What is clary sage

Clary sage (Salvia sclarea), is a biennial or short-lived herb in the genus Salvia. It is native to the northern Mediterranean Basin, along with some areas in north Africa and Central Asia. The plant has a lengthy history as a medicinal herb, and is currently grown for its essential oil ¹. The distilled clary sage essential oil is used widely in perfumes and as a muscatel flavoring for vermouths (red or white wine flavoured with aromatic herbs), wines, and liqueurs ¹. It is also used in aromatherapy ².

Clary sage (Salvia sclarea) is an important aromatic plant of the mint family that has various pharmacological properties, including antioxidant and antimicrobial activities ³. Blended essential oils containing clary sage, lavender and marjoram have been found to relieve pain in women with dysmenorrhea (painful periods) ⁴. In rats, clary sage has anti-depressant activity through modulation of the dopaminergic pathway ⁵. Despite its widespread use in aromatherapy and its therapeutic activities, little is known about the mechanisms of action of clary sage.

Clary sage extract, Sclareol, that is commonly used in perfumery and as a flavoring agent in people’s diets in China and the Mediterranean area has been shown in test tube can inhibit the growth of tumor but not that of the normal cells ⁶. Sclareol has low toxicity and slows down the tumor growth in vivo (mice study) and diverts the  immune response towards Th1 by increasing the level of IFN-γ and decreasing the level of IL-4 as well as modulating the T regulatory cells. These parameters make Sclareol a candidate to be used as chemoimmunotherapy of cancer ⁶.

Clary sage oil benefits

Constituents of Salvia sclarea oil

Detailed analysis of the clary sage oil showed 56 constituents, out of which linalyl acetate (57.9%) and linalool (12.4%) were determined as the main ones ⁷. Moreover, α-pinene (4.5%), α-terpineol (3.5%), sabinene (3.3%), β-pinene (3.0%), geranyl acetate (1.6%), myrcene (1.5%) and neryl acetate (1.0%) were identified in large quantities (see Table 1).

Table 1. Clary sage essential oil constituents

[Source ⁷]

This study ⁷ showed that the clary sage essential oil has the strong anti-staphylococcal activity against clinical strains isolated from wound infections. Interestingly, the strains of species Staphylococcus aureus and Staphylococcus epidermidis were more susceptible to the clary sage oil, followed by strains of Staphylococcus xylosus. Staphylococcus aureus strains including MRSA (methicillin-resistant Staphylococcus aureus – the most resistant staph bacteria that’s become resistant to many of the antibiotics used to treat ordinary staph infections) ⁷. Linalyl acetate (57.9%) and linalool (12.4%) were found to be the main compounds out of 56 constituents of the clary sage oil.

Clary sage oil has been found to contain significant levels of the psychoactive monoterpane linalool ⁸. In a study on experimental mice, where the mice received oil supplemented food from the age of 4 weeks or from conception via their pregnant dams. Each age group received either clary sage oil– or sunflower oil–enriched feed. Dominant animals, whose pregnant mothers received clary sage oil–enriched feed from the date of conception, showed a significant reduction of dominant and anxiety-like behavior, in comparison to their sunflower oil–treated counterparts. Clary sage oil–treated submissive animals exhibited a similar tendency, and showed a significant reduction in blood corticosterone levels. These findings support the hypothesis that clary sage oil possesses anxiolytic properties ⁸.

In another rats study subjected to immobilization stress, clary sage treatment of rats contributed in recovery from endothelial dysfunction by decreasing oxidative stress and increasing nitric oxide production and endothelial nitric oxide synthase expression ⁹. Endothelial dysfunction in hypertensive patients has also been associated with decreased production of nitric oxide, a key vasodilator released by the endothelium. Nitric oxide has been associated with various endothelial functions, including the regulation of vascular tone, platelet aggregation, and vascular smooth muscle cell proliferation ¹⁰. Therefore, endothelial dysfunction may result from the reduced activity of endothelial nitric oxide synthase and the resulting decreased bioavailability of nitric oxide ¹¹.

Clary oil was also found to alleviate stress and have antidepressive effects in a mouse model, effects manifested by activation of paths with dopamine characteristics ⁵. In addition, inhalation of clary oil vapors for 20 minutes by patients with gingivitis was found to reduce the strain and stress of patients undergoing dental treatment ¹².

In a human study ¹³ examining the effects of inhalation of clary oil or lavender oil vapors (both of which contain high concentrations of linalyl acetate) at concentrations of 5%, involving women who underwent urodynamic assessments for urinary incontinence. The clary oil group experienced a significant decrease in systolic blood pressure compared with the control (almond oil) and lavender oil groups, a significant decrease in diastolic blood pressure compared with the lavender oil group and a significant decrease in respiratory rate compared with the control group. This study showed clary oil inhalation may be useful in inducing relaxation in female urinary incontinence patients undergoing urodynamic assessments ¹³.

Clary sage extracts and essential oil possess antioxidant and antimicrobial properties ¹⁴. Dźamić et al. ¹⁵ showed fungicidal activity of the sage oil against Aspergillus, Penicillium, Fusarium, Trichoderma, Mucor, Candida and also its fungistatic and fungicidal activity against Cladosporium, Trichophyton, Alternaria and Phoma in very low levels. Hristova et al. ¹⁶ presented interesting results connected with high activity of the clary sage oil against many clinical strains of Candida species.

References

1. Clebsch, Betsy; Barner, Carol D. (2003). The New Book of Salvias. Timber Press. p. 261. ISBN 978-0-88192-560-9.
2. Kintzios, Spiridon E. (2000). Sage: The Genus Salvia. CRC Press. p. 20. ISBN 978-90-5823-005-8.
3. A diterpene synthase from the clary sage Salvia sclarea catalyzes the cyclization of geranylgeranyl diphosphate to (8R)-hydroxy-copalyl diphosphate. Günnewich N, Higashi Y, Feng X, Choi KB, Schmidt J, Kutchan TM. Phytochemistry. 2013 Jul; 91():93-9. https://www.ncbi.nlm.nih.gov/pubmed/22959531/
4. Pain relief assessment by aromatic essential oil massage on outpatients with primary dysmenorrhea: a randomized, double-blind clinical trial. Ou MC, Hsu TF, Lai AC, Lin YT, Lin CC. J Obstet Gynaecol Res. 2012 May; 38(5):817-22. https://www.ncbi.nlm.nih.gov/pubmed/22435409/
5. Antidepressant-like effect of Salvia sclarea is explained by modulation of dopamine activities in rats. Seol GH, Shim HS, Kim PJ, Moon HK, Lee KH, Shim I, Suh SH, Min SS. J Ethnopharmacol. 2010 Jul 6; 130(1):187-90. https://www.ncbi.nlm.nih.gov/pubmed/20441789/
6. Sclareol Reduces CD4+ CD25+ FoxP3+ T-reg Cells in a Breast Cancer Model in Vivo. Iran. J. Immunol. March 2013, 10 (1), 10-21. http://iji.sums.ac.ir/article_16799_0599e23ef41e82bd28b6be2d4b1ba4b2.pdf
7. Sienkiewicz M, Głowacka A, Poznańska-Kurowska K, Kaszuba A, Urbaniak A, Kowalczyk E. The effect of clary sage oil on staphylococci responsible for wound infections. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2015;32(1):21-26. doi:10.5114/pdia.2014.40957. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4360007/
8. Moshe Gross, Elimelech Nesher, Tatiana Tikhonov, Olga Raz, and Albert Pinhasov. Journal of Medicinal Food. March 2013, 16(3): 216-222. https://doi.org/10.1089/jmf.2012.0137
9. Yang HJ, Kim KY, Kang P, Lee HS, Seol GH. Effects of Salvia sclarea on chronic immobilization stress induced endothelial dysfunction in rats. BMC Complementary and Alternative Medicine. 2014;14:396. doi:10.1186/1472-6882-14-396. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4200217/
10. Association of lipid peroxidation with endothelial dysfunction in patients with overt hypothyroidism. Tejovathi B, Suchitra MM, Suresh V, Reddy VS, Sachan A, Srinivas Rao PV, Bitla AR. Exp Clin Endocrinol Diabetes. 2013 May; 121(5):306-9. https://www.ncbi.nlm.nih.gov/pubmed/23450331/
11. Endothelial dysfunction. Endemann DH, Schiffrin EL. J Am Soc Nephrol. 2004 Aug; 15(8):1983-92. https://www.ncbi.nlm.nih.gov/pubmed/15284284/
12. You JH. Kim MY. Moon HK, et al. Effect of clary sage-inhalation on pain and stress during the treatment of periodontitis. J Korean Acad Oral Health. 2011;1:32–40.
13. Seol GH, Lee YH, Kang P, You JH, Park M, Min SS. Randomized Controlled Trial for Salvia sclarea or Lavandula angustifolia: Differential Effects on Blood Pressure in Female Patients with Urinary Incontinence Undergoing Urodynamic Examination. Journal of Alternative and Complementary Medicine. 2013;19(7):664-670. doi:10.1089/acm.2012.0148. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3700459/
14. Gülçin I. Evaluation of the antioxidant and antimicrobial activities of clary sage (Salvia sclarea L.) Turk J Agric For. 2004;28:25–33.
15. Dźamić A, Sokovic M, Ristic M, et al. Chemical composition and antifungal activity of Salvia sclarea (Lamiaceae) essential oil. Arch Biol Sci. 2008;60:233–7.
16. Hristova Y, Gochev V, Wanner J, et al. Chemical composition and antifungal activity of essential oil of Salvia sclarea L. from Bulgaria against clinical isolates of Candida species. J BioSci Biotech. 2013;2:39–44.