Essential OilsAMANDA SPENCER, APRN, NP-C

Disclosures

u I have a financial relationship with an essential oil company

Objectives

u Understand quality standards for essential oils

u Understand basic essential oil safety

u Identify 1-3 common uses of top oils

u Understand basic chemistry/mechanism of action for chemical constituents

u Identify 1-3 oil/drug interactions or precautions

Quality Standards for Essential Oils

u All oils are not created equal

u Sourcing matters

u In-House and 3rd Party Testing

u GC/MSu One of the most common tests used to identify chemical constituents

u Every batch testing versus “routine testing”

u Transparency

u Can be “faked’ through highly sophisticated adulteration

u Proteomic Profiling – “EO Fingerprint”u Effect on signaling pathways

u Cannot be “faked”

u Synergy Important

Sourcing

u Native/Indiginous versus greenhouseu Latitude/Altitude Differencesu Manuka in New Zealand (North, East Cape, Southern… different chemical makeup just miles apart)u Cannot fully replicate natureu Time of year/time of day (Jasmine blossoms at night)

u Methodsu Steam distilled – most commonu Cold pressed from rind – citrusu Absolutes – oil chemically extracted from plant (Jasmine)

u Ethical considerationsu Sustainability

Essential Oil Testing

u GC/MS

u Lavender “Pass” https://s3-us-west-2.amazonaws.com/qualityreports.sourcetoyou.com/2018/06/Lavender+181525.pdf

u Lavender “Fail” https://remedygrove.com/traditional/Essential-Oil-Safety-Chemist-Uncovers-Adulterated-EOs-Sold-as-Pure-at-WalMart

u Proteomic Profiling

u Newer

u Involves systematic separation, identification, and characterization of proteins in a biologic sampleu Test the effect an EO has on expression of proteins

u Increasing or decreasing signaling pathways

Essential Oil Safety

u Do not put oils in eyes, ears, or noseu Neat application versus diluting with carrier oil

u Top carrier oils (fractionated coconut oil, almond oil, grapeseed oil, jojoba oil)u Reduced risk of skin reactions

u Dilute out with carrier oil if a skin reaction occurs

u Recommended for “hot oils” or when using oils on children, sensitive skin, elderly, pregnant women

u Citrus oils contain furocoumarinsu Photosensitivity, avoid direct sunlight for 12-72 hours depending on the citrus oil

u Follow instructions on bottle regarding topical or internal useu Internal use: dosing is usually 1-2 drops at a timeu Keep out of reach of children…just like you would medication

Most Commonly Used Oils

u Single oils versus blends

u Lemon

u Lavender

u Peppermint

u Melaleuca/Tea Tree

u Eucalyptus

Lemon

u Cold pressed from rind

u Commonly used for

u Cleansing (antimicrobial, antiseptic)

u Uplifting mood

u Allergies

u Nausea

Lemon Chemistry

u Main Constituents

u d-limoneneu Monoterpene (alkene)

u Antioxidant activity, antiviral

u alpha-pinenes & beta-pinenesu Monoterpenes (alkene)

u Antiseptic, expectorant, anti-inflammatory (inhibits COX-2, thus inhibiting PGE2)

alpha-pinene

beta-pinene

Lavender

u Steam Distilled

u Commonly used for

u Calming/Anxiety

u Sleep

u Pain

u Allergies

u Skin irritations (minor burns, bites, abrasions, rash)

Lavender Chemistry

u Main Constituents

u Linaloolu Monoterpene Alcohol: antibacterial, antiviral, increase

blood circulation, high resistance to oxidation, which can help cells revert to normal function and activity; anti-spasmodic, sedative, and anti-fungal

u alpha-terpineolu Monoterpene Alcohol; inhibit histamine production,

decrease production of inflammation mediators

u Linalyl acetateu Monoterpene Ester: found in mildest oils, calming,

relaxing, balancing; anti-fungal, anti-spasmodic; anti-hypertensive (stroke prevention), recovery from cell damage from toxins

Peppermint

u Steam distilled

u Commonly used for

u Alertness/Energy

u Fever/Hot Flashes

u Muscle Tension

u Headaches

u GI Discomfort

Peppermint Chemistry

u Main Constituents

u Mentholu Monoterpene Alcohol: antibacterial, antiviral, increase

blood circulation, high resistance to oxidation, which can help cells revert to normal function and activity; anti-spasmodic, sedative, and anti-fungal

u Menthoneu Ketone: stimulate cell regeneration, promote tissue

formation, liquefy mucous, support upper respiratory system

u alpha and beta-pinenesu Monoterpenes (alkene): Antiseptic, expectorant, anti-

inflammatory (inhibits COX-2, thus inhibiting PGE2)

Menthol

Menthone

alpha-pinene

beta-pinene

Melaleuca/Tea Tree

u Steam distilled

u Commonly used for

u Viruses

u Bacteria

u Fungi

u Wounds

u Acne

Melaleuca/Tea Tree Chemistry

u Main Constituents

u alpha-terpinenes & gamma-terpinenesu monoterpene alkenes (antibacterial,

antifungal)

u terpinen-4-olu Monoterpene alcohol (antiviral, antibacterial,

antifungal)

alpha terpinene gamma terpinene

terpinen-4-ol

Eucalyptus

u Steam Distilled

u Commonly used for

u Congestion/Cough

u Viruses/Infections

u Respiratory Support

u Cleaning Disinfectant

Eucalpytus Chemistry

u Main Constitiuents

u eucalyptol (1,8-cineole)u Monoterpene ether: expectorant,

mucolytic, anti-inflammatory (especially in airways), inhibitor of leukotrienes and PGE2

u alpha-terpineolu Monoterpene alcohol: antibacterial,

antiviral, increase blood circulation, high resistance to oxidation which can help cells revert to normal function and activity; inhibit histamine production, decrease production of inflammation mediators

eucalyptol (1,8-cineole)

Oil-Drug Interactions

u Some EOs and/or their metabolites may be metabolized in the CYP450 pathway. Patients should continue to monitor their blood pressure and heart rate if they are on medications affecting these. Check drug levels if on a narrow-therapeutic index medication.

u Grapefruit EO does not have the same metabolic concerns as grapefruit juice or grapefruit

u Wintergreen and Birch EOs can have a “blood thinning” effect due to high levels of methyl salicylate. This is most profound with internal use, which is unsafe with these two oils. Topical use has less of an effect and diffusing has essentially no effect on coagulation.

Precautions for EO use

u There is abundant research supporting safety of EOs when used appropriately

u Internal use of EOs is somewhat controversial but many have been given GRAS status by the FDA. When in doubt, check the labeling.

u Be mindful of safety information (diluting, citrus oils and photosensitivity, etc)

u Understanding the chemical components of an EO can help understand how it works in the body

More information

u Aromatic Plant Research Center (APRC)

u Tisserand Institute

u Modern Essentials textbook

u MAD Oilers Guide to Essential Oils and Drug Interactinos: Over 700 Prescription and Over the Counter Medication Interactions

References

u Aromatic Plant Research Center. (2018). GC/MS report on lavender. https://s3-us-west-2.amazonaws.com/qualityreports.sourcetoyou.com/2018/06/Lavender+181525.pdf

u Ashour, H. (2008). Antibacterial, antifungal, and anticancer activities of volatile oils and extracts from stems, leaves, and flowers of eucalyptus sideroxylon and eucalpytus torquata. Cancer Biology and Therapy

u Bagg, J., Jackson, M., Patrina, M., Ramage, G. (2006). Susceptibility to melaleuca alternifolia (tea tree) oil of yeasts isolated from the mouths of patients with advanced cancer. Oral Oncology

u Bassett, I., Panowetz, D., Barnetson, R., (1990). A comparison study of tea tree oil versus benzyoylperoxide in the treatment of acne. Medical Journal of Austrailia

u Borhani, A., Motazedian, S., Rezali, R., Mohammadi, F., Pourmokhatari, M., Khodaei, S., Vossoughi, M., Miri, R. (2010). Cutaneous application of menthol 10% solution as an abortive treatment of migraine without aura; a randomized, double-blind, placebo controlled, crostover study. International Journal of Clinical Practice

u Crop & Food Research Broadsheet. (2002). Essential oil production from manuka and kanuka. Crop & Food Research Broadsheet. 116

u Cuaron, J., Dulal, S., Song, Y., Singh, A., Montelongo, C., Yu, W., Nagarajan, V., Jayaswal, R., Wilkinson, B., Gustafson, J. (2013). Tea tree oil-induced transcriptional alterations in Staphylococcus aureas. Phytotherapy Research

u Dhifi, W., Bellili, S., Jazi, S., Bahloul, N., Mnif, W. (2016). Essential oils’ chemical characterization and investigation of some biological activities: A critical review. medicines 3(25). DOI 10.3390

References cont

u Inouye, S., Yamaguchi, H., Takizawa, T. (2001). Screening of the antibacterial effects of a variety of essential oils on respiratory tract pathogens, using a modified dilution assay method. Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy

u Ferrara, L., Naviglio, D., Armone Carusa A. (2012). Cytological aspects of the effects of a nasal spray consisting of standardized extract of citrus lemon and essential oils in allergic rhinopathy. ISRN Pharmaceutics

u Frerot, E., & Decorzant, E. (2004). Quantification of total furocoumarins in citrisu oils by HPLC coupled with UV, fluorescence, and mass detection. Journal of Agricultural Food Chemistry 52 (23) 6879-6886. DOI: 10.1021/jf040164p

u Grassman, J., Schneider, D., Weiser, D., Elstner, EF. (2001). Antioxidant effects of lemon oil and its components of copper induced oxidation of low density lipoprotein. Arzneimittel-Forschung

u Goal, N., Kim, H., Lao, RP. (2005). Chronobiology International

u Hartman, D., Coetzee, JC. (2002). Two US practitioners’ experience of using essential oils for wound care. Journal of Wound Care

u Hsieh, Y., Kwon, S., Lee, H., Seol, G. (2018). Linalyl acetate prevents hypertension-related ischemic injury. PLOS one. https://doi.org/10.1371/journal.pone.0198082

u Ilmberger, J., Hueberger, E., Mahrhofer, C., Dessovic, H., Kowarik, D., Bauchbauer, G. (2001). The influence of essential oils on human attention and alertness. Chemical Senses

u Jandara, V., Hudson D., deWett, P., Innes, P., Rode, H., (2000). Cooling the burn wound: evaluation of different modalities. Burns: Journal of the International Society for Burn Injuries

u Juergens, U., Stober, M., Schmidt-Schilling, L., Kleuver, T., Vetter, H. (1998). Anti-inflammatory effects of eucalyptol (1,8-cineole) in bronchial asthma: inhibition of arachidonic acid metabolism in human blood monocytes ex vivo. European Journal of Medical Research 3: 407-412

References cont.

u Khanna, R., McDonald, J., Levesque, B. (2014). Peppermint oil for the treatment of irritable bowel syndrome; a systematic reviewand meta-analysis. Journal of Clinical Gastroenterology

u Kim, MJ., Nam, ES., Paik, SI. (2005). The effects of aromatherapy on pain, depression, and life-satisfaction of arthritis patients. Taehan Kanho Hakhoe Chi

u Pappas, R. (2017). GC/MS report on lavender. https://remedygrove.com/traditional/Essential-Oil-Safety-Chemist-Uncovers-Adulterated-EOs-Sold-as-Pure-at-WalMart

u Sadlon, A., Lamson, D., (2010). Immune-modifying and antimicrobial effects of eucalyptus oil and simple inhalation devices. Alternative Medicine Review: A Journal of Clinical Therapeutics

u Shin, Y., Hsieh, Y., Kwon, S., Lee, H., Seol, G. (1985). Linalyl acetate restores endothelial dysfunction and hemodynamic alterations in diabetic rats exposed to chronic immobilization stress. Journal of Applied Physiology. 1;124(5):1274-1283. doi: 10.1152/japplphysiol.01018.2017

u Ueno-Ilo, T., Shibakura, M., Yokota, K., Aoe, M., Hyoda, T., Shinohata, R., Kanehiro, A., Tanimoto, M., Kataoka, M. (2014). Lavender essential oil inhalation suppresses allergic airway inflammation and mucous cell hyperplasia in a murine model of asthma. Life Sciences

u Xu, J., Shao, X., Wei, Y., Xu, F., & Wang, H. (2017). iTRAQ proteomic analysis reveals that metabolic pathways involving energy metabolism are affected by tea tree oil in Botrytis cinerea. Frontiers in Microbiology 8(1989). doi: 10.3389/fmicb.2017.01989

u Yavari Kia, P., Safajou, F., Shahnazi, M., Nazemiyeh, H. (2014). The effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy: A double-blinded, randomized, controlled clinical trial. Iranian Red Crescent Medical Journal