Common Sage Benefits, Usage, Medicinal Properties, Nutrition, Dosage, Preparations, safety, science backed and traditional view

Common Sage (Salvia officinalis - L.) also known as Kitchen sage, Small Leaf Sage, Garden Sage, True Sage, Dalmatian Sage, Szalwia lekarska.

 

Sage generally grows about a foot or more high, with wiry stems. The leaves are set in pairs on the stem and are 1 1/2 to 2 inches long, stalked, oblong, rounded at the ends, finely wrinkled by a strongly-marked network of veins on both sides, greyish-green in colour, softly hairy and beneath glandular. The flowers are in whorls, purplish and the corollas lipped. They blossom in August. All parts of the plant have a strong, scented odour and a warm, bitter, somewhat astringent taste, due to the volatile oil contained in the tissues.

Sage is found in its natural wild condition from Spain along the Mediterranean coast up to and including the east side of the Adriatic; it grows in profusion on the mountains and hills in Croatia and Dalmatia, and on the islands of Veglia and Cherso in Quarnero Gulf, being found mostly where there is a limestone formation with very little soil. When wild it is much like the common garden Sage, though more shrubby in appearance and has a more penetrating odour, being more spicy and astringent than the cultivated plant. The best kind, it is stated, grows on the islands of Veglia and Cherso, near Fiume, where the surrounding district is known as the Sage region. The collection of Sage forms an important cottage industry in Dalmatia. During its blooming season, moreover, the bees gather the nectar and genuine Sage honey commands there the highest price, owing to its flavour.

In cultivation, Sage is a very variable species, and in gardens varieties may be found with narrower leaves, crisped, red, or variegated leaves and smaller or white flowers. The form of the calyx teeth also varies, and the tube of the corolla is sometimes much longer. The two usually absent upper stamens are sometimes present in very small-sterile hooks. The Red Sage and the Broad-leaved variety of the White (or Green) Sage - both of which are used and have been proved to be the best for medical purposes - and the narrow-leaved White Sage, which is best for culinary purposes as a seasoning, are classed merely as varieties of Salvza officinalis, not as separate species. There is a variety called Spanish, or Lavender-leaved Sage and another called Wormwood Sage, which is very frequent.

A Spanish variety, called S. Candelabrum, is a hardy perennial, the upper lip of its flower greenish yellow, the lower a rich violet, thus presenting a fine contrast.

 

Part used: leaf

 

Constituents: essential oil (cineole, borneol, and thujone), tannic acid, vitamins A, C, B6, E, and K, oleic acid, ursolic acid, flavones, flavonoids, polyphenols, chlorogenic acid, calcium, manganese, zinc, copper, caffeic acid, nicotinamide, iron, carnosol, carnosic acid, fumaric acid, rosmarinic acid, ellagic acid, glycosides, and estrogenic substances.

 

Flavour/Temps: Astringent, Bitter, Pungent, Dry and Cold

Stabilizing, Relaxing, Astringing, Restoring and Solidifying

 

Tropism: Digestive, Respiratory, Immune, Female Disorders, Stomach, Intestines, Nerve, Pituitary, Lungs, Uterus, Fluids

 

Meridians: Lung, Liver, Spleen, Kidney, ren, chong meridians

Air, Fluid bodies

 

Key actions in western medicine: Diuretic, Haemostatic, Emmenagogue, Neurologic, Antihidrotic,Tonic, Digestive, Antispasmodic, Pesticide, Astringent, Anti-inflammatory, Antioxidant, Antiseptic, Antimicrobial, Carminative, Relaxant, Antibacterial,  Anticancer, Antidiabetic, Antifungal, Antiparasitic, Anxiolytic, Antiviral,

 

Indications in western medicine: nervous headaches, diarrhoea, heartburn, bronchitis, chronic asthma, Alzheimer’s, memory loss, depression, anxiety, lung cancer, night sweats, hot flashes, mouth sores, skin rashes, cold sores, gum disease, sore throat, cold and flu onset (esp. with sore throat), fevers, typhoid fever, measles, joint pain, lethargy, periodontal disease, excessive lactation (also for waning), aid stomach and menstrual cramping, colds and flu, stop sweating, aid menses, enteritis and mucous colitis, dry up mother’s milk post nursing,  lowers cholesterol and lipid levels, diabetes, excess saliva or perspiration production, bruises, ulcers, sores, abscesses, mouth ulcers, hypotension, chronic wounds, neurasthenia, rickets, coma, rhinitis and sinusitis (esp. chronic) amnesia, paralysis, pituitary deficiencies (hypofunctioning), immune deficiency, autoimmune disorders, chronic debility (from stress, overwork, disease or constitution), chronic infections (esp. lungs, mouth, sinuses, throat, gums incl. stomatitis, tonsilitis and gingivitis), leukorrhea, cystitis, urethritis, sore muscles, toothache, skin conditions (incl. hairloos, acne, scrofula, eczema), adrenal deficiency, Gonadal/Oestrogen deficiency (menstrual disorders incl. Infertility, dysmenorrhea, amenorrhea), PMS (with irritability, fatigue and depression), Menopausal syndrome (with irritability, fatigue, hot flashes and night sweats), Prophylactic and remedial during labour (failure to progress during labour).

 

Key in eastern medicine: Tonifies Qi, Blood and Essence, generates Strength and relieve Fatigue; Resolves Phlegm, Promote Expectoration, Open the Chest and Relieve Wheezing;; Tonify Reproductive Qi Regulates and Promotes Menstruation; Harmonize menopause and Restore Oestrogen; Aids Skin Repair; Opens the Mind; Promotes Digestion, Resolves Mucus-Damp, Stops Secretions, Stops Discharges and Improves Appetite; Promotes Tissue repair, Stimulates Immunity and Benefits Skin; Restores Adrenal Cortex and Rise Blood Pressure.

 

Indications in eastern medicine: Uterus blood deficiency (delayed, scanty or no periods with dry vagina, dry skin and cramps); Qi, Essence and Blood Neuroendocrine deficiency (shortness of breath, debility, chronic fatigue, senility, low resistance, excessive daytime sweating); Shao yin-stage heat (debility, night sweats, low tidal feaver); Intestines mucous-damp, spleen damp (indigestion, fatigue, appetite loss, abdominal pain and bloating, loose mucous stool  alternating with hard); External wind-heat (fever, slight chills, sore throat); genitourinary damp (scanty menstruation and clear vaginal discharges); External wind-cold with head damp-cold ( sinus/nasal congestions, watery discharge, chills, postnasal drip); Lung phlegm-damp with Qi constraint (tight chest, wheezing, cough with sputum expectoration)

 

Ground: Melancholic and Phlegmatic temperaments/krases

Self-Reliant Yang/Ming Metal and Dependant/Tai Yin Earth

Sensitive/Tai Yin Metal biotypes

 

Preparations: Infusion, Tincture, Liquid extract, Decoction, Infused oil, Essential oil

 

Dosage 3 times a day unless otherwise instructed by herbalist:

Infusion 1-12g

Decoction 1-12g

Tincture 1:3, 1-3ml, 45% ethanol

Tincture 1:5 2-5ml, 45% ethanol

Liquid Extract 1:1 0.7-2ml, 45% ethanol

Essential oil 1 drop in a gel capsule topped with olive oil, once a day

 

Note: For cold and flu with sinus congestion or sore throat treatment best to drink hot infusion.

Note: Tincture is most efficient preparation

Note: Short decoction or infusion prepared without cover will diminish Sage antiseptic qualities as essential oil evaporate, Rudolf Breus reports that ferment essential to the bone marrow, intervertebral disk and to the glands is released during this preparation. Also, Sage astringent quantities are increased as longer preparation pushes out tannins.

Note: Sage leaf is very good for many external remedy preparations vaginal steams, washes, pessaries, liniments, douches, and gargles(to produce great gargle Sage should be combined with tannic remedy like Lady`s Mantle, Tormentil root or Selfheal spike).

 

Synergy examples: Combine with Lady`s Mantle for super effective gargle

 

Cautions: Medium strength remedy with very moderate chronic toxicity. Sage has medium strength therapeutic status and should be used in formulas rather then on its own for long term treatment. Always get 1-2 weeks off after 4-8 weeks treatment with Sage on its own.

Using sage essential oil is safe for daily use with frequent 5 days breaks (Schnaubelt1985).

Taking sage leaf in large amounts, or inappropriately using sage oil, can cause vomiting, vertigo, palpitations, seizures, and kidney or liver damage. Twelve or more drops of the essential oil is considered toxic.

 

Contradictions: Pregnancy and Nursing. Epileptic seizures.

 

Interactions with drugs: None known

 

Side effects: Orally, topically, and when inhaled, sage seems to be well tolerated.

Most common side effects:

Orally: Abdominal pain, agitation, diarrhoea, dizziness, nausea, and vomiting.

Topically: Burning, dermatitis, pain.

 

Pharmacokinetics

Absorption: Animal research suggests that rosmarinic acid, a constituent of sage, is poorly absorbed across the intestines. Several sage monoterpenoids, including limonene and alpha-pinene, might penetrate the skin after topical application.

Metabolism: Alpha and beta-thujone, constituents of sage, are metabolized in the liver to 7-hydroxy-alpha-thujone, 4-hydroxy-alpha-thujone, 4-hydroxy-beta-thujone, and 7,8-dehydro-alpha-thujone. The hydroxylated metabolites are susceptible to glucuronidation.

 

 

 

History Folklore:

The Common Sage, the familiar plant of the kitchen garden, is an evergreen undershrub, not a native of these islands, its natural habitat being the northern shores of the Mediterranean. It has been cultivated for culinary and medicinal purposes for many centuries in England, France and Germany, being sufficiently hardy to stand any ordinary winter outside. Gerard mentions it as being in 1597 a well-known herb in English gardens, several varieties growing in his own garden at Holborn.

In the United States pharmacopoeia, the leaves are still officially prescribed, as they were formerly in the London pharmacopoeia, but in Europe generally, Sage is now neglected by the regular medical practitioner, though is still used in domestic medicine. Among the Ancients and throughout the Middle Ages it was in high repute: Cur moriatur homo cui Salvia crescit in horto? ('Why should a man die whilst sage grows in his garden?') has a corresponding English proverb:

'He that would live for aye,

Must eat Sage in May.'

The herb is sometimes spoken of as S. salvatrix ('Sage the Saviour'). An old tradition recommends that Rue shall be planted among the Sage, so as to keep away noxious toads from the valued and cherished plants. It was held that this plant would thrive or wither, just as the owner's business prospered or failed, and in Bucks, another tradition maintained that the wife rules when Sage grows vigorously in the garden.

In the Jura district of France, in Franche-Comte, the herb is supposed to mitigate grief, mental and bodily, and Pepys in his Diary says: 'Between Gosport and Southampton we observed a little churchyard where it was customary to sow all the graves with Sage.'

 

The following is a translation of an old French saying:

'Sage helps the nerves and by its powerful might

Palsy is cured and fever put to flight,'

and Gerard says:

'Sage is singularly good for the head and brain, it quickeneth the senses and memory, strengtheneth the sinews, restoreth health to those that have the palsy, and taketh away shakey trembling of the members.'

He shared the popular belief that it was efficacious against the bitings of serpents, and says:

'No man need to doubt of the wholesomeness of Sage Ale, being brewed as it should be with Sage, Betony, Scabious, Spikenard, Squinnette (Squinancywort) and Fennell Seed.'

Many kinds of Sage have been used as substitutes for tea, the Chinese having been said to prefer Sage Tea to their own native product, at one time bartering for it with the Dutch and giving thrice the quantity of their choicest tea in exchange. It is recorded that George Whitfield, when at Oxford in 1733, lived wholesomely, if sparingly, on a diet of Sage Tea, sugar and coarse bread. Balsamic Sage, S. grandiflora, a broad-leaved Sage with many-flowered whorls of blossoms, used to be preferred to all others for making tea. An infusion of Speedwell (Veronica officinalis), Sage and Wood Betony is said to make an excellent beverage for breakfast, as a substitute for tea, Speedwell having somewhat the flavour of Chinese green tea. In Holland the leaves of S. glutinosa, the yellow-flowered Hardy Sage, both flowers and foliage of which exhale a pleasant odour, are used to give flavour to country wines, and a good wine is made by boiling with sugar, the leaves and flowers of another Sage, S. sclarea, the Garden Clary. The latter is known in France as 'Toute bonne' - for its medicinal virtues.

It was formerly thought that Sage used in the making of Cheese improved its flavour, and Gay refers to this in a poem:

'Marbled with Sage, the hardening cheese she pressed.'

Italian peasants eat Sage as a preservative of health, and many other country people eat the leaves with bread and butter, than which, it has been said, there is no better and more wholesome way of taking it.

A species of Sage, S. pomifera, the APPLEBEARING SAGE, of a very peculiar growth, is common on some of the Greek islands. It has firm, fleshy protuberances of about 3/4 inch thickness, swelling out from the branches of the plant and supposed to be produced in the same manner as oak apples, by the puncture of an insect of the Cynips genus. These excrescences are semi-transparent like jelly. They are called Sage Apples, and under that name are to be met with in the markets. They are candied with sugar and made into a kind of sweetmeat and conserve which is regarded by the Greeks as a great delicacy, and is said to possess healing and salutary qualities. It has an agreeable and astringent flavour. This plant is considerably larger than the common Sage of our gardens and its flavour and smell are much more powerful, being more like a mixture of Lavender and Sage. It grows very abundantly in Candia, Syros and Crete, where it attains to the size of a small shrub. The leaves are collected annually, dried and used medicinally as an infusion, the Greeks being particular as to the time and manner in which they are collected, the date being May 1, before sunrise. The infusion produces profuse perspiration, languor, and even faintness if used to excess. There is a smaller Salvia in Greece, the S. Candica, without excrescences.

 

Another south European species, an annual, S. Horminum, the RED-TOPPED SAGE, has its whorls of flowers terminated by clusters of small purple or red leaves, being for this peculiarity often grown in gardens as an ornamental plant. The leaves and seed of this species, put into the vat, while fermenting, greatly increase the inebriating quality of the liquor. An infusion of the leaves has been considered a good gargle for sore gums, and powdered makes a good snuff.

 

Mrs. M. Grieve write:

"Certain varieties of Sage seeds are mucilaginous and nutritive, and are used in Mexico by the Indians as food, under the name of Chia.

The Sage oil of commerce is obtained from the herb S. officinalis, and distilled to a considerable extent in Dalmatia and recently in Spain, but from a different species of Salvia. A certain amount of oil is also distilled in Germany. The oil distilled in Dalmatia and in Germany is of typically Sage odour, and is used for flavouring purposes. The botanical origin of Spanish Sage oil is now identified as S. triloba, closely allied to S. officinalis, though probably other species may also be employed. The odour of the Spanish oil more closely resembles that of Spike Lavender than the Sage oil distilled in Germany for flavouring purposes, and is as a rule derived from the wild Dalmatian herb, S. officinalis. The resemblance of the Spanish oil to Spike Lavender oil suggests the possibility of its use for adulterative purposes, and it is an open secret that admixture of the Spanish Sage oil with Spanish Spike Lavender oil does take place to a considerable extent, though this can be detected by chemical analysis. It is closer in character to the oil of S. sclarea, Clary oil, which has a decided lavender odour, although in the oil of S. triloba, the ester percentage does not appear to be as high as in the oil of the S. sclarea variety. Pure Dalmatian or German Sage oil is soluble in two volumes of 80 per cent alcohol, Spanish Sage oil is soluble in six volumes of 70 per cent alcohol. Sage oil contains a hydrocarbon called Salvene; pinene and cineol are probably present in small amount, together with borneol, a small quantity of esters, and the ketone thujone, the active principle which confers the power of resisting putrefaction in animal substances. Dextro-camphor is also present in traces. A body has been isolated by certain chemists called Salviol, which is now known to be identical with Thujone.English distilled Sage oil has been said to contain Cedrene. Cypria, a native of the island of Cyprus, yields an essential oil, having a camphoraceous odour and containing about 75 per cent of Eucalyptol. Mellifer (syn. Ramona stachyoides) is a labiate plant found in South California, known as BLACK SAGE, with similar constituents, and traces of formic acid. Sage Tea or infusion of Sage is a valuable agent in the delirium of fevers and in the nervous excitement frequently accompanying brain and nervous diseases and has considerable reputation as a remedy, given in small and oft-repeated doses. It is highly serviceable as a stimulant tonic in debility of the stomach and nervous system and weakness of digestion generally. It was for this reason that the Chinese valued it, giving it the preference to their own tea. It is considered a useful medicine in typhoid fever and beneficial in biliousness and liver complaints, kidney troubles, haemorrhage from the lungs or stomach, for colds in the head as well as sore throat and quinsy and measles, for pains in the joints, lethargy and palsy. It will check excessive perspiration in phthisis cases, and is useful as an emmenagogue. A cup of the strong infusion will be found good to relieve nervous headache.The infusion made strong, without the lemons and sugar, is an excellent lotion for ulcers and to heal raw abrasions of the skin. It has also been popularly used as an application to the scalp, to darken the hair. The fresh leaves, rubbed on the teeth, will cleanse them and strengthen the gums. Sage is a common ingredient in tooth-powders.The volatile oil is said to be a violent epileptiform convulsant, resembling the essential oils of absinthe and nutmeg. When smelt for some time it is said to cause a sort of intoxication and giddiness. It is sometimes prescribed in doses of 1 to 3 drops, and used for removing heavy collections of mucus from the respiratory organs. It is a useful ingredient in embrocations for rheumatism. In cases where heat is required, Sage has been considered valuable when applied externally in bags, as a poultice and fomentation. In Sussex, at one time, to munch Sage leaves on nine consecutive mornings, whilst fasting, was a country cure for ague, and the dried leaves have been smoked in pipes as a remedy for asthma.In the region where Sage grows wild, its leaves are boiled in vinegar and used as a tonic."

Among many uses of the herb, Culpepper says that it is:

'Good for diseases of the liver and to make blood. A decoction of the leaves and branches of Sage made and drunk, saith Dioscorides, provokes urine and causeth the hair to become black. It stayeth the bleeding of wounds and cleaneth ulcers and sores. Three spoonsful of the juice of Sage taken fasting with a little honey arrests spitting or vomiting of blood in consumption. It is profitable for all pains in the head coming of cold rheumatic humours, as also for all pains in the joints, whether inwardly or outwardly. The juice of Sage in warm water cureth hoarseness and cough. Pliny saith it cureth stinging and biting serpents. Sage is of excellent use to help the memory, warming and quickening the senses. The juice of Sage drunk with vinegar hath been of use in the time of the plague at all times. Gargles are made with Sage, Rosemary, Honeysuckles and Plantains, boiled in wine or water with some honey or alum put thereto, to wash sore mouths and throats, as need requireth. It is very good for stitch or pains in the sides coming of wind, if the place be fomented warm with the decoction in wine and the herb also, after boiling, be laid warm thereto.'

 

 

Research has indicated that using both S. officinalis and S. lavandulaefolia for 4 months helped to improve learning, memory, and cognitive function in individuals with moderate Alzheimer’s disease.

One study has shown that using sage three times a day for 2 months helped to lower LDL (“bad”) cholesterol and lipid levels in the blood. Spanish sage (S. lavandulaefolia) may increase blood pressure, while common sage (Salvia officinalis) is noted for lowering blood pressure.

Spanish sage (S. lavandulaefolia), does not contain the compound thujone that is found in common sage (Salvia officinalis). Thujone is the compound that can be toxic in high doses.

People who used sage regularly in their diets seem to have a 54% reduced chance of contracting lung cancer compared to those who did not use sage.

Early research indicates that sage extract used daily for 8 weeks can improve symptoms commonly associated with menopause, such as hot flashes, vaginal dryness, and night sweats. Sage contains oestrogen-like compounds that allow them to bind to particular receptors in your brain to help improve memory and treat hot flashes and excessive sweating. It has a long history of use for reducing menopause symptoms.

Clinical research shows that taking common sage extract 330 mg daily for 8 weeks modestly reduces body mass index (BMI), diastolic blood pressure, and fasting blood glucose, and modestly improves measures of insulin resistance, when compared with placebo in individuals with PCOS. However, there was no effect on waist to hip ratio or systolic blood pressure

A recent study has shown sage to be effective in reducing blood glucose levels in rats with type 1 diabetes. Mice with type 2 diabetes that used sage tea showed the same effects as if they had been using metformin, a drug commonly prescribed to manage blood sugar levels.

Sage can be used as a hair rinse to help treat dandruff, as well as promote hair shine and growth. A 2% extract of sage can be applied to the skin to help soothe sunburns.

Sage has been used since ancient times to ward off evil and snakebites, as well as to increase female fertility.

Sage has long been a symbol of wisdom and immortality. In the Middle Ages, it symbolized domestic virtue and in the Victorian era, it meant a happy home and hospitality.

Clinical research shows that taking a specific product providing common sage polyphenols and Spanish sage terpenoids, either as a single dose or daily for 29 days, modestly improves working memory and accuracy when compared with placebo. A single dose of this product contains common sage leaf extract 400 mg and Spanish sage essential oil 200 mg. In addition, preliminary clinical research shows that Spanish sage essential oil 25-50 mcL orally as a single dose seems to dose-dependently enhance some measures of cognitive performance in young adults by a small amount.

When used as aromatherapy, essential oils of common sage, but not Spanish sage, seem to improve quality of memory and secondary memory. Neither species improves speed of memory nor working memory when used as aromatherapy. In this study, five drops of common sage essential oil and 5 mL water were placed on a warmed stone and allowed to diffuse for 5 minutes prior to exposure.

Oral sage seems to be beneficial for reducing low-density lipoprotein (LDL) cholesterol and triglyceride levels.

Clinical research in adults with mixed hyperlipidaemia types shows that taking common sage leaf extract 500 mg, standardized to quercetin 2.16%, three times daily for 2 months reduces LDL cholesterol and triglyceride levels by about 20% and 23%, respectively, and increases high-density lipoprotein (HDL) cholesterol levels by 20%, when compared with placebo. Also, preliminary clinical research in adults with type 2 diabetes and hypercholesterolemia shows that taking common sage leaf extract 500 mg three times daily for 3 months lowers total cholesterol by 17%, LDL cholesterol by 36%, and triglycerides by 56%, and increases HDL cholesterol by 28%, when compared with placebo.

Clinical research shows that taking a thujone-free common sage extract 280 mg daily for 4 weeks reduces overall symptoms of menopause by 39% when compared with placebo. About 41% of patients taking common sage had at least a 50% reduction in symptoms, compared with 8% of those taking placebo. Hot flushes, sleep problems, joint and muscle discomfort, irritability, and physical and mental exhaustion were improved, whereas urogenital symptoms such as sexual desire and vaginal dryness were not. Other clinical research shows that taking common sage extract 300 mg daily for 3 months moderately reduces overall symptoms of menopause after about 10 weeks when compared with placebo. However, there was no effect on vaginal dryness, physical and mental exhaustion, or urinary incontinence. Another small clinical study shows that taking a specific thujone-free common sage extract 280 mg daily for 56 days reduces daily hot flash frequency by 40% and reduces hot flash intensity when compared with baseline. The validity of these findings is limited by the lack of a comparator group.

Clinical research in healthy, older adults shows that taking a single dose of common sage extract 333 mg improves accuracy of attention and some measures of memory when compared with placebo. However, not all doses were effective and some measures of cognitive function were not affected.

Preliminary clinical research shows that taking extracts of common sage and Spanish sage orally seems to improve cognitive function in patients with mild to moderate Alzheimer disease when used for up to 4 months. In one study, a fixed dose of common sage hydroalcoholic extract, equivalent to 1 gram of sage per day, was used for 4 months. In the other, an extract of Spanish sage titrated up to 2.5 mg three times daily for 6 weeks was used.

Preliminary clinical research in patients with prostate cancer receiving ADT shows that taking common sage extract 150 mg three times daily with meals for 4 weeks reduces hot flash severity by 48% and hot flash frequency by 42% when compared with baseline. These improvements were maintained with an additional 8 weeks of treatment.

In young, healthy, physically active adults, taking a specific supplement containing 400 mg common sage leaf extract and 200 mg Spanish sage oil, orally 2 hours prior to a 40-minute stationary cycling session at 80% of maximum aerobic power, lowers perceived exertion scores and improves working memory and reaction times when compared with placebo.

A small clinical study in patients undergoing chemotherapy shows that using common sage oil 2 mL topically during 15-minute sessions of Swedish abdominal massage twice daily for 3 days modestly reduces nausea severity scores, but does not affect vomiting frequency, when compared with massage alone.

A small clinical study in adults with type 2 diabetes shows that taking common sage leaf extract 500 mg three times daily for 3 months lowers fasting blood glucose by 32% and glycated hemoglobin (HbA1c) by 23% when compared with placebo . However, another small clinical study in patients with type 2 diabetes shows that taking common sage extract 150 mg three times daily for 3 months does not lower fasting blood glucose or HbA1c when compared with placebo, although there is a modest reduction in 2-hour postprandial blood glucose levels. A meta-analysis of 3 small studies, including the 2 described above, shows that taking common sage, 150-500 mg three times daily for 2-3 months, modestly reduces fasting blood glucose and 2-hour postprandial blood glucose levels, as well as HbA1c, when compared with placebo.

Preliminary clinical research in patients receiving palliative cancer care shows that rinsing the mouth with 10-15 mL of a solution containing common sage, twice for 30 seconds four times daily for 4 days, in conjunction with standard care involving brushing and an oral gel, is as effective as normal saline for improving overall oral health and modestly more effective than normal saline for improving dry mouth. The rinse was made by steeping 2.5 grams dried sage leaf in 100 mL boiled water for two minutes.

Clinical research shows that topical application of a cream containing either sage alone or sage with rhubarb, starting within 1 day of the first symptoms and continuing for 10-14 days, heals herpes labialis legions in 7.6 days or 6.7 days, respectively, compared to a healing time of 6.3 days with acyclovir cream. The combination of sage and rhubarb also improves the time to healing and reduces pain when compared with sage alone. The cream provided 23 mg sage extract, with or without 23 mg rhubarb extract, per gram and was applied every 2-4 hours while awake.

Preliminary clinical research in patients with sore throat due to acute pharyngitis or tonsillitis shows that applying a combination spray product containing common sage leaf tincture 430 mg/mL, Echinacea flowering aerial parts tincture 863.3 mg/mL, and Echinacea root tincture 45.5 mg/mL, every 2 hours up to 10 times daily for up to 5 consecutive days improves symptoms as effectively as a chlorhexidine-lidocaine spray.

A moderate-sized observational study in patients aged 12-75 years old with acute tonsillopharyngitis suggests that taking lozenges containing sage extract 378.5 mg and echinacea extract 5 times daily for 4 days reduces throat pain and tonsillopharyngitis symptoms when compared to baseline, both acutely within 90 minutes and after 4 days of treatment.

 

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