Sage
Salvia officinalis L. (Labiatae), garden sage, true sage, broad-leafed sage

Location
Sage is native to the Mediterranean region but now occurs in a wide diversity of habitats and at almost all latitudes (Walters 2006).

Description
The sage plant is a small shrub, up to 70 centimeters in height. Its leaves are aromatic and have a sweet scent. Its flowers are blue-violet and arranged in whorls. Sage leaves are stalked (3-5 centimeters in length and 1-2.5 centimeters in width) and the venation is distinctly reticulated. Sage leaves are pungent tasting (Wren 1988).

History
“He that would live for aye, Must eat sage in May” is a proverb that indicates the folkloric belief in sage as a magical cure-all herb (Grieve 1984). Its use in history dates back to the ancient Greek and Roman times where this herb was used for copious ailments (examples include and are definitely not limited to insomnia, measles, seasickness, venereal disease and worms). It is also believed that Charlemagne ordered sage to be grown in his gardens. In the 10th century, Arab physicians even claimed that sage extended life to the point of immortality (Tyler 1999).

Although sage has been linked to many cultures worldwide, it is believed to have originated in Syria and spread through the Mediterranean and then to the rest of the world via trade routes. Apparently, the Chinese would trade with the Dutch, three times the amount of their green tea for European sage (Tyler 1999). In ancient Egypt, it was used to promote menstruation and increase fertility in women (Dweck 1987).

Sage is used in Europe as a home remedy more frequently than in the United States. In Europe, sage is used to decrease salivation and spasms; it is also used as a carminative in colds and coughs (Spoerke 1982).

Also, sage is used all over the world in many dishes. In Italy, sage is used in a veal sauce. In Germany, the herb is used in eel and sausage dishes. In the Middle East, it is used in salads and in America, it is used in poultry, especially in Thanksgiving turkey (Hutson 2003).

Sage has been used as an insect repellant and perfume (Spoerke 1982).

Current medicinal uses
True to its Latin name (Salvia means “to heal”) sage has many medicinal properties. Sage is accredited with antibacterial, antifungal, antiseptic, antispasmodic, astringent, carminative, diuretic, hypoglycemic, and estrogenic effects. When taken as a tea, sage has a calming effect on sweat glands and reduces perspiration (Dweck 1987). One human pilot trial claimed that sage tea ingestion improved lipid profiles by lowering plasma LDL cholesterol and total cholesterol levels as well as increasing antioxidant defense (Sa 2009). Sage also shows promise as an herbal treatment for Alzheimer’s disease. Patients with mild to moderate Alzheimer’s disease who were administered 60 drops/day of Salvia officinalis during a 4-month, parallel group, placebo-controlled study apparently showed significant cognitive improvement over control subjects (P = 0.03) (Akhondzadeh 2003).

When used as a compress, cream, or infusion, sage leaves may benefit some dermatologic conditions. A prospective, randomized, double-blind, placebo-controlled study showed that sage extract was as effective as a hydrocortisone cream in reducing ultraviolet radiation-induced erythema (Reuter 2007). Additionally, an herbal wash of its fresh leaves may have some benefit for sores and wounds. When used as a gargle or mouthwash, it can soothe the mucus membrane of the mouth and throat, and can be beneficial for bleeding gums, mouth ulcers, and bad breath (Dweck 1987).

Adverse effects
Sage should not be consumed in large, chronic doses because it contains thujone and is neurotoxic (Dweck 1987). One case report describes poisoning in an individual following ingestion of sage oil for acne (Centini 1987). Sage can stimulate the muscles of the uterus and should be avoided during pregnancy. The essential oil of sagemay causes seizures.

Comments
Sage leaves contain 1-2.5% volatile oil, composed of thujone, terpene, camphor, and salvene. Sage oil is not recommended for aromatherapy. The most common cosmetic use of sage leaves is for hair treatments. An infusion of fresh sage leaves can be applied to the scalp to keep hair dark, shiny, and healthy.

References
Akhondzadeh S, Noroozian M, Mohammadi M, Ohadinia S, Jamshidi A, Khani M. "Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomized and placebo-controlled trial". J Clin Pharm Ther. Feb 2003; 28 (1): 53–9.

Centini F. “A case of sage oil poisoning.” Zacchia 1987; 60: 263–174.

Dweck A. The folklore and cosmetic use of various Salvia species. Wiltshire, 1987.

Foster S. and Tyler VE. Tyler’s Honest Herbal: A Sensible Guide to Use of Herbs and Related Remedies. The Haworth Press, Inc. Binghampton, New York, 1999.

Fugh-Berman, Adriane. The 5-Minute Herb & Dietary Supplement Consult. Lippincott Williams & Wilkins, Philadelphia, 2003.

Hutson, Lucinda. The Herb Garden Cookbook. Gulf Publishing Company. Texas, 2003. Reuter J, Jocher A, Hornstein S, Mönting JS, Schempp CM. “Sage extract rich in phenolic diterpenes inhibits ultraviolet-induced erythema in vivo.”Planta Med. 73(11): Sep. 2007, 1190-1.

Sa CM, Ramos AA, Azevedo MF, Lima CF, Fernandes-Ferreira M, Pereira-Wilson C. “Sage tea drinking improves lipid profile and antioxidant defenses in humans.” Int J Mol Sci. 10(9): 2009, 9; 3937-50.

Walters, Dirk R., Keil, David J., Murrell, Zack E. Vascular Plant Taxonomy, 5th ed. Dubuque: Kendall/Hut Publishing Co., 2006.