Transcription:
Aromatherapy: Uses, Benefits and Safety

Cheryl Martin (Host): Aromatherapy can smell wonderful, but did you know there's more to it than just scent? There's a science behind which oils to choose and how you use them. There are also some safety measures to keep in mind. You'll learn what you need to know to use essential oils and aromatherapy safely, and their biggest benefit from Kathryn Fritze, an integrative and holistic nurse at University of Maryland, St. Joseph Medical Center.

Host: Welcome to the Live Greater podcast series, information for a healthier you from the University of Maryland Medical System. I'm Cheryl Martin. Kathy, first of all, what is aromatherapy?

Kathryn Fritze: Well, thank you for inviting me and I'm happy to share information about aromatherapy. First of all, I'll tell you what it's not. Aromatherapy is not Yankee Candle. It's not Bath and Body Works. And it's not your Glade Air Fresheners. It's the use of a natural scent or aromas taken from plants, trees, flowers, berries, roots, those kinds of things to stimulate beneficial and therapeutic effects on living beings. And that could be people or it could be animals as well.

And primarily, aromatherapy is used through simply inhalation of scents, although there are applications for use on skin with oils that are diluted in what they call carrier oils, a fatty rich oil. And that's because aromatherapy with essential oils, essential oils are a very concentrated form of the components. And humans have approximately a thousand distinct scent receptors in their olfactory bulbs at the top of the nose, and each receptor is tuned to a particular type of odor or scent. And we have physical and emotional effects as a response to these chemical signals that are absorbed in the olfactory bulbs at the top of the nose, that communicate directly to the limbic center of the brain, the emotional center of the brain with the aromatic compounds. And that produces different effects on us, physical effects, emotional effects. And in every day life, we experience these effects. For instance, we feel more awake and alert when we smell our morning coffee or we might feel more cheerful when a coworker peels that tangerine or orange in the lunchroom and everybody goes, "Ah, how wonderful." You know, a little smile happens and maybe we feel calm and peaceful when we smell fragrant flowers. So, we're exposed to aromatherapy all the time, but it's become kind of a popular buzzword because of the way that we are using them in their more concentrated form.

Cheryl Martin (Host): Now, Kathy, what science supports the use of aromatherapy and essential oils?

Kathryn Fritze: There are actually quite a few studies that support the use of it. There's a very complex chemistry to essential oils that we get from plants. It's much like a person that you know, you don't just know them by the tip of their nose, you know them by the whole shape of their face and the way that they walk and the tone of their voice and the way that they smell and all those sort of things. It's very much the same with aromatherapies because they are very, very complex molecules from living things. But there is a lot of research done on them. There's decades of human experience and anecdotal knowledge about using scents for health and wellbeing. There's also research, not so much double blind placebo-controlled research because it's really hard to double blind people to things that smell very distinctly, so that makes things a little complicated. But there's a lot of research into what are the human experiences when folks are exposed to the different scents and on a specific chemical components and what response the body's neurochemistry and biochemistry has to those components.

Host: What are the biggest benefits?

Kathryn Fritze: So, that's a complicated question because it depends on what oil you're talking about. There are a number of different oils that are used. And the benefits that we look to get from them here in hospital are to decrease anxiety, to bring up the mood in depression and low energy, to open the airways for freer breathing, to support digestion, to promote more restorative sleep, to decrease pain, to decrease inflammation of, say, rashes and things like that. So, it depends on what oil you're talking about.

And when you talk about essential oils, frequently they're referred to with their common name, but it's more appropriate to refer to them by their botanical name because a common name for a plant can apply to a number of different, we'll say, genus and species of the plant. And each of the plants has their own personality, like each member of your family has its own personality. So, it's important to be clear of which oil specifically from which plant you're talking about.

Lavender, which is commonly referred to as lavender, specifically the one most commonly used is Lavandula angustifolia is unquestionably the most widely used and well-known essential oil and has been used for many purposes over time. Lots of folks will be familiar with tossing a lavender sachet in their drawer to keep the moths away from theirs woolens. It's used as a deodorants. It's used in lots of commercial cosmetic products, perfumes, deodorants, lotions, soaps, things like that. It's used as a sleep aid, a pillow spray. It's used for pain relief for headache and bug bites and things like that. It helps to even out one's mood to make one feel more calm. And it's been shown in lots of qualitative studies with people to have these effects in opposition to a placebo that is used, something else that smells nice but isn't lavender, for instance. And interestingly enough, lavender was used as an antimicrobial to prevent infections, before the advent of antibiotics was used during World War I and World War II in the dressings for wounded soldiers, which is pretty interesting. It was used specifically and known to decrease the poor outcomes for an infection called gas gangrene.

And actually, lavender specifically started the whole study, we'll say, of aromatherapy and that term aromatherapy was coined by a French perfume chemist named Rene Gattefosse, who folklore says he had a terrible lab accident and a fire, and he burned his skin very badly and he plunged his arm into the closest vat that he could find, which happened to be lavender oil. And voila, and no pain, it was completely gone and his arm healed without any scarring. That's not exactly the truth. The truth is that there was a lab accident. He did burn himself very badly. He was on fire. He went outside, rolled around in the grass to extinguish the fire. Unfortunately, because the bacteria in the grass had set up an infection in his arm, he treated himself with lavender essential oil, knowing its properties, its cooling properties. Yet, he was amazed at how his arm healed. The pain did go away immediately, and he had no scarring. So, that's the beginning of lavender oil. And he devoted the rest of his life to really studying the medicinal qualities of lavender oil and other essential oils.

But peppermint's been used forever for, one, to open up the airways to help you breathe more easily, both in your lungs and in your sinuses. It's been used to calm nervous belly or indigestion. It's known to be an antispasmodic. It also has antimicrobial properties. It has pain-alleviating properties. It has body cooling properties, it can bring a fever down. It relieves mental fatigue.

Sweet orange, Citrus sinensis, who hasn't enjoyed the sweet scent of a freshly-peeled orange? It's known to be uplifting. It has been shown in studies to be antidepressant, to be anti-inflammatory. It's also antiseptic and bactericidal, people use it to clean their countertops and what have you, and to clean vegetables, things like that, to kill bacterial contamination, what have you. It calms cramping in the tummy. So, those are just the qualitative properties of it.

Host: So, these are some of the most popular scents, the lavender and the peppermint and the sweet orange that are used?

Kathryn Fritze: Yes. In common usage, yes. Those are the most popular scents.

Host: And also in the hospital as well, these are the most popular ones used?

Kathryn Fritze: Yeah, in the hospital as well. Lavender is used to help folks be calm, but also to help with headaches and things like that, and to promote sleep. The citrus is not just sweet orange, but also grapefruit is a really popular one to be used in the hospital. Surprisingly, that's the one that the medical practitioners like the most, it helps them to feel calm. You know, hospitals don't always smell great and the citrus oils are very bright and uplifting. They have a lot of top notes. They kind of spread out in the area very quickly and then they sort of dissipate very quickly, so they don't hang around, they're not clinging. And peppermint in general for medications and surgeries and dressings and things that cause nausea. You know, for people, peppermint is a really great one for freshening the air, for helping to soothe the tummy, for opening up your airway, help people to breathe more easily. So yeah, those are very commonly used.

Host: What safety measures, if any, need to be taken?

Kathryn Fritze: Well, safety measures, one, you want to be sure that you have what you think you have. You want to really be using an essential oil. You don't want to be using one that is a chemical composition that was made in a lab. You want to make sure you have the real thing. You want to make sure, of course, that you have the patient's consent. You don't ever want to surprise use any kind of chemical or medical intervention on people without their consent and their permission. You want to use a well-ventilated room. You want the oil to be able to do its work and then to dissipate completely, so it's not hanging around. You want to be aware, of course, of patient's allergies or sensitivities. You want to know about their age and their physical conditions. Like if they have hypertension or if they have epilepsy, or if they have asthma, if they have any kind of hormone-sensitive cancer, for instance. So, you want to be aware of their medical situation, but also their preferences. As I said, you want to make sure that you have the authentic thing, you really have an essential oil that you can trust its quality.

Host: And how do you test or how do you know the authenticity?

Kathryn Fritze: Well, you need to know your suppliers. You need to order them from a reputable company. You will, first of all, read the label as it says ingredients. And if it has all sorts of chemical-sounding names like ethers and Esthers and glycols and things like that, that's not what you want. You want something that says in the ingredient list, not just peppermint, but it'll say Mentha piperita, like that is the ingredient. It will tell you the name of the plant that's in it, and it shouldn't have lots of other different additives in it. So, you want to be sure that you have that.

The company will have information on their website where you buy it, and oftentimes on the label of the bottle that says it's GCMS-certified, which means gas chromatography and mass spectrometry certified, which means they actually looked at this oil in a computer that maps out the possibly a hundred constituents and their relative quantity within that particular oil, so that it matches, we'll say, the genetic profile of the plant that you think that they are. So, that's not something that the individual does, but that's something that the company that provides the essential oil does, and that should be listed on their website and should be listed on their label as saying it's GCMS-certified.

Important to know is that marketing words like natural or therapeutics grade or a pure or those kind of things actually have no legal definition, so they don't really mean anything. You really want to go back to the website of the company where you bought it and find out what they say about its quality and how it was confirmed that you have what you think you have.

Host: Now, are there any contraindications, in other words, symptoms or conditions that make using essential oils or aromatherapy risky?

Kathryn Fritze: Yeah. Well, allergy would be an obvious one. If someone is allergic to lavender, that is not an oil that you would choose to use, so that's an obvious one, and sensitivities in general.

People's response to essential oils is not simply a biologic response, it's also an emotional response. So if someone has a very strong emotional aversion to or association with a particular oil, it's probably best to avoid that oil because they will have physical manifestations, we call them psychosomatic, meaning your mind produces a physical manifestation, which by the way happens all the time. You see television that has an ad for pickles and suddenly your mouth starts to water, that's psychosomatic. But it is your body reacting to your sensory input to prepare itself for whatever might be coming in. So, that's another contraindication if somebody really is avoidant of it.

But you want to be very cautious using essential oils with people who have reactive airway disease or asthma, for instance. Those who have sensitive or injured or thinning skin, if you were using oils as a topical application, people who are using medications on their skin, certain oils can increase or decrease or block the effects of the medications that you're using. Generally speaking, the risk of diffusion, small amounts of oil, like drops of oil into the air, according to Robert Tisserand, who wrote the definitive book on safety with essential oils. He said that the relative risk of diffusion is negligible for people. You get into trouble when people try to ingest essential oils, which is strongly cautioned against unless you're working with someone who is very familiar with essential oils, medical person who study them knows exactly what's going on, it's strongly suggested that you do not ingest them, so don't swallow essential oils, don't add them to your water. But you can use lots of them on your skin as long as they're well diluted in carrier oil.

Diffusion is not so much of a risk for people, relatively negligible risk, as long as they don't have reactive airway disease, asthma, things like that. Topical applications, you want to be careful not to use any essential oils, which are the concentrated form, directly on your skin. You want to dilute them in a carrier oil. And when I say a carrier oil, what I mean is like a vegetable oil type, like coconut oil for instance or olive oil or grape seed oil or jojoba oil or other kind of oil. And there are specific percentage levels of dilution that you would use that would be safe to apply for folks.

Another precaution would be not to use expressed citrus oils directly on the skin and then in a lotion or whatever, and then go out and be exposed to the sun because there is a very well known problem with dermatitis and very nasty blistering that may not show up for 12 to 24 hours, but may last for weeks to months and be really a very bad exposure. So, citrus oils applied to the skin, you want to avoid sun exposure for about 18 hours after you do that, so that's another precaution that you would take with oils.

Host: This is a lot of great information, Kathy. Just in wrapping up, any other takeaways you have for us? We've covered quite a bit.

Kathryn Fritze: There are quite a few considerations. One is generally don't use essential oils around your cats. They have problems dealing with these as far as their liver and can be toxic to them. Dogs are very sensitive with and have a very acute sense of smell, and they need to be able to get out and away from any area where you might be diffusing essential oils and into the fresh air.

Infants, very delicate beings. We should generally avoid diffusion and certainly application of any essential oils to infants under the age of two. You want to be especially careful with any child under the age of two. You want to avoid peppermint at all costs because peppermint oil has an effect on their breathing response and the respiratory reflex. And just like blowing air in a baby's face and cold things in the baby, the menthols in the peppermint will have them stop breathing. So, you don't use peppermint around the baby.

You want to be very cautious about using any kind of essential oil around pregnant women in their first trimester, for sure, either diffused into the air or applied to them topically. After the first trimester, there are certain oils that should be avoided at all costs because of their potential for fetal malformation. Generally, those are oils that are not used very much. Listen very quickly just so people know. Sweet birch, carrot seed, cassia, cinnamon bark, hiba wood, Spanish lavender, which is not the lavender we usually use, it's called stoechas, which is the species of that lavender; lemon grass, which is one that's more commonly used; oregano, Spanish sage, savin, wintergreen, wormwood, green yarrow, and zedoary, which are obscure oils, but don't use them if you're pregnant at all.

And epileptics should avoid things like thujone or hyssop oils because of an increased seizure risk. People who have hormone-sensitive, estrogen-sensitive cancers should avoid fennel, clary sage and geranium because of their potential increase estrogen. And people who are on anticoagulants like warfarin should avoid wintergreen because wintergreen has methyl salicylate, much like aspirin or the NSAIDs, and can cause decrease in the platelet aggregation and an increased risk of bleeding.

But here's a bonus for you for things that people are worried about that they don't need to be worried about, lavender oil is actually not an estrogen stimulant. And so, folks can use lavender oil if they have hormone-dependent cancers or in pregnancy or those kind of things, it's not a problem. It will not cause feminization of voice, what have you. That's a rumor that goes around. And grapefruit oil is fine to be either used in a carrier oil in a massage or used in diffusion, even for people who cannot drink grapefruit juice or eat grapefruits with their medication, because the grapefruit oil does not have any of the component problem with their medication absorption.

Host: Kathy Fritze, you have given us a great education on the benefits of aromatherapy and essential oils and how to use them safely. Thank you so much.

Kathryn Fritze: You're welcome very much. I'd like to just add a few little tips here and resources to go to for a lot more information. One is that you could devote your entire life to the study of essential oils. It's fascinating and very complicated, and indeed many people have. But I would recommend that you just take your time getting to know just a few essential oils really well. They're very concentrated substances. Don't be afraid to use them, but treat them with respect for their potency. Know that less is more and it's much better to be safe than sorry. Don't apply them to your skin or add them to your bath water undiluted in a carrier oil.

And two references that I think are really very useful, one is called the Encyclopedia of Essential Oils, written by Julia Lawless. And another is a wonderful, professional, and free resource for lots of information on essential oil safety and the use of essential oils and where to get them and how to know about their quality, an amazing resource. It's the aromaweb.com, A-R-O-M-A-W-E-B.com. They have safety guidelines and they have profiles for 130 different essential oils with all the information you could possibly want.

Host: Kathy, thank you. Thanks so much.

Kathryn Fritze: You're very welcome. Thank you for inviting me.

Host: You can find more shows just like this one at umms.org/podcast and on YouTube. Thanks for listening to Live Greater Health and Wellness Podcast, brought to you by the University of Maryland Medical System. We look forward to you joining us again, and please share this on your social media.