup, and fevers in children (36). It has been
used as an emmenagogue and a uterine tonic in women. It is also effective in arthritis, back
pain, bedsores and stomach cramps.
5. SCIENTIFIC EVALUATION OF CHAMOMILE
5.1 Anti-inflammatory and antiphlogistic properties
The flowers of chamomile contain 1–2% volatile oils including alpha-bisabolol, alpha-
bisabolol oxides A & B, and matricin (usually converted to chamazulene and other
flavonoids which possess anti-inflammatory and antiphlogistic properties (12,19,35,36). A
study in human volunteers demonstrated that chamomile flavonoids and essential oils
penetrate below the skin surface into the deeper skin layers (37). This is important for their
use as topical antiphlogistic (anti-inflammatory) agents. One of chamomile’s anti-
inflammatory activities involve the inhibition of LPS-induced prostaglandin E(2) release and
attenuation of cyclooxygenase (COX-2) enzyme activity without affecting the constitutive
form, COX-1 (38).
5.2 Anticancer activity
Most evaluations of tumor growth inhibition by chamomile involve studies with apigenin
which is one of the bioactive constituents of chamomile. Studies on preclinical models of
skin, prostate, breast and ovarian cancer have shown promising growth inhibitory effects
(39–43). In a recently conducted study, chamomile extracts were shown to cause minimal
growth inhibitory effects on normal cells, but showed significant reductions in cell viability
in various human cancer cell lines. Chamomile exposure induced apoptosis in cancer cells
but not in normal cells at similar doses (18). The efficacy of the novel agent TBS-101, a
mixture of seven standardized botanical extracts including chamomile has been recently
tested. The results confirm it to have a good safety profile with significant anticancer
activities against androgen-refractory human prostrate cancer PC-3 cells, both in vitro and in
vivo situation (44).
5.3 Common cold
Common cold (acute viral nasopharyngitis) is the most common human disease. It is a mild
viral infectious disease of the upper respiratory system. Typically common cold is not life-
threatening, although its complications (such as pneumonia) can lead to death, if not
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properly treated. Studies indicate that inhaling steam with chamomile extract has been
helpful in common cold symptoms (45); however, further research is needed to confirm
these findings.
5.4 Cardiovascular conditions
It has been suggested that regular use of flavonoids consumed in food may reduce the risk of
death from coronary heart disease in elderly men (46). A study assessed the flavonoid intake
of 805 men aged 65–84 years who were followed up for 5 years. Flavonoid intake (analyzed
in tertiles) was significantly inversely associated with mortality from coronary heart disease
and showed an inverse relation with incidence of myocardial infarction. In another study
(47), on twelve patients with cardiac disease who underwent cardiac catheterization,
hemodynamic measurements obtained prior to and 30 minutes after the oral ingestion of
chamomile tea exhibited a small but significant increase in the mean brachial artery
pressure. No other significant hemodynamic changes were observed after chamomile
consumption. Ten of the twelve patients fell into a deep sleep shortly after drinking the
beverage. A large, well-designed randomized controlled trial is needed to assess the
potential value of chamomile in improving cardiac health.
5.5 Colic/Diarrhea conditions
An apple pectin-chamomile extract may help shorten the course of diarrhea in children as
well as relieve symptoms associated with the condition (47). Two clinical trials have
evaluated the efficacy of chamomile for the treatment of colic in children. Chamomile tea
was combined with other herbs (German chamomile, vervain, licorice, fennel, balm mint)
for administration. In a prospective, randomized, double-blind, placebo-controlled study, 68
healthy term infants who had colic (2 to 8 weeks old) received either herbal tea or placebo
(glucose, flavoring). Each infant was offered treatment with every bout of colic, up to 150
mL/dose, no more than three times a day. After 7 days of treatment, parents reported that the
tea eliminated the colic in 57% of the infants, whereas placebo was helpful in only 26%
(P<0.01). No adverse effects with regard to the number of nighttime awakenings were noted
in either group (48). Another study examined the effects of a chamomile extract and apple
pectin preparation in 79 children (age 0.5–5.5 y) with acute, non-complicated diarrhea who
received either the chamomile/pectin preparation (n = 39) or a placebo (n = 40) for 3 days.
Diarrhea ended sooner in children treated with chamomile and pectin (85%), than in the
placebo group (58%) (49). These results provide evidence that chamomile can be used
safely to treat infant colic disorders.
5.6 Eczema
Topical applications of chamomile have been shown to be moderately effective in the
treatment of atopic eczema (50). It was found to be about 60% as effective as 0.25%
hydrocortisone cream (51). Roman chamomile of the Manzana type (Kamillosan (R)) may
ease discomfort associated with eczema when applied as a cream containing chamomile
extract. The Manzana type of chamomile is rich in active ingredients and does not exhibit
chamomile-related allergenic potential. In a partially double-blind, randomized study carried
out as a half-side comparison, Kamillosan(R) cream was compared with 0.5%
hydrocortisone cream and a placebo consisting only of vehicle cream in patients suffering
from medium-degree atopic eczema (52). After 2 weeks of treatment, Kamillosan(R) cream
showed a slight superiority over 0.5% hydrocortisone and a marginal difference as compared
to placebo. Further research is needed to evaluate the usefulness of topical chamomile in
managing eczema.
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5.7 Gastrointestinal conditions
Chamomile is used traditionally for numerous gastrointestinal conditions, including
digestive disorders, "spasm" or colic, upset stomach, flatulence (gas), ulcers, and
gastrointestinal irritation (53). Chamomile is especially helpful in dispelling gas, soothing
the stomach, and relaxing the muscles that move food through the intestines. The protective
effect of a commercial preparation (STW5, Iberogast), containing the extracts of bitter
candy tuft, lemon balm leaf, chamomile flower, caraway fruit, peppermint leaf, liquorice
root, Angelica root, milk thistle fruit and greater celandine herb, against the development of
gastric ulcers has been previously reported (54). STW5 extracts produced a dose dependent
anti-ulcerogenic effect associated with a reduced acid output, an increased mucin secretion,
an increase in prostaglandin E (2) release and a decrease in leukotrienes. The results
obtained demonstrated that STW5 not only lowered gastric acidity as effectively as a
commercial antacid, but was more effective in inhibiting secondary hyperacidity (54).
5.8 Hemorrhoids
Studies suggest that chamomile ointment may improve hemorrhoids. Tinctures of
chamomile can also be used in a sitz bath format. Tincture of Roman chamomile may reduce
inflammation associated with hemorrhoids (55,56).
5.9 Health Promotion
It has been claimed that consumption of chamomile tea boosts the immune system and helps
fight infections associated with colds. The health promoting benefits of chamomile was
assessed in a study which involved fourteen volunteers who each drank five cups of the
herbal tea daily for two consecutive weeks. Daily urine samples were taken and tested
throughout the study, both before and after drinking chamomile tea. Drinking chamomile
was associated with a significant increase in urinary levels of hippurate and glycine, which
have been associated with increased antibacterial activity (57). In another study, chamomile
relieved hypertensive symptoms and decreased the systolic blood pressure significantly,
increasing urinary output (58). Additional studies are needed before a more definitive link
between chamomile and its alleged health benefits can be established.
5.10 Inflammatory conditions
Inflammation is associated with many gastrointestinal disorders complaints, such as
esophageal reflux, diverticular disease, and inflammatory disease (59–61). Studies in
preclinical models suggest that chamomile inhibits Helicobacter pylori, the bacteria that can
contribute to stomach ulcers (60). Chamomile is believed to be helpful in reducing smooth
muscle spasms associated with various gastrointestinal inflammatory disorders. Chamomile
is often used to treat mild skin irritations, including sunburn, rashes, sores and even eye
inflammations (62–65) but its value in treating these conditions has not been shown with
evidence-based research.
5.11 Mucositis
Mouth ulcers are a common condition with a variety of etiologies (66). Stomatitis is a major
dose-limiting toxicity from bolus 5-fluorouracil-based (5-FU) chemotherapy regimens. A
double-blind, placebo-controlled clinical trial including 164 patients was conducted (22).
Patients were entered into the study at the time of their first cycle of 5-FU-based
chemotherapy and were randomized to receive a chamomile or placebo mouthwash thrice
daily for 14 days. There was no suggestion of any stomatitis difference between patients
randomized to either protocol arm. There was also no suggestion of toxicity. Similar results
were obtained with another prospective trial on chamomile in this situation. Data obtained
from these clinical trials did not support the pre study hypothesis that chamomile could
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decrease 5-FU-induced stomatitis. The results remain unclear if chamomile is helpful in this
situation.
5.12 Osteoporosis
Osteoporosis is a metabolic bone disease resulting from low bone mass (osteopenia) due to
excessive bone resorption. Sufferers are prone to bone fractures from relatively minor
trauma. Agents which include selective estrogen receptor modulators or SERMs,
biphosphonates, calcitonin are frequently used to prevent bone loss. To prevent bone loss
that occurs with increasing age, chamomile extract was evaluated for its ability to stimulate
the differentiation and mineralization of osteoblastic cells. Chamomile extract was shown to
stimulate osteoblastic cell differentiation and to exhibit an anti-estrogenic effect, suggesting
an estrogen receptor-related mechanism (67). However, further studies are needed before it
can be considered for clinical use.
5.13 Sleep aid/sedation
Traditionally, chamomile preparations such as tea and essential oil aromatherapy have been
used to treat insomnia and to induce sedation (calming effects). Chamomile is widely
regarded as a mild tranquillizer and sleep-inducer. Sedative effects may be due to the
flavonoid, apigenin that binds to benzodiazepine receptors in the brain (68). Studies in
preclinical models have shown anticonvulsant and CNS depressant effects respectively.
Clinical trials are notable for their absence, although ten cardiac patients are reported to have
immediately fallen into a deep sleep lasting for 90 minutes after drinking chamomile tea
(47). Chamomile extracts exhibit benzodiazepine-like hypnotic activity (69). In another
study, inhalation of the vapor of chamomile oil reduced a stress-induced increase in plasma
adrenocorticotropic hormone (ACTH) levels. Diazepam, co-administered with the
chamomile oil vapor, further reduced ACTH levels, while flumazenile, a BDZ antagonist
blocked the effect of chamomile oil vapor on ACTH. According to Paladini et al. (70), the
separation index (ratio between the maximal anxiolytic dose and the minimal sedative dose)
for diazepam is 3 while for apigenin it is 10. Compounds, other than apigenin, present in
extracts of chamomile can also bind BDZ and GABA receptors in the brain and might be
responsible for some sedative effect; however, many of these compounds are as yet
unidentified.
5.14 Anxiety and seizure
Chamomile has been reported in the treatment of generalized anxiety disorder (GAD). But
the reports seem contradictory as an earlier report suggests that German chamomile showed
significant inhibition of GAD activity (71). The recent results from the controlled clinical
trial on chamomile extract for GAD suggests that it may have modest anxiolytic activity in
patients with mild to moderate GAD (72). Extracts of chamomile (M. recutita) possess
suitable effects on seizure induced by picrotoxin (73). Furthermore, apigenin has been
shown to reduce the latency in the onset of picrotoxin-induced convulsions and reduction in
locomotor activity but did not demonstrate any anxiolytic, myorelaxant, or anticonvulsant
activities (16).
5.15 Diabetes
Studies suggest that chamomile ameliorates hyperglycemia and diabetic complications by
suppressing blood sugar levels, increasing liver glycogen storage and inhibition of sorbitol
in the human erythrocytes (74). The pharmacological activity of chamomile extract has
shown to be independent of insulin secretion (75), and studies further reveal its protective
effect on pancreatic beta cells in diminishing hyperglycemia-related oxidative stress (76).
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Additional studies are required to evaluate the usefulness of chamomile in managing
diabetes.
5.16 Sore throat/hoarseness
The efficacy of lubrication of the endo-tracheal tube cuff with chamomile before intubation
on postoperative sore throat and hoarseness was determined in a randomized double-blind
study. 161 patients whose American Society of Anesthesiologists (ASA) physical status was
I or II, and undergoing elective surgical, orthopedic, gynecological or urological surgeries
were divided in two groups. The study group received 10 puffs of chamomile extract
(Kamillosan M spray, total 370 mg of Chamomile extract) at the site of the cuff of the
endotracheal tube for lubrication, while the control group did not receive any lubrication
before intubations. Standard general anesthesia with tracheal intubations was given in both
groups. 41 out of 81 patients (50.6%) in the chamomile group reported no postoperative sore
throat in the post-anesthesia care unit compared with 45 out of 80 patients (56.3%) in the
control group. Postoperative sore throat and hoarseness both in the post-anesthesia care unit
and at 24 h post-operation were not statistically different. Lubrication of endo-tracheal tube
cuff with chamomile extract spray before intubations can not prevent post operative sore
throat and hoarseness (77). Similar results were obtained in another double blind study (78).
5.17 Vaginitis
Vaginal inflammation is common in women of all ages. Vaginitis is associated with itching,
vaginal discharge, or pain with urination. Atrophic vaginitis most commonly occurs in
menopausal and postmenopausal women, and its occurrence is often associated with reduced
levels of estrogen. Chamomile douche may improve symptoms of vaginitis with few side
effects (79). There is insufficient research data to allow conclusions concerning possible
potential benefits of chamomile for this condition.
5.18 Wound healing
The efficacy of topical use of chamomile to enhance wound healing was evaluated in a
double-blind trial on 14 patients who underwent dermabrasion of tattoos. The effects on
drying and epithelialization were observed, and chamomile was judged to be statistically
efficacious in producing wound drying and in speeding epithelialization (80). Antimicrobial
activity of the extract against various microorganisms was also assessed. The test group, on
day 15, exhibited a greater reduction in the wound area when compared with the controls
(61 % versus 48%), faster epithelialization and a significantly higher wound-breaking
strength. In addition, wet and dry granulation tissue weight and hydroxyproline content were
significantly higher. The increased rate of wound contraction, together with the increased
wound-breaking strength, hydroxyproline content and histological observations, support the
use of M. recutita in wound management (81). Recent studies suggest that chamomile
caused complete wound healing faster than corticosteroids (82). However, further studies are
needed before it can be considered for clinical use.
5.19 Quality-of-life in cancer patients
Essential oils obtained from Roman chamomile are the basic ingredients of aromatherapy.
Clinical trials of aromatherapy in cancer patients have shown no statistically significant
differences between treated and untreated patients (83). Another pilot study investigated the
effects of aromatherapy massage on the anxiety and self-esteem experience in Korean
elderly women. A quasi-experimental, control group, pretest-posttest design used 36 elderly
females: 16 in the experimental group and 20 in the control group. Aromatherapy massage
using lavender, chamomile, rosemary, and lemon was given to the experimental group only.
Each massage session lasted 20 min, and was performed 3 times per week for two 3-week
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periods with an intervening 1-week break. The intervention produced significant differences
in the anxiety and self-esteem. These results suggest that aromatherapy massage exerts
positive effects on anxiety and self-esteem (84–86). However, more objective, clinical
measures should be applied in a future study with a randomized placebo-controlled design.
6.0 CONTRAINDICATIONS AND SAFETY ISSUES WITH CHAMOMILE
A relatively low percentage of people are sensitive to chamomile and develop allergic
reactions (87). People sensitive to ragweed and chrysanthemums or other members of the
Compositae family are more prone to develop contact allergies to chamomile, especially if
they take other drugs that help to trigger the sensitization. A large-scale clinical trial was
conducted in Hamburg, Germany, between 1985 and 1991 to study the development of
contact dermatitis secondary to exposure to a mixture of components derived from the
Compositae family. Twelve species of the Compositae family, including German
chamomile, were selected and tested individually when the mixture induced allergic
reactions. During the study, 3,851 individuals were tested using a patch with the plant
extract (88). Of these patients, 118 (3.1%) experienced an allergic reaction. Further tests
revealed that feverfew elicited the most allergic reactions (70.1% of patients) followed by
chrysanthemums (63.6%) and tansy (60.8%). Chamomile fell in the middle range (56.5%).
A study involving 686 subjects exposed either to a sesquiterpene lactone mixture or a
mixture of Compositae extracts led to allergic reactions in 4.5% of subjects (89). In another
study it was shown that eye washing with chamomile tea in hay fever patients who have
conjunctivitis exacerbates the eye inflammation, whereas no worsening of eye inflammation
was noted when chamomile tea was ingested orally (90). Chamomile is listed on the FDA's
GRAS (generally recognized as safe) list. It is possible that some reports of allergic
reactions to chamomile may be due to contamination of chamomile by "dog chamomile," a
highly allergenic and bad-tasting plant of similar appearance. Evidence of cross-reactivity of
chamomile with other drugs is not well documented, and further study of this issue is needed
prior to reaching conclusions. Safety in young children, pregnant or nursing women, or
those with liver or kidney disease has not been established, although there have not been any
credible reports of toxicity caused by this common beverage tea.
7.0 CONCLUSIONS
Chamomile has been used as an herbal medication since ancient times, is still popular today
and probably will continue to be used in the future because it contains various bioactive
phytochemicals that could provide therapeutic effects. Chamomile can help in improving
cardiovascular conditions, stimulate immune system and provide some protection against
cancer. Establishing whether or not therapeutic effects of chamomile are beneficial to
patients will require research and generation of scientific evidence. There is a need for
continued efforts that focuses on pre-clinical studies with chamomile involving animal
models of various diseases. This may then be consequently validated in clinical trials that
will help in developing chamomile as a promising therapeutic agent. Without such evidence,
it will remain unclear whether these untested and unproven medical treatments are truly
beneficial. It is advisable that the discriminate and proper use of chamomile preparations
could be safe and provide therapeutic benefits however the indiscriminate or improper use
can be unsafe and harmful.
Abbreviations
ACTH Adrenocorticotropic hormone
ASA American Society of Anesthesiologists
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BDZ benzodiazepine
CAM Complementary and alternative medicine
COX cyclooxygenase
5-FU 5-fluorouracil
GABA gamma-aminobutyric acid
GAD generalized anxiety disorder
LPS Lipopolysaccharide
SERM Selective estrogen receptor modulators
Acknowledgments
The original work from author’s laboratory outlined in this review was supported by United States Public Health
Service Grants RO1 AT002709 and RO1 CA108512
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... Many groups of chemical components with biological properties are present in chamomile (Table S1). More than 120 compounds have been identified in it, including 36 flavonoids and 28 terpenoids, of which mainly the latter two groups are responsible for the medicinal properties of this plant [10,14,15]. Chamomile flowers' main constituents are terpenoids, α-bisabolol, chamazulene (1-15%), and apigenin [10]. ...
... Chamomile flowers have an essential oil content ranging from 0.24 to 2.0 percent. The European Pharmacopoeia recommends that the oil content of chamomile should be no less than 4 mL/kg [14]. The essential oil extracted from German chamomile is a dark blue and thick liquid that possesses a strong and distinctive herbal fragrance [4]. ...
... Chamomile is among the oldest, most extensively utilized, and thoroughly documented medicinal plants worldwide [14]. For thousands of years, chamomile has been employed in herbal medicine. ...
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C Chamomile (Matricaria chamomilla L.) is one of the world's oldest, and best-documented Asteraceae family medicinal herbs. It is now a popular and widely used therapeutic plant material in folk and traditional medicine. The plant includes numerous components. More than 120 secondary metabolites were identified in it, including flavonoids, terpenoids, sesquiterpenes, coumarins, essential oils, and organic acids. Due to its rich chemical composition, chamomile has many beneficial properties. These include anti-inflammatory, antibacterial, antiseptic, antispasmodic, sedative, antitumor, antioxidant, hypoglycemic, hypotensive, anti-allergic, antidepressant, antianxiety, analgesic, antipruritic, antidiarrheal, hepatoprotective and neuroprotective effects. Chamomile's effectiveness in treating various skin issues is also attributed to its diverse bioactive components. The research delving into chamomile's therapeutic potential reveals that its historical use for skin conditions is not merely based on folklore, but is substantiated by the intricate interactions among its chemical constituents at the molecular level. The goal of this review is to synthesize existing knowledge about chamomile's traditional uses in the treatment of inflammatory skin disorders, with a focus on the findings reported in contemporary scientific literature by scanning PubMed and Scopus for research.
... Indeed, it is well established that PD is characterised by the selective degeneration of neurons containing NM, particularly in the substantia nigra pars compacta (SNpc), leading to the hallmark motor symptoms of PD [9]. Following this evidence and considering the traditional medicinal uses of chamomile, such as inducing calmness and relaxation [3], in our ongoing investigation on tyrosinase inhibitory activity of C. nobile green extracts [10], for all isolated compounds, a tyrosinase inhibition assay was performed. As reported in Figure 3, flavonoids 6, 7, and 9 and scopolin 1 showed the highest inhibition, with IC 50 values in a range of 32.09-50.84 ...
... (SNpc), leading to the hallmark motor symptoms of PD [9]. Following this evidence and considering the traditional medicinal uses of chamomile, such as inducing calmness and relaxation [3], in our ongoing investigation on tyrosinase inhibitory activity of C. nobile green extracts [10], for all isolated compounds, a tyrosinase inhibition assay was performed. As reported in Figure 3, flavonoids 6, 7, and 9 and scopolin 1 showed the highest inhibition, with IC50 values in a range of 32.09-50.84 ...
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The ageing of the world population has led to an increase in the incidence of neurodegenerative diseases. In this regard, plants have become an important source of bioactive principles that are able to act on multiple targets. Chamaemelum nobile (L.) All. is a perennial herb of the Asteraceae family, known as Roman chamomile, less studied in the scientific literature than the more common Matricaria chamomilla. Flavonoids and sesquiterpene lactones represent the main secondary metabolites. Among these, nobilin and its derivatives are considered the main components. With the aim of performing a phytochemical investigation, the extract of the fresh aerial parts of C. nobile was firstly analysed by LC-(+)ESI/QExactive/MS/MS, which guided the isolation of 15 compounds (coumarins, glucoside derivatives, flavonoids, and germacrane-type sesquiterpene lactones) characterised by 1D and 2D NMR spectroscopy. The presence of a derivative of nobilin, never been reported before, was highlighted. Moreover, for all isolated compounds, acetylcholinesterase and tyrosinase inhibitory activity were tested by spectrophotometric assays. The results showed that the tested compounds presented interesting tyrosinase (IC50 values: 32.09–412.02 µM) and acetylcholinesterase inhibitory activity (IC50 values: 181.58–387.99 µM). In detail, apigenin 7-O-rutinoside (6) showed the highest tyrosinase and AchE inhibitory activity, with IC50 values of 32.09 and 181.58 µM, respectively.
... Because of its anti-inflammatory, antioxidant, and antibacterial qualities, a recent study emphasizes its potential in contemporary medicine and cosmetics [7]. Some of its constituents, such as chamazulene and bisabolol, are responsible for its medicinal properties [8]. Investigating its chemical makeup and its uses in medicine, cosmetics, and holistic well-being are the goals of this work [9][10][11]. ...
... Chamomile has been widely used to treat wounds, skin irritation, burns, chickenpox, ear and eye infections, and nasal inflammation [9,12,13]; [14]. According to scientific analysis, extracted essential oils of chamomile were discovered to include -bisabolol oxide A and B and other flavonoids with anti-inflammatory and antiphlogistic activities [8]. These plants are most recognized for their calming properties when eaten as tea, frequently served with honey or lemon [6]. ...
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Matricaria recutita, commonly known as chamomile, is extensively utilized in the pharmaceutical, cosmetic, and food industries for its medicinal and essential oil properties. Local people from the Karnali Province of Nepal use this plant against skin and vaginal infection by bacteria and fungi. This research focuses on extracting essential oil through hydro-distillation, followed by Gas Chromatography-Mass Spectroscopy (GC-MS) to identify its chemical constituents and antioxidant and antimicrobial activities against bacteria and fungi responsible for common skin infections. The GC-MS analysis of the essential oil from M. recutita identified eleven chemical components. The major constituents, with respective area percentages at retention times 37.16, 11.79, and 7.88 in the GC chromatogram, were -farnesene (46.56%), -bisabolol oxide-A (11.79%), and menthol (7.88%). Limonene, methyl salicylate, and -bisabolol oxide-B also constituted the lowest area percentages at 1.36%, 1.59%, and 1.62%, respectively. The essential oil exhibited significant antioxidant activity with IC50 = 0.1924 µL/mL. Additionally, the essential oil exhibited notable antibacterial activity against Staphylococcus aureus ATCC6538P and Candida albicans, displaying zones of inhibition measuring 10.64 mm and 14.44 mm, respectively. The broth method also revealed that the MIC is above the 250 mg/mL range and has more potential for inhibition.
... In addition to its calming properties, chamomile has various other health benefits: Sleep Aid: Its modest sedative effects assist enhances sleep quality, especially in people who suffer from insomnia [4]. Conclusion: Chamomile is a promising natural anxiety therapy, supported by both traditional and modern scientific data. ...
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The rising frequency of anxiety disorders, combined with the limitations of current treatment choices, has sparked interest in alternative and complementary therapies. Plants with a history of traditional medicinal usage are especially appealing because of their natural origin and the possibility of fewer adverse effects. This review looks at the antianxiety properties of six medicinal plants: chamomile (Matricaria chamomilla), calendula (Calendula officinalis), arnica (Arnica montana), echinacea (Echinacea purpurea), sneezeweed (Helenium autumnale), and sunflower (Helianthus annus). Based on a thorough examination of existing scientific literature, the bioactive chemicals, mechanisms of action, and experimental evidence supporting their anxiolytic effects are critically analysed. Chamomile, which is high in apigenin and other flavonoids, has demonstrated strong anxiolytic efficacy in both preclinical and clinical investigations, principally through regulation of GABAergic pathways. Calendula, which has long been used for its calming qualities, has antioxidant and anti-inflammatory properties that may indirectly help to reduce anxiety. Arnica, while well-known for its topical anti-inflammatory properties, includes sesquiterpene lactones, which show potential in modulating stress-related pathways. Echinacea, which is widely known for its immunomodulatory properties, has lately shown anxiolytic activity, mostly through interaction with endocannabinoid receptors. Sneezeweed, a lesser-studied plant, has helenalin, a chemical that has neuroprotective and putative mood-modulating properties. Finally, sunflower seeds and extracts, which are high in magnesium and polyphenols, may help with anxiety by influencing neurochemical balance and the stress response pathways. The study highlights major breakthroughs in phytochemical analyses and mechanistic investigations, but it also indicates important information gaps. Most studies focus on in vitro or animal models, with few clinical trials to prove efficacy and safety in humans. Furthermore, differences in plant extraction processes, doses, and study designs make it difficult to compare outcomes between studies. Despite these limitations, the reviewed information suggests that these plants have potential as sources for the creation of new anxiolytic drugs. Future research should concentrate on well-designed clinical trials, standardized extraction processes, and the understanding of molecular mechanisms to confirm these plants' medicinal potential. By combining traditional knowledge with modern scientific methodologies, this review emphasizes the need of researching plant-based medicines for anxiety control.
... Albrecht et al. (2014) conducted a non-interventional study illustrating the significant improvement in symptoms of acute diarrhea among patients with various gastrointestinal disorders, highlighting its effectiveness across treatment modalities, including monotherapy and as part of combination therapy [183]. Complementing this, Gupta (2010) reviewed the extensive historical and medicinal background of chamomile, detailing its application in treating a wide range of ailments, including gastrointestinal disorders, which underscores the herb's broad therapeutic potential [184]. Al-Hashem (2010) demonstrated the gastroprotective effects of chamomile against ethanol-induced ulcers in rats, presenting a strong case for its use in preventive strategies for gastric ulcers [185]. ...
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... 24 From ancient times, the daisy family member German chamomile (Matricaria recutita) has been used topically and topically to cure a range of illnesses, including dermatitis, mouth or skin inflammation and gastrointestinal tract symptoms. 25 Chamomile from Germany is known to possess a vital blue oil that includes flavonoids, α-bisabolol, chamazulene and sesquiterpene alcohol, which is responsible for its anti-arthritic, healing of wounds and antibacterial properties. ...
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Does Echinacea fight the common cold? Does St. John's Wort (SJW) really counteract depression? What about chondroitin for joint health? Today's healthcare professionals are increasingly confronted with questions from patients who want to use herbal supplements to treat various conditions. A critical and scientific assessment of medicinal plant research by an internationally recognized researcher and writer in the field, Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals, Third Edition combines the scientific aspects of herbal medicine, phytomedicine, and pharmacognosy with the modern clinical trials that support the rationale for using plant products in healthcare. A Decade's Worth of Updates The original edition of this volume was authored by the late Professor Varro E. Tyler, a true giant in the field of pharmacognosy and pharmacy education. Following in Tyler's footsteps, Dennis V.C. Awang, co-editor of the journal Phytomedicine, recognized the need for a revised third edition, in light of how quickly the clinical literature surrounding the dietary supplement market is growing. Millions of consumers are demanding natural treatment options from their doctors and pharmacies in a variety of forms, from herbal teas to tinctures and capsules. Tyler's Herbs of Choice: The Therapeutic Use of Phytomedicinals, Third Edition effectively fosters understanding in patients and practitioners of the role that herbs and phytomedicinal products can play in both self-care and healthcare.
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Introduction: The common chamomile (Isocarpha Cubana Blake) is a plant commonly used by Cuban people. It has the same properties scientifically tested on the sweet chamomile (Matricaria Recutita, L.). A few studies have been related to it and none has demonstrated that the plant has the properties attributed to it. A preliminary pharmacognostic study dealt favorably with the possible similarities of both plants. It was the basis that determined the study of its pre-clinical pharmacological effects. Materials and methods: The anti-inflammatory action was evaluated by means of the model of induced inflammation by carragenin which values the acute effect. It was completed with the two other models of inflammation: that of granuloma to evaluate the chronic effect of the extract and that of auricular edema to evaluate the topic anti-inflammatory action of the cream. Taking into account the wide use of this plant by our population as an anti-diarrheic and digestive medication, its effect on the intestinal duct was also studied. Results: The fluid extract diminished the percentage of acute inflammation produced by carragenin in three dose levels, being this dose effect dependent and similar to that of indomethacin. In the same way, it inhibited significantly the production of granulomatous tissue in the model of chronic inflammation. However, the chamomile cream at 5 % was not able to diminish, in a topic way, the inflammatory effect produced by the croton oil. While studying its activity on the intestinal tract the extract acted out as an anti-diarrheic medication, being able to decrease the laxative effect of glycerin. Conclusions: The fluid extract of the common chamomile demonstrated to have acute and chronic anti-inflammatory action as well as anti-diarrheic effect while the chamomile cream at 5 % did not have anti-inflammatory effect in a topic way.