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From the Townsend Letter
January 2019

Exploring the Complexities and Caveats of Safe Internal Use of Essential Oils for Pain:
Highlighting Intestinal Discomfort, Part 2
by Sarah A. LoBisco, ND, IFMCP
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What the Science Says: Internal Usage and Conversion Measurements for the Application of Essential Oils
With knowledge of which essential oils to use for abdominal pain and a tool for conversions for dosages for administration, I will now review what is in the literature for internal adminstration of these selected essential oils.

Peppermint Essential Oil
According to Examine, the dosage for peppermint essential oil "does not follow a particular dosage,"131 but is often standardized for menthol content. Quality and standards are once again validated as imperative for efficacy by this review. The authors summarize the research on this oil's administration as follows:

Oral supplementation of peppermint oil for the purpose of gastrointestinal health and motility involves consuming anywhere between 450-750 mg of the oil daily in 2-3 divided doses, and this is around 0.1-0.2 mL of the oil itself per dosage. The exact optimal dosage of peppermint is not known, and the numbers reflect a menthol content somewhere between 33-50%.*
Usage of peppermint for the treatment of headaches involves having a solution of 10% peppermint oil and applying a relatively thin layer to the front of your head upon the start of a headache, with another application after 15 minutes and 30 minutes (for three applications in total).
Usage of peppermint for aromatherapy does not follow any particular dosing, and similar to other forms of aromatherapy it should be used as either an oil or in a distiller until a pleasant aroma permeates the vicinity.
Any form of peppermint oil should be effective although for persons who experience heartburn (acid reflux) and wish to supplement with peppermint oil for their intestines, then an enteric coated capsule would be useful (since the muscle relaxing effects may affect the esophagous if the capsule breaks prematurely).131

The American Botanical Council's Expanded German E Commission on peppermint further validates this reported dosage and administration.132 It states:

Unless otherwise prescribed: 6–12 drops per day essential oil and Galenical preparations for internal and external application.
Essential oil: Average single dose 0.2 ml.
Essential oil enterically coated form: Average daily dose 0.6 ml (for IBS).
Inhalant: Add 3–4 drops of essential oil to hot water; deeply inhale the steam vapor.
Essential oil: Some drops rubbed in the affected skin areas (may be diluted with lukewarm water or vegetable oil).
Liniment: Oily preparation containing 5–20% essential oil in base of paraffin or vegetable oil applied locally by friction method.
Ointment or unguent: Semi-solid preparation containing 5–20% essential oil in base of petroleum jelly or lanolin spread on linen for local application.
Nasal ointment: Semi-solid preparation containing 1–5% essential oil.
Tincture: Aqueous-alcoholic preparation containing 5–10% essential oil for local application.

BioDisruptThe German E Commission has more specific quality and internal standards for essential oils than found in the United States. It reports on the constituents and their percentages that must be contained for a bottle of peppermint essential oil to be considered pharmaceutical grade, beyond menthol:

European pharmacopeial grade peppermint oil is the volatile oil distilled with steam from the fresh aerial parts of the flowering plant. Its relative density must be between 0.900 and 0.916, refractive index between 1.457 and 1.467, optical rotation between –10 and –30, among other quantitative standards. Identity must be confirmed by thin-layer chromatography (TLC), organoleptic evaluation, and quantitative analysis of internal composition by gas chromatography. It must contain 1.0–5.0% limonene, 3.5–14.0% cineole, 14.0–32.0% menthone, 1.0–9.0% menthofuran, 1.5–10.0% isomenthone, 2.8–10.0% menthylacetate, 30.0–55.0% menthol, maximum 4.0% pulegone, and maximum 1.0% carvone (Ph.Eur.3, 1997).French pharmacopeial grade peppermint oil must contain not less than 44% menthol, from 4.5–10% esters calculated as menthyl acetate, and from 15–32% carbonyl compounds calculated as menthone. TLC is used for identification, quantification of compounds, and verification of the absence of visible bands corresponding to carvone, pulegone, and isomenthone (Bruneton, 1995; Ph.Fr.X, 1990).132

An example of how to use Table 1 for converting the .1-.2 ml indicated dosage to drops of essential oils is as follows:

  • .2 ml of peppermint oil equates to approximately .067 oz
           (1 oz =30 ml).
  • There are 600 drops of essential oil in one ounce.
  • .067 oz of 600 drops totals approximately one drop two to three times a day. This equates to six to 12 drops per day.

Fennel Essential Oil
The American Botanical Council's Expanded German E Commission reports on the dosage and administration for fennel essential oil110 as follows:

Unless otherwise prescribed: 0.1-0.6 ml essential oil or equivalent Galenical preparations for internal use.
Essential oil: 0.1-0.6 ml.
Fennel honey or fennel syrup with 0.5 g fennel oil/kg [=0.5:1000 (w/w)]:
Adult: 10-20 g.
Children 4-10 years: 6-10 g.
Children 1-4 years: 3-6 g.
Duration of administration: Unless otherwise advised by a physician or pharmacist, one should not consume fennel oil for an extended period (several weeks).110

Other sources do not contain direct references to dosage.

Oregano Essential Oil
Examine states the following regarding dosage for oregano oil:

The only study on using oil of oregano for oral supplementation used a dose of 600 mg. To make tea, steep 15 g of oregano leaves in 250 mL of water.
The tea is traditionally used to aid digestion, while the oil has antibacterial properties that may boost the immune system.
Both the tea and oil is usually supplemented once a day.

Since the study cited is based on an emulsified oil, not an essential oil, this information is misleading.133 Using Table 1:

  • 1 drop = 30 mg.
  • The dosage reported would be 600 mg/30 mg, which would equate to 20 drops of pure essential oil. This is not an ideal dose.133,134

I did find one human trial of 104 subjects that used oregano oil in a formulation. The study found the efficacy of herbal treatment to be equivalent to Rifaximin for treatment of SIBO. For the intervention, one of the two formulations randomized contained .1 ml of oregano oil. This would be equivalent to approximately .5-1 drop of oregano oil.151

Ginger Essential Oil
Neither of the monographs for ginger in Examine152 and the American Botanical Council's Expanded German E Commission153 state a dosage for the internal usage of essential oil of ginger, as they do the herb. Natural Medicines Database authors report on nasocutaneous administration and inhalation of ginger oil as follows:

Chemotherapy-induced nausea and vomiting: An aroma-therapy necklace containing two drops of ginger essential oil has been used for 2 minutes three times daily for 5 days starting with chemotherapy.
Postoperative nausea and vomiting: A 5% solution of ginger essential oil, administered nasocutaneously, has been used preoperatively. Aromatherapy with ginger alone, or in combination with spearmint, peppermint, and cardamom, has been inhaled through the nose and exhaled through the mouth three times postoperatively.154

The conversion of drops of essential oil in a 5% solution of ginger oil would be as follows:

  • 1 oz. = 600 drops
  • 6 drops of EO per oz. of carrier oil = 1% dilution (1% of 600 drops)
  • 30 drops of EO per oz. of carrier oil= 5% dilution (5% of 600 drops)

Essential Oils and the Microbiome
Since healing the intestinal tract via the "Five R" program includes removing the cause (e.g., microbes) and re-inoculating the good bacteria, it is important to pause and discuss how essential oils, which are often deemed "antimicrobial," impact the microbiome. From my research and experience, I believe that high quality essential oils likely balance microbe activity. Specifically, there is supporting evidence that as they eliminate overgrowth, they also spare commensal organisms and protect our tissues.
I will now provide a brief review of the scientific literature regarding this topic. First, I will give a quick summary on their antimicrobial actions and use with antibiotics. Then, I will provide the compelling vivo and in vitro trials. This, in combination with years of clinical experience and experts' opinions, provides support for assisting with positively balancing the intestinal microbiome.

The Antimicrobial Properties of Essential Oils
The antimicrobial activity of essential oils on pathogenic bacteria is diverse. In a review on the effects, the authors differentiate the actions of essential oils (EOs) to their isolates. The authors state:

The mechanism of action of EOs depends on their chemical composition, and their antimicrobial activity is not attributable to a unique mechanism but is instead a cascade of reactions involving the entire bacterial cell; together, these properties are referred to as the "essential oils versatility". In general, EOs act to inhibit the growth of bacterial cells and also inhibit the production of toxic bacterial metabolites. Most EOs have a more powerful effect on Gram-positive bacteria than Gram-negative species, and this effect is most likely due to differences in the cell membrane compositions.155

A proposed mechanism of essential oils on microbe destruction consists of their toxic effects on membrane structure. These include "degradation of the cell wall, damaging the cytoplasmic membrane, cytoplasm coagulation, damaging membrane proteins, increased permeability leading to leakage of cell contents, reducing proton motive force, reducing intracellular ATP pool via decreased ATP synthesis and augmented hydrolysis that is separate from the increased membrane permeability and reducing membrane potential via increased membrane permeability."155
Essential oils have also been reported to interfere with quorum sensing (bacteria's regulation of gene expression related to changes in cell-population density) and decrease bacterial virulence factors.155
They may also be helpful in combination with antibiotics to prevent resistance. In a 2014 article titled, "Essential Oils, A New Horizon in Combating Bacterial Antibiotic Resistance," the authors explain that essential oils' versatile properties make them a novel approach for a "drug compound." This is because essential oils have more than one therapeutic effect due to their many biological impacts. This contrasts with a drug's mechanism which is skewed to act on one pathway in the body, not accounting for effects on the body's other functions. The article states:

Various essential oils have been reviewed to possess different biological properties such as anti-inflammatory, sedative, digestive, antimicrobial, antiviral, antioxidant as well as cytotoxic activities. These findings highlight an exciting scientific interest whereby essential oils warrant special attention because they represent a distinctive group of possible novel drug compounds due to their chemical and structural variance that makes them functionally versatile.156

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