DRUGS AND SUPPLEMENTS

Rosemary (Rosmarinus officinalis)

March 22, 2017

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Rosemary (Rosmarinus officinalis)

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Albus (cultivar), alecrim (Portuguese), alpha-pinene, Arp (cultivar), Aureus (cultivar), Benenden Blue (cultivar), biberiye (Turkish), Blue Boy (cultivar), borneol, bornyl acetate, caffeic acid, (-)-camphene, camphor, carnosic acid, carnosol, cineole, cis-4-glucosyloxycinnamic acid, Colorlife® powdered rosemary concentrate, compass plant, compass-weed, dendrolivano (Greek), dentrolivano (Greek), dew of the sea, diosmin, diterpenes, eklil kuhi (Persian), epirosmanol, eriocitrin, eucalyptol, Fierabras, flavones, genkwanin, Golden Rain (cultivar), harilik rosmariin (Estonian), hasalban (Turkish), Herbalox® Type O oleoresin rosemary extract, Herbor 025, hesperidin, hispidulin 7-O-glucoside, honey of rosemary, Hungary water, iklil al-jabal (Arabic), Incensier (cultivar), Irene (cultivar), isoscutellarein, Ken Taylor (cultivar), kuşdili otu (Turkish), lá hu'o'ng thao (Vietnamese), Labiatae (family), Lamiaceae (family), luteolin, linalool, Lockwood de Forest (cultivar), Majorca Pink (cultivar), mannenrou (Japanese), methanol (MeOH), (-)-methyl jasmonate, methylcarnosic acid, mi die xiang (Chinese), Miss Jessop's Upright (cultivar), monoterpenes, old man, oleoresin rosemary, Oxy'less®, p-cymene, phenols, pilgrim's flower, Pinkie (cultivar), polar plant, polyphenolic compounds, Prostratus (cultivar), Pyramidalis (cultivar), Queen of Hungary water, quinate, ro ju ma ri (Korean), romaní (Catalan), romarin (French), romarin commun (French), romer (Catalan), romero (Spanish, Tagalog), romero común (Spanish), roozumari (Japanese), roozumarii (Japanese), rosemary honey (Miel de La Alcarria, Spain), Roseus (cultivar), rosmanol, Rosmanox®, rosmaquinone A, rosmaquinone B, rosmariin (Estonian), rosmariini (Finnish), rosmarin (Danish, German, Norwegian, Swedish), rósmarín (Icelandic), Rosmarini folium, rosmarinic acid, rosmarino (Italian), Rosmarinus acid, Rosmarinus officinalis, Rosmarinus officinalis L. var. genuina forma erectus, Rosmarinus tomentosus, rosmario (Spanish), rosumarin (Japanese), rozemarijn (Dutch), rozmari (Greek, Persian), rozmarin (Bulgarian, Hebrew, Romanian, Russian), rozmarín (Slovakian), rožmarin (Slovenian), rozmarín lekársky (Slovakian), rozmaring (Hungarian), rozmaryn (Polish, Ukranian), rozmarýn lékařský (Czech), rozmaryn spravzhnii (Ukranian), rozmarýna (Czech), rozmarýna lékařská (Czech), rozumarii (Japanese), ružmarin (Croatian, Serbian), saedogg (Icelandic), seco-hinokiol, Severn Sea (cultivar), Spanish rosemary, Suffolk Blue (cultivar), thymol, triterpenes, Tuscan blue (cultivar), verbenone.

Background

  • Rosemary (Rosmarinus officinalis) is a common evergreen shrub grown in many parts of the world. The fresh and dried leaves are used as a food preservative and in traditional Mediterranean cuisine as a flavoring agent. Historically, rosemary has been used medicinally to treat renal colic and dysmenorrhea (painful menstruation). It has also been used to relieve symptoms caused by lung or breathing (respiratory) disorders and to stimulate the growth of hair. Today, extracts of rosemary are often used in aromatherapy to treat anxiety-related conditions and to increase alertness.

  • Well-conducted human trials investigating rosemary are lacking. Rosemary appears to hold promise in the improvement of mental state when used in aromatherapy and as a treatment for alopecia. Rosemary leaf is approved by Germany's Commission E for the treatment of dyspepsia, and rosemary oil (used externally) is approved for joint pain and poor circulation.

Scientific Evidence

Uses

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*

Alopecia areata (loss of hair)

Traditionally, rosemary is used to increase circulation in the scalp and possibly promote hair growth. Limited research has indicated some small benefit with the use of essential oils of rosemary, thyme, lavender, and Atlas cedar for the treatment of alopecia areata. However, more research is warranted in this area.

C

Anxiety/stress

Traditionally, rosemary extract is used in aromatherapy for its purported benefits in mental health, such as relieving anxiety, enhancing mood, altering pain perception, and increasing alertness and improving recall. Studies have reported improvements in stress and alertness, feelings of contentment, as well as quality of memory recall and secondary memory factors. Additional studies are required.

C

Breast cancer (adjuvant)

Limited research has indicated that a diet consisting of balsamic vinegar from apples and honey, with seabuckthorn berry, rosemary, sage and basil extracts, whole wheat bread with 2.5% of the nutraceutical mixture VITAPAN, and grape seed extract may be capable of reducing oxidative stress and improving well-being in women with breast cancer. However, the effects of rosemary alone are unclear. Additional research is required.

C

Cognitive performance enhancement

Early research has indicated that aromatherapy with essential oils from rosemary may enhance cognitive performance. However, more research is warranted in this area.

C

Constipation

Early research has indicated that aromatherapy with essential oils from rosemary, lemon, and peppermint, combined with abdominal massage, may help alleviate constipation in the elderly. However, more research is warranted in this area.

C

Dermatitis (skin conditions)

Early research has suggested that a combination of marigold and rosemary extracts may have a significant protective effect for contact dermatitis. However, more research is warranted in this area.

C

Rheumatic diseases (rheumatism pain)

Although information in humans is limited, the essential oil of rosemary may reduce pain. Several clinical trials have examined the effects of rosemary, in combination with other essential oils, on pain associated with rheumatic diseases in humans. However, more research is needed in this area.

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 against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. 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 health care professional.

  • Abortifacient (induces abortion), acne, Alzheimer's disease, amyotrophic lateral sclerosis (ALS), analgesic (pain reduction), anthelmintic (expels worms), antiaging, antibacterial, anticoagulant (blood thinner), antifungal, anti-inflammatory, antimicrobial, antioxidant, antispasmodic, appetite stimulation, atherosclerosis (hardening of the arteries), bronchial asthma, cancer, cardiovascular disease, carminative (prevents gas), cataracts, chemotherapy (adjunct), cholagogue (promotes discharge of bile), colic, colon cancer, dandruff, depression, diabetes mellitus, diagnostic procedure (cell culture media for candida identification), diaphoretic (increases sweating), diuretic (increases urine), drug withdrawal (morphine), dry skin, dysmenorrhea (painful menstruation), dyspepsia, eczema, epilepsy, expectorant, food additive (animal feed), food preservative, gout, halitosis (bad breath), headache, hepatoprotection (liver protection), herpes labialis, HIV infection, hypercholesterolemia (high cholesterol), hyperglycemia (high blood sugar), hypertension (high blood pressure), hyperthyroid (overactive thyroid), immunostimulation, infections (drug-resistant), ischemic heart disease, joint pain, lice, liver cirrhosis, memory enhancement, metabolic disorders (bone), methicillin-resistant Staphylococcus aureus (MRSA), muscle relaxant (smooth muscle), nerve regeneration, obesity, osteoporosis, paralysis, Parkinson's disease (sporadic), peptic ulcer disease, peripheral vascular disease, photoprotection (protection from UV radiation), poor circulation, psychiatric disorders, quality of life, renal colic, respiratory disorders, skin care, skin conditions (excessive oil secretion, cellulite), sperm motility, stomach ulcers caused by Helicobacter pylori bacteria, tonic, toxicity (dieldrin-induced neurotoxicity), wound healing, wrinkle prevention.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

  • There is no proven safe or effective dose of rosemary for adults. Traditionally, 4-6 grams of rosemary has been taken by mouth daily. Rosemary has been used in aromatherapy. Rosemary essential oil should not taken by mouth.

  • For stress and anxiety, the following has been used in aromatherapy: four drops of pure rosemary essential oil applied to an aromatherapy diffuser pad, five minutes before use; three drops of rosemary essential oil applied to a piece of cotton and added to an inhaler, three minutes before use. For cognitive performance enhancement, four drops of pure rosemary essential oil has been applied to an aromatherapy diffuser pad, five minutes before use.

Children (under 18 years old)

  • There is no proven safe or effective dose of rosemary for 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 rosemary, its constituents, or any member of the Labiatae or Lamiaceae families. Rosemary may cause contact dermatitis or erythema (skin reactions), as well as occupational asthma.

Side Effects and Warnings

  • Rosemary may increase the metabolism of hormones, such as estrogen, reducing levels in the body.

  • Rosemary oil may have toxic effects if taken by mouth. Taking rosemary twigs by mouth may lead to gastrointestinal complications.

  • Rosemary may increase or decrease blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider. Medication adjustments may be necessary.

  • Rosemary may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Rosemary may inhibit an enzyme involved in blood pressure regulation. Caution is advised in patients taking drugs, herbs, or supplements that lower blood pressure.

  • Rosemary may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased or decreased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

  • Use cautiously in patients at risk for iron deficiency, as rosemary may decrease iron levels.

  • Use cautiously in patients who are pregnant or trying to become pregnant, due to evidence of hormone-altering activity, toxic effects to embryos, and abortion inducing effects.

  • Use cautiously in patients taking ciprofloxacin, cyclosporine, or salicylates.

  • Use cautiously in patients predisposed to seizure or epilepsy, as seizures have been associated with use of rosemary.

  • Avoid in patients taking lithium.

  • Avoid in individuals with a known allergy or hypersensitivity to rosemary, its constituents, or any member of the Labiatae or Lamiaceae families.

Pregnancy and Breastfeeding

  • Rosemary is not recommended during pregnancy or breastfeeding, due to lack of sufficient human data. Potential effects of rosemary include hormone-altering activity, toxic effects to embryos, abortion-inducing effects, decreased sperm production, and decreased sperm motility.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. 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.

Interactions with Drugs

  • Rosemary may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Rosemary may inhibit an enzyme involved in blood pressure regulation. Caution is advised in patients taking drugs, herbs, or supplements that lower blood pressure.

  • Rosemary may alter blood sugar levels. Caution is advised when using medications that may also affect blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

  • Rosemary may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be altered in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Individuals using any medications should check the package insert and speak with a healthcare professional, including a pharmacist, about possible interactions.

  • Rosemary may also interact with lithium, diuretics (which increase urine production), salicylates, aminophylline, analgesics (pain reducers), antianxiety agents, antibiotics, anti-inflammatories, anticancer agents, antispasmodic agents, ciprofloxacin, cyclosporine, hormonal agents, iron, and weight loss agents.

Interactions with Herbs and Dietary Supplements

  • Rosemary may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Rosemary may inhibit an enzyme involved in blood pressure regulation. Caution is advised in patients taking drugs, herbs, or supplements that lower blood pressure.

  • Rosemary may alter blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Rosemary may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

  • Rosemary may also interact with diuretics (herbs or supplements that increase urine production), analgesics (pain reducers), antianxiety herbs or supplements, antibacterials, anti-inflammatories, anticancer herbs or supplements, antispasmodic herbs or supplements, hormonal herbs or supplements, iron, lycopene, and weight loss herbs or supplements.

Author Information

  • 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).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Burnett KM, Solterbeck LA, and Strapp CM. Scent and mood state following an anxiety-provoking task. Psychol. Rep 2004;95(2):707-722. View Abstract

  2. Dragan S, Nicola T, Ilina R, et al. Role of multi-component functional foods in the complex treatment of patients with advanced breast cancer. Rev.Med Chir Soc.Med Nat.Iasi 2007;111(4):877-884. View Abstract

  3. Fuchs SM, Schliemann-Willers S, Fischer TW, et al. Protective effects of different marigold (Calendula officinalis L.) and rosemary cream preparations against sodium-lauryl-sulfate-induced irritant contact dermatitis. Skin Pharmacol Physiol 2005;18(4):195-200. View Abstract

  4. Gobert M, Martin B, Ferlay A, et al. Plant polyphenols associated with vitamin E can reduce plasma lipoperoxidation in dairy cows given n-3 polyunsaturated fatty acids. J Dairy Sci 2009;92(12):6095-6104. View Abstract

  5. Greenlee H, Atkinson C, Stanczyk FZ, et al. A pilot and feasibility study on the effects of naturopathic botanical and dietary interventions on sex steroid hormone metabolism in premenopausal women. Cancer Epidemiol.Biomarkers Prev 2007;16(8):1601-1609. View Abstract

  6. Hay IC, Jamieson M, and Ormerod AD. Randomized trial of aromatherapy. Successful treatment for alopecia areata. Arch Dermatol 1998;134(11):1349-1352. View Abstract

  7. Kim MA, Sakong JK, Kim EJ, et al. [Effect of aromatherapy massage for the relief of constipation in the elderly]. Taehan Kanho.Hakhoe.Chi 2005;35(1):56-64. View Abstract

  8. Kim MJ, Nam ES, and Paik SI, [The effects of aromatherapy on pain, depression, and life satisfaction of arthritis patients]. Taehan Kanho.Hakhoe.Chi 2005;35(1):186-194. View Abstract

  9. Lukaczer D, Darland G, Tripp M, et al. A pilot trial evaluating Meta050, a proprietary combination of reduced iso-alpha acids, rosemary extract and oleanolic acid in patients with arthritis and fibromyalgia. Phytother.Res 2005;19(10):864-869. View Abstract

  10. Martinez AL, Gonzalez-Trujano ME, Pellicer F, et al. Antinociceptive effect and GC/MS analysis of Rosmarinus officinalis L. essential oil from its aerial parts. Planta Med 2009;75(5):508-511. View Abstract

  11. McCaffrey R, Thomas DJ, and Kinzelman AO. The effects of lavender and rosemary essential oils on test-taking anxiety among graduate nursing students. Holist.Nurs.Pract 2009;23(2):88-93. View Abstract

  12. Minich DM, Bland JS, Katke J, et al. Clinical safety and efficacy of NG440: a novel combination of rho iso-alpha acids from hops, rosemary, and oleanolic acid for inflammatory conditions. Can.J Physiol Pharmacol 2007;85(9):872-883. View Abstract

  13. Moss M, Cook J, Wesnes K, et al. Aromas of rosemary and lavender essential oils differentially affect cognition and mood in healthy adults. Int J Neurosci 2003;113(1):15-38. View Abstract

  14. Park MK and Lee ES. [The effect of aroma inhalation method on stress responses of nursing students.]. Taehan Kanho.Hakhoe.Chi 2004;34(2):344-351. View Abstract

Copyright © 2013 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.

Updated:  

March 22, 2017