Aromatherapy
***Disclaimer: This blog is not meant to be used as legal or medical
advice. It is written as my person perspective on how medical
professionals could blend western medicine with other modalities***
Aromatherapy is a rather broad topic. This is a modality that I
engage in and was happy to research. It includes such a variety of products, that this
will be a topic I come back to in the future.
Technically, it includes using aroma as medicine; however, it is generally agreed within typical users that it refers specifically to the volatile or essential oils of a variety of products. The proposed (and not well understood) mechanism of action is that the inhaled chemicals enter the blood stream through the lungs or trigger synapses in the nose which relay directly with the limbic system in the brain. We do know that the nerves associated with the sense of smell route directly into the brain without going through the brain stem. We also know that some drugs can be absorbed through the lungs. Again, we are unsure that either of these mechanisms are actually functioning for aromatherapy, but it is the theory.
The most common and familiar route of administration is inhalation; however, it may also be used topically or orally. One must be careful with the latter two routes, because some concentrations may irritate the skin and some formulations may be toxic if ingested. Most essential oils are gathered from various plant parts including petals, leaves, stems, roots, seeds, or fruit.
These extractions happen by one of 3 different processes including steam distillation, cold press, and carbon dioxide distillation. Steam distillation requires pulverization and boiling of the plant product. The steam is collected and the volatile oils are pulled out with the steam. There is a process of extracting the oil from the water afterward. In cold press, the plant product is literally just squeezed until the oils come out. This is uncommon, because few plant parts are “wet” enough to extract much from this method. However, orange oil can easily be expressed by squeezing an orange rind. Carbon dioxide distillation is similar to steam distillation, except it happens under high pressure. Liquid carbon dioxide extracts the oils out of the product. When the pressure is released, the carbon dioxide simply evaporates away from the oils. This is thought to protect compounds that may be sensitive to heat.
As you can see, there are different ways of extraction and different parts of the plant. Different companies have vastly different costs with potentially different formulations, purity, or concentrations. It is hard to tell for sure without sophisticated equipment what comes in that bottle. There have even been reports of companies tampering their oils by adding manufactured compounds. With such a broad selection of products it would be impossible to flatly accept or reject aromatherapy across the board. This will be a topic I revisit in the future to discuss some of the other purported merits of aromatherapy.
Aromatherapy has been used for infections of many kinds (and specifically herpes, including chicken pox and shingles), pain, depression, and poor sleep. As with many complementary and alternative medicines, you’ll notice many self-reported diseases. Unfortunately, it is difficult to design appropriate blinding for aromatherapy. It becomes clear to the patient that they either smell something or they don’t. Or they smell lavender or something that is definitely not lavender. So at this time, I have been unsuccessful at finding very strong clinical trials regarding infections. There were some promising abstracts I saw, but I was unable to get the full trials. However, there have been some interesting studies with lavender for mild to moderate sleeping disorders.
One trial in particular intrigued me for a number of reasons. Lillehei A. S. et al looked at self reported sleep habits of a group of college students – notorious for being a little sleep deprived, but otherwise healthy. This study based on over a dozen similar studies gave the participants sleep hygiene techniques and a patch to sleep with on their chest for about a week. The patch was either infused with a small amount of lavender or blank. They were also given a Fitbit to monitor their sleep via technology and given journals to write about how they slept. Although they ended up needing to rely on the sleep journals, this was an interesting use of technology that might prove more effective in later studies as technology continues to improve. The results of the trial were also intriguing. Although both groups improved in their sleep quality (due to both groups receiving sleep hygiene tips), the lavender group showed stronger improvements in quality of sleep. At the two week post-assessment, the lavender group had maintained higher quality of sleep without further intervention.
Although aromatherapy may prove to have other benefits, there is
significant evidence that lavender can help patients that have mild to
moderate sleep difficulties. It may be particularly useful for college
students who may not have more time to invest in sleep, but could use
better quality sleep. It is important to emphasize the use of good
sleep hygiene in conjunction with lavender. As for aromatherapy in
general, I should note that these are plant-based products, and
therefore, can be allergenic. Some may even bother pregnant females to
the point of terminating the pregnancy. Ultimately, aromatherapy can be
powerful, so I recommend caution not only in choosing scents, but
manufacturers as well.
Now it’s you’re turn. What aromatherapy products have you used? Did it work the way you wanted it to? Are there products you think people should stay away from? What’s your opinion? Send me an email at integratedpharmacist@gmail.com. If you are enjoying this podcast, please rate and review it wherever you get your podcasts and be sure to tell a friend who might enjoy it as well. Thank you for listening and we'll see you next time with The Integrated Pharmacist Podcast.
References:
Lillehei AS, Halcón LL, Savik K, Reis R. Effect of inhaled lavender and sleep hygiene on self-reported sleep issues: a randomized controlled trial. J Altern Complement Med. 2015;21:430–438.
Technically, it includes using aroma as medicine; however, it is generally agreed within typical users that it refers specifically to the volatile or essential oils of a variety of products. The proposed (and not well understood) mechanism of action is that the inhaled chemicals enter the blood stream through the lungs or trigger synapses in the nose which relay directly with the limbic system in the brain. We do know that the nerves associated with the sense of smell route directly into the brain without going through the brain stem. We also know that some drugs can be absorbed through the lungs. Again, we are unsure that either of these mechanisms are actually functioning for aromatherapy, but it is the theory.
The most common and familiar route of administration is inhalation; however, it may also be used topically or orally. One must be careful with the latter two routes, because some concentrations may irritate the skin and some formulations may be toxic if ingested. Most essential oils are gathered from various plant parts including petals, leaves, stems, roots, seeds, or fruit.
These extractions happen by one of 3 different processes including steam distillation, cold press, and carbon dioxide distillation. Steam distillation requires pulverization and boiling of the plant product. The steam is collected and the volatile oils are pulled out with the steam. There is a process of extracting the oil from the water afterward. In cold press, the plant product is literally just squeezed until the oils come out. This is uncommon, because few plant parts are “wet” enough to extract much from this method. However, orange oil can easily be expressed by squeezing an orange rind. Carbon dioxide distillation is similar to steam distillation, except it happens under high pressure. Liquid carbon dioxide extracts the oils out of the product. When the pressure is released, the carbon dioxide simply evaporates away from the oils. This is thought to protect compounds that may be sensitive to heat.
As you can see, there are different ways of extraction and different parts of the plant. Different companies have vastly different costs with potentially different formulations, purity, or concentrations. It is hard to tell for sure without sophisticated equipment what comes in that bottle. There have even been reports of companies tampering their oils by adding manufactured compounds. With such a broad selection of products it would be impossible to flatly accept or reject aromatherapy across the board. This will be a topic I revisit in the future to discuss some of the other purported merits of aromatherapy.
Aromatherapy has been used for infections of many kinds (and specifically herpes, including chicken pox and shingles), pain, depression, and poor sleep. As with many complementary and alternative medicines, you’ll notice many self-reported diseases. Unfortunately, it is difficult to design appropriate blinding for aromatherapy. It becomes clear to the patient that they either smell something or they don’t. Or they smell lavender or something that is definitely not lavender. So at this time, I have been unsuccessful at finding very strong clinical trials regarding infections. There were some promising abstracts I saw, but I was unable to get the full trials. However, there have been some interesting studies with lavender for mild to moderate sleeping disorders.
One trial in particular intrigued me for a number of reasons. Lillehei A. S. et al looked at self reported sleep habits of a group of college students – notorious for being a little sleep deprived, but otherwise healthy. This study based on over a dozen similar studies gave the participants sleep hygiene techniques and a patch to sleep with on their chest for about a week. The patch was either infused with a small amount of lavender or blank. They were also given a Fitbit to monitor their sleep via technology and given journals to write about how they slept. Although they ended up needing to rely on the sleep journals, this was an interesting use of technology that might prove more effective in later studies as technology continues to improve. The results of the trial were also intriguing. Although both groups improved in their sleep quality (due to both groups receiving sleep hygiene tips), the lavender group showed stronger improvements in quality of sleep. At the two week post-assessment, the lavender group had maintained higher quality of sleep without further intervention.
Now it’s you’re turn. What aromatherapy products have you used? Did it work the way you wanted it to? Are there products you think people should stay away from? What’s your opinion? Send me an email at integratedpharmacist@gmail.com. If you are enjoying this podcast, please rate and review it wherever you get your podcasts and be sure to tell a friend who might enjoy it as well. Thank you for listening and we'll see you next time with The Integrated Pharmacist Podcast.
References:
Lillehei AS, Halcón LL, Savik K, Reis R. Effect of inhaled lavender and sleep hygiene on self-reported sleep issues: a randomized controlled trial. J Altern Complement Med. 2015;21:430–438.
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