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Other common
name(s): peppermint oil, mint, balm mint, brandy mint,
green mint
Scientific/medical
name(s): Mentha
piperitae
Description
Peppermint is a plant native to Europe and is now cultivated
widely in the United States and Canada. The oil from the leaves and
flowering tops of the plant is used in herbal remedies. Its main active
ingredients are menthol and menthone.
Overview
Available scientific evidence does not support claims that
peppermint oil is effective in treating side effects related to
chemotherapy and radiation. However, there is some evidence that it may
be effective in controlling nausea after surgery. Preliminary studies
suggest that direct contact with peppermint oil may be helpful in
reducing spasms in the esophagus and intestines during endoscopies and
other procedures. There is mixed evidence that enteric-coated
peppermint oil (supplements that are coated so that they are not
absorbed by the body until they reach the small intestine) might be
helpful in treating symptoms of irritable bowel syndrome, such as
cramps. It is known to worsen acid reflux in some people. Strong vapors
of menthol or peppermint can cause breathing problems for some people,
especially infants.
How is it promoted for use?
Proponents claim peppermint oil improves digestion and
relieves intestinal ailments such as gas, indigestion, cramps,
diarrhea, and symptoms of irritable bowel syndrome and food poisoning.
Some say it has a soothing effect and reduces anxiety.
Sprays and inhalants containing peppermint oil are promoted to
relieve sore throats, toothaches, colds, coughs, laryngitis,
bronchitis, nasal congestion, and inflammation of the mouth and throat.
Another reported use of peppermint oil is to apply it to the forehead
and temples to relieve tension headaches. Some claim that salves made
from menthol (one of the major active ingredients in peppermint) ease
muscle pain and soreness associated with injuries, arthritis,
rheumatism, and neuralgia. Menthol vapors are also believed to relieve
respiratory and sinus congestion.
Aromatherapists claim the scent of peppermint improves
concentration, stimulates the mind and body, decreases inflammation,
improves digestion, and relieves stomach pain (see Aromatherapy).
What does it involve?
Peppermint oil is the most frequently used form of the
peppermint plant. The pure oil or a liquid extract containing the oil
can be taken directly or swallowed in capsules. It is also made in
enteric-coated capsules, which are designed to melt after they pass
through the stomach. Peppermint is also available as a spray and
inhalant for treating ailments of the throat, mouth, nose, sinuses, and
lungs. The leaves are sometimes brewed as a tea.
Peppermint oil is on the Commission E (Germany's regulatory
agency for herbs) list of approved herbs. Common dosages are 1 to 2
capsules 3 times a day for irritable bowel syndrome; 1 tablespoon of
leaves in a cup of boiling water for tea, 2 or 3 times a day; 3 to 4
drops in hot water for inhalation; 1% to 5% essential oil for nasal
ointments; and 5% to 20% essential oil for other ointments applied to
the skin.
Many well-known commercial products also contain menthol in
salve form, which is rubbed directly on the skin or has its vapors
inhaled. Peppermint is often used to flavor toothpaste, mouthwash,
cosmetics, chewing gum, candy, and pharmaceuticicals.
What is the history behind it?
Peppermint may have been used as a digestive aid thousands of
years ago in ancient Egypt. More recently, peppermint has been used as
a folk remedy for vomiting, morning sickness, respiratory infections,
and menstrual problems. Preparations containing menthol have a long
history as a treatment for muscle soreness and pain, itching, sunburn,
and to clear nasal congestion.
What is the evidence?
There are many anecdotal reports supporting the use of
peppermint as a treatment for various digestive and breathing
complaints. However, there is not enough scientific evidence available
to conclude that peppermint lives up to all the claims made by
proponents, especially its use as a treatment for stomach cancer or any
other type of cancer.
Although available scientific evidence does not support claims
that peppermint oil is effective in treating side effects related to
chemotherapy and radiation therapy, it was found to be useful in
controlling nausea after surgery. A randomized clinical trial in the UK
found that patients who received peppermint oil before surgery had less
nausea after surgery than those who did not.
In 2002, researchers discovered a nerve ending that responded
to cold and to menthol. This may explain the cooling sensation from
menthol, as well as its common use as an inhalant to reduce congestion
in the nose. However, available studies do not yet show whether it
actually "opens" the nose or improves breathing when a person has a
cold.
There is debate about whether peppermint oil is effective in
treating irritable bowel syndrome. Several randomized controlled trials
suggest that enteric-coated peppermint may be helpful, but the studies
have been small and have not followed the patients very long.
Well-designed larger studies are needed to determine whether this holds
true.
Some early evidence suggests that instilling peppermint oil
into the colon during a barium enema (an x-ray test of the bowel) may
reduce intestinal spasms and decrease the need for intravenous
antispasm medications. A recent study suggests that taking peppermint
oil by mouth can reduce intestinal spasms during barium enema
examination. A Japanese study looked at introducing peppermint oil
directly into the esophagus to reduce spasms in the muscle ring above
the stomach during endoscopy. The researchers reported it worked more
quickly than an injection of a standard antispasmodic medicine.
However, more well-controlled studies are needed to make definite
conclusions. These results need to be checked in larger clinical trials
before being routinely recommended.
Studies that looked at applying peppermint oil to the forehead
and temples to help tension headache suggested it might be useful in
some people, but further studies are needed to determine whether this
is truly helpful for tension headache
Aromatherapy using peppermint oil for nausea after surgery
showed it to be no more effective than isopropyl alcohol or a salt
water placebo. A gauze pad containing the liquid was placed under the
patient's nose, and the patient was asked to breathe deeply through the
nose and exhale through the mouth. Nausea scores were the same across
the groups, and only 52% of patients required conventional medicines to
control their nausea. Four out of five patients were satisfied with how
their nausea was managed. In this case, the change in patients'
breathing may have helped more than the aroma being tested.
Are there any possible problems or
complications?
This product is sold as a
dietary supplement in the United States. Unlike companies that produce
drugs (which must provide the FDA with results of detailed testing
showing their product is safe and effective before the drug is approved
for sale), the companies that make supplements do not have to show
evidence of safety or health benefits to the FDA before selling their
products. Supplement products without any reliable scientific evidence
of health benefits may still be sold as long as the companies selling
them do not claim the supplements can prevent, treat, or cure any
specific disease. Some such products may not contain the amount of the
herb or substance that is written on the label, and some may include
other substances (contaminants). Though the FDA has written new rules
to improve the quality of manufacturing processes for dietary
supplements and the accurate listing of supplement ingredients, these
rules do not take full effect until 2010. And, the new rules do not
address the safety of supplement ingredients or their effects on health
when proper manufacturing techniques are used.
Most such
supplements have not been tested to find out if they interact with
medicines, foods, or other herbs and supplements. Even though some
reports of interactions and harmful effects may be published, full
studies of interactions and effects are not often available. Because of
these limitations, any information on ill effects and interactions
below should be considered incomplete.
Peppermint is considered safe when taken by nonallergic people
in normal doses. It can cause irritation when applied to the skin.
Because peppermint may increase symptoms of acid reflux disease and
hiatal hernia, people with these conditions are advised to avoid the
herb. People with gall stones or liver damage should also use caution
when using peppermint. Peppermint oil and menthol products should not
be applied to the nose or face of an infant or small child since they
could cause trouble breathing.
Rare cases of allergic rashes, hives, asthma, and other
reactions have been reported in people who are sensitive to peppermint
or its components.
Acid-reducing medicines may allow enteric-coated peppermint to
be released before it leaves the stomach, which may reduce its effect
on an irritable bowel. Peppermint oil may interact with other medicines
as well, so it is helpful to talk with your doctor or pharmacist about
all medicines and supplements that you are taking.
Menthone (which makes up around 20% of peppermint oil) was
given to rats for 4 weeks by mouth. It affected kidney and liver
function, and very high doses caused cyst-like spaces in the brainstem.
In other animal studies, large doses have caused weakness, seizures,
and brain damage.
Menthol is considered to be the most toxic component of
peppermint oil. As little as 2 grams are thought to be fatal in some,
although people have survived higher doses.
In work settings, those who handle menthol are cautioned that
it can irritate the eyes. Eyes should be thoroughly flushed if contact
occurs. For skin contact, wash with soap and water. Stomach upset with
pain, vomiting, vertigo, drowsiness, and coma may result from
ingestion, and death may occur due to lung failure.
Peppermint oil should not be taken by injection; a recent
report describes the case of a young woman who had serious lung damage
after intravenous injection of peppermint oil. She survived but
required intensive care and the support of a breathing machine for 13
days. Taking any type of oil by injection can cause serious effects,
including death.
Peppermint oils, when taken by mouth, can affect the way that
other drugs are absorbed by the body and may interfere with antacids,
medicines for high blood pressure, and others. Mint salves and creams
can cause the ingredients in other creams and ointments to be absorbed
more quickly. Other potential interactions between peppermint and other
drugs and herbs should be considered. Some of these combinations may be
dangerous. Always tell your doctor and pharmacist about any herbs you
are taking. Relying on this type of treatment alone and avoiding or
delaying conventional medical care for cancer may have serious health
consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Anderson LA, Gross JB. Aromatherapy with peppermint, isopropyl
alcohol, or placebo is equally effective in relieving postoperative
nausea. J Perianesth
Nurs. 2004;19:29-35.
Behrends M, Beiderlinden M, Peters J. Acute lung injury after
peppermint oil injection. Anesth
Analg. 2005;101:1160-1162.
Blumenthal M, ed. The
Complete German Commission E Monographs: Therapeutic Guide to Herbal
Medicines. Austin, TX: American Botanical Council; 1998.
dos Santos MA, Santos Galvão CE, Morato Castro F.
Menthol-induced asthma: a case report. J Investig Allergol Clin Immunol.
2001;11:56-58.
Fetrow CW, Avila JR. Professional's
Handbook of Complementary & Alternative Medicines.
Philadelphia, PA: Lippincott Williams & Wilkins; 2004.
Gruenwald J. PDR
for Herbal Medicines. 3rd ed. Montvale, NJ: Thomson PDR;
2004.
Hiki N, Kurosaka H, Tatsutomi Y, Shimoyama S, Tsuji E, Kojima
J, Shimizu N, Ono H, Hirooka T, Noguchi C, Mafune K, Kaminishi M.
Peppermint oil reduces gastric spasm during upper endoscopy: a
randomized, double-blind, double-dummy controlled trial. Gastrointest Endosc.
2003;57:475-482.
Kingham JG. Peppermint oil and colon spasm. Lancet.
1995;346:986.
Madisch A, Heydenreich CJ, Wieland V, Hufnagel R, Hotz J.
Treatment of functional dyspepsia with a fixed peppermint oil and
caraway oil combination preparation as compared to cisapride. A
multicenter, reference-controlled double-blind equivalence study. Arzneimittelforschung.
1999;49:925-932.
Madsen C, Würtzen G, Carstensen J. Short-term
toxicity study in rats dosed with menthone. Toxicol Lett.
1986;32:147-152.
Manufacturer's product information: levo-Menthol. J.T. Baker
Web site. http://www.jtbaker.com/msds/englishhtml/m1131.htm. Accessed
January 24, 2006.
McKemy DD, Neuhausser WM, Julius D. Identification of a cold
receptor reveals a general role for TRP channels in thermosensation. Nature.
2002;416:52-58.
Mizuno S, Kato K, Ono Y, Yano K, Kurosaka H, Takahashi A,
Abeta H, Kushiro T, Miyamoto S, Kurihara R, Hiki N, Kaminishi M,
Iwasaki A, Arakawa Y. Oral peppermint oil is a useful antispasmodic for
double-contrast barium meal examination. J Gastroenterol Hepatol.
2006;21:1297-1301.
Nair B. Final report on the safety assessment of Mentha
Piperita (Peppermint) Oil, Mentha Piperita (Peppermint) Leaf Extract,
Mentha Piperita (Peppermint) Leaf, and Mentha Piperita (Peppermint)
Leaf Water. Int J
Toxicol. 2001;20 Suppl 3:61-73.
Peppermint (mentha x piperita l.). Medline Plus Web site.
http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-peppermint.html.
Updated January 1, 2008. Accessed June 6, 2008.
Pittler MH, Ernst E. Peppermint oil for irritable bowel
syndrome: a critical review and metaanalysis. Am J Gastroenterol.
1998;93:1131-1135.
Tate S. Peppermint oil: a treatment for postoperative nausea. J Adv Nurs.
1997;26:543-549.
Note: This information may not cover
all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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