Peppermint: Benefits, Dosage, Contraindications
Other name(s)
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Scientific name(s)
Mentha d piperita
Family or group:
Plants
Active ingredients:
Eucalyptol
Carvone
Menthol
Pulegone
Menthone
Indications
Rating methodology
EFSA approval.
Irritable Bowel Syndrome ✪✪✪✪✪
Irritable bowel syndrome (IBS) is characterized by abnormal contractions of intestinal muscles, causing pain, bloating, and bowel disturbances such as diarrhea or constipation. This condition can be exacerbated by stress factors and is often linked to inappropriate eating habits and intestinal dysbiosis. According to a meta-analysis, peppermint oil administered in capsule form has shown significant efficacy in the treatment of IBS symptoms, including abdominal pain and bloating. These capsules release the oil directly in the small intestine, minimizing side effects such as reflux by avoiding excessive relaxation of the lower esophageal sphincter. The study also highlights that benefits are generally achieved after two weeks of treatment, although long-term effects remain uncertain, with studies included not exceeding 12 weeks. Most studies used 1 to 2 enteric-coated peppermint oil capsules orally two to four times a day. Each capsule provides about 0.2 ml of peppermint oil or 180-225 mg of peppermint oil. In addition to its use in monotherapy, peppermint oil has been tested in combination with other herbs as in the product Iberogast (including lemon balm, milk thistle, Caraway, chamomile, licorice, and others), and another product, Atrantil, which combines peppermint with quebracho extract and horse chestnut, showing a reduction in constipation and bloating symptoms in patients with constipation-predominant IBS. Although the recommendations of the American College of Gastroenterology are cautious due to the limited quality of evidence, they recognize the efficacy of this therapy for short-term relief. Similarly, the British Society of Gastroenterology evaluates peppermint oil as a potentially effective treatment for global symptoms and abdominal pain associated with IBS. However, they note that long-term efficacy has not been established and mention gastroesophageal reflux as a common side effect.
Posologie
Oral administration
0.6 - 1.2 mL
infusion, essential oil, Atrantil, capsules, Iberogast
Synergies
Systematic review and meta-analysis: efficacy of peppermint oil in irritable bowel syndrome
Efficacy and Safety of Peppermint Oil in a Randomized, Double-Blind Trial of Patients With Irritable Bowel Syndrome
Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome
Response of irritable bowel syndrome with constipation patients administered a combined quebracho/conker tree/M. balsamea Willd extract
ACG Clinical Guideline: Management of Irritable Bowel Syndrome
Peppermint Oil Treatment for Irritable Bowel Syndrome: A Randomized Placebo-Controlled Trial
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
British Society of Gastroenterology guidelines on the management of irritable bowel syndrome
Digestive Issues, Digestive Spasms ✪✪✪✪✪
Clinical research suggests that peppermint oil, combined with caraway oil, can significantly improve quality of life and reduce symptoms of dyspepsia, such as the feeling of fullness, pain, and mild gastrointestinal spasms. These results were achieved with specific products like Enteroplant and Menthacarin, administered two to three times a day in doses of 90 mg of peppermint oil and 50 mg of caraway oil over a period of 4 weeks. This combination was compared and found to be as effective as cisapride, a former medication used to treat dyspepsia symptoms. Additionally, the product Iberogast, which includes peppermint leaf extract and other plants like lemon balm and chamomile, taken in 1 mL three times a day, showed a significant reduction in the severity of dyspepsia symptoms in a meta-analysis of clinical studies. This treatment helps to relieve symptoms like acid reflux, epigastric pain, cramps, nausea, and vomiting.
Posologie
Orally
50 mg
infusion, essential oil, Carmenthin®, Iberogast
A randomized placebo-controlled trial on the effects of Menthacarin, a proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of life in patients with functional dyspepsia
European Union herbal monograph on Mentha x piperita L., folium
Menthacarin, a Proprietary Peppermint Oil and Caraway Oil Combination, Improves Multiple Complaints in Patients with Functional Gastrointestinal Disorders: A Systematic Review and Meta-Analysis
A Combination of Peppermint Oil and Caraway Oil for the Treatment of Functional Dyspepsia: A Systematic Review and Meta-Analysis
Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial
Migraine ✪✪✪✪✪
Peppermint, applied topically, has proven effective in relieving tension headaches. In one study, a 10% peppermint oil solution in ethanol was applied to the forehead and temples, showing a significant reduction in headache intensity in 15 minutes, comparable to the effect of a 1000 mg dose of paracetamol. An additional study examined the effect of menthol, an active component of peppermint, found in topical treatments for migraines without aura. The 10% menthol skin application produced a significant effect on pain, surpassing a placebo and also improving associated symptoms such as nausea and sensitivity to light and sound. Preliminary research also shows that intranasal peppermint oil at 1.5% can be as effective as intranasal lidocaine at 4% in reducing migraine intensity, with effects felt in just 5 minutes for some patients. These results suggest that peppermint oil could offer a natural, quick alternative for treating migraine and headache symptoms.
Posologie
Topically, nasally, orally
2 drops
essential oil
Comparing the Effect of Intranasal Lidocaine 4% with Peppermint Essential Oil Drop 1.5% on Migraine Attacks: A Double-Blind Clinical Trial
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters
Nausea and Vomiting ✪✪✪✪✪
Peppermint oil shows promising results for treating nausea from various origins. In the case of chemotherapy-induced nausea, adding 40 drops of peppermint oil in 20 mL of water every 8 hours was effective in reducing the severity of nausea and vomiting. For postoperative nausea, inhalation of peppermint oil vapors also showed significant benefits in reducing nausea among gynecological patients. Moreover, a study with children suffering from acute leukemia used essential oil diffusion with 2 drops of peppermint and 3 drops of lemon oil, effectively reducing the severity of nausea and vomiting associated with treatment. However, a Cochrane review on aromatherapy for postoperative nausea found no reliable evidence of the efficacy of peppermint oil, highlighting the need for more rigorous research to validate these results. a
Posologie
By inhalation
2 drops
essential oil
The Effects of Peppermint Oil on Nausea, Vomiting and Retching in Cancer Patients Undergoing Chemotherapy: An Open Label Quasi-Randomized Controlled Pilot Study
The Effect of Combined Inhalation Aromatherapy with Lemon and Peppermint on Nausea and Vomiting of Pregnancy: A Double-Blind, Randomized Clinical Trial
The Effect of Peppermint (Mentha piperita) Extract on the Severity of Nausea, Vomiting and Anorexia in Patients with Breast Cancer Undergoing Chemotherapy: A Randomized Controlled Trial
Infant Colic ✪✪✪✪✪
In a double-blind crossover study, 1 drop/kg of body weight of peppermint was compared with simethicone in 30 infants with colic. After 14 days of treatment, a reduction in the frequency and duration of colic episodes was observed in both groups, indicating that peppermint might be as effective as simethicone. These encouraging results call for further clinical trials.
Posologie
Orally
1 1 drop/Kg
essential oil
ENT Infections ✪✪✪✪✪
Peppermint oil and menthol are traditionally used in the treatment of respiratory infections. Balms containing menthol are commonly applied to relieve bronchitis. Additionally, inhaling menthol, although it does not affect nasal mucosal temperature or nasal airflow, directly stimulates cold receptors, thus inducing a cooling sensation that may give the impression of clearing the nasal passages. a For cold and cough symptoms, the use of menthol-based nasal ointments (1-5 %) is also an approved traditional remedy for relieving these conditions according to the EMA.
Posologie
By inhalation, nasal, topical, oral
2 drops
infusion, essential oil, ointment, balm
Muscle Pain ✪✪✪✪✪
Peppermint essential oil is traditionally used to relieve localized muscle pain according to the EMA.
Posologie
Topically
2 drops
essential oil, ointment
Insect Bites, Itching ✪✪✪✪✪
Preliminary clinical studies suggest that topically applied peppermint oil may improve itching from various origins. For itching related to renal, hepatic, or diabetic problems, the topical application of a 5% peppermint oil solution in petroleum jelly twice a day for two weeks showed improvement of symptoms compared to petroleum jelly alone. Another study demonstrated that the application of a gel containing 3.6% peppermint oil, 1.4% menthol, and 2.5% methyl salicylate significantly reduced the severity of itching due to burn scars up to seven days after application. Peppermint oil is recognized as a traditional medicinal product for the symptomatic relief of localized pruritic conditions on intact skin.
Posologie
Topically
2 drops
gel, essential oil
The effect of peppermint oil on symptomatic treatment of pruritus in pregnant women
Effective symptomatic treatment for severe and intractable pruritus associated with severe burn-induced hypertrophic scars: A prospective, multicenter, controlled trial
https://www.ema.europa.eu/en/documents/herbal-monograph/european-union-herbal-monograph-mentha-x-piperita-l-aetheroleum-revision-1en.pdf
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
Properties
Antispasmodic
The antispasmodic effect of peppermint is mainly due to its active component, menthol, which acts on the transient receptor potential melastatin 8 (TRPM8) channels in sensory neurons. Activation of these channels allows the entry of Ca2+ ions into cells, thus modulating the activity of gastrointestinal smooth muscles. Studies have shown that peppermint essential oil, applied topically or ingested, relaxes these muscles and reduces intragastric pressure. These properties make it an effective remedy against spasms and digestive pain, notably used in the treatment of irritable bowel syndrome.
Usages associés
Digestive Effect
Peppermint is renowned for its carminative activity, which involves relaxing gastrointestinal sphincters, thus facilitating belching and the passage of gas. This mechanism helps relieve symptoms of bloating and flatulence. In addition to its carminative effects, peppermint oil is employed to treat irritable bowel syndrome (IBS) due to its antispasmodic effects. It slows down the natural movement of the intestine, thereby helping relax the smooth muscles of the gastrointestinal tract. This is partly due to the action of menthol, which may block calcium channels. Menthol also acts as a kappa-opioid receptor agonist and possesses serotonergic antagonist properties, contributing to preventing excessive contractions often observed in IBS patients. Preliminary studies indicate that peppermint oil, administered in capsules combined with caraway oil, can reduce gastroduodenal motility and decrease excessive stomach sensitivity, which plays a role in the development of symptoms related to functional gastrointestinal disorders.
Usages associés
Antimicrobial
Peppermint oil and its main constituent, menthol, have demonstrated significant antibacterial and antifungal properties. They also potentiate the effect of certain antibiotics like oxytetracycline. Peppermint oil has shown an ability to inhibit various pathogenic bacteria such as Helicobacter pylori, Staphylococcus aureus, Escherichia coli, and multi-resistant strains of Shigella sonnei. In addition to its antibacterial activity, peppermint oil has proven effective against pathogenic fungi such as Candida albicans and Trichophyton mentagrophytes, even rivaling commercial fungicides. The joint use of peppermint oil with antibiotics has revealed synergistic effects, notably by increasing the susceptibility of Escherichia coli to antibiotic treatments and significantly reducing the minimum inhibitory concentrations of medications.
Usages associés
Antioxidant
The polyphenolic compounds of peppermint, such as luteolin-7-O-rutinoside, eriocitrin, and rosmarinic acid, demonstrate significant antioxidant activity. Peppermint essential oil and its constituents, menthone and isomenthone, also possess antioxidant properties. Comparatively, peppermint and lemon balm stand out for their powerful antioxidant and free radical scavenging effect, surpassing other plant extracts such as caraway or German chamomile or even angelica.
Choleretic
Peppermint essential oil and tea, along with its flavonoids, exhibit choleretic activity, promoting the secretion of bile. Aqueous extracts of peppermint leaves also have choleretic effects. Peppermint oil relaxes the gallbladder and small intestine, modulating transit time and increasing bile acid secretion while reducing cholesterol in bile, through upregulation of the genes related to bile acid synthesis.
Usages associés
Analgesic
Peppermint oil has demonstrated significant analgesic effects, notably by reducing pain sensitivity in controlled studies. Menthol, one of its active components, plays a key role by modulating GABA receptors and sodium ion channels, contributing to its analgesic action. When applied topically, menthol also acts on kappa-opioid receptors, alleviating the perception of pain and itchiness. Furthermore, inhaling peppermint essential oil can relieve chronic pain by promoting relaxation through a parasympathetic response stimulated by touch and smell.
Usages associés
Neurological
L-menthol, a component of peppermint, increases the perception of cold and reduces that of heat by stimulating cold receptors, useful for relieving respiratory discomfort. Inhalation of menthol also enhances the sensation of nasal airflow and provides a freshness in the nasal cavity, influencing the greater palatine nerve. Moreover, studies in mice show that peppermint oil stimulates motor activity, linked to an effect of mental stimulation, by inhibiting the uptake of dopamine, potentially via the action of menthone.
Safety dosage
Adult from 16 years: 3 g - 6 g (infusion)
- Infusion: 3 g to 6 g for 150 ml of water, infuse for 10 minutes, several times a day. - Essential oil capsules: Most studies report doses of about 0.2-0.5 ml two to four times a day. - Inhalation: 3-4 drops added to hot water. - Tincture (1:5, 45% ethanol): 2 to 3 mL, 3 times a day. - External use (analgesic or irritations): 0.1% to 16% of the preparation. - Tension headaches: 10% solution applied to the skin of the forehead and temples.
Child from 4 to 16 years: 3 g - 6 g (infusion)
Children from 4 years, daily dose in infusion: - 4-10 years, 3-5 g - 10-16 years, 3-6 g For digestive disorders, adult proportions adjusted to the child's weight.
Interactions
Médicaments
CYTOCHROME P450 1A2: weak interaction
Research shows that peppermint oil and leaves inhibit the CYP1A2 enzyme, responsible for the metabolism of many medications. Drugs affected by this enzyme include clozapine (antipsychotic) and theophylline (asthma treatment). Medical supervision is advised to adjust dosages if necessary.
Cytochrome P450 3A4: moderate interaction
Peppermint oil at 600 mg inhibits the CYP3A4 enzyme, increasing the efficacy of felodipine, a drug of this family. Affected drugs also include statins like atorvastatin, certain sedatives like midazolam, and anti-HIV medications like ritonavir. A medical consultation is recommended to adjust doses if necessary.
Precautions
Pregnant woman: use with caution
Data is insufficient, consult a healthcare professional
Breastfeeding woman: use with caution
Data is insufficient, consult a healthcare professional
