Chamomile capsules vs tea

Study Shows Chamomile Capsules Ease Anxiety Symptoms

Generalized anxiety disorder (GAD) has a wide array of psychological and physical symptoms. Although prescription drugs can help, they often have undesirable side effects. Many people experiencing symptoms of anxiety do not seek medical attention, turning instead to alternatives. One traditional remedy in widespread use is the herb chamomile. However, scientific evidence to support the use of chamomile for anxiety has been lacking.

NCCAM-funded researchers at the University of Pennsylvania recently conducted a randomized, double-blind, placebo-controlled trial to test the effects of chamomile extract in patients diagnosed with mild to moderate GAD. For 8 weeks, the 57 participants received either chamomile capsules containing 220 mg of pharmaceutical-grade extract from Matricaria recutita (German chamomile), standardized to 1.2 percent of the constituent apigenin; or chamomile-scented placebo capsules containing lactose. The initial dose of one capsule daily was increased to two capsules daily at week 2; dosages were then adjusted incrementally (up to five capsules) in some participants. Researchers used the Hamilton Anxiety Rating (HAM-A) and other tests to measure changes in anxiety symptoms over the course of the study; dosage adjustments were based on HAM-A scores.

Compared with placebo, chamomile was associated with a greater reduction in mean HAM-A scores—the study’s primary outcome measure. The difference was clinically meaningful and statistically significant. Chamomile also compared favorably with placebo on other outcome measures (although the differences were not statistically significant), and was well tolerated by participants.

These results suggest that chamomile may have modest benefits for some people with mild to moderate GAD. As this was the first controlled trial of chamomile extract for anxiety, the researchers note that additional studies using larger samples and studying effects for longer periods of time would be helpful. They also point out that other chamomile species, preparations (e.g., extracts standardized to constituents other than apigenin), and formulations (e.g., oil or tea) might produce different results.

Chamomile tea. Photo: Getty Images

I’ve always been a pretty anxious person. I used to freak out on the regular while back in college, and now I panic at the prospect of a crowded sample sale or a promising job interview. I generally try to keep my anxiety in check by working out regularly and avoiding the president’s tweets — but sometimes I still find myself tossing and turning at night (wondering what, exactly, is going on with that sinkhole). So I’m always on the lookout for new ways to help relieve my anxiety, and some friends recently suggested I start drinking chamomile tea to help with my nerves. To see if it might actually be able to help me calm down, I consulted with two experts.

First of all, what exactly is chamomile? Well, chamomile is actually an incredibly popular herb, and it’s often used for medicinal purposes. There are two different chamomile plants: German chamomile and English chamomile. Dr. Chris D’Adamo, an assistant professor at the University of Maryland School of Medicine, told me that German chamomile is the one that’s most commonly used medicinally. The plant has actually been used therapeutically for “hundreds of years, if not more,” Dr. D’Adamo explained, and it’s most commonly used to help people calm down, relieve stomach issues, help with inflammation, and treat skin conditions.

So, what about anxiety? As it turns out, studies have shown chamomile to be effective in aiding with relaxation, and also helping with anxiety, depression, and insomnia. Of course, since it’s an herb, it’s not going to have as strong of an effect on a person’s anxiety as a pharmaceutical drug like Klonopin or Ativan, but Dr. D’Adamo told me that chamomile has still been shown to have “meaningful benefits.” In fact, a small 2016 study in the journal Phytomedicine found that long-term chamomile use “significantly” reduces moderate-to-severe symptoms of generalized anxiety disorder (one of the most common anxiety disorders). However, Dr. D’Adamo explained that there still isn’t too much information about how exactly chamomile works to ease anxiety, but still, it’s shown to at least be helpful.

But is that just a placebo effect? I asked Dr. D’Adamo if part of the reason chamomile tea might help with anxiety is the ritual of it all — you know, sitting down and actually slowly sipping hot tea as you clear your mind, which sounds very relaxing and calming in my opinion. He told me that there have actually been placebo-controlled studies on the benefits of chamomile, which found that its powers extend far beyond just the placebo effect (though he also said sure, the ritual may help with a person’s relaxation). “When people have anxiety and they’re looking for non-pharmacological treatments, chamomile is always one of the first to come up,” he said.

How should I take chamomile? According to registered dietitian Amy Shapiro, you can take your chamomile a couple of ways. The most popular way, of course, is through tea, which you can find prepackaged, or you can make yourself. If you do want to go the DIY route, Shapiro recommends using three to four tablespoons of dried chamomile (which you can easily pick up at a farmer’s market), pour hot water on top of it, then cover for five to ten minutes. If you want to use fresh chamomile, all you have to do is add it to hot water and let it steep for about three minutes. And then, the non-tea way to get chamomile is in supplement form.

Who should stay away from chamomile? Luckily, chamomile is generally pretty safe, and a person is usually fine to have up to few cups per day, Dr. D’Adamo explained. However, chamomile is not recommended for anyone who is taking anticoagulant medications or is about to have surgery, according to the doctor. Shapiro added that people with asthma or who are pregnant might also want to steer clear of it, as well as anyone who’s allergic to sunflower products, because chamomile is in that same family.

Chamomile

Chamomile is an herb also known as Camomille, Blue Chamomile, Camomèle, Echte Kamille, Feldkamille, Fleur de Camomile, Kamillen, Kleine Kamille, Manzanilla, Matricaire, Matricaria chamomilla, Petite Camomille, Pin Heads, Sweet False Chamomile, and other names.

Chamomile is a common flavoring agent in foods and beverages, and other products such as mouthwash, soaps, and cosmetics. When used as a food product, chamomile is not likely to produce health benefits or side effects. When used as a medicinal product, chamomile may produce both desired and unwanted effects on the body.

Chamomile has been used in alternative medicine as a possibly effective aid in treating anxiety, upset stomach, colic (intestinal gas), or diarrhea. Chamomile may also be possibly effective in treating or preventing mouth ulcers caused by chemotherapy or radiation treatment. Chamomile may have been combined with other plants or extracts in a specific preparation to treat these conditions.

Chamomile has also been used to treat insomnia, gingivitis (gum disease), and skin irritation. However, research has shown that chamomile may not be effective in treating these conditions.

Other uses not proven with research have included hemorrhoids, vaginal infection, skin wounds, and common cold symptoms.

It is not certain whether chamomile is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Chamomile should not be used in place of medication prescribed for you by your doctor.

Chamomile is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Chamomile may also be used for purposes not listed in this product guide.

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

You should not use chamomile if you have:

  • past or present cancer of the breast, ovary, or uterus; or
  • a history of endometriosis or uterine fibroids.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

  • pollen allergies (especially to ragweed, herbs, chrysanthemums, marigolds, daisies, other plants).

It is not known whether chamomile will harm an unborn baby. Avoid using this product if you are pregnant.

Chamomile might make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy while using chamomile.

It is not known whether chamomile passes into breast milk or if it could harm a nursing baby. Avoid using this product if you are breast-feeding a baby.

What are the benefits of chamomile tea?

The potential benefits of chamomile tea, for which there is the most evidence, include:

1. Reducing menstrual pain

Several studies have linked chamomile tea to reduced severity of menstrual cramps. A 2010 study, for example, found that consuming chamomile tea for a month could reduce the pain of menstrual cramps. Women in the study also reported less anxiety and distress associated with period pain.

2. Treating diabetes and lowering blood sugar

Again, some studies have found that chamomile tea can lower blood sugar in people with diabetes. Research does not show that chamomile is a viable substitute for diabetes medications, but it may be a helpful supplement to existing treatments.

Similarly, a 2008 study of rats found that consistent consumption of chamomile tea might prevent blood sugar from increasing. This effect reduces the long-term risk of diabetes complications, suggesting that chamomile could improve diabetes outcomes.

3. Slowing or preventing osteoporosis

Osteoporosis is the progressive loss of bone density. This loss increases the risk of broken bones and stooped posture. While anyone can develop osteoporosis, it is most common among post-menopausal women. This tendency may be due to the effects of estrogen.

A 2004 study found that chamomile tea might have anti-estrogenic effects. It also helped promote bone density, but the study’s authors caution that further research is needed to prove this apparent benefit.

4. Reducing inflammation

Inflammation is an immune system reaction to fight infection. Chamomile tea contains chemical compounds that may reduce inflammation. However, long-term inflammation is linked to a wide range of health problems, including hemorrhoids, gastrointestinal pain, arthritis, autoimmune disorders, and even depression.

5. Cancer treatment and prevention

Some studies suggest that chamomile tea may target cancer cells, or even prevent those cells from developing in the first place. However, research so far is inconclusive, and scientists say more work is needed to prove chamomile’s anti-cancer claims. Also, most research has looked at clinical models in animals, not humans.

A 2012 study compared the cancer-fighting powers of marigold and chamomile teas. Both were able to target cancer tumors selectively, but the effects of marigold tea were more potent.

6. Helping with sleep and relaxation

Share on PinterestChamomile tea is thought to help people fall asleep.

Chamomile tea is widely thought to help people relax and fall asleep. Few clinical trials have tested this, however.

In one review of the current evidence, 10 of 12 cardiovascular patients are quoted as having fallen asleep shortly after consuming chamomile tea. A handful of other studies looking at clinical models also suggest that chamomile tea may help people relax.

In a study using rats, chamomile extract helped sleep-disturbed rodents fall asleep. Many researchers believe that chamomile tea may function like a benzodiazepine. Benzodiazepines are prescription drugs that can reduce anxiety and induce sleep. Some research suggests that chamomile binds to benzodiazepine receptors.

A review looking at the ability of chamomile tea to reduce anxiety is inconclusive. Some studies show a modest anti-anxiety benefit, but others do not.

7. Treating cold symptoms

Anecdotal evidence and some studies suggest that inhaling steam with chamomile extract can relieve some of the symptoms of the common cold. But this benefit is not proven yet.

8. Treatment for mild skin conditions

A small 1987 study found that applying chamomile extract directly to a wound assisted healing. Likewise, a few studies have found that chamomile ointments may help with eczema and mild inflammatory skin conditions, although they are not as effective as hydrocortisone cream.

Chamomile Drug Interactions

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  • Interactions
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A total of 53 drugs are known to interact with chamomile.

  • 1 moderate drug interaction
  • 52 minor drug interactions

Show all medications in the database that may interact with chamomile.

Check for interactions

Type in a drug name to check for interactions with chamomile.

Most frequently checked interactions

View interaction reports for chamomile and the medicines listed below.

  • 5-HTP (5-hydroxytryptophan)
  • Advil (ibuprofen)
  • Aleve (naproxen)
  • anise
  • Aspirin Low Strength (aspirin)
  • Benadryl (diphenhydramine)
  • Claritin (loratadine)
  • CoQ10 (ubiquinone)
  • Fish Oil (omega-3 polyunsaturated fatty acids)
  • Flonase (fluticasone nasal)
  • ginger
  • Ginger Root (ginger)
  • Ginkgo Biloba (ginkgo)
  • green tea
  • honey
  • ibuprofen
  • lavender
  • lemon
  • melatonin
  • Paracetamol (acetaminophen)
  • Probiotic Formula (bifidobacterium infantis / lactobacillus acidophilus)
  • Sleep (diphenhydramine)
  • Tylenol (acetaminophen)
  • Valerian Root (valerian)
  • Vitamin B Complex 100 (multivitamin)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin B6 (pyridoxine)
  • Vitamin C (ascorbic acid)
  • Vitamin D3 (cholecalciferol)
  • Xanax (alprazolam)
  • Zyrtec (cetirizine)
  • Breastfeeding
  • En Español
  • Drug class: herbal products
  • Burns, External
  • Gas
  • Diarrhea
  • Fever
  • … +7 more

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major

Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.

Moderate

Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.

Minor

Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Unknown

No interaction information available.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Herbal Supplements May Be Dangerous When You Take Certain Prescription Drugs

A number of common herbal supplements, including green tea and Ginkgo biloba, can interact with prescription medications, according to a new research review published in the British Journal of Clinical Pharmacology. These interactions can make drugs less effective—and may even be dangerous or deadly.

Doctors know that herbs can affect medication regimens, wrote the researchers, from the South African Medical Research Council, in their new paper. But because people often don’t disclose to their healthcare providers what over-the-counter drugs and supplements they’re taking, it’s difficult for scientists to keep track of which drug and supplement combinations should be avoided.

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The new review analyzed 49 case reports of adverse drug reactions, along with two observational studies. Most people in the analysis were being treated for heart disease, cancer or kidney transplants, and were taking warfarin, statins, chemotherapy drugs or immunosuppressants. Some also had depression, anxiety or neurological disorders, and were being treated with antidepressant, antipsychotic or anticonvulsant medications.

Among the case reports, researchers determined that herb-drug interactions were “probable” for 51% of the reports, and “highly probable” for about 8%. About 37% were classified as possible herb-drug interactions, while only 4% were considered doubtful.

In one case report, a patient who took statins complained of intense leg cramps and pain—a commonly reported side effect—after drinking three cups of green tea a day. The reaction was attributed to green tea’s effects on statin levels in the blood, the researchers wrote, although they say more research is needed to rule out other possible causes.

In another report, a patient died after having a seizure while swimming, even though he was regularly taking anticonvulsant drugs for his condition. His autopsy, however, showed decreased levels of those drugs in his blood, likely due to the way Ginkgo biloba supplements—which he’d also been taking regularly—had affected their metabolism.

Taking herbal supplements has also been associated with worsening depression symptoms in people taking antidepressants, the authors wrote in their paper, and with organ rejection in those who had received kidney, heart or liver transplants. For cancer patients, chemotherapy drugs have been shown to interact with herbal supplements including ginseng, echinacea and chokeberry juice.

The analysis also showed that patients taking warfarin, a blood thinner, reported “clinically significant interactions” after taking herbal medicines containing sage, flaxseed, St. John’s wort, cranberry, goji juice and chamomilla. These herbs may affect the metabolism of warfarin, the researchers hypothesize, which may reduce its anticoagulation abilities or cause bleeding episodes.

The authors say that more studies in the laboratory—and more thorough observations of real people—are needed to provide stronger evidence about specific herb-drug interactions. “This approach will inform drug regulatory agencies and pharmaceutical companies about the need to update information in package inserts of medicines to avoid untoward adverse effects, based on available data,” they write.

It also serves as a reminder that patients should always disclose any medicines or supplements they’re taking—even products marketed as natural or herbal—to their doctors and pharmacists, especially when they’re prescribed a new drug.

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PMC

Interpretation

Despite known interaction between amiodarone and warfarin that potentiates the latter’s anticoagulation effects,1 the patient in this case had been taking both medications concurrently for 3 years without previous incidence of hemorrhage. Moreover, she had not had any episode of hemorrhage since the mitral valve replacement. Her platelet counts were within the normal range at all times, and her INR before the hospital admission recounted here was within the therapeutic range for anticoagulation for a mechanical mitral valve (INR 2.5– 3.5). Some new exposure between the 2 emergency department visits must therefore have been responsible for the elevated INR recorded.

According to the patient’s daughter, who verifies her medications, there was no possibility of warfarin overdose during that time; consultation with the patient’s pharmacist revealed no change in warfarin dosage over the previous 11 months. Review of the patient’s other medications did not reveal any potential interactants with warfarin, and the patient consumed no antiplatelet agents at any time. She denied any change in her diet in the days before her hospital admission. As a result, we ascribe the occurrence of this hemorrhage to the simultaneous and excessive use of chamomile products.

It is highly likely that an herb–drug pharmacodynamic interaction accounted for the increased bleeding observed (Box 1). Specifically, the coumarin constituent of chamomile may have worked in synergy with warfarin and resulted in supratherapeutic anticoagulation, which would explain her increased INR. Although a pharmacokinetic interaction cannot be ruled out, we do not believe it was clinically significant in this particular case.

The cytochrome P450 1A2 isoenzyme (CYP1A2) is the most sensitive to inhibition by chamomile.6 Only the R-enantiomer of warfarin, which exhibits little anticoagulant activity, is metabolized by this isoenzyme, and inhibition of its metabolism does not result in any changes in the INR.7 The anticoagulant activity of warfarin resides primarily in the S-enantiomer that is metabolized by CYP2C9. Chamomile is only a weak inhibitor of this isoenzyme.6

To the best of our knowledge, this is the first documented report of an interaction between warfarin and M. chamomilla; only a potential for interaction has been noted before. We believe that patients should be educated about the potential risk of using herbal products in general, and chamomile products in particular, while being treated with warfarin.

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