Common Trade Names

Biodynamic Lemon Balm Liquid Herbal Extract.

Common Forms

Lemon balm (Melissa officinalis L.) is usually taken as a tea made from either dried or fresh leaves. Liquid extracts are available. Preparation of a poultice has also been reported in the lay literature and a formulated cream has been used in some clinical trials.

Source

M. officinalis is a member of the mint family. Active chemical constituents can be found in the leaves and stems. The leaves are opposite, ovate, bluntly serrate, and acuminate. The flowers are bilabiate and range in color from white to light blue.

Chemical components

Numerous compounds have been isolated from lemon balm, including caffeic acid, citral, citronellal, eugenol, geraniol, choline, and an unidentified glycoside.

Actions

The efficacy of eugenol in dental analgesia is well established, and it is probably this component that accounts for the usefulness of lemon balm in toothache. Aqueous methanoJic extracts have demonstrated a concentration-dependent inhibition of lipid peroxidation. Early scientific data reported possible antibacterial and antiviral properties of lemon balm. These reports have been supported by data that indicates potent activity against HIV-1 by aqueous extracts . In vitro studies have also demonstrated antiprotozoal activity against Trypanosoma brucei specificially . Additional research has indicated that certain constituents of the plant (caffeic acid and an unidentified glycoside) inhibit protein synthesis by direct interference with elongation factor 2. Numerous studies by various laboratories have supported these data. This may account for the antiviral activity of the herb. Ethanolic extracts have demonstrated an affinity for cholinergic receptors in human cerebral cortical tissue. This affinity was predominantly for nicotinic receptors with less but significant affinity for muscarinic receptors . Clinical trials of lemon balm cream for local treatment of herpes labialis demonstrated significant improvement in time to heal, spread of lesions, and attenuation of symptoms relative to placebo control . No animal or human studies exist to establish the toxicity of lemon balm.

Reported Uses

Nonmedical uses of lemon balm include its use in potpourri, herb pillows, and cosmetics and as a garnish or herb in cooking. The lay literature touts numerous therapeutic benefits for lemon balm, including its use as an antiflatulent, an antipyretic, an antispasmodic, a carminative, an emmenagogue, a sedative, a stomachic, and a sudorific. It has also been used by herbalists as a treatment for asthma, chronic bronchial catarrh, headache and vertigo in pregnancy, hysteria, melancholy, migraine headache, and toothache. Other uses purported for lemon balm as a poultice for local treatment of wounds, tumors, and insect bites; I,) relieve menstrual cramps; and in the treatment of herpes simplex lesions. Proposed cholinergic activity has led to lemon balm’s being suggested as an alternative therapy for various derangements of memory, IIlduding Alzheimer’s disease . No data exist that establish the extent of use of lemon balm by the public.

Dosage

I ,emon balm is most often taken as a tea, prepared from either fresh or dried leaves. The tea is prepared by steeping a bag of leaves (1 tsp) for about 5 minutes in hot water. Sometimes a stronger tea is made by placing 1,1/2 tbsp of the leaves in1 pt of boiling water, covering it, and steeping it for 15 minutes before straining. Dosage for the liquid extract is recommended to be 2 to 4 ml P.O, t.i.d.

Adverse Reactions

Skin: local irritation.

Other: hypersensitivity reactions.

Interactions

None reported.

Contraindications and precautions

No contraindications or precautions have been reported for lemon balm. One study that examined the ability of different antiviral compounds used in the treatment of herpes simplex to evoke a sensitivity reaction reported that an extract of lemon balm induced a weak response (less than the antiviral tromantadine) in guinea pigs. People who have a propensity to develop allergic reactions should use the herb cautiously. A second study examined the mutagenic properties of several medicinal plants, using an Aspergillus nidulans plate incorporation assay as the model. No mutagenic or genotoxic effects were noted for either aqueous or alcoholic extracts of lemon balm. No other studies using more stringent models of mutagenicity, teratogenicity, or genotoxicity exist. Given the ability of caffeic acid and the glycoside to inhibit protein synthesis, the use of lemon balm in pregnancy should be strongly discouraged, despite its purported efficacy in treating gravidal headache and dizziness.

Special considerations

Caution the patient who is prone to allergic reactions to avoid using lemon balm.

Advise pregnant patients to avoid using lemon balm.

Advise the patient to consult a health care provider before using herbal preparations because a treatment that has been clinically researched and proved effective may be available.

Although no known chemical interactions have been reported in clinical studies, consideration must be given to the pharmacologic properties of the herbal product and the potential for exacerbation of the intended therapeutic effect of conventional drugs.

Commentary

Potential benefit may be possible when lemon balm is used as recommended. A few scientific studies do support the possible efficacy of certain constituents as an anti-inflammatory and a memory aid. No clinical studies support these uses nor has the toxicological profile of these actions been determined.

The widespread use of lemon balm in cooking implies that it is probably safe when ingested in small amounts. Most information concerning its medical uses comes from the lay literature and does not constitute a valid recommendation for its use. Extensive scientific research is needed to provide a basis for the use of caffeic acid, the glycoside, or some derivative of these chemicals as an antiviral. Also, controlled scientific and clinical studies are needed to establish safe therapeutic doses and adverse effect and toxicity profiles of lemon balm.