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Lemon balm (Melissa officinalis L.)

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Also listed as: Melissa officinalis
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • Balm, balm mint, bee balm, blue balm, Citra, citronellae, citronmelisse, common balm, cure-all, dropsy plant, English balm, folia citronellae, folia melissae citratae, garden balm, gastrovegetalin, hjertensfryd, honey plant, kneipp melisse pflanzensaft, Labiatae/Lamiaceae (family), lemon melissa, lomaherpan, melissa, Melissa officinalis, Melissa officinalis L., melissae, melissae folium, Melisse (German and French), melissenblatt, melissengeist, sweet balm, sweet mary, toronjil (Spanish), valverde boutons de fievre crème.

Background
  • Lemon balm (Melissa officinalis) is an herb with a lemon scent native to southern Europe. Historically, lemon balm has been said to possess sedative/tranquilizing, anti-gas, fever-reducing, antibacterial, spasmolytic, hypotensive (blood pressure lowering), memory-enhancing, menstrual-inducing, and thyroid-related effects and has been proposed by some to be an herbal cure-all. Laboratory data suggest that lemon balm may contain high concentrations of antioxidants.
  • The German Commission E recommends lemon balm for nervous sleep disorders and functional gastrointestinal complaints. The European Scientific Cooperative on Phytotherapy (ESCOP) recommends its use for tenseness, restlessness, and irritability. Lemon balm has been placed on the U.S. Food and Drug Administration (FDA) GRAS (generally regarded as safe) list. No serious side effects have been reported, although there is limited research of long-term effects.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Rigorous clinical data is lacking. Preliminary clinical studies demonstrate promising effects.
B


Limited data is available supporting the use of lemon balm as a treatment of agitation in dementia patients. Additional study is necessary before a conclusion can be drawn.
C


Preliminary human evidence has been published that supports the use of lemon balm for anxiety, commonly referred to in the literature as psycho-vegetative disturbances. Further research is needed to confirm these results.
C


Clinical data suggest that the use of standardized lemon balm extract has some effect on particular self-reported measures of mood and cognition through cholinergic activities. More rigorous studies need to be conducted using patient-relevant outcomes to better assess the validity of these results as they apply to patient care.
C


Limited clinical evidence is available supporting the use of lemon balm for the treatment of chronic colitis.
C


Clinical evidence of varying quality suggests that lemon balm may help reduce dyspepsia as a component of combination products. However, further research is necessary before a conclusion can be drawn.
C


High-quality clinical evidence supporting the use of lemon balm as a sedative/hypnotic is lacking. The available evidence is conflicting. Additional study is required to better support the use of lemon balm as a sedative/hypnotic.
C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Analgesic (pain reliever), anorexia, anticholinergic (drug that blocks the action of acetylcholine, a neurotransmitter in the brain, often effective in reducing the tremor of Parkinson's disease), anti-gas, antihistaminic, antisecretory, antispasmodic, anti-ulcerogenic, antiviral, aromatic, attention deficit and hyperactivity disorder (ADHD), cancer, chronic bronchitis, chronic fatigue syndrome, colic, coughs, depression, digestive aid, fever reduction, flatulence, flatulent colic, gastrointestinal disorders, Graves' disease, heart conditions, high blood pressure, HIV, influenza, insect bites, insomnia, irregular menstrual periods, irritable bowel syndrome (IBS), intestinal relaxant, memory enhancer, migraine, nausea, nervous palpitations, nervous stomach, neuralgia (nerve pain), neurasthenia (nervous exhaustion), promoting menstrual flow, promoting sweating, restlessness, sedative, shingles, skin irritations, sleep disorders, tension headache, toothache, tranquilizer, vasodilatation, vomiting, wound healing (topical).

Dosing

Adults (18 years and older)

  • There is no proven effective dose for lemon balm. A common dose of lemon balm is one cup of tea taken several times per day as needed. A dosage of 2-6 milliliters three times per day (1:5 in 45% alcohol) as a tincture has been used historically. Lemon balm extract in a dose of 60 drops per day has been cited in research on patients with Alzheimer's disease for improvement in cognition.
  • Lemon balm is also commonly used in combination with other herbs and supplements. Examples of some products include Songha Night® (valerian extract and lemon balm extract), Klosterfrau Melissengeist® (essential oils of lemon balm, orange peel, cinnamon, and myristica), and Iberogast® (Matricata recutita, Iberis amara, Angelica archangelica, Carum carvi, Silybum marianum, lemon balm, Chelidonium majus, Glycyrrhiza glabra, and Mentha x piperita).
  • Creams and teas containing lemon balm have also been applied on the skin to treat herpes.

Children (under 18 years old)

  • There is no proven safe or effective dose for lemon balm in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in individuals with a known allergy or hypersensitivity to lemon balm. Hypersensitivity reactions have been reported, including contact dermatitis.

Side Effects and Warnings

  • Lemon balm is likely safe when applied on the skin or taken by mouth in recommended doses (up to 30 days) in otherwise healthy adults and when consumed in amounts found in foods. Lemon balm has been given generally regarded as safe (GRAS) status in the United States with a maximum level of 0.5% in baked goods. However, lemon balm preparations may contain trace amounts of lead. A study evaluating metal dispersion in food crops suggested that the soil in which some plants are grown may be contaminated by lead from environmental pollution and therefore may cause the plant to contain trace amounts of the element.
  • Contact dermatitis, local reddening, burning sensation, paresthesia, residual pigmentation, and dermal irritation on application of cream have been reported. One case of irritation and one case of exacerbation of herpes symptoms were reported when lemon balm was applied on the skin. Cases of nausea and diarrhea have been reported.
  • Lemon balm may also cause headache or EEG changes. It may also reduce alertness, so caution should be used when driving or operating heavy machinery. Sleep disturbances and tiredness have been reported with a combination of lemon balm and valerian (although sedative properties of Valeriana officinalis alone are well-described and the additional effects of lemon balm are not clear in this combination).
  • Although not well studied in humans, lemon balm may also increase intraocular (inside the eye) pressure and cause palpitations. Use cautiously in patients with glaucoma as anecdotal reports have suggested that lemon balm may increase intraocular pressure.
  • Preliminary study suggests that constituents of lemon balm may block the binding of thyroid-stimulating hormone (TSH) to its receptor by acting both on the hormone and the receptor itself. Studies have suggested that patients with thyroid problems such as Graves' disease use caution due to the potential for thyroid hormone inhibition. Lemon balm may interfere with thyroid hormone replacement therapy.

Pregnancy and Breastfeeding

  • Lemon balm is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

Interactions

Interactions with Drugs

  • In theory, alcohol use with lemon balm may increase the sedative effects of alcohol. Combination use of lemon balm with other sedatives may also result in additive effects. However, no additive effects of alcohol were shown when combined with a Valeriana officinalis-Humulus lupulus-lemon balm combination product.
  • Although not well studied in humans, lemon balm has been reported to increase the hypnotic effects of barbiturates.
  • Although not well studied in humans, lemon balm may increase intraocular pressure, thereby diminishing effects of glaucoma medications. Caution is advised.
  • Lemon balm may reduce pituitary and serum thyroid stimulating hormone (TSH) concentrations. Constituents of lemon balm may block the binding of TSH to its receptor by acting on both the hormone and the receptor itself. Thus, in theory, lemon balm may interfere with thyroid hormone replacement therapy.
  • Lemon balm may displace drugs bound to nicotinic and muscarinic receptors, as demonstrated in clinical trials with the displacement of nicotine and scopolamine from these receptors. Consult with a qualified healthcare professional, including a pharmacist, to check for interactions.
  • Lemon balm may inhibit concentrations of serotonin and therefore may interact with drugs that affect concentrations of serotonin. Caution is advised in patients taking selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa®), escitalopram oxalate (Lexapro®), fluoxetine (Prozac®), or paroxetine (Paxil®).

Interactions with Herbs and Dietary Supplements

  • A study examining efficacy and safety of herbal sedatives suggested that combination use of sedative herbs with lemon balm may result in additive effects. Such herbs include German chamomile, hops (Humulus lupulus), or kava.
  • Although not well studied in humans, lemon balm may increase intraocular pressure, thereby diminishing effects of glaucoma treatments. Caution is advised.
  • Lemon balm may reduce pituitary and serum thyroid stimulating hormone (TSH) concentrations. One study suggested that constituents of lemon balm may block the binding of TSH to its receptor by acting both on the hormone and the receptor itself. Consult with a qualified healthcare professional, including a pharmacist, to check for interactions.
  • Lemon balm may inhibit concentrations of serotonin and therefore may interact with herbs that affect concentrations of serotonin. Caution is advised.
  • Lemon balm may displace herbs or supplements bound to nicotinic and muscarinic receptors, as demonstrated in clinical trials with the displacement of nicotine and scopolamine from these receptors. Consult with a qualified healthcare professional, including a pharmacist, to check for interactions.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomised, placebo controlled trial. J Neurol Neurosurg Psychiatry 2003;74(7):863-866.
  2. Allahverdiyev A, Duran N, Ozguven M, et al. Antiviral activity of the volatile oils of Melissa officinalis L. against Herpes simplex virus type-2. Phytomedicine 2004;11(7-8):657-661.
  3. Ballard CG, O'Brien JT, Reichelt K, et al. Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: the results of a double-blind, placebo- controlled trial with Melissa. J Clin Psychiatry 2002;63(7):553-558.
  4. Buchner KH, Hellings H, Huber M, et al. [Double blind study as evidence of the therapeutic effect of Melissengeist on psycho-vegetative syndromes]. Medizinische Klinik 1974;69(23):1032-1036.
  5. Cerny AS, Schmid K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers; a double-blind placebo-controlled, multicentre study. Fitoterapia 1999;70(3):221-228.
  6. Friedman M, Henika PR, Levin CE, et al. Antibacterial activities of plant essential oils and their components against Escherichia coli O157:H7 and Salmonella enterica in apple juice. J Agric Food Chem 2004;52(19):6042-6048.
  7. Gazola R, Machado D, Ruggiero C, et al. Lippia alba, Melissa officinalis and Cymbopogon citratus: effects of the aqueous extracts on the isolated hearts of rats. Pharmacol Res 2004;50(5):477-480.
  8. Ivanova D, Gerova D, Chervenkov T, et al. Polyphenols and antioxidant capacity of Bulgarian medicinal plants. J Ethnopharmacol 2005;96(1-2):145-150.
  9. Kennedy DO, Little W, Scholey AB. Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (Lemon Balm). Psychosom Med 2004;66(4):607-613.
  10. Lindahl O, Lindwall L. Double blind study of a valerian preparation. Pharmacol Biochem Behav 1989;32(4):1065-1066.
  11. Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69(1):45-52.
  12. Madisch A, Melderis H, Mayr G, et al. [A plant extract and its modified preparation in functional dyspepsia. Results of a double-blind placebo controlled comparative study]. Z Gastroenterol 2001;39(7):511-517.
  13. Salah SM, Jager AK. Screening of traditionally used Lebanese herbs for neurological activities. J Ethnopharmacol 2005;97(1):145-149.
  14. Vogt M, Tausch I, Wölbling RH, et al. [Melissa extract in herpes simplex: a double-blind placebo-controlled study]. Der Allgemeinarzt 1991;13:832-841.
  15. Widy-Tyszkiewicz E, Schminda R. A randomized double blind study of sedative effects of phytotherapeutic containing valerian, hops, balm and motherwort versus placebo. Herb Polon 1997;2:154-159.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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