Peppermint Oil

Here
at ScienceBlogs, and medical blogs in general, are generally
somewhat dismissive of complimentary and alternative medicine.
 Every once in a while, though, something comes up that is
positive.  



This is from American Family Physician, and is openly available.



href="http://www.aafp.org/afp/20070401/1027.html">Peppermint
Oil


BENJAMIN KLIGLER, M.D., M.P.H., Albert Einstein College
of
Medicine of Yeshiva University, Bronx, New York

SAPNA CHAUDHARY, D.O., Beth Israel Continuum Center for Health and
Healing, New York, New York



Peppermint leaf and peppermint oil have a long history of use for
digestive disorders. Recent evidence suggests that enteric-coated
peppermint oil may be effective in relieving some of the symptoms of
irritable bowel syndrome. A combination product including peppermint
oil and caraway oil seems to be moderately effective in the treatment
of non-ulcer dyspepsia. Topical application of peppermint oil may be
effective in the treatment of tension headache. Because of its relaxing
effects on smooth muscle, peppermint oil given via enema has been
modestly effective for relief of colonic spasm in patients undergoing
barium enemas. Peppermint oil is well tolerated at the commonly
recommended dosage, but it may cause significant adverse effects at
higher dosages.
(Am Fam Physician 2007;75:1027-30.
Copyright ©
2007 American Academy of Family Physicians.)



Notice
the caution that one must observe dosing guidelines, just as one would
do with a pharmaceutical product.  There is a risk of adverse
effects, just as there is with a pharmaceutical product.
 There is a risk of drug interactions, too, as it inhibits the
cytochrome P450 enzyme 1A2.



It is highly doubtful that the drug interactions would be significant
with topical application, but one would need to do careful studies to
demonstrate that.  



What is the evidence?



class="sort" align="center" border="1"
cellpadding="2" cellspacing="0" width="500">
valign="middle">

SORT:
KEY RECOMMENDATIONS FOR PRACTICE

Clinical
recommendation

Evidence rating

References

Peppermint oil seems to be a
safe alternative for reducing symptoms of irritable bowel syndrome,
although the evidence supporting this use is unclear.

B

4, 9

Peppermint oil given via enema
can be used for reducing colonic spasm in patients undergoing barium
enema.

B

10, 11

In combination with caraway
oil, peppermint oil can be used for reducing symptoms of non-ulcer
dyspepsia.

B

12, 13

Peppermint oil can be applied
topically to relieve headache.

B

15, 16


A = consistent,
good-quality patient-oriented evidence; B = inconsistent or
limited-quality patient-oriented evidence; C = consensus,
disease-oriented evidence, usual practice, expert opinion, or case
series. For information about the SORT evidence
rating system, see page 957 or href="http://www.aafp.org/afpsort.xml">http://www.aafp.org/afpsort.xml.



Not
the greatest, but not bad for a CAM product.  Your milage
may vary.  If you are curious about their implementation of
evidence-based medicine, check the link about the SORT
system.



Tags
Categories

More like this

In discussing "alternative" medicine it's impossible not to discuss, at least briefly, placebo effects. Indeed, one of the most common complaints I (and others) voice about clinical trials of alternative medicine is lack of adequate placebo controls. Just type "acupuncture" in the search box in the…
I write quite a bit about placebo effects. Of course, part of the reason is that placebo effects are just plain interesting from a scientific perspective. After all, if one can relieve symptoms with inert sugar pills or other ineffective interventions because of the power of expectation, that’s…
I thought I might start developing chest pain when I read it, but to my shock NCCAM has actually funded some worthwhile research! Even more amazingly, NCCAM described it in a press release! Too bad it supports the contention that acupuncture is nothing more than placebo and that the attention given…
With the latest Big Pharma debacle ("Hey, let's shoot ourselves in the other foot") from the Prozacasaurus' overmarketing of Zyprexa (see Grrl's, Jake's, and David's (addendum, 12/21) blog entries on the subject), this recent (and free access) article from PLoS Medicine: Educating Health…

took enteric coated peppermint capsules once, specifically designed for IBS sufferers. just once. I ended up extremely nauseous and threw up. definitely not a good treatment for me.

One of the issues with even the "safe" compounds is that people take these things and don't consider them drugs. They omit them them when you ask about medications -- it's hard enough just to get people to give an accurate list of vitamins. They do not make the connection even if they dutifully read the package insert of a medicine that may talk about enzyme inhibition or induction.
To a large extent this is fostered by the manufacturers, who want these to remain unregulated by the FDA.