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Peppermint (Mentha x piperita)

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Also listed as: Mentha x piperita, Menthol
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • A-bourbonene, alpha-humulene, alpha-pinene, anisic acid, balm mint, beta-myrcene, beta-pinene, black mitchum, black peppermint, brandy mint, caffeic acid, camphor, carvone, chlorogenic acid, cineol, cobalt, coumarin, curled mint, diastereomeric mintlactone, diosmin, eriocitrin, feullis de menthe (French), folia Menthae piperitae, flavonoids, frantsila, hesperidin, hydroxymintlactone, iron, isomenthone, isomintlactone, isopentyl isovalerate, isorhoifolin, Japanese peppermint, Katzenkraut (German), Kubanskaia-6 peppermint, Kubanskaya-6 peppermint, lamb mint, limonene, linalool, lithospermic acid, luteolin, luteolin 7-O-beta-glucuronide, luteolin-7-rutinoside, menta prima (Italian), Mentha arvensis L. var piperascens, mentha extract, Mentha longifolia, Mentha piperita, Mentha piperita var. officinalis, Mentha piperita var. vulgaris, Mentha x piperita, Menthae longifoliae, Menthae piperitae aetheroleum, Menthae piperitae folium, menthe anglaise (French), menthe poivre (French), menthe poivree (French), menthofuran, menthofurolactone, menthol, menthone, menthyl acetate, methyl rosmarinate, mintlactones, Mitcham peppermint, monoterpenes, narirutin, Native Wilmet, neomenthol, oleum Menthae piperitae, Our Lady's mint, pebermynte (Danish), Pfefferminz (German), Pfefferminze (German), phenols, piperitone, Polyhybrid-7, Porminzen, pulegone, rosmarinic acid, rutin, rutinoside, Schmecker, sterols, terpenes, terpenoids, vitamin A, volatile oil, white peppermint, WS(R) 1340.

Background
  • Peppermint is a flowering plant that grows throughout Europe and North America and is widely cultivated for its fragrant oil. Peppermint oil has been used historically for numerous health conditions, including common cold symptoms, cramps, headache, indigestion, joint pain, and nausea. Peppermint leaf has been used for stomach or intestinal disorders and for gallbladder disease.
  • Peppermint oil is available in bulk herb oil, enteric-coated capsules, soft gelatin capsules, and in liquid form. In small doses, such as in tea or chewing gum, peppermint is generally believed to be safe in healthy, non-pregnant, non-allergic adults. The United States is a principal producer of peppermint, and the largest markets for peppermint oil are manufacturers of chewing gum, toothpaste, mouthwash, and pharmaceuticals.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Based on human studies, the use of peppermint to improve irritable bowel syndrome (IBS) symptoms is currently supported.

A


Peppermint oil may be beneficial in reducing intestinal spasm during and after endoscopic procedures. However, more research is needed before a firm conclusion can be made.

B


Using peppermint gel during breastfeeding may help prevent cracked nipples, reduce pain, and increase duration and number of feeds during breastfeeding. Additional research is needed to confirm early study findings.

B


Application of diluted peppermint oil to the forehead and temples has been tested in people with headache. It is not clear if this is an effective treatment.

B


There is preliminary evidence that a combination of peppermint oil and caraway oil may be beneficial for dyspepsia (heartburn) symptoms. It should be noted that heartburn can actually be a side effect of taking oral peppermint oil. Patients with chronic heartburn should be evaluated by a qualified healthcare provider.

B


In early study, a peppermint oil hot compress on the abdomen has been shown to provide some relief for abdominal distention. At this time, there is currently a lack of sufficient evidence to draw a firm conclusion regarding the use of peppermint for this condition. More research is needed.

C


Peppermint oil has been found to reduce the pain children experience during acute phases of irritable bowel syndrome (IBS) as well as recurrent abdominal pain. Peppermint may also reduce pain locally and coat the lower intestine. Additional studies are needed before a conclusion can be made.

C


Early research suggests that cleaning the mouth with an essential oil mixture of diluted tea tree, peppermint, and lemon may improve bad breath in intensive care unit patients. The use of peppermint oil-flavored mouthwash, candy, and gum to improve breath is supported extensively by anecdotal and traditional use. High-quality study that investigates peppermint alone is needed.

C


There is insufficient research on the use of peppermint in the treatment or prevention of the common cold. Additional study using peppermint alone is needed.

C


There is currently insufficient evidence regarding the use of peppermint for dental plaque and gingivitis. Additional research using peppermint alone is needed.

C


There is insufficient evidence regarding the use of peppermint for hot flashes. Additional research using peppermint alone is needed.

C


There is currently insufficient evidence regarding the use of peppermint for itching. More high quality research is needed.

C


In preliminary study, peppermint aroma has shown mixed effects on cognition, attention, and alertness. Additional research is required before a firm conclusion can be made.

C


There is currently insufficient research available to determine if there are benefits of peppermint oil in the treatment of post-herpetic neuralgia. More high quality studies are needed in this area.

C


There is insufficient evidence to evaluate the potential benefit of peppermint oil in the treatment of postoperative nausea. More high quality studies are needed in this area.

C


There is currently insufficient evidence regarding the use of peppermint for stress. More high quality studies are needed in this area.

C


Aromatherapy with peppermint oil, lavender, and rosemary has been used to reduce shoulder pain and improve motor power in patients recovering from strokes. Although treatment appeared to have beneficial effects, it is unclear if this was caused by peppermint oil or the other two herbs used. Additional studies using peppermint oil alone are needed.

C


Peppermint oil has been traditionally inhaled to relieve nasal and pulmonary congestion. While some preliminary evidence has suggested that inhalation of peppermint oil may have benefit in the treatment of tuberculosis, additional high-quality research is required before a firm conclusion can be made.

C


Peppermint tea added to other therapies has been used in the treatment of urinary tract infections. It is not clear if this is an effective treatment, and it is not recommended to rely on peppermint tea alone to treat this condition.

C


There is currently a lack of sufficient evidence to recommend for or against the use of peppermint oil to affect vigilance following brain injuries. More high quality studies are needed in this area.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Allergic rhinitis, analgesic (pain reliever), anorexia, antacid, anti-inflammatory, antimicrobial, antioxidant, antiviral, arthritis, anxiety, bile duct disorders, bronchitis, calming, cancer, candidal infection, carminative (relieves gas), catarrh, chicken pox, constipation, cramps, depression, enteritis, fatigue, fever reducer, fibromyositis, gallbladder disorders, gallstones, gas, gastritis, gonorrhea, , hair growth, heart disease, hepatitis, herpes, high blood pressure, HIV, ileus, immune system function, inflammation of oral mucosa, influenza, insecticide, intestinal colic, joint pain/stiffness, lice, liver disorders, local anesthetic, loss of appetite, menstrual pain, mental disorders, methicillin-resistant (MRSA), migraine, mosquito repellant, motility disorders, mouth and throat inflammation, musculoskeletal pain, myalgia (muscle pain), nervousness, neuralgia (nerve pain), pain, parasitic infection, peptic ulcer disease, pharyngitis, poisoning (arsenic), pregnancy-induced nausea and vomiting, radiation protection, respiratory disorders, respiratory tract infection, rheumatism, rhinitis, sinusitis, sleep aid, spermicide, stimulant, sun block, tendonitis, toothache, urticaria (hives), vomiting, warts.

Dosing

Adults (18 years and older)

  • Peppermint oil should be used cautiously, as doses of the constituent menthol over 1 gram per kilogram of body weight may be deadly. Some sources recommend using peppermint oil preparations on the skin no more than 3 to 4 times per day.
  • For intestinal or digestion disorders, doses of 0.2 to 0.4 milliliters of peppermint oil in enteric-coated capsules, dilute preparations, or suspensions have been taken three times daily by mouth.
  • For sore throat, lozenges containing 2 to 10 milligrams of peppermint oil have been taken by mouth.
  • As an anti-spasm agent, five drops of peppermint oil in 10 milliliters of water has been used by mouth.
  • As an infusion (tea), 3 to 6 grams of peppermint leaf has been taken by mouth daily for vomiting.
  • For headache relief, 10% peppermint oil (in methanol) has been applied to the skin (forehead and temples) multiple times per day.
  • For abdominal distention, 0.5 to 1 milliliter of peppermint oil in 2 liters of hot water soaked on a towel has been applied to the abdomen for 20-30 minutes three times daily.
  • For breast tenderness, peppermint gel has been applied to the nipples and a peppermint water-soaked cotton ball has been applied for 14 days.
  • For postherpetic neuralgia, peppermint oil (2-4 drops; standardized to 10% menthol) has been massaged into the skin 3-4 times daily.
  • For stroke recovery (hemiplegic shoulder pain), peppermint aromatherapy acupressure sessions lasting for 20 minutes have been performed twice-daily for two weeks.
  • As an inhalation, 3 to 4 drops of peppermint oil added to 150 milliliters of hot water and inhaled up to three times per day or 1% to 5% peppermint essential oil as a nasal ointment has been used to relieve congestion.
  • For mental performance enhancement, 4 drops of peppermint essential oil has been applied to a diffuser pad and placed inside the work cubicle.
  • 8 to 40 milliliters of peppermint oil has been infused into the lumen of the intestine to treat spasms of the colon.

Children (younger than 18 years)

  • For irritable bowel syndrome in children 8-10 years old, 0.1 to 0.2 milliliters Colpemin® has been taken by mouth three times daily for two weeks. Medical supervision is advised. Avoid applying peppermint oil around the facial or chest areas of infants and young children, especially around the nose.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Allergic reactions may occur from using peppermint or menthol by mouth or on the skin, including throat closing (laryngeal spasm), breathing problems (bronchial constriction or asthma symptoms), or skin rash, hives, or contact dermatitis. People with known allergy to peppermint leaf or oil should avoid peppermint products.

Side Effects and Warnings

  • Peppermint oil may be safe in small doses, although multiple adverse effects are possible. When used on the skin, peppermint oil may cause allergic reactions, skin rash, hives, mouth ulcers or sores, chemical burn, and eye irritation. Lung injury has occurred following an injection of peppermint oil. Peppermint oil taken by mouth may cause headache, dizziness, heartburn, anal burning, slow heart rate, dental caries, gingivitis, denture softening, or muscle tremor. Very large doses of peppermint oil taken by mouth have resulted in muscle weakness, brain damage, and seizure.
  • Menthol, a constituent of peppermint oil that is included in mouthwashes, toothpastes, mentholated cigarettes, and decongestant "rubs" or lozenges, has been associated with multiple adverse effects, such as serious breathing difficulties, asthma, skin bruising, and mouth sores. These effects are can be worse in infants and young children. Although small amounts may be safe in non-allergic adults, higher doses may be deadly in humans or may cause brain damage. Use on the skin may also cause rash, severe skin damage, or kidney damage. Inhalation of large doses of menthol may lead to dizziness, confusion, muscle weakness, nausea, or double vision.
  • Peppermint may cause dyspepsia (heartburn). Use cautiously in patients with gastrointestinal disorders such as gastroesophageal reflux disease, achlorhydria, and hiatal hernia.
  • Peppermint may cause kidney damage. Use cautiously in individuals with kidney disorders or in those taking drugs that may damage the kidneys.
  • Peppermint may cause liver damage. Use cautiously in individuals with liver problems or in those who are using drugs that may damage the liver.
  • Use cautiously in men, as peppermint has been shown to reduce free testosterone levels without affecting total testosterone levels.
  • Use cautiously in patients with underlying heart conditions, sexual dysfunction, iron deficiency, glucose-6-phosphate dehydrogenase (G6PD) deficiency, or gallbladder disease.
  • Use cautiously in patients taking cyclosporine, salicylates, cytochrome P450-metabolized agents, aminophylline, agents used on the skin, or when used on the skin in combination with a heating pad.
  • Avoid in patients with known allergy to peppermint, its constituents, or other members of the Lamiaceae (Labiatae) family.
  • Avoid excessive consumption of peppermint, as it has been associated with dental caries, gingivitis, and denture softening.
  • Avoid use of peppermint oil around the facial or chest areas of infants and young children, especially around the nose, because the menthol constituent may induce apnea, bronchial spasm, or severe respiratory effects such as respiratory arrest if applied directly to these areas.

Pregnancy and Breastfeeding

  • Peppermint preparations are commonly used during pregnancy for conditions like morning sickness; however, data are limited regarding safety and efficacy.
  • Peppermint oil has been used on the nipple to prevent cracks in breastfeeding women.

Interactions

Interactions with Drugs

  • Peppermint oil may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using these medications should check the package insert and speak with a qualified healthcare provider including a pharmacist about possible interactions.
  • Peppermint may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.
  • Peppermint may lower blood sugar levels. Caution is advised when using drugs that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Peppermint may also interact with 5-fluorouracil (5-FU), acyclovir, aminophylline, antibiotics, antifungals, anti-inflammatory agents, antiprotozoals, anti-spasmodic agents, antiulcer agents, benzoic acid, caffeine, calcium channel blockers, cardiovascular agents, cough medicines, corticosteroids, cyclosporine, diclofenac, drugs toxic to the liver, hormonal agents, interleukins, iron salts, neostigmine, onsansetron, oxytetracycline, pain relievers, propranolol, salicyclic acid, tetracaine, venlafaxine, or zidovudine.

Interactions with Herbs and Supplements

  • Peppermint oil may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may be too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system. Patients using these medications should check the package insert and speak with a qualified healthcare provider including a pharmacist about possible interactions.
  • Peppermint may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.
  • Peppermint may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Peppermint may also interact with pain relievers, antibacterials, antifungals, anti-inflammatory herbs and supplements, antiparasitics, anti-spasmodic herbs and supplements, antiulcer herbs and supplements, basil, caffeine, cardiovascular herbs and supplements, herbs or supplements that suppress cough, herbs or supplements that are toxic to the liver, hormonal herbs and supplements, herbs or supplements that are used on the skin, herbs or supplements that suppress the immune system, iron, quercetin, salicylate-containing herbs or supplements, or vitamin D.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Behrends M, Beiderlinden M, Peters J. Acute lung injury after peppermint oil injection. Anesth Analg 2005;101(4):1160-1162.
  2. Cappello G, Spezzaferro M, Grossi L, et al. Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial. Dig Liver Dis 2007 Jun;39(6):530-6.
  3. Hiki N, Kurosaka H, Tatsutomi Y, et al. Peppermint oil reduces gastric spasm during upper endoscopy: a randomized, double-blind, double-dummy controlled trial. Gastrointest Endosc 2003;57(4):475-482.
  4. Hur MH, Park J, Maddock-Jennings W et al. Reduction of mouth malodour and volatile sulphur compounds in intensive care patients using an essential oil mouthwash. Phytother Res 2007 Jul;21(7):641-3.
  5. Inamori M, Akiyama T, Akimoto K, et al. Early effects of peppermint oil on gastric emptying: a crossover study using a continuous real-time 13C breath test (BreathID system). J Gastroenterol 2007 Jul;42(7):539-42. Epub 2007 Jul 25.
  6. Kalavala M, Hughes TM, Goodwin RG, et al. Allergic contact dermatitis to peppermint foot spray. Contact Dermatitis. 2007 Jul;57(1):57-8.
  7. Kline RM, Kline JJ, Di Palma J, et al. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children. J Pediatr 2001;138(1):125-128.
  8. Liu JH, Chen GH, Yeh HZ, et al. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial. J Gastroenterol 1997;32(6):765-768.
  9. Madisch A, Heydenreich CJ, Wieland V, et al. 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(11):925-932.
  10. Melli MS, Rashidi MR, Nokhoodchi A, et al. A randomized trial of peppermint gel, lanolin ointment, and placebo gel to prevent nipple crack in primiparous breastfeeding women. Med Sci Monit 2007 Sep;13(9):CR406-411.
  11. Pittler MH, Ernst E. Peppermint oil for irritable bowel syndrome: a critical review and meta-analysis. Am J Gastroenterol 1998;93(7):1131-1135.
  12. Shin BC, Lee MS. Effects of aromatherapy acupressure on hemiplegic shoulder pain and motor power in stroke patients: a pilot study. J Altern Complement Med 2007 Mar;13(2):247-51.
  13. Shkurupii VA, Kazarinova NV, Ogirenko AP, et al. [Efficiency of the use of peppermint (Mentha piperita L) essential oil inhalations in the combined multi-drug therapy for pulmonary tuberculosis]. Probl Tuberk 2002;(4):36-9.
  14. Tate S. Peppermint oil: a treatment for postoperative nausea. J Adv Nurs 1997;26(3):543-549.
  15. Veal L. The potential effectiveness of essential oils as a treatment for headlice. Pediculus humanus capitis. Complement Ther Nurs Midwifery 1996;2(4):97-101.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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