Who Can't Take Sage? A Guide to Precautions and Contraindications

October 30, 2025 •

4 min read

According to the National Center for Complementary and Integrative Health (NCCIH), sage is likely safe when consumed in food amounts, but potentially unsafe in high doses. Knowing who can't take sage is crucial for preventing serious side effects, particularly for individuals with pre-existing conditions or those on specific medications. This guide covers the important safety considerations for this popular herb.

Quick Summary

An overview of sage contraindications for certain individuals and medical conditions. It covers risks associated with high doses, the presence of thujone, and potential interactions with medications, especially for those who are pregnant, breastfeeding, or have epilepsy.

Key Points

Pregnant and Breastfeeding Women: Sage is generally considered unsafe in medicinal doses for pregnant women due to potential uterine stimulation and for breastfeeding mothers due to possible reduction of milk supply.
Individuals with Seizure Disorders: High concentrations of thujone, a compound in common sage, can trigger seizures and is dangerous for those with epilepsy.
Hormone-Sensitive Conditions: Some sage species have estrogenic properties, making it risky for people with breast cancer, ovarian cancer, or endometriosis.
Diabetics on Medication: Sage can lower blood sugar and may cause hypoglycemia when combined with diabetes medications.
Blood Pressure Concerns: Depending on the species, sage can either lower or raise blood pressure, posing a risk for individuals with hypertension or hypotension, especially when on medication.
Children: Avoid sage essential oils and teas for children due to neurotoxicity risks; only small, culinary amounts in food are safe for toddlers.
Drug Interactions: Sage can interact with anticonvulsants, antidiabetes drugs, and sedatives, potentially altering their effectiveness.
Avoid High Doses: For all populations, high doses of sage or concentrated forms (like essential oils) are associated with toxicity and should be avoided.

Understanding Sage Precautions

While commonly used in cooking, sage can be potent in concentrated forms, like essential oils and supplements. The primary concern is a compound called thujone, which is present in common sage (Salvia officinalis). Thujone can be toxic in high doses and has been linked to seizures and damage to the liver and nervous system. The amount of thujone can vary depending on the plant species, harvest time, and growing conditions. This makes understanding who can't take sage particularly important for those considering medicinal use.

Sage and Pregnancy

Pregnant women are strongly advised to avoid taking sage in medicinal amounts. The thujone found in some sage species can cause uterine contractions, which may increase the risk of miscarriage. While small culinary amounts are generally considered safe, concentrated forms like teas, tinctures, and supplements should be avoided entirely. This precaution is critical for protecting both the mother and the developing fetus.

Sage During Breastfeeding

Taking sage while breastfeeding is possibly unsafe and is often discouraged. There is a concern that the thujone in sage might reduce milk supply. Though some traditional uses claim otherwise, there is a lack of scientific consensus on its effects on lactation, and the potential risk makes it advisable to avoid. New mothers should discuss any herbal supplement with a healthcare provider before use.

Seizure Disorders and Sage

Individuals with epilepsy or other seizure disorders should avoid sage, especially in concentrations higher than those found in food. The thujone in common sage is a neurotoxin that can trigger seizures. Ingesting sage essential oil has even been linked to accidental seizures in children. This makes it a serious contraindication for those with seizure-related conditions. Sage may also interfere with anticonvulsant medications, potentially decreasing their effectiveness.

Hormone-Sensitive Conditions

Certain sage species, like Spanish sage (Salvia lavandulaefolia), may have estrogen-like effects. This poses a risk for individuals with hormone-sensitive conditions, such as breast cancer, ovarian cancer, uterine cancer, endometriosis, or uterine fibroids. For these individuals, sage could potentially worsen their condition. Always consult a doctor before using sage if you have a hormone-sensitive condition.

Diabetes and Blood Sugar

Sage has been shown to lower blood sugar levels. This can be dangerous for individuals with diabetes who are already taking blood-sugar-lowering medications. The combination could lead to hypoglycemia, or dangerously low blood sugar. If you have diabetes and are considering using sage, it is crucial to monitor your blood sugar closely and consult your healthcare provider to potentially adjust medication dosages.

Blood Pressure Medications and Sage

Sage can affect blood pressure, but the effect depends on the species. Common sage (Salvia officinalis) can lower blood pressure, while Spanish sage (Salvia lavandulaefolia) might increase it. People on medication for high or low blood pressure should monitor their levels carefully and consult their doctor before using sage in medicinal amounts. Taking sage alongside antihypertensive drugs could cause blood pressure to drop too low.

Comparison of Sage Risks


Condition / Population	Risk with Sage (Medicinal Doses)	Explanation
Pregnancy	High Risk	Can stimulate uterine contractions and lead to miscarriage.
Breastfeeding	Moderate-High Risk	May reduce milk supply due to thujone content.
Seizure Disorders	High Risk	Thujone is a neurotoxin that can trigger seizures.
Hormone-Sensitive Conditions	Moderate Risk	Some sage species have estrogen-like effects.
Diabetes	Moderate Risk	Can lower blood sugar, interacting with diabetes medications.
Blood Pressure Issues	Moderate Risk	Effects vary by species; can cause dangerously high or low pressure.
Children	High Risk	Essential oils are toxic; internal use of teas is strongly discouraged.

Summary of Precautions

For most healthy adults, culinary amounts of sage are safe. The risks arise with higher doses, supplements, and essential oils. It is critical to exercise caution and consult a healthcare professional before using sage in medicinal quantities, particularly for those with pre-existing conditions or taking other medications. The toxicity of thujone is a consistent concern across sensitive populations.

Conclusion

While a powerful and useful herb, sage is not for everyone. Individuals who are pregnant or breastfeeding, have a history of seizures, or suffer from hormone-sensitive conditions should strictly avoid medicinal use. Furthermore, those with diabetes, blood pressure issues, or who are taking sedative medications must use caution due to potential drug interactions. Always prioritize consulting a healthcare provider to ensure your safety before incorporating sage supplements or high-dose treatments into your wellness routine. Informed use is the safest use when it comes to potent herbs like sage. For further reading, an authoritative source on herbal safety is available through the UTEP Herbal Safety website.

Precautions for Children

Sage essential oil is potentially neurotoxic and should be avoided internally for children. Even sage tea is not recommended for infants and young children due to the risk of toxicity. Only small, culinary amounts in food are considered safe for babies and toddlers, with proper preparation.

Potential Drug Interactions

Sage can interact with several medications, altering their effects and potentially causing harm.

Antidiabetes Drugs: Sage can lower blood sugar, potentially causing hypoglycemia when combined with diabetes medication.
Anticonvulsants: The thujone in sage can interfere with seizure medications, increasing the risk of seizures.
Sedatives: Sage can cause sleepiness, and when taken with sedative medications, it can lead to excessive drowsiness or breathing problems.

Frequently Asked Questions

No, it is generally considered unsafe to consume sage in medicinal amounts during pregnancy. The thujone content in some sage species can cause uterine contractions and may increase the risk of miscarriage. Consult a healthcare provider before using any herbal supplements during pregnancy.

Yes, taking sage while breastfeeding is possibly unsafe as the thujone in sage might reduce milk supply. It is best to avoid it in medicinal quantities and discuss any herbal use with a doctor.

Common sage contains a neurotoxin called thujone, which can trigger seizures. Due to this risk, individuals with epilepsy or other seizure disorders should not take sage in amounts higher than those found in food.

Yes, certain sage species like Spanish sage may have estrogen-like effects. This can be problematic for individuals with conditions sensitive to hormones, such as breast cancer, uterine cancer, or endometriosis.

Yes, sage can lower blood sugar levels, and taking it with antidiabetes medication could cause dangerously low blood sugar (hypoglycemia). If you have diabetes, consult your doctor before using sage and monitor your blood sugar closely.

Sage can affect blood pressure differently depending on the species. Common sage can lower blood pressure, which is a concern for people with hypotension, while Spanish sage might increase it, affecting those with hypertension. Monitor your blood pressure closely and consult a healthcare provider.

Sage essential oil and teas are not recommended for children due to the risk of toxicity, including seizures. Only small, culinary amounts of fresh or dried sage mixed into food are generally considered safe for babies and toddlers.