Essential Oils in Musculoskeletal and Neural Pain

Photo of lavender flowers and essential oil bottle by Marco Verch Professional Photographer via Flickr. CC BY 2.0 licence.

There have been many studies on the use of essential oils for pain, and a wide range of essential oils has been studied in this regard. Though the quality of the studies is not necessarily always good, this must be weighed against the fact that most of the studies report positive results. Evidence-based medicine should not be interpreted to mean that anything but randomised double-blind placebo-controlled clinical trials should be disregarded. This is not only unrealistic, but also unworkable when dealing with real life scenarios. Lesser quality evidence should be considered if the direction in which it points is unequivocal, unless larger and better trials contradict this evidence.

Sarmento-Neto et al. (2015) carried out a review of studies of antinociceptive activity of essential oils. In the studies reviewed the antinociceptive activities of 31 essential oils were demonstrated in rodents and the mechanism of action identified (peripheral or central). The lack of clinical studies was attributed to the need for more extensive pre-clinical investigations on the toxicity and safety of the essential oils. Among the better known and more commonly available Old World essential oils demonstarting antinociceptive activity were: clove (Eugenia caryophyllata), common basil (Ocimum basilicum), eucalyptus (Corymbia citriodora / syn. Eucalyptus citriodora), German chamomile (Matricaria recutita), ginger (Zingiber officinale), Indian valerian (Valeriana jatamansi / syn. Valeriana wallichii), lemon (Citrus limon), lemongrass (Cymbopogon spp.), and summer savory (Satureja hortensis). Mechanisms of action identified were mainly peripheral although some essential oils acted centrally at least in part (common basil, ginger, lemon). Oils of clove, common basil, ginger and lemon were found to have opioid agonist activity.

A paper by Barão Paixão et al. (2021) presented a systematic review of the published research evaluating topical and inhaled essential oils in rheumatic diseases. Three rheumatic diseases were included in the reviewed studies: fibromyalgia, osteoar­thritis, and rheumatoid arthritis. Thirteen studies fulfilled the inclusion criteria, of which 12 found the tested essential oils to be effective against pain. Massage was the most used method of essential oil application, with two studies using inhalation. Lavender essential oil was the most used followed by rosemary, eucalyptus and ginger and peppermint.

[1] Sarmento-Neto JF, do Nascimento LG, Felipe CF, de Sousa DP. Analgesic Potential of Essential Oils. Molecules. 2015;21(1):E20. Published 2015 Dec 23. doi:10.3390/molecules21010020

[2] Barão Paixão VL, Freire de Carvalho J. Essential oil therapy in rheumatic diseases: A systematic review. Complement Ther Clin Pract. 2021;43:101391. doi:10.1016/j.ctcp.2021.101391

Robert Hale, 27 July 2022.

Common Basil and Respiratory Disorders

A review by Aminian et al. (2022) [1] finds common basil (Ocimum basilicum) preparations to be effective in symptom relief, and in some cases prevention, of obstructive respiratory disorders.

Ocimum basilicum L. Image from Aminian et al. (2022) [1]


Ocimum basilicum L. (O. basilicum) and its constituents show anti-inflammatory, immunomodulatory, and antioxidant effects. The plant has been mainly utilized in traditional medicine for the treatment of respiratory disorders. In the present article, effects of O. basilicum and its main constituents on respiratory disorders, assessed by experimental and clinical studies, were reviewed. Relevant studies were searched in PubMed, Science Direct, Medline, and Embase databases using relevant keywords including “Ocimum basilicum,” “basilicums,” “linalool,” “respiratory disease,” “asthma,” “obstructive pulmonary disease,” “bronchodilatory,” “bronchitis,” “lung cancer,” and “pulmonary fibrosis,” and other related keywords. The reviewed articles showed both relieving and preventing effects of the plant and its ingredients on obstructive pulmonary diseases such as chronic obstructive pulmonary disease (COPD), asthma, and other respiratory disorders such as bronchitis, aspergillosis tuberculosis, and lung cancer. The results of the reviewed articles suggest the therapeutic potential of O. basilicum and its constituent, linalool, on respiratory disorders.’

[1] Aminian AR, Mohebbati R, Boskabady MH. The Effect of Ocimum basilicum L. and Its Main Ingredients on Respiratory Disorders: An Experimental, Preclinical, and Clinical Review. Front Pharmacol. 2022;12:805391. Published 2022 Jan 3. doi:10.3389/fphar.2021.805391

Mycotoxins in Medicinal Herbs: An Under-Appreciated Risk?

Fungal organisms are a normal part of the microbiome of plants. Some of these fungal organisms produce secondary metabolites which are toxic to animals and people. Some mycotoxins are potent carcinogens [1]. Much of the research on these and the risk to health posed by them has been done on commercial crop vegetables. There is current concern about the potentially increasing risk of aflatoxin in US maize due to climate change [2]. Also under the microscope, so to speak, are organic crops because they are not subject to the same mycotoxin control measures as non-organic crops [3].

But mycotoxin contamination of herbal products also represents a possible risk for human health. One study, the aim of which was to assess the extent of this problem, analysed a variety of herbal-based supplements from Czech and US markets – including milk thistle, red clover, flax seed, soy, green barley, nettle, goji berries and yucca – for the presence of 57 mycotoxins. Mycotoxin contamination was found to be more prevalent than expected, with 96% of the 69 herbal supplement samples containing detectable mycotoxins. The highest mycotoxin concentrations were found in milk thistle-based supplements (up to 37 mg/kg). [4]

Milk thistle (Silybum marianum L.) seed head. Public domain image from

Caldeirao et al. (2021) carried out a study of fourteen mycotoxins in a range of herbs in the Brazilian market, as dried herbs and infusions. They found mycotoxin contamination in 42 out of 58 herb samples (72%). In herbal infusions however, the occurrence of mycotoxins was 88% lesser than those in raw products. But despite this, the authors assessed that in the case of HT-2 toxin and in the case of some herbal infusions also aflatoxins and ochratoxin A, the levels found in infusions posed potential health risks. [5]

Hassan et al. (2022) evaluated the prevalence of aflatoxin B1 (AFB1) and ochratoxin A (OTA) in thyme and thyme-based products, related dietary exposure, and cancer risk for regular and high consumption. From the abstract:

A total of 160 samples were collected, and 32 composite samples were analyzed. AFB1 and OTA were respectively found in 84% … and 38% … of the samples. AFB1 exceeded the limits in 41% … and 25% … of the samples according to the Lebanese and European standards, respectively. OTA was unacceptable in only 6% … and 3% … of the samples according to the Lebanese and European standards, respectively.

After estimating daily exposure levels for Lebanese consumers on the basis of a food-frequency questionnaire, the authors calculate that the AFB1 exposure from dried thyme as a herb would account for 0.41 additional cancer cases per 100,000 persons, and from thyme-based products 0.35 additional cases per 100,000. [6]

However, a Latvian study concluded that while 90% of dry herb samples were contaminated with 1-8 mycotoxins, and despite high levels of extraction into infusion for some of them, intake risk assessment indicated that the tested herbal infusions were safe for consumers. [7]

And in a study of seven mycotoxins in supplements made with fifteen different single herbs and two compound supplements for two kinds of complaints, Pallarés et al. (2022) found that, although mycotoxin contamination was quite prevalent (58.3% of organic versus 41.1% of conventional samples) estimated daily intakes for mycotoxins, calculated according to the supplement manufacturers’ recommended dosages, were in general far below Tolerable Daily Intakes (TDIs). [8]

Moreover, Do et al. (2015) point out that exposure and toxicities can be diversely influenced by the other constituents of medicinal plants. They comment:

Although the occurrence and exposure of mycotoxins in most medicinal herbs and spices in various countries are inevitable, many of the bioactive components in these agricultural commodities have been known to regulate the fungal growth, mycotoxin production and their toxic actions in the plant and its herbivores, including human beings and domestic animals. These endogenous components are thus crucial attenuators by reducing the inevitable exposure and toxicities when taken in together with the contaminated mycotoxins.

Nevertheless, they also warn that:

… since some natural endogenous components could enhance the toxicity of mycotoxins via metabolic activation or retarded secretion by complex formation with mycotoxins, extensive investigations into these interactions is warranted. [9]

Pallarés et al. (2022), despite their encoraging findings (see above), also warn that:

The rising market of herbal products in Europe and worldwide makes necessary the control of mycotoxins and other chemical contaminates in such products. Poor practices during harvesting, handling, storage, and distribution stages affect the quality and safety of medicinal herbs, so the implementation of good manu-
facturing practices is essential to reduce mycotoxins presence.
[My highlighting] [8].

Aspergillus flavus Link. Photo by Swathi Sridharan via Flickr. CC BY-SA 2.0 licence.

This brief post cannot pretend to be anything approaching a comprehensive review of this subject. It simply aims to sample a few recent papers in order to alert the herbal community to what may be a lesser known or under recognised issue.

Yu et al. (2021) have provided a review [10], the abstract of which reads as follows:

Herbal medicines have been applied in clinical treatment worldwide, whose significant curative effect attracts considerable global research attention. However, as the herbal medicine industry
develops continuously in recent years, new challenges including monitoring the quality and safety of herbal medicines appear in this industry. Numerous cases of fungal and mycotoxin contamination have been reported that affected the quality and safety of herbal medicines. The main mycotoxins found in herbal medicines include aflatoxin, ochratoxin A, and fumonisin B, which cause substantial harm to human health. They are mainly produced by species from Aspergillus, Penicillium, and Fusarium. Various reports have focused on studying the conditions for fungal growth and mycotoxin synthesis to provide references for prevention. The chemical compounds and antagonism microorganisms were also explored to inhibit fungal growth, and decrease mycotoxin accumulation. This review discusses natural occurrence of three main fungal genera (Aspergillus, Penicillium, and Fusarium) and three main mycotoxins (aflatoxin, ochratoxin A, and fumonisin B) in herbal medicines, analyzing the endogenous and exogenous factors that affect fungal growth and mycotoxin production. Moreover, the prevention methods of fungal contamination are included.

Important questions remain for the small scale herbalist wildcrafting or growing herbs to make medicines for family and friends. Laboratory testing is expensive and may not be locally available. It is clearly impossible to remove all possibility that mycotoxins will be present in their herbal preparations. So what steps can be taken to minimise the risk? At the present time I can offer only the following:

  • Inspect all fresh herbs closely for any signs of mould, disease or or less than perfect quality.
  • Use them fresh or process them immediately.
  • If drying the herbs, make sure they are fully dried.
  • Store in airtight jars in a cool, dry space out of direct sunlight.
  • Inspect regularly for signs of deterioration.
  • Use dried herbs within two years.
  • When making ethanolic tinctures make sure the ethanol content is sufficient to prevent microbial growth.
  • Make sure herb material is completely covered by the menstruum.
  • Allow as little air space in the jar as possible.
  • Shake well regularly.
  • Strain at no more than 6 weeks.


[1] Wikipedia. Mycotoxin. N.d. Accessed 11th July 2022.

[2] Bailee Henderson. The Future of Aflatoxin in U.S. Corn. 23rd June 2020. Food safety Magazine. Accessed 11th July 2022.

[3] Wageningen University and Research. EU project Safe Organic Vegetables. N.d. Accessed 11th July 2022.

[4] Veprikova Z, Zachariasova M, Dzuman Z et al. Mycotoxins in Plant-Based Dietary Supplements: Hidden Health Risk for Consumers. 2015. J. Agric. Food Chem. 2015; 63(29):6633–6643. Abstract:

[5] Caldeirão L, Sousa J, Nunes LCG et al. Herbs and herbal infusions: Determination of natural contaminants (mycotoxins and trace elements) and evaluation of their exposure,
Food Research International. 2021; 144(110322).

[6] Hassan HF, Koaik L, Khoury AE et al. Dietary Exposure and Risk Assessment of Mycotoxins in Thyme and Thyme-Based Products Marketed in Lebanon. Toxins. 2022; 14(5):331.

[7] Reinholds I, Bogdanova E, Pugajeva I, Bartkevics V. Mycotoxins in herbal teas marketed in Latvia and dietary exposure assessment. Food Additives & Contaminants: Part B. 2019; 12(3):199-208. DOI: 10.1080/19393210.2019.1597927

[8] Pallarés N, Berrada H, Font G, Ferrer E. Mycotoxins occurrence in medicinal herbs dietary supplements and exposure assessment. 2022. J Food Sci Technol. 2022; 59(7):2830–2841.

[9] Do KH, An TJ, Oh S-K, Moon Y. Nation-Based Occurrence and Endogenous Biological Reduction of Mycotoxins in Medicinal Herbs and Spices. Toxins. 2015; 7(10):4111-4130.

[10] Yu J, Yang M, Han J, Pang X. Fungal and mycotoxin occurrence, affecting factors, and prevention in herbal medicines: a review. Toxin Reviews. 2021. DOI: 10.1080/15569543.2021.1925696

Copyright (c) Robert Hale 2022.

Plants of the Mint family in Iranian Folk Medicine

Melissa officinalis L., a member of the mint family (Labiatae). Photo by Gideon Pisanty (Gidip) גדעון פיזנטי, CC BY 3.0, via Wikimedia Commons.

Abstract of “Labiatae Family in folk Medicine in Iran: from Ethnobotany to Pharmacology” [1]:

“Labiatae family is well represented in Iran by 46 genera and 410 species and subspecies. Many members of this family are used in traditional and folk medicine. Also they are used as culinary and ornamental plants. There are no distinct references on the ethnobotany and ethnopharmacology of the family in Iran and most of the publications and documents related to the uses of these species are both in Persian and not comprehensive. In this article we reviewed all the available publication on this family. Also documentation from unpublished resources and ethnobotanical surveys has been included. Based on our literature search, out of the total number of the Labiatae family in Iran, 18% of the species are used for medicinal purposes. Leaves are the most used plant parts. Medicinal applications are classified into 13 main categories. A number of pharmacological and experimental studies have been reviewed, which confirm some of the traditional applications and also show the headline for future works on this family.”

This paper also details in tabular form the folk uses of over 70 members of the mint family (Labiatae) in Iran with notes on the pharmacological activity of many of them from scientific studies.

This paper is an open access article. The PDF is available for download.

[1] Naghibi, F., Mosaddegh, M., Mohammadi Motamed, M., Ghorbani, A. (2010). Labiatae Family in folk Medicine in Iran: from Ethnobotany to Pharmacology. Iranian Journal of Pharmaceutical Research, Volume 4(Number 2), 63-79.

Phytotherapy for Polycystic Ovary Syndrome

Flax (Linum usitatissimum L.). Public domain photo from

Azin and Khazali (2021) of Shahid Beheshti University, Tehran, Iran, carried out a literature review of studies concerning the potential role of herbs in the treatment of polycystic ovary syndrome (PCOS), a frequently encountered female complaint.

The 31 studies reviewed collectively covered 25 different herbs, two Traditional Chinese Medicine (TCM) and one Ayurvedic formulae, and four isolates from herbs (berberine, curcumin, soy isoflavone and quercetin).

Of the 25 herbs in the studies, 9 are native to the area of interest of this blog, the Mediterranean and Near East: aloe vera (Aloe
), anise (Pimpinella anisum), fennel (Foeniculum
), fenugreek (Trigonella foenum-graecum), flax seed (Linum usitatissimum), hazelnut (Corylus avellana), liquorice (Glycyrrhiza glabra), nettle and pomegranate (Punica granatum).

Of the studies done with these herbs, three were done with human subjects, the other with animal models. Two were done with women with PCOS. Some of the studies showed clinical benefits for PCOS, others showed improved hormone profiles consistent with better potential PCOS outcomes, others still improved secondary complications of PCOS such as metabolic syndrome.

The table below summarises in very basic form some data from the review.

HerbClinical benefits for PCOSImproved hormone profileImproved complications of PCOSHuman/
Aloe vera**A
Flax seed**H
Liquorice**A, H

Azin F. & Khazali H. (2021). Phytotherapy of polycystic ovary syndrome: A review. International Journal of Reproductive BioMedicine Volume 20, Issue no. 1,