The Dangers of Thujone in Sage
Sage, particularly common sage (Salvia officinalis), contains a compound called thujone. In small culinary amounts, this is not a concern for most healthy individuals. However, when consumed in high concentrations, such as in supplements, essential oils, or excessive amounts of tea, thujone can be toxic. Toxicity can manifest as seizures, dizziness, and nervous system damage. Therefore, for many, the safety of sage is entirely dose-dependent and contingent on individual health circumstances.
Who Needs to Be Careful with Sage?
Several groups of people need to exercise caution or completely avoid sage to prevent adverse health reactions.
1. Pregnant and Breastfeeding Women The use of sage during pregnancy is strongly discouraged. Thujone in common sage can induce uterine contractions and may lead to miscarriage. During breastfeeding, sage is thought to decrease breast milk supply, making it unsafe for nursing mothers. Clary sage, a different variety, is also contraindicated in early pregnancy due to its potential to stimulate the uterus.
2. Individuals with Seizure Disorders Because of its thujone content, common sage can trigger seizures in susceptible individuals. People with epilepsy or other seizure disorders should avoid sage, especially in concentrated or medicinal forms, as it could interfere with their condition and medications.
3. People with Hormone-Sensitive Conditions
Spanish sage (Salvia lavandulaefolia) may mimic the effects of estrogen in the body. Those with hormone-sensitive conditions like breast cancer, uterine cancer, ovarian cancer, or endometriosis should avoid consuming Spanish sage in quantities larger than those used in cooking.
4. Patients on Specific Medications Sage can interact with various medications, altering their effectiveness. These interactions are a major reason why individuals on long-term prescriptions should consult a doctor before consuming sage medicinally.
- Antidiabetic drugs: Sage has blood sugar-lowering properties, which can cause hypoglycemia (abnormally low blood sugar) when combined with diabetes medications.
- Anticonvulsants: Sage can increase the risk of seizures and may decrease the effectiveness of medications meant to prevent them.
- Sedatives (CNS depressants): Combining sage with sedatives can cause excessive drowsiness and slowed breathing.
- Blood pressure medications: While common sage might lower blood pressure, some species like Spanish sage might increase it. This can cause dangerous fluctuations for those on antihypertensive drugs.
Potential Side Effects of Overconsumption
Even for those without pre-existing conditions, excessive or prolonged consumption of sage can cause several adverse effects. The risk depends on the amount and frequency of intake.
- Gastrointestinal Issues: High doses can lead to stomach upset, nausea, or vomiting.
- Cardiovascular Issues: Excessive intake may cause an increased heart rate or blood pressure irregularities.
- Nervous System Effects: Beyond seizures, high doses of thujone can also cause dizziness and a lack of coordination.
Culinary vs. Medicinal Sage Intake
For most people, using sage for culinary purposes is perfectly safe. The amount used to season food is small and not concentrated enough to pose a risk. The danger arises when sage is used in medicinal doses, such as high-concentration extracts, oils, or large quantities of tea over an extended period. The level of thujone can vary based on the sage species, harvest time, and growing conditions.
| Aspect | Culinary Use | Medicinal Use (Cautionary) |
|---|---|---|
| Quantity | Small, as a spice in food | Large quantities, supplements, extracts, essential oils |
| Frequency | Occasional | Frequent, prolonged periods |
| Thujone Risk | Very low | High, potential for toxicity |
| Preparation | Fresh or dried leaves in cooking | Concentrated extracts, essential oils (not for ingestion), potent teas |
| Safety | Generally safe for most healthy people | High risk for sensitive populations and drug interactions |
Conclusion
While sage offers numerous potential health benefits, its consumption in medicinal or high-dose forms is not suitable for everyone. Individuals who are pregnant or breastfeeding, have seizure disorders, or are on specific medications should avoid sage unless under a doctor's supervision. For the general population, moderate culinary use is typically safe. Always consult a healthcare provider before using sage supplements or extracts to ensure it is safe for your specific health needs. Understanding who should not eat sage is crucial for preventing serious and unnecessary health complications. For more information, the National Center for Complementary and Integrative Health offers resources on herbal safety.
