History and Origin
The Compositae (Asteraceae) family includes the well-known medicinal plant species chamomile, which is sometimes referred to as "the star among medicinal species." Even though chamomile is native to southern and eastern Europe, it is also cultivated in Yugoslavia, Brazil, Germany, France, and Hungary. Additionally, it may be found in North Africa, South and North America, Asia, Australia, and New Zealand.
Since ancient times, German chamomile has been used for herbal remedies and was well-known in Greece, Egypt, and Rome. The Anglo-Saxons believed that this herbaceous plant was one of the nine holy herbs that the Lord had given to humanity. (1) Because of its apple-like scent, the term "chamomile" is derived from two Greek words that mean "ground apple." (3) Decades of conventional and scientific usage and studies have shown its nutritional, cosmetic, and multitherapeutic properties. It may be found in 26 different pharmacopoeias.
German chamomile is the fifth-top-selling herb in the world and has significant economic worth due to its wide range of medicinal uses. There are several uses for the blue essential oil found in M. chamomilla flowers.
For use in herbal teas, dried chamomile flowers are also quite popular. Consequently, the plant can be purchased as a flower head or blue oil. Chamomile oil is known commercially as "blue oil" on the international market. (1)
Essential oils and infusions can be found in a variety of commercial products, such as detergents, lotions, soaps, perfumes, ointments, hair products, confections, herbal teas, and baked goods. (2)
Chamomile Plant Structure
German chamomile is an annual plant (1) that grows best in a light, sandy loam with abundant moisture at pH 6. (5) It has thin, spindly roots that only penetrate the soil flatly. The stem is upright and strongly branched, reaching a height of 10-80 cm. The bi- to tripinnate leaves are long and narrow. (1) Its flowers are daisy-like, with white petals and yellow centers. (6) The golden yellow tubular florets with 5 teeth are 1.5–2.5 mm long. The 11–27 white petals, arranged concentrically, range in size from 6–11 mm in length and 3.5 mm in width.
The receptacle has a width of 6–8 mm. Flat at first and conical, cone-shaped later, hollow (a key distinguishing feature of Matricaria, including German chamomile), and free of paleae. The fruit is an achene that is yellowish-brown in color. The medicinal parts of German chamomile consist of the entire flowering herb or only the flowers. (4)
Fig. 1 The photo of Matricaria chamomilla
Chamomile Health Benefits
1. Calming Anxiety and Stress
In 2019, a study was conducted to investigate the effect of German chamomile flower tea on symptoms of anxiety in the elderly. The study was done on 54 patients (men and women aged 60–74) with generalized anxiety disorder (GAD) for 8 weeks. Based on the results, chamomile tea can significantly reduce the common symptoms of anxiety, and it can be used for handling and improving anxiety. (7)
In 2016, a study was done to evaluate the effects of long-term use of German chamomile flowers on reducing the symptoms of generalized anxiety disorder (GAD). 179 patients with GAD were treated with German chamomile extract (500 mg capsule, 3 times a day) for 38 weeks. The extraction solvents were ethanol (70%) and water. The results showed that long-term German chamomile use was safe and significantly reduced moderate-to-severe GAD symptoms. Furthermore, it might be effective in improving blood pressure and weight loss. (8)
2. Improving Digestive System Function
In 2014, a study was done to investigate the antidiarrheal properties of German chamomile flower decoction extract in rats. The results showed that chamomile decoction produced significant protection against diarrhea and intestinal fluid accumulation. These findings suggested that chamomile decoction is effective in the treatment and management of digestive system disorders such as diarrhea. (9)
Dried chamomile flowers are one of the richest sources of apigenin. According to researchers, apigenin might hinder the ability of gastrointestinal cancers to progress and spread. (10) Chamomile tea contains quite low concentrations of apigenin but includes high levels of apigenin-7-O-glucoside. (11) Glycosides of apigenin are cleaved in the gastrointestinal tract to be absorbed and distributed as apigenin itself. For this reason, the gastrointestinal tract is exposed to higher concentrations of apigenin than tissues at other locations. (10)
German chamomile flowers are used to extract an essential oil that mainly contains two terpenoids: α-bisabolol and chamazulene. (11) The chamomile extract that contains bisabolol and chamazulene is effective in reducing the symptoms of irritable bowel syndrome (IBS), including severe abdominal pain, bloating, nausea, stool consistency, and changes in bowel habits. (12) Also, apigenin and bisabolol in chamomile essential oil have spasmolytic effects on gastrointestinal smooth muscles. This effect is comparable to papaverine (an antispasmodic drug). (3)
STW5 is a commercially available herbal preparation that contains a hydroethanolic extract of German chamomile (20%). (13) According to studies, STW5 can prevent the development of gastric ulcers by reducing gastric acid secretion and lowering gastric acidity. (11)
3. Regulating Blood Glucose Levels
In 2008, researchers investigated the effects of chamomile tea and its major components on the prevention of hyperglycemia (high blood glucose) and the protection or improvement of diabetic complications in diabetics. The major components include coumarins (umbelliferone, herniarin, esculetin, and isoscopoletin), flavonoids (apigenin, luteolin, and quercetin), and sesquiterpenes (bisabolol and farnesene).
It was found that chamomile tea, esculetin, and quercetin compounds are effective in lowering blood sugar levels. These results clearly suggest that daily consumption of chamomile tea with meals can contribute to the prevention of the progression of hyperglycemia and diabetic complications such as cataracts, retinopathy, neuropathy, and nephropathy. (14)
Moreover, in another 2008 study, the researchers investigated the effect of the aerial part of chamomile ethanolic extract on preventing high blood glucose in diabetic rats. The diabetic rats were treated with different doses of the extract (including 20, 50, and 100 mg/kg) for 14 days. It was observed that treatment with different doses of chamomile extract significantly reduced postprandial blood glucose levels and protected the pancreatic β-cells. (15) Pancreatic β-cells are responsible for insulin secretion and the control of plasma glucose levels. (16)
4. Regulating Blood Fat Levels
In 2015, a study aimed to assess the effects of chamomile tea consumption on serum lipid profiles (including blood total cholesterol, LDL cholesterol, HDL cholesterol, and triglyceride levels). The participants were 30- to 60-year-old patients with type 2 diabetes mellitus (T2DM) (males and females). For 8 weeks, the participants consumed chamomile tea (3 g/150 mL of hot water) three times a day, just after meals. It was observed that chamomile tea significantly decreased total cholesterol, triglycerides, and LDL cholesterol. No significant changes were shown in serum HDL cholesterol levels. Therefore, it can be concluded that chamomile tea has some beneficial effects on lowering blood cholesterol and triglyceride levels. (17)
In a 2018 study, the effects of consumption of chamomile hydroalcoholic extract (80% ethanol and 20% distilled water) on total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride levels, and hardening and narrowing of arteries due to the accumulation of fatty deposits on the inside of the arterial walls were evaluated on rats that received a high cholesterol diet.
The effects of the chamomile extract on lowering blood cholesterol and triglyceride levels were compared with those of lovastatin. The chamomile extract prevented an increase in blood total cholesterol, LDL cholesterol, and triglyceride levels in a dose-dependent manner. Also, no symptom of the accumulation of fatty deposits on the inside of the arterial walls was observed. These effects of chamomile were similar to Lovastatin effects. (18)
5. Anti-Pain
The most important dissatisfaction of post-operative orthopedic patients is severe and intolerable pain. In 2020, the researchers evaluated the effect of chamomile tea consumption on pain intensity and pain management in patients after orthopedic surgery. In this study, 1 tea bag containing 1 g of chamomile was put in 150 mL of boiling water and then prescribed to the patients three times a day for three days. It was observed that drinking chamomile tea significantly reduced pain intensity and increased satisfaction with pain management after orthopedic surgery. (19)
In addition, in 2017, the effect of chamomile tea consumption on inflammation and pain was studied among rheumatoid arthritis patients. Rheumatoid arthritis (RA) is a kind of inflammatory arthritis that affects the joints. The patients received 6 g/day chamomile tea in two teabags twice a day for 42 days. This study showed that chamomile tea could decrease inflammation and alleviate pain. (20)
In 2015, the efficacy and safety of applying chamomile oil to the skin for the treatment of knee osteoarthritis were assessed. The patients were asked to apply the oil three times a day for three weeks. They were allowed to use acetaminophen as an analgesic. It was found that chamomile oil significantly reduced the patients' need for pain relief medication compared to the patients who didn’t use this treatment. (21)
What Are Chamomile Side Effects?
1. When Consumed by Mouth: German chamomile is likely safe when consumed in amounts found in food. When used orally as a medication for brief periods, it is possibly safe.
2. When Applied to the Skin: German chamomile is possibly safe when applied to the skin.
It may, however, induce allergic skin reactions. German chamomile can cause eye irritation when applied to the area around the eyes.
3. Pregnancy and Breastfeeding: There isn't enough trustworthy information to say whether German chamomile is safe to use while pregnant or breastfeeding. Therefore, avoid it to be safe.
4. Children: German chamomile is possibly safe as a short-term medication, whether taken orally or used topically.
Early research shows that:
- Several products containing German chamomile are safe for young children to use orally for up to one week.
- For up to six weeks, children and teens may safely apply German chamomile oil to their skin at night.
5. Hormone-Sensitive Conditions such as Ovarian Cancer, Breast Cancer, Uterine Cancer, Uterine Fibroids, or Endometriosis: German chamomile may have physiological effects similar to those of estrogen. Avoid using German chamomile if you have any conditions that could be worsened by exposure to estrogen.
6. Surgery: German chamomile and surgical anesthetics may interact. Therefore, stop using it at least two weeks before your planned operation.
7. Allergies to Ragweed or Related Plants: German chamomile may cause an allergic response in those who are allergic to plants in the Asteraceae/Compositae family. Ragweed, daisies, marigolds, chrysanthemums, and many more herbs are all members of this family. (22)
A case report indicates chamomile may precipitate severe anaphylactic reactions in patients with hay fever and bronchial asthma caused by a variety of pollens. (4)
Generally, every person may be allergic to certain herbs and spices. This sensitivity must first be diagnosed by the person and, secondarily, by the physician. However, these allergic reactions do not cause chronic or acute side effects, and after identifying the allergenic plant and removing it from the diet, allergy-related complications will be eliminated.
No company or product can be aware of the allergic reactions of different bodies in advance. The body's incompatibility with one or more specific herbs rarely occurs, but consumers may encounter it anyway.
Nutritional Information
Nutritional analysis of chamomile dried flower powder showed that the powder contains moisture, fiber, ash, macronutrients (including protein, fat, and carbohydrate), and micronutrients including vitamin C and minerals (iron, zinc, and calcium). (23)
Chamomile Daily Dosage
A single dose is approximately 3 g as an infusion.
An infusion is prepared by pouring one cup (150 mL) of boiling water over 3 g of chamomile. One cup of freshly made tea is administered 3–4 times daily. (4)
Bioactive Compounds
It has been determined that chamomile has 120 different chemical components, such as coumarins, flavonoids, and terpenoids. Active chemical constituents of German chamomile include:
Terpenoids: α-bisabolol, α-bisabolol oxide A and B, chamazulene, sesquiterpenes;
Flavonoids: apigenin, luteolin, quercetin;
Coumarins: umbelliferone;
Spiroethers: en-yn dicycloether;
Other constituents are anthemic acid, choline, tannin, and polysaccharides. (3)
German chamomile flowers have 0.24% to 2.0% blue-colored volatile oil (essential oil). The age and place of origin of the flowers affect yield. The European Pharmacopoeia recommends chamomile contain no less than 4 mL/kg of blue essential oil.
The two main components, chamazulene and alpha-bisabolol, make up 50–65% of the volatile oil content overall. (6)
In another study, it was found that chamazulene and bisabolol comprise about 5% and 50% of German chamomile’s essential oil, respectively. (3)
Chamazulene provides a blue color to the oil; chamazulene is not present in the raw flower head but forms during distillation from matricin. (5) The best way to preserve chamazulene and bisabolol is in an alcoholic tincture since they are very unstable. (11)
Best Time to Consume
1-2 hours before or after meals.
As a mild tranquilizer and sleep-inducer, one cup of chamomile tea about 45 minutes before bed. (24)
For reducing blood glucose levels, one cup of chamomile tea immediately after meals. (25)
Possible Drug Interactions
1. Birth Control Pills (Contraceptive Drugs): Estrogen is included in certain birth control tablets. German chamomile may possess some properties similar to estrogen. However, it is not as potent as birth control tablets' estrogen. Combining German chamomile with birth control pills may make them less effective.
Ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and other combinations are birth control tablets.
2. Estrogens: Although German chamomile is not as potent as estrogen tablets, it may have some of the same effects when taken in large quantities. If estrogen tablets are taken with German chamomile, the effects of the pills may be lessened.
Conjugated estrogens (Premarin), estradiol, ethinylestradiol, and other compounds are included in several estrogen tablets.
3. Drugs Altered by the Liver (Substrates of Cytochrome P450 3A4 (CYP3A4)) / Substrates of Cytochrome P450 1A2 (CYP1A2)): The liver changes and breaks down several drugs. German chamomile may slow down the rate at which the liver breaks down these drugs. Taking it along with some of these medications can increase their effects and side effects. Therefore, consult your doctor before taking German chamomile if you are taking any drugs that are affected by the liver. Some medications changed by the liver include:
CYP3A4 substrates: triazolam (Halcion), lovastatin (Mevacor), fexofenadine (Allegra), ketoconazole (Nizoral), itraconazole (Sporanox), and a number of others.
CYP1A2 substrates: verapamil (Calan, Isoptin, etc.), theophylline (Theo-Dur, etc.), ondansetron (Zofran), amitriptyline (Elavil), propranolol (Inderal), haloperidol (Haldol), and others.
4. Sedative Medicines (CNS Depressants and Benzodiazepines): German chamomile might cause sleepiness and drowsiness. Sedatives are drugs that make you feel drowsy. Thus, combining German chamomile with sedative drugs may result in excessive sleepiness.
Pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), morphine, zolpidem (Ambien), fentanyl (Duragesic, Sublimaze), and other drugs are examples of CNS depressants. Triazolam (Halcion), alprazolam (Xanax), diazepam (Valium), temazepam (Restoril), clonazepam (Klonopin), and midazolam (Versed) are benzodiazepines.
5. Tamoxifen (Nolvadex): Hormones in the body can have an impact on some cancer types. Cancers that are impacted by the body's estrogen levels are known as estrogen-sensitive cancers. Tamoxifen, also known as Nolvadex, is used to treat and prevent certain cancers. German chamomile appears to have an impact on the body's estrogen levels as well. Therefore, it might decrease the effectiveness of tamoxifen (Nolvadex). So, if you are taking tamoxifen (Nolvadex), avoid using German chamomile.
6. Warfarin (Coumadin): This medication is intended to reduce the rate at which blood clots. German chamomile may boost its effects. Therefore, combining warfarin (Coumadin) and German chamomile together may reduce blood clotting too much and result in bleeding and bruises. (22)
Traditional Use
Chamomile is extensively consumed as a tea or tonic. It is used internally to treat anxiety, hysteria, convulsions, nightmares, insomnia, and other sleep problems.
One of chamomile’s main roles is as a multipurpose digestive aid to treat gastrointestinal disturbances, including flatulence, indigestion, diarrhea, anorexia, motion sickness, nausea, and vomiting.
It is used to treat colic, croup, and fevers in children and as an emmenagogue and uterine tonic in women. (3)
In the sixth century, it was used to treat back pain, neuralgia (pain in a nerve pathway), rheumatism, skin conditions, headaches, and gout. (4)
Some Questions about Chamomile
How many times a day can you drink chamomile tea?
One cup of freshly made chamomile tea (3 g/150 mL) is administered 3–4 times daily. (4)
Does chamomile cause drowsiness? / Does chamomile tea actually make you sleepy?
Chamomile has calming effects and improves sleep quality. (26) Apigenin, a flavonoid that binds to benzodiazepine (BDZ) receptors in the brain, may be responsible for the sedative effects. Other than apigenin, chemicals found in chamomile extracts can bind BDZ and GABA receptors in the brain and may be responsible for certain sedative effects; however, many of these compounds are yet unknown. (11)
Is chamomile good for PCOS?
According to the studies, chamomile consumption decreases serum testosterone levels in women with PCOS. (27)
How much chamomile can I drink while pregnant? / Why is chamomile tea safe during pregnancy?
The use of chamomile plants during pregnancy has been linked to an increased risk of miscarriage and preterm labor. In addition, in a review of herbs used to treat morning sickness, chamomile was found to be unsafe in 6% of studies. So, stay on the safe side and avoid it. (28)
Does chamomile tea affect the baby?
Taking chamomile tea orally or topically for a short period is POSSIBLY SAFE for children. It is recommended to start with very small doses.
Does chamomile lighten skin?
Melanogenesis can be induced by exposing the skin to UV light or/and pro-inflammatory stimuli. As a result, the use of anti-inflammatory agents may be a useful method for delaying and preventing skin hyperpigmentation caused by inflammation. Hypopigmentation is caused by chamomile extract. Therefore, topical use of formulations containing German chamomile extract may be effective for skin bleaching. (29)
Does chamomile clog pores? / Is chamomile Hydrating for skin?
Chamomile showed astringent, antioxidant, and healing properties. In traditional medicine, chamomile has been utilized to treat inflammatory disorders of the skin. It is now used in the treatment of skin irritations, burns, skin wounds, eczema, cracked nipples, and other skin disorders. Based on a 2013 study, formulations containing German chamomile extract can provide important benefits for skin hydration and maintaining the skin barrier function. (30)
Is chamomile tea OK while breastfeeding?
Stay on the safe side and avoid chamomile tea while breastfeeding.
Does chamomile help hair growth? / What happens if you put chamomile in your hair? / Does chamomile thicken hair? / How do I use chamomile tea for my hair?
Androgen-inducible transforming growth factor β (TGF-β1) can suppress hair growth in androgenetic alopecia (AGA). Apigenin was found to decrease levels of TGF-β1 expression. Apigenin also stimulates the elongation of hair follicles. Therefore, apigenin promotes hair growth by downregulating the TGF-β1 gene. (31)
According to a study, concomitant administration of 7% chamomile extract (which contains active ingredient of apigenin) and 5% minoxidil solution leads to a reduction in the severity and duration of cutaneous side effects caused by minoxidil solution use in the treatment of male androgenic alopecia (MAA). It can improve the patient's compliance to treatment and, as a result, the chance of MAA treatment. (32)
How do you know if you are allergic to chamomile tea? / Does chamomile make allergies worse? / Can chamomile give you hives?
Those who are allergic to plants in the Asteraceae/Compositae family may experience an allergic reaction when using German chamomile.
Note: Generally, every person may be allergic to certain herbs and spices. In rare cases, allergic reactions (skin afflictions, edema) have been observed following herb consumption.
Who should not use chamomile?
In general, when prescribed therapeutic doses are administered correctly, there are no recognized health risks or adverse reactions.
Before drinking this tea, consult your doctor if you have any of the following condition: During pregnancy and breast-feeding, before a scheduled surgery, or people with hormone-sensitive conditions.
Does chamomile have caffeine? / Is chamomile tea a stimulant?
Chamomile tea is a soothing herbal tea that is naturally caffeine-free.
What is chamomile and honey tea good for?
Scientifically, chamomile is effective in treating stomach ulcers and acid reflux. Honey has healing properties and can aid in the healing of a variety of wounds, including ulcers. As a result, the combination of honey and chamomile can effectively treat gastric ulcers.
Is chamomile tea with honey good for sleep?
Honey may promote melatonin formation due to its possible tryptophan content (a precursor to melatonin), which both aids in the initiation of sleep and the release of hormones that facilitate whole-body recovery during sleep. (33) Furthermore, chamomile contains the flavonoid apigenin, which has sedative properties. (34) So, chamomile tea with honey reduces anxiety and helps you fall asleep.
Is chamomile tea good for detoxing?
In a study conducted on mice, researchers found that chamomile decoction (boiled for 5 minutes) can help detoxify the kidneys and liver and improve their function by reducing blood creatinine and urea levels, as well as lowering liver enzymes. (35)
Additionally, chamomile is beneficial in reducing liver damage caused by toxins and pesticides used in agriculture. (36)
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