What Is Sage?

Common sage (Salvia officinalis) is an aromatic plant that is usually dried and used as a culinary herb. For centuries, sage also has also been used in both Eastern and Western cultures as a medicinal plant.

In recent years, scientists have studied the use of sage or sage extracts in preventing or treating some common medical conditions, such as high cholesterol, inflammatory conditions, and hot flashes.

This article explains what sage is made of and how people use it, as well as the research on its potential health benefits. It also explains the multiple ways that sage can be taken and how it can be taken safely.

Uses of Sage

There are numerous varieties of sage used for culinary and medical purposes. The most common is Salvia officinalis (also known as common sage). Other edible varietals include Salvia lavandulaefolia and Salvia plebeia.

Sage contains a few different ingredients that are thought to have health benefits. These include:

• Camphor: This oily substance gives sage its pungent aroma. Popularly used in topical creams and ointments, camphor actively stimulates nerve endings. It produces a warm sensation when vigorously applied or a cool sensation when applied gently.
• Carnosic acid and carnosol: These have antioxidant and anti-inflammatory properties. They directly activate a molecule known as peroxisome proliferator-activated receptor gamma (PPAR-gamma). PPAR-gamma helps regulate blood sugar, lipids, and inflammation, among other things.
• Phenolic acids: These are plant-based chemicals that have antioxidant properties, protecting cells from the oxidative damage caused by free radicals.

For complementary or alternative therapies, sage has been used for:

• Cold sores
• Fatigue
• High cholesterol
• Hot flashes
• Memory issues
• Sore throat
• Sunburn
• Upset stomach
  

There is evidence, albeit sparse, to support some of the benefits of sage.

Cancer Prevention

Scientists have shown that components of S. officinalis or S. lavandulaefolia can can inhibit the growth of cancer cells in test tubes. These components include carnosol, rosmarinic acid, and ursolic acid. They've been shown to have activity against the following types of cancer cells:

• Breast cancer
• Colon cancer
• Chronic myeloid leukemia
• Prostate cancer
• Liver cancer
• Small-cell lung carcinoma

While animal studies don't always translate to humans, a 2017 review of studies reported that rosmarinic acid given daily to mice prevented skin cancer and bone metastasis from breast cancer.

This doesn't necessarily mean sage can prevent cancer in humans. Determining that will require trials in people. As one group of researchers said: "... extensive pharmacological and chemical experiments, together with human metabolic studies, should be the focus of our future studies."

Lower Cholesterol

One study, published in the journal Phytotherapeutic Research, concluded that sage has cholesterol-lowering effects. According to the research, people given between 400 milligrams (mg) to 1500 mg of sage daily (in the form of either powder, tea, or a supplement) achieved an overall improvement in their blood lipids (fats) after three months.

Among the findings:

• Total cholesterol levels were lowered by 16% to 20%.
• Low-density lipoprotein (LDL) cholesterol (known as "bad cholesterol") was reduced by at least 12%.
• High-density lipoprotein (HDL) cholesterol (known as "good cholesterol") was increased by up to 20%.
• Triglycerides (another type of fat in the blood) were lowered by at least 18%.

However, other studies have not demonstrated similar results.

Improved Memory

There is evidence, though limited, to suggest that sage can improve memory and information processing.

A 2017 review suggested that two types of phenolic acid found in sage—rosmarinic acid and caffeic acid—improved alertness and cognitive skills in mice.

Other studies included in the review found that sage and its active ingredients were associated with improvements in:

• Short-term memory
• Alertness
• Speed recall
• Mood

Anti-Inflammatory Effects

Sage may be beneficial in providing relief for inflammatory conditions such as sore throat and sunburn.

A study from Switzerland showed that an oral spray made from extract of sage and echinacea was just as effective in treating an acute sore throat as the combination of chlorhexidine and lidocaine. Chlorhexidine and lidocaine are pharmaceutical drugs commonly used in oral anesthetics. This combination may also help relieve tonsillitis pain and speed the healing of cold sores when applied as a salve or ointment.

Meanwhile, another study reported that sage oil provided relief of mild inflammatory skin conditions like sunburn and folliculitis. Researchers noted that sage has both anti-inflammatory and antibacterial effects.

Hot Flashes

Hot flashes and night sweats are common symptoms of menopause. A study published in the International Journal of Medical Research and Health Sciences reported that taking a 100 mg daily dose of sage for eight weeks reduced the incidence of hot flashes and other menopause symptoms. Moreover, it appeared to do so without influencing hormone levels.

What Are the Side Effects of Sage?

When consumed as a spice in food, sage is considered safe for adults and children. As a supplement, sage does not usually cause side effects at recommended dosages.

Healthcare professionals generally agree that:

• Sage should be safe when taken in medicinal amounts for no more than two months.
  
• Sage applied to the skin is possibly safe when used for up to one week.
• Sage essential oil, inhaled as aromatherapy, should be safe.

Precautions

Like some other essential oils, sage oil can be toxic and should never be taken orally. Even when applied topically, the oil must be diluted or it could cause rash or irritation.

Dosage: How Much Sage Should I Take?

Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs. 

The recommended dosage of supplemental sage generally ranges from 280 mg to 1,500 mg by mouth daily for up to 12 weeks. If you use sage capsules or extracts, never consume more than the recommended dose on the product label.

What Happens If I Take Too Much Sage?

Sage may be unsafe when taken in high doses or for a long time. Some species of sage, including common sage (Salvia officinalis), contain a chemical called thujone. Too much thujone can cause seizures and damage the liver and nervous system.

Interactions

Sage can make anticonvulsant drugs less effective if used in excess. These drugs include:

• Phenobarbital
• Mysoline (primidone)
• Depakote (valproic acid)
• Neurontin (gabapentin)
• Tegretol (carbamazepine)
• Dilantin (phenytoin)

If you take diabetes medications, the excessive use of sage can trigger a potentially severe drop in blood sugar, leading to hypoglycemia. Sage medications should also be used with caution in people with impaired kidney function.

Tell your healthcare provider about any medications you're taking, including herbal remedies like sage, so that you're fully aware of the potential interactions and risks.

Sources of Sage and What to Look For

Sage supplements usually come in pill, gel cap, or capsule form.

People also take sage:

• "Organically," meaning by chewing a certain amount of leaves from a sage plant
• Through a tincture, by combining a dried version of the herb with alcohol
• By boiling a tea with powdered sage leaves
• Through topical creams and ointments, though these products are usually used for skin irritation
• By inhaling the essential oil as aromatherapy

Dried and fresh sage can be found at most grocery stores. Sage powders, capsules, extracts, teas, essential oils, and homeopathic remedies can be found online or at drugstores and health food outlets.

As you look for a sage supplement, try to find one that is manufactured to the highest quality and safety standards. The best way to do this is to check the label for a seal of approval from an independent, third-party certifying body, such as the U.S. Pharmacopeia (USP), NSF International, or ConsumerLab.

Summary

Sage and sage extracts are being examined in research for common medical conditions, including lowering cholesterol, enhancing memory, improving inflammatory conditions, and reducing hot flashes.

Doses of up to 1,500 mg per day are generally considered safe and well-tolerated by healthy people.

A Word From Verywell

It can be easy to get enthused about an herb like sage, particularly when you hear about all the discomforts and maladies that some people swear it can either ease or cure.

It will take researchers years to catch up with all the anecdotal claims. Until then, it's wise to follow the advice of the National Institutes of Health, which notes that "herbal remedies are a type of dietary supplement. They are not medicines."

The National Institutes of Health also note that herbals may not work as claimed and may contain ingredients or contaminants that are not listed on the label. Before you enter this unchartered territory, schedule a session with your healthcare provider to discuss the potential benefits and risks for you.