The Medicinal HerbFebruary 2015
By Michael Downey
A wealth of compelling evidence has revealed sage (Salvia officinalis) to be an easy way to spice up not only your meals, but your health. Sage provides an array of complex compounds such as chlorogenic acid, tannic acids, resins, estrogenic substances, and potent flavones.1 Research points to sage’s power to help lower glucose, cholesterol, and triglyceride levels in diabetics,2 enhance mood and cognitive performance,3 inhibit inflammation,4,5 and reduce the hot flashes of menopause.6 But perhaps most remarkable, experts now recognize the memory-enhancing capacity of sage in individuals with7 and without8 Alzheimer’s disease.
A Multitude Of Protective Compounds
Sage, with its grayish-green leaves that give off a unique, pleasant aroma, is native to the Mediterranean area. A relative of the mint family, this herb has been valued for thousands of years in that region for its broad range of uses in cooking and medicine.9
Sage contains a wide assortment of bioactive compounds. Its essential oil contains cineol, borneol, and thujone. Its leaves contain tannic acid; resins called oleic acid, ursonic acid, and ursolic acid; bitter substances called cornsole and cornsolic acid; estrogenic substances; and fumaric, chlorogenic, caffeic, and nicotinic acids—as well as a powerful class of bioflavonoids known as flavones.1
Sage flavones include apigenin, diosmetin, and luteolin.10 Apigenin may stimulate adult neurogenesis—the generation of neuronal cells in the adult brain—by promoting a process called neuronal differentiation.11 Diosmetin may inhibit the proliferation of breast cancer cells,12,13 and it has been suggested that it may be protective against cardiovascular disease.13 Luteolin has been shown to exert various pharmacological effects, such as anti-inflammatory, antimicrobial, and anticancer activities—including cancer chemopreventive and chemotherapeutic potential.14 In fact, evidence suggests that luteolin may help inhibit the development of UVB-induced skin cancer.15
Natural Improvement Of Alzheimer’s Symptoms
Sage may offer a novel natural treatment for Alzheimer’s disease by improving memory and information processing.
In research published in the Journal of Clinical Pharmacy and Therapeutics, scientists conducted a randomized, placebo-controlled clinical trial to assess the effectiveness and safety of 60 daily drops of either liquid sage extract or placebo on patients with mild to moderate Alzheimer’s disease. Subjects were aged 65 to 80 years old.
After four months, sage produced significantly better cognitive outcomes as measured by two standardized tests known as the cognitive subscale of Alzheimer’s Disease Assessment Scale (ADAS-cog) and the Clinical Dementia Rating (CDR).2
There were no significant differences in side effects, although agitation was less frequent in the treatment group.2
But scientists wondered: Does sage improve memory only in those afflicted with memory-destroying Alzheimer’s disease—or can it provide similar memory enhancement for individuals who do not have this disease?
Boosting Memory Performance In Healthy Individuals
Researchers set out to determine sage’s effects on memory and cognition in healthy individuals without memory problems.
First, they examined sage’s memory effects on older individuals. They set up a clinical trial of a most rigorous type: a randomized, balanced, placebo-controlled, five-period, varying dose, crossover study. Twenty volunteers, all of whom were over 65 years of age, were given a placebo and different doses of sage extract—167, 333, 666, and 1,332 mg—on four days. There was a seven-day washout period between each of the testing days. On testing days, cognitive performance was measured, using the Cognitive Drug Research computerized assessment system, at baseline and at one, two-and-a-half, four, and six hours after treatment.
Memory performance after placebo treatment characteristically declined throughout the day. However, after treatment with sage, participants showed significant memory enhancement at all assessment times throughout the testing days, most especially on the 333 mg testing day. Results demonstrated that sage improves accuracy of attention and delivers a significant benefit to memory consolidation in older patients without Alzheimer’s disease.16
Next, a group of British researchers investigated whether sage boosts memory in young adults without memory problems.
They set up two crossover studies, which were balanced, placebo-controlled, and double-blind. In the first study, 20 participants were given placebo and sage essential oil extracts in doses of 50, 100, and 150 microliters. In the second experiment, 24 participants took 25 and 50 microliters of the sage extract and placebo. The sage used was Spanish sage (Salvia lavandulaefolia), and there was a seven-day washout period between the different dosage days. On test days, the Cognitive Drug Research computerized assessment system was given prior to treatment and again at one, two-and-a-half, four, and six hours after treatment.
In both of these crossover trials, the researchers found that the 50 microliter dose of sage essential oil significantly boosted immediate word recall. In the journal Pharmacological Biochemical Behavior, the study authors wrote, “These results represent the first systematic evidence that Salvia (sage) is capable of acute modulation of cognition in healthy young adults.”8
Enhancing Mood And Alertness
Sage has long been associated with a calming and spirit-lifting effect.
Intrigued by this potential, scientists conducted a double-blind crossover study in which they gave 30 healthy participants, with an average age of 24.4, three different treatments: dried sage leaf in 300 and 600 mg dosages and placebo. This occurred on three separate days, each seven days apart. On each of these dosage days, mood was assessed pre-dose, plus both one and four hours after treatment.
Measured by the Bond-Lader mood scales, the higher dosage of sage resulted in improvements—at both one and four hours post-dose—in all three of the factors assessed by these scales: alertness, contentedness, and calmness.3
Published in the journal Neuropsychopharmacology, the study report concluded that, “The results of the current study confirm that acute administration of S. officinalis (sage) can beneficially modulate mood in healthy young participants.”3
Inhibiting Inflammatory Diseases
Potent anti-inflammatory sage components such as luteolin and rosmarinic acid may help inhibit inflammation in conditions such as arthritis, asthma, and inflammatory acne.
Luteolin has shown exceptional inhibition of TANK-binding kinase 1 (TBK1), an enzyme believed to play a role in the development of inflammatory diseases. Published in Biochemical Pharmacology, a study reported that luteolin had the strongest inhibitory activity against TBK1 among six tested natural anti-inflammatory compounds.17
The rosmarinic acid in sage supports this anti-inflammatory effect by inhibiting enzymes linked to inflammatory responses.18
A 2013 study reported in the Journal of Ethnopharmacology examined the published research on 71 herbs and found that sage provides an array of critical anti-inflammatory properties.19
Sage extracts have been shown to inhibit NF-kB, a protein complex that controls many genes involved in inflammation and that is chronically active in many inflammatory diseases ranging from atherosclerosis to inflammatory bowel disease.19
This review also found that sage extracts can:19
- Decrease pro-inflammatory interleukin-6 (IL-6),
- Inhibit release of tumor necrosis factor (TNF-a), cell-signaling proteins that were involved in systemic inflammation,
- Inhibit formation of pro-inflammatory leukotrienes,
- Increase the anti-inflammatory cytokine interleukin-10 (IL-10), and
- Reduce COX-2, an enzyme that is elevated during inflammation.
Reducing Glucose Levels And Improving Lipid Profiles In Diabetics
A team of researchers in Iran demonstrated that, in patients with type II diabetes, sage provides antihyperglycemic effects and improves lipid profile.
In a randomized, placebo-controlled study, half of a group of 80 hyperlipidemic type II diabetics were given a 500 mg capsule of sage leaf extract three times a day, while other participants were given a placebo.
After three months, the sage treatment showed various beneficial effects on blood sugar and blood lipids. Sage lowered fasting glucose by 32.2%, lowered glycated hemoglobin (HbA1c) by 22.7%, reduced total cholesterol by 16.9%, decreased triglycerides by 56.4%, lowered LDL cholesterol by 35.6%, and raised HDL cholesterol by 27.6%.2
No adverse effects were reported.
Decreasing Menopausal Hot Flashes And Sweating
In traditional folk medicine, sage was long used a remedy for excessive sweating and hot flashes. In recent years, scientists have investigated this potential benefit.
Menopausal women with at least five daily hot flashes were given a once-daily tablet of fresh sage leaves for about two months.
With each week that passed, the participants experienced a significant drop in both the number and severity of hot flashes. After the eight-week period, the mean number of mild hot flashes had decreased by 46%, moderate hot flashes by 62%, severe hot flashes by 79%, and very severe hot flashes had decreased by 100%!
Other menopausal symptoms—including psychological and urogenital problems—were also greatly reduced by the sage therapy. Treatment was well tolerated.6
Sage is a source of powerful acid compounds, resins, and flavones. Published studies now recognize that sage provides memory improvement both in Alzheimer’s patients and in young and old healthy persons. It inhibits inflammatory diseases, diabetic factors, and menopausal hot flashes. Sage not only spices up main dishes—it protects your memory, mood, and health.
If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.
- Available at: http://www.cancer.gov/drugdictionary?cdrid=574480. Accessed October 31, 2014.
- Kianbakhta 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. Compl Ther Med. 2013 Oct;21(5):441-6.
- Kennedy DO, Pace S, Haskell C, Okello EJ, Milne A, Scholey AB. Effects of cholinesterase inhibiting sage (Salvia officinalis) on mood, anxiety and performance on a psychological stressor battery. Neuropsychopharmacology. 2006 Apr;31(4):845-52.
- 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 May;75(2-3):125-32.
- Qnais EY, Abu-Dieyeh M, Abdulla FA, Abdalla SS. The antinociceptive and anti-inflammatory effects of Salvia officinalis leaf aqueous and butanol extracts. Pharm Biol. 2010 Oct;48(10):1149-56.
- Bommer S, Klein P, Suter A. First time proof of sage’s tolerability and efficacy in menopausal women with hot flushes. Adv Ther. 2011 Jun;28(6):490-500.
- Akhondzadeh S, Noroozian M, Mohammadi M, Ohadinia S, Jamshidi AH, Khani M. 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 Feb;28(1):53-9.
- Tildesley NT, Kennedy DO, Perry EK, et al. Salvia lavandulaefolia (Spanish sage) enhances memory in healthy young volunteers. Pharmacol Biochem Behav. 2003 Jun;75(3):669-74.
- Abu-Darwish MS, Cabral C, Ferreira IV, et al. Essential oil of common sage (Salvia officinalis L.) from Jordan: assessment of safety in mammalian cells and its antifungal and anti-inflammatory potential. Biomed Res Int. 2013;2013:538940.
- Available at: http://www.whfoods.com/genpage.php?tname=foodspice&dbid=76#healthbenefits. Accessed October 31, 2014.
- Available at: http://informahealthcare.com/doi/abs/10.1517/13543770902721279. Accessed October 31, 2014.
- Androutsopoulos VP, Mahale S, Arroo RR, Potter G. Anticancer effects of the flavonoid diosmetin on cell cycle progression and proliferation of MDA-MB 468 breast cancer cells due to CYP1 activation. Oncol Rep. 2009 Jun;21(6):1525-8.
- Available at: http://www.rightdiagnosis.com/vitamin/diosmetin.htm. Accessed October 31, 2014.
- López-Lázaro M. Distribution and biological activities of the flavonoid luteolin. Mini Rev Med Chem. 2009 Jan;9(1):31-59.
- Byun S, Lee KW, Jung SK, et al. Luteolin inhibits protein kinase C(epsilon) and c-Src activities and UVB-induced skin cancer. Cancer Res. 2010 Mar 15;70(6):2415-23.
- 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;198(1):127-39.
- Lee JK, Kim SY, Kim YS, Lee WH, Hwang DH, Lee JY. Suppression of the TRIF-dependent signaling pathway of toll-like receptors by luteolin. Biochem Pharmacol. 2009 Apr 15;77(8):1391-400.
- Gamaro GD, Suyenaga E, Borsoi M, Lermen J, Pereira P, Ardenghi P. Effect of rosmarinic and caffeic acids on inflammatory and nociception process in rats. ISRN Pharmacol. 2011;2011:451682.
- Vogl S, Picker P, Mihaly-Bison J, et al. Ethnopharmacological in vitro studies on Austria’s folk medicine—an unexplored lore in vitro anti-inflammatory activities of 71 Austrian traditional herbal drugs. J Ethnopharmacology. 2013 Oct;149(3):750-71.
- Available at: http://nutritiondata.self.com/facts/spices-and-herbs/208/2. Accessed October 31, 2014.