The herb sage has a long history of use in food and medicine. In Mediterranean cultures it was used internally to treat excessive menstrual bleeding, increase fertility, aid memory, reduce symptoms of arthritis, and reduce breast engorgement during weaning. It was used topically for treatment of wounds, sprains, and muscle injuries, and as a gargle for sore throat, hoarseness, and cough.
Sage has been approved by Germany’s Commission E for internal use in the treatment of dyspepsia (non-specific digestive distress) and excessive sweating, and for topical use in the treatment of inflammation of the mucous membranes of the throat and nose. However, only double-blind, placebo-controlled studies can prove that a treatment really works, and no studies of this type have been performed using sage for any of these purposes other than sore throat. (For information on why such studies are essential, see Why Does This Database Rely on Double-blind Studies?)
A double-blind study of 286 people found that a throat spray made using sage at a 15% concentration significantly reduced sore throat pain as compared to placebo.
Additionally, in double-blind trials performed in Iran, 42 people with Alzheimer’s disease were given either a sage extract or placebo for 4 months.1 The results appeared to suggest a modest improvement in mental function in the sage group as compared to the placebo group.
In another double-blind, placebo-controlled study, either placebo or sage essential oil was given to 24 healthy people using a crossover design.2 The results showed possible improvement in some, but not all, aspects of mental function, but the design of the study was such that the results are difficult to trust. The same was true for another small study involving 20 older healthy subjects who took various doses of sage extract. Short term benefit was seen at a dose of 333 mg per day.13 A similar sized study (with similar flaws) found weak hints that sage leaf might improve mood and reduce anxiety level.12
Much weaker evidence, too weak to rely upon at all, hints that sage might have liver protective,3-5anti-cancer,6 immunomodulatory (alters immune function),7 antimicrobial,8anti-anxiety,9 and anti-inflammatory activity.10
A small randomized trial involving 67 people with high cholesterol found evidence to support the use of sage leaf extract (500 mg every 8 hours) for modestly lowering total and LDL cholesterol levels.14 In another randomized trial of 86 people, with high cholesterol and diabetes, sage leaf extract improved fasting glucose, HbA1c, cholesterol (HDL and LDL), and trigycerides when compared to placebo.15
For use as tea or gargle, 1–3 grams of dried sage is steeped in a cup of water, and taken three times daily. The equivalent dose of tincture or extract may also be used
As a widely used food spice, sage is thought to have a relatively high level of safety. However, comprehensive safety studies have not been performed. Sage essential oil contains the neurotoxic substance thujone. Maximum safe doses in young children, pregnant or nursing women, or people with severe liver or kidney disease have not been established.
Akhondzadeh S, Noroozian M, Mohammadi M, et al. Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial. J Clin Pharm Ther. 2003;28:53–9.
Tildesley NT, Kennedy DO, Perry EK, et al. Positive modulation of mood and cognitive performance following administration of acute doses of Salvia lavandulaefolia essential oil to healthy young volunteers. Physiol Behav. 2005;83:699–709.
Amin A, Hamza AA. Hepatoprotective effects of Hibiscus, Rosmarinus and Salvia on azathioprine-induced toxicity in rats. Life Sci. 2005;77:266–78.
Lima CF, Andrade PB, Seabra RM, et al. The drinking of a Salvia officinalis infusion improves liver antioxidant status in mice and rats. J Ethnopharmacol. 2005;97:383–9.
Lima CF, Carvalho F, Fernandes E, et al. Evaluation of toxic/protective effects of the essential oil of Salviaofficinalis on freshly isolated rat hepatocytes. Toxicol In Vitro. 2004;18:457–65.
Vujosevic M, Blagojevic J. Antimutagenic effects of extracts from sage ( Salvia officinalis) in mammalian system in vivo. Acta Vet Hung. 2004;52:439–43.
Capek P, Hribalova V. Water-soluble polysaccharides from Salvia officinalis L. possessing immunomodulatory activity. Phytochemistry. 2004;65:1983–92.
Rota C, Carraminana JJ, Burillo J, et al. In vitro antimicrobial activity of essential oils from aromatic plants against selected foodborne pathogens. J Food Prot. 2004;67:1252–6.
Kavvadias D, Monschein V, Sand P, et al. Constituents of sage ( Salvia officinalis) with in vitro affinity to human brain benzodiazepine receptor. Planta Med. 2003;69:113–7.
Baricevic D, Sosa S, Della Loggia R, et al. Topical anti-inflammatory activity of Salvia officinalis L. leaves: the relevance of ursolic acid. J Ethnopharmacol. 2001;75:125–32.
Saller R, Buechi S, Meyrat R, et al. Combined herbal preparation for topical treatment of Herpes labialis. Forsch Komplementarmed Klass Naturheilkd. 2002;8:373–82.
Kennedy DO, Pace S, Haskell C, et al. Effects of cholinesterase inhibiting sage ( Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology. 2005 Oct 5 [Epub ahead of print]
Scholey AB, Tildesley NT, Ballard CG, et al. An extract of Salvia (sage) with anticholinesterase properties improves memory and attention in healthy older volunteers. Psychopharmacology (Berl). 2008 Mar 19.
Kianbakht S, Abasi B, Perham M, Hashem Dabaghian F. Antihyperlipidemic effects of Salvia officinalis L. leaf extract in patients with hyperlipidemia: a randomized double-blind placebo-controlled clinical trial. Phytother Res. 2011;25(12):1849-1853.
Kianbakht S, Dabaghian FH. Improved glycemic control and lipid profile in hyperlipidemic type 2 diabetic patients consuming Salvia officinalis L. leaf extract: a randomized placebo. Controlled clinical trial. Complement Ther Med. 2013;21(5):441-446.
Last reviewed September 2014 by EBSCO CAM Review Board
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