Integrative
medicine (IM) is healing-oriented
medicine that takes account of the whole person, including all aspects
of lifestyle. It emphasizes the therapeutic relationship between practitioner
and patient, is informed by evidence, and makes use of all appropriate
therapies.[1] [2]
This
is why integrative medicine excels where mainstream medical practice fails
because an integrative approach to health care best supports the body’s natural
ability to combat a variety of illnesses and injuries that cause disease. In
fact there are tens of thousands of studies supporting numerous natural
remedies as valuable adjuncts for many health conditions and diseases the
evidence for which can be accessed in the U.S. National Library of Medicine’s
database PubMed.[3]
An
integrative approach to healthcare combines the best of both allopathic (modern/Western)
and complementary medicine and applies the safest, least invasive, and most
effective remedies first and when utilized prudently can improve the lives of
men and women from all walks of life.[3]
Evidence-based
utilization of essential oils has existed since the sixteenth century when the
Germans greatly advanced the knowledge of essential oil distillation. The
German model of essential oil therapy focused on inhalation better known as
aromatherapy which current studies suggest has a profound effect on
psychophysiology. [4] [5]
In the
early 20th century, French chemists and physicians began
experimenting with and investigating the topical and oral administration of
essential oils. The French model developed a deep understanding of the
pharmacology, toxicology, and physiology regarding therapeutic administration
of non-diluted (a.k.a. neat) essential oils.[4]
In the
1950s Marguerite Maury, an Austrian born biochemist and nurse, introduced the
therapeutic application of essential oils in England via aromatherapy massage. Her
life’s work was based solely on the principles that we can remain youthful in
our attitude, energies and beliefs if we only take the time to look at how we
take care of ourselves.[6] She
advocated the heavy dilution of essential oils prior to topical application but
because she was not a medical doctor she discouraged oral administration. Her
methodology, which became the British model of essential oil therapy, was vital
to a greater comprehension of the safety, possible drug interactions, and
health contraindications of essential oils.[4]
The 21st
century approach to essential oil therapy, the one I am advocating here, is an
evidence-based model which has taken the best aspects of these aforementioned
models and has established modern protocols based on the consensus of user
testimonials and, most importantly, scientific evidence to determine safe
therapeutic applications for numerous health issues.
The
evidence-based model of essential oil therapy first takes into account current
medical literature and clinical case reports because contraindications do exist,
primarily with regard to drug interaction. Many essential oils could interact
with certain medications and therefore it is important for the layperson to
seek the advice of their health-care practitioner before integrating any of the
recommended protocols because some medical conditions require a more cautious
use of essential oils.
This
model incorporates three methods of administration of essential oils:
inhalation, topical, and oral.
Inhalation
is the safest way to administer essential oils and provides several benefits
which include soothing
throat infections [7],
overcoming
mental fatigue and exhaustion, encouraging the expulsion of
mucous, relieving
stress, anxiety, and nervous tension,
and purifying the air (removing toxins, killing airborne
germs, altering mood, encouraging restful sleep).[8] In
fact the medical field has utilized inhalation therapy of essential oils to
treat acute and chronic bronchitis, acute sinusitis, and the reduction of
asthmatic symptoms.[9] A
study published in the March 2016 edition of Complementary Therapies in Medicine examined the use and
effectiveness of essential oil therapeutic interventions on pain, nausea, and
anxiety, when provided by nurses to patients in acute hospital settings across
a large health system between February 1, 2012 and June 30, 2014.[10] During
the course of the study a total of 10,372 essential oil therapy sessions were
administered, 77.6% were inhaled, 19.0% were topical, and 3.3% were a
combination of both. The most frequently used essential oil was lavender [Lavandula angustifolia] (49.5%) followed
by ginger [Zingiber officinale] (21.2%),
sweet marjoram [Origanum majorana]
(12.3%), mandarin [Citrus reiculata]
(9.4%), and a combination of oils (7.6%).
Nurses collected patients’ self-reported pain, nausea, and anxiety scores directly prior to and within 60 minutes of the aromatherapy session. The results of this study found that sweet marjoram resulted in the largest single oil average pain change while an unspecified combination of the four oils also showed a clinically relevant change in overall subjective pain change [NOTE: Tabular data from this study indicates that ginger, lavender, and sweet marjoram are indicated[11] for this particular outcome.] Lavender [12] and sweet marjoram followed by mandarin resulted in the most clinically relevant applications for anxiety while ginger and mandarin exhibited the most clinically relevant applications for nausea. While this study was not a randomized control trial it does suggest that patients who receive essential oil therapy in conjunction to standard medical care report, on average, statistically significant decreases in pain, anxiety, and nausea. [7] [13] There was also evidence that indicates these four essential oils may help with symptom relief beyond their indication(s) for use.[7]
Topical
application of essential oils is administered in a range of dilution from neat
to highly diluted so that each person is able to customize his or her usage
according to their current state of health, body physiology, skin sensitivity,
and level of comfort. Dilution with carrier oil (i.e. coconut oil, olive oil, sesame seed oil, sweet almond oil) is ideal to avoid
sensitization and irritation especially for “hot” oils like oregano, thyme, and
cinnamon, however, maximum strength is recommended for serious injuries, burns,
infections, wounds, or severe illnesses but should only be utilized in this way
for short periods by those who are sensitive.[14] Additionally,
carrier oils prolong the therapeutic verve of essential oils especially when
administering to influence mood and emotions because the aroma is available for
a longer period of time. Once applied to the skin, essential oil compounds
rapidly penetrate the tissues and enter the bloodstream quickly.[12] Once
in the bloodstream, essential oils are attracted to (due to its lipophilic [15]
characteristics) and able to penetrate the phospholipid membrane [16] (a
thin oil-like barrier) of the cell to deliver nutrients to the cell nucleus[17] [18]
[19]
[20]
[21]
hence
why drug companies produce treatments (i.e. cancer drugs) that are encased by
liposomes [22] [23] and
why essential oils can affect cell function, behavior, and overall well-being. The
terpenes [24] found
in essential oils have a significant role in controlling the central nervous
system as well as anti-inflammatory effects on the cells of the human body.[8] Essential oils and their individual aroma components have also shown cancer
suppressive inactivity [25] [26]
when
tested on a number of human
cancer cell lines including glioma [27] [28],
tumors,
breast cancer [29], leukemia
and others.[30] [31]
Oral
administration of essential oils allows for greater precision in dosing,
increased convenience, as well as good degree and rate of uptake by the body in
their physiologically active form. However, administered in this way increases
the risk of drug interactions and stomach irritation hence why
contraindications and safety precautions MUST
be checked before administering essential oils orally.[32] Oral
administration can be done four ways: in a vegetable capsule, in a
beverage (water, almond milk, herbal tea), in honey, or directly on or under
the tongue. In fact, sublingual (under the tongue) administration bypasses the
digestive tract of the body due to the high concentration of capillaries under
the tongue allowing essential oils to be absorbed directly into the
bloodstream.[31] Adverse
reactions to essential oils are considerably lower and less severe than those
of prescribed medication and, based on current data, when utilized in
reasonable doses for a practical period of time oral administration of
essential oils can be a significant integrative adjunct to standard medical
treatment.[31]
Method(s)
of essential oil application is dependent on the condition, its severity, and
the familiarity of the individual with a certain oil(s) and/or protocol. The
effectiveness of essential oil therapy can be exponentially increased by
utilizing more than one application method at a time but should always be
diluted according to age, current state of health, and body size. Therefore, be
prepared, have a supply of pure, authentic oils [not the fragrance-grade kind
often sold for use as perfumes or as scents] before finding yourself in a
situation where you need them especially if you know you have a specific health
condition. Oil purity is paramount, many
oils sold today (up to 98%) are used for perfumes and are manipulated for
consistency of scent rather than use in aromatherapy applications.[33] Common
adulterations of essential oils include synthetic menthol added to peppermint
oil, synthetic phenyl ethyl alcohol added to rose otto, adding lavandin to
lavender, diluting citronella with lemongrass, or using cinnamon leaf instead
of bark.33 Synthetic/adulterated
essential oils can cause significant harm and while they may elicit results in
the short term over time can produce allergies, headaches, chemical
sensitivities, and result in body toxicity.[33] Ensure
using pure oil by purchasing from a manufacturer that has expertise in the
distillation process, takes a
clinical approach to essential oil development, personally involved in the
farming and cultivation process, verifies
purity with their own laboratories as well as third-party testing facilities and educated scientists. In closing keep one fact in mind, there is
no autonomous level of quality or excellence that is accepted as the norm or by
which actual attainments are judged for “Therapeutic Grade” and while many
companies promote their own
therapeutic grade standard, one should be aware that there is no
universally accepted independent body that certifies essential oils as
therapeutic grade. A fair and factually correct statement that nobody (i.e. marketing
companies and traditional aromatherapists) can disagree with.[34]
[1]
Arizona Center for Integrative Medicine. "What Is Integrative
Medicine?"Arizona Center for Integrative Medicine. The University
of Arizona, n.d. Web. 13 Apr. 2016. http://integrativemedicine.arizona.edu/about/definition.html>.
[2]
Dossey B, Keegan L. Holistic Nursing: A Handbook for Practice.
6th ed. United States: Jones & Bartlett Learning: 2013
[3] Johnson,
Scott A. Surviving
When Modern Medicine Fails: A Definitive Guide to Essential Oils That Could
save Your Life during a Crisis. 3rd ed. North Charleston, SC:
CreateSpace, 2014. 8-9. Print.
[4] Johnson,
Scott A. Surviving When Modern Medicine Fails: A Definitive Guide to
Essential Oils That Could save Your Life during a Crisis. 3rd ed. North
Charleston, SC: CreateSpace, 2014. 14-16. Print.
[5] physiological psychology: a branch of
psychology that studies the interactions between physical or chemical processes
in the body and mental states or behavior
[6] Austin,
Ken. "Marguerite Maury." Oils and Plants~ The Aromatherapy
and Herbal Health Website. Http://www.magiwebs.com/, n.d. Web. 13 Apr.
2016. <http://www.oilsandplants.com/maury.htm>. Madame
Marguerite Maury (1895-1968) was an Austrian born biochemist who became
interested in what was to become aromatherapy.
[8] Johnson,
Scott A. Surviving When Modern Medicine Fails: A Definitive Guide to
Essential Oils That Could save Your Life during a Crisis. 3rd ed. North
Charleston, SC: CreateSpace, 2014. 90. Print.
[9] Rajendran,
Mini Priya, Blessed Beautlin Pallaiyan, and Nija Selvaraj. "Chemical
Composition, Antibacterial and Antioxidant Profile of Essential Oil from Murraya
Koenigii (L.) Leaves." Avicenna Journal of Phytomedicine.
Mashhad University of Medical Sciences, n.d. Web. 16 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104627/>.
[10] Johnson,
Jill R., Rachael L. Rivard, Kristen H. Griffin, Alison K. Kolste, Denise
Joswiak, Mary Ellen Kinney, and Jeffery A. Dusek. "The
Effectiveness of Nurse-delivered Aromatherapy in an Acute Care Setting." Complementary
Therapies in Medicine 25 (2016): 164-69. Web.
[11] Ou,
Ming-Chiu, Tsung-Fu Hsu, Andrew C. Lai, Yu-Ting Lin, and Chia-Ching Lin. "Pain Relief Assessment by
Aromatic Essential Oil Massage on Outpatients with Primary Dysmenorrhea: A
Randomized, Double-blind Clinical Trial." Journal of
Obstetrics and Gynaecology Research 38.5 (2012): 817-22. Web.
[12] Najafi,
Zahra, Mohsen Taghadosi, Khadijeh Sharifi, Alireza Farrokhian, and Zahra
Tagharrobi. "The
Effects of Inhalation Aromatherapy on Anxiety in Patients With Myocardial
Infarction: Randomized Clinical Trial."Iranian Red Crescent Medical
Journal Iran Red Crescent Med J 16.8 (2014): n. pag. Web.
[13]
The single arm observational design is appropriate for exploring the
aromatherapy program in a real-world hospital setting which is indicated by the
following: Black N. Why
we need observational studies to evaluate the effectiveness of health care.
BMJ. 1996;312(7040):1215-1218 -
Atkins D. Creating and
synthesizing evidence with decision makers in mind: integrating evidence from
clinical trials and other study designs. Med Care. 2007;45(10 Supl. 2):S16-22
[14] Johnson,
Scott A. Evidence-
Based Essential Oil Therapy: The Ultimate Guide to the Therapeutic and Clinical
Application of Essential Oils. Middletown, De.: CreateSpace Independent,
2015. 30-31. Print.
[15] lipophilic: having a chemical affinity
for lipids
[16] lipid: a biological compound that is
not soluble in water, e.g. a fat. The group also includes waxes, oils, sterols,
triglycerides, phosphatides, and phospholipids.
[17]
Cox, SD, Mann CM, Markham JL, et al. The mode of antimicrobial
action of the essential oil of Melaleuca alternifolia (tea tree oil). J Appl Microbiol. 2000 Jan;88(1): 170-5.
[18]
Bakkali F, Averbeck S, Averbeck D, et al. Biological
effects of essential oils - A review. Food
Chem Toxicol. 2008 Feb;46: 466-475.
[19]
Cristani M, D’Arrigo M, Mandalari G, et al. Interaction of four
monoterpenes contained in essential oils with model membranes: Implications for
their antibacterial activity. J Agric
Food Chem. 2007 Jul 25;55(15):6300-8
[20]
Buchbauer G, Jirovetz L, Jager W, et al. Fragrance compounds and
essential oils with sedative effects upon inhalation. J Pharm Sci. 1993 Jun;82(6):660-4
[21]
Burt S. Essential oils:
their antibacterial properties and potential applications in foods-a review. Int J food Microbial. 2004 Aug
1;94(3):223-53
[22] "What
Is a Liposome?" News-Medical.net. Https://plus.google.com/+News-medicalNet/posts,
17 Feb. 2010. Web. 16 Apr. 2016. <http://www.news-medical.net/life-sciences/What-is-a-Liposome.aspx>
[23] Detoni,
Cassia B., Diêgo Madureira De Oliveirac, Islane E. Santo, André São Pedro,
Ramon El-Bachac, Eudes Da Silva Velozoa, Domingos Ferreirad, Bruno Sarmentod,
and Elaine C. De Magalhães Cabral-Albuquerque. "Evaluation of
Thermal-oxidative Stability and Antiglioma Activity of Zanthoxylum Tingoassuiba
Essential Oil Entrapped into Multi- and Unilamellar Liposomes." National
Center for Biotechnology Information. U.S. National Library of Medicine, 6
May 2011. Web. 20 Apr. 2016. < http://www.ncbi.nlm.nih.gov/pubmed/21548711/
>.
[24] terpene: an aromatic hydrocarbon
obtained from plant oils
[25] inactivity: describes a disease that,
though present in the body, is not developing or producing any symptoms
[26] Bayala,
Bagora, Imaël HN Bassole, Riccardo Scifo, Charlemagne Gnoula, Laurent Morel,
Jean-Marc A. Lobaccaro, and Jacques Simpore. "Anticancer Activity of
Essential Oils and Their Chemical Components - a Review." American
Journal of Cancer Research. E-Century Publishing Corporation, 19 Nov. 2014.
Web. 20 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266698/>.
[27] Quassinti,
Luana, Giulio Lupidi, Filippo Maggi, Gianni Sagratini, Fabrizio Papa, Sauro
Vittori, Armandodoriano Bianco, and Massimo Bramucci. "Antioxidant and
Antiproliferative Activity of Hypericum Hircinum L. Subsp. Majus (Aiton) N.
Robson Essential Oil." National Center for Biotechnology
Information. U.S. National Library of Medicine, 5 Apr. 2012. Web. 20 Apr.
2016. <http://www.ncbi.nlm.nih.gov/pubmed/22480321/>.
[28] Hsu,
Shu-Shong, Ko-Long Lin, Chiang-Ting Chou, An-Jen Chiang, Wei-Zhe Liang,
Hong-Tai Chang, Jeng-Yu Tsai, Wei-Chuan Liao, Fong-Dee Huang, Jong Khing Huang,
I-Shu Chen, Shuih-Inn Liu, Chun-Chi Kuo, and Chung-Ren Jan. "Effect of
Thymol on Ca2+ Homeostasis and Viability in Human Glioblastoma
Cells." National Center for Biotechnology Information. U.S.
National Library of Medicine, 2 Sept. 2011. Web. 20 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pubmed/21914442/>.
[29] Suhail,
Mahmoud M., Weijuan Wu, Fadee G. Mondalek, Kar-Ming Fung, Pin-Tsen Shih,
Yu-Ting Fang, Cole Woolley, Gary Young, and Hsueh-Kung Lin. "Boswellia
Sacra Essential Oil Induces Tumor Cell-specific Apoptosis and Suppresses Tumor
Aggressiveness in Cultured Human Breast Cancer Cells." BMC
Complementary and Alternative Medicine. BioMed Central Ltd, 15 Dec. 2011.
Web. 20 Apr. 2016. <http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-11-129>.
[30] Iyer
D, Uma DP. Phyto-pharmacology of Murraya koenigii. Pharmacognosy Reviews.
2008;2:180–184.
[31] Ni,
Xiao, Mahmoud M. Suhail, Qing Yang, Amy Cao, Kar-Ming Fung, Russell G. Postier,
Cole Woolley, Gary Young, Jingzhe Zhang, and Hsueh-Kung Lin. "Frankincense
Essential Oil Prepared from Hydrodistillation ofBoswellia Sacra Gum
Resins Induces Human Pancreatic Cancer Cell Death in Cultures and in a
Xenograft Murine Model." BMC Complementary and Alternative
Medicine. BioMed Central, 13 Dec. 2012. Web. 20 Apr. 2016. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538159/>.
[32] Johnson,
Scott A. Evidence-
Based Essential Oil Therapy: The Ultimate Guide to the Therapeutic and Clinical
Application of Essential Oils. Middletown, De.: CreateSpace
Independent, 2015. 44-47. Print.
[33] Johnson,
Scott A. Evidence-
Based Essential Oil Therapy: The Ultimate Guide to the Therapeutic and Clinical
Application of Essential Oils. Middletown, De.: CreateSpace
Independent, 2015. 16-18. Print.
[34] Pappas,
Robert. "Essential Oil Myths." Essential Oil University (EOU).
Essential Oil University, LLC, n.d. Web. 21 Apr. 2016. <https://essentialoils.org/news/eo_myths>.
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