Although sage has not been the subject of many clinical studies, many of its constituents demonstrate significant pharmacological effects, providing a theoretical basis for some of its uses.
Sage has been traditionally used to treat excessive perspiration and salivation, as well as dysmenorrhoea, diarrhea, galactorrhoea, sweats associated with menopause and to cease lactation. An open study of 80 patients confirmed that it can reduce perspiration. The high tannin content of the herb provides a theoretical basis for its use.
DYSPEPSIA AND LACK OF APPETITE
Sage’s reported antispasmodic action and bitter constituents support its use in treating loss of appetite, gastritis, flatulence, bloating and dyspepsia. These uses await support from clinical research.
INFLAMMATION OF MUCOUS MEMBRANES
Topically, sage is used as a gargle for laryngitis, pharyngitis, stomatitis, gingivitis, glossitis, minor oral injuries and inflammation of the nasal mucosa. These uses can be based on the pharmacological activity of its chemical components. In an open-label, single-blind, RCT of 420 patients, the non-steroidal anti-inflammatory drug, benzydamine hydrochloride, was found to be more effective than sage in relieving postoperative pain when used as a mouthwash after tonsillectomy in children and adults.
Sage has been found to have less antitussive effects than codeine, but a significantly higher or similar effect to dropropizine. A small, double-blind study has suggested that use of an essential oil spray or gargle formulation that includes sage may help relieve snoring.
Since ancient times sage has been used to enhance memory and treat dementia. More recently, cholinergic activities have been demonstrated in vitro and in vivo, suggesting that it may be useful in treating Alzheimer’s disease. A randomised placebo-controlled study undertaken at three centres assessed the effects of sage extract (60 drops/day) in 42 subjects with mild to moderate Alzheimer’s disease. Initially, subjects had a score of 12 or less on the cognitive subscale of Alzheimer’s Disease Assessment Scale (ADAS-cog) and two or less on the Clinical Dementia Rating (CDR). At 4 months, sage extract produced a significantly better outcome on cognitive functions than placebo in both test scales and was well tolerated.
In 2003, two placebo-controlled, double-blind crossover studies involving 44 healthy young adults investigated the effects of different strengths of standardised essential oil of S. lavandulaefolia on memory. Both studies found that a 50-microlitredose of Salvia essential oil significantly improved immediate word recall and was able to modulate cognition. In another placebo-controlled, double-blind, crossover study involving 24 subjects, Spanish sage (S. lavandulaefolia) essential oil was found to enhance cognitive performance and mood in healthy young adults.
Sage is commonly used by modern herbalists in prescriptions for menopause in order to treat hot flushes, night sweats, and for its oestrogenic effect. As yet there is no clinical evidence available to confirm effectiveness for these indications.
Sage: Other Uses
As an inhalant, sage is used for asthma. In foods, it is used as a culinary spice. In manufacturing, sage is used as a fragrance component in soaps and cosmetics.
Sage: Dosage Range
• Infusion of dried herb: 1-4 g three times daily.
• Tincture (1:1): 1-4 ml_ three times daily.
• Essential oil: 2-3 drops in 100 mL water several times daily.
• Gargle or rinse (use warm infusion): 2.5 g cut leaf in 100 mL water; or 2-3 drops essential oil in 100 mL water; or use 5 mL fluid extract diluted in a glass of water, several times daily.