What Is Sage?

Sage is an herb commonly found in the spice rack of many Americans. Sage is usually dried and used to add flavor to entrees, such as Thanksgiving stuffing. Sage also has medicinal properties that people have used for centuries in both Eastern and Western cultures.

In recent years, scientists have studied how effective sage or sage extracts can be in preventing or treating some common medical conditions.

This article explains what sage is made of and how people use it, as well as the research on its potential health benefits for lowering cholesterol, enhancing memory, improving inflammatory conditions, and reducing hot flashes. This article also explains the multiple ways that sage can be taken and how it can be taken safely.

What Is Sage Made Of?

Components of sage that are believed to have therapeutic properties include camphor, carnosic acid, carnosol, and phenolic acids.

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

What Is Sage Used For?

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

When used 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 the benefits of sage.

Cancer Prevention

Scientists have shown that components of S. officinalis or S. lavandulaefolia (including carnosol, rosmarinic acid, and ursolic acid) can inhibit the growth of cancer cells in test tubes, including breast cancer, colon cancer, chronic myeloid leukemia, prostate cancer, liver cancer, and small-cell lung carcinoma.

While test-tube results infrequently translate to humans, a 2017 review of studies reported that rosmarinic acid given daily to mice was able to prevent skin cancer and bone metastasis from breast cancer.

None of this should suggest that eating or drinking sage can prevent cancer. Nevertheless, a group of researchers have said: "...extensive pharmacological and chemical experiments, together with human metabolic studies, should be the focus of our future studies."

Lower Cholesterol

Sage's activation of the PPAR gamma molecule, which promotes metabolism and suppresses inflammation, may be most apparent in its impact on cholesterol. One study, published in the journal Phytotherapeutic Research, concluded that this effect is more than marginal. According to the research, people who were provided between 400 milligrams to 1500 milligrams 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%.

Other studies have not demonstrated similar results. Moreover, while the activation of PPAR gamma is associated with improved blood sugar, this effect has not been seen when taking sage or a sage extract.

Improved Memory

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

While the evidence remains sparse, a 2017 research review suggested that substances in sage can influence biological mechanisms associated with cognition. According to the research, two types of phenolic acid found in sage—rosmarinic acid and caffeic acid—have been shown to improve alertness and cognitive skills in mice.

Other studies included in the review consistently showed improvements in short-term memory, alertness, and speed recall. Improved mood and alertness were also cited.

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 extract of sage and echinacea, when used as an oral spray, was just as effective in treating an acute sore throat as the combination of chlorhexidine and lidocaine, pharmaceutical drugs commonly used in oral anesthetics. It is these same properties that are believed to be effective in relieving tonsillitis pain or speeding the healing of cold sores when applied as a salve or ointment.

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

Hot Flashes

Hot flashes and night sweats are common symptoms for women experiencing menopause. A study published in the International Journal of Medical Research and Health Sciences reported that a 100-milligram daily dose of S. officinalis (sage), delivered in an oral tablet over eight weeks, reduced the incidence of these and other menopausal symptoms when compared to women who took a placebo.

Moreover, it appeared to do so without influencing hormone levels, and sage has not been shown to help women with abnormal periods.

Dosage and Preparation

Sage supplements usually come in pill, gel cap, or capsule form. The range generally falls from 280 mg to 1,500 mg by mouth daily for up to 12 weeks. Doses of up to 1,2000 milligrams per day are generally considered safe and well tolerated by healthy people.

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 irritations

Possible Side Effects

When consumed as a spice in food, sage is considered safe for adults and children.

Healthcare professionals generally agree that:

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

Sage can also make anticonvulsant drugs less effective if used in excess, including phenobarbital, Mysoline (primidone), Depakote (valproic acid), Neurontin (gabapentin), Tegretol (carbamazepine), and Dilantin (phenytoin).

The excessive use of sage if you're taking diabetes medications can trigger a potentially severe drop in blood sugar, leading to hypoglycemia. If you use sage capsules or extracts, never consume more than the recommended dose on the product label. Sage medications should 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.

What to Look For

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 is one of those "must-have" herbs found in many spice racks to season a wide variety of culinary creations. And sage or sage extracts are also being examined in research for common medical conditions, including lowering cholesterol, enhancing memory, improving inflammatory conditions, and reducing hot flashes. Doses of up to 1,2000 milligrams per day are generally considered safe and well-tolerated by healthy people. There are several ways to take sage, and each method requires taking special precautions.

A Word From Verywell

It can be easy to get enthused about an herb like sage, particularly when you review a complete list of 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 evidence. 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." It further notes 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 so you can compare and contrast the potential benefits vs. the risks.