Dietary Supplements and their Uses: German Chamomile

by Marissa Sheldon, MPH

Scientific names: Matricaria recutita L.,1 Chamomilla recutita,2 Anthemis L.,3 Chamaemelum nobile (L.) All.4

Description: Chamomile is a flowering plant in the same family as daisies.5 There are two main types of chamomile, German and Roman. (Contrary to what one may think, these names do not refer to where the plants originated.) While they are used for similar medicinal purposes, German chamomile is the more popular variety.5 Therefore, this article will be referring to the German variety unless otherwise noted. 

Chamomile flowers, which grow on long, thin green stems, are often less than an inch wide with white petals surrounding a yellow, cone-shaped center5 and have a strong, apple-like scent.6,7 The plants begin to bloom in early summer and are self-seeding,6 meaning that they will rebloom each year without human intervention. Chamomile will grow indoors or outdoors, as long as the plant receives ample sunshine and moisture.6 Flowers should be harvested when they are in full-bloom6 and are either dried to use in teas or capsules, or crushed and steamed to create an oil or liquid extract.5  

Nutrients: Chamomile does not have significant nutritional value. One cup of brewed chamomile tea contains:8

  • 2.37 calories
  • 0 grams (g) protein
  • 0 g fat
  • 0.47 g total carbohydrates
  • 0 g dietary fiber
  • 0 g sugar
  • 2.37 milligrams (mg) sodium
  • 0.104 mg manganese (4.52% daily value)
  • 0.036 mg copper (4.0% DV)
  • 0.024 mg thiamin (2.0% DV)
  • 0.19 mg iron (1.06% DV)
  • 0.095 mg zinc (0.86% DV)
  • 2.37 micrograms (mcg) folate (0.59% DV)
  • 2.37 mg magnesium (0.56% DV)
  • 21.3 mg potassium (0.45% DV)
  • 4.74 mg calcium (0.36% DV)

Geographic origin: German Chamomile is native to southern and eastern Europe,9 and was used by the ancient Greeks, Romans, and Egyptians.2,5,9 Now, chamomile is grown worldwide, most commonly in countries including Germany, Hungary, France, Russia, Yugoslavia, Brazil, India, and China.9,10 

Current form of consumption: Chamomile is most often consumed in an herbal tea or as an oral supplement in the form of a capsule, tablet, or oil.5,11 The dried flowers or unsteeped tea leaves can be used for cooking or baking, as in the recipes listed later in this article. Chamomile is also available as a liquid extract that can be consumed or used for aromatherapy or topical skin applications.5,12  

History of use as medicine: Chamomile is thought to be one of the oldest medicinal herbs known to man, dating back to the ancient Egyptians, Romans, and Greeks.2,5,9,13 Dried and crushed chamomile flowers were used by the Egyptians and Greeks to treat skin conditions resulting from dry, harsh weather.14 Chamomile has also used in traditional Chinese medicine, which originated more than 2,000 years ago, for its calming effects.10 

For hundreds of years, chamomile has been used, in one form or another, to treat wounds, bruises, canker sores, sciatica, hemorrhoids, diaper rash, chicken pox, ear infections, colic, conjunctivitis, nasal congestion, skin inflammation, anxiety, insomnia, and upset stomach.13  

Current Uses and Scientific Literature Review: While, as noted above, chamomile is often promoted as a treatment for a wide variety of conditions,2,5,7,13 there is limited research available to prove its benefits.2,5,11,15 The following studies, while promising, do not have enough support to draw definitive conclusions. 

Note: Before reviewing the literature, it is important to note that many peer-reviewed studies may be biased because of industry-funded research to promote product sales, and a conflict of interest is not always disclosed (see information from biologist and nutritionist Marion Nestle on sponsored research here). In this article, we have done our best to exclude any industry-funded studies. As discussed in the Food as Medicine Report (on page 158, specifically), there is a need for more government funding for food as medicine initiatives. 

Cancer Prevention
Chamomile extracts and essential oils have been studied in laboratory settings to observe their effects on various types of cancer cells. More research is needed to understand the exact mechanisms by which chamomile works to treat and prevent cancer and to identify a safe and effective dosage for humans.

  • Chamomile Essential Oil and Breast Cancer (in vitro): An et al (2023)16 examined the effects of chamomile essential oil on triple-negative breast cancer (an aggressive form of breast cancer) cells and determined that the essential oil was able to slow down the cancer cells’ growth and movement, which may be associated with the high content of a compound called terpenoids found in the chamomile.  
  • Chamomile Extract and Cancer (in vitro): Khan et al (2023)17 tested the effects of chamomile extracts on prostate cancer cells. The results indicated that the extracts had both antioxidant and anti-cancer properties. Al-Dabbagh et al (2019)18 observed similar effects in liver cancer cells, with a greater anti-cancer effect resulting from a larger treatment dose of the extract.
  • Apigenin and Cancer Prevention (review): Flavonoids are substances with therapeutic properties naturally found in fruits and vegetables.19 Apigenin is a type of flavonoid found in chamomile and other fruits, vegetables, and herbs. A review conducted by Kowalczyk et al (2017)20 concluded that apigenin protects against a variety of cancers, although the exact mechanisms remain unclear. Nabavi et al (2015)21 also reviewed the literature on apigenin, specifically as it relates to breast cancer, and found five laboratory studies showing its anti-cancer properties. Lefort and Blay (2013)22 reviewed the effects of apigenin on gastrointestinal cancers and discovered that it has been shown to slow cancer cell growth, increase cell death, prevent the spread of tumors, and block the development of blood vessels that help tumors grow.
  • Early Demonstration of Anti-Cancer Properties (in vitro): Srivastava and Gupta (2007)23 claim to have provided the first study demonstrating the anti-cancer effects of chamomile. They treated various types of cancer cells and healthy cells with chamomile extract. The extract had a minimal effect on healthy cells, whereas the treated cancer cells exhibited increased cell death. The researchers noted that apigenin was a component in the extract that seemed to have the greatest anti-cancer effect.

Management of Cancer Treatment Side Effects
Chamomile has often been used to treat skin irritation and promote wound healing.23 The following studies are examples of its use to manage skin-related side effects of radiation treatment, but more research is needed to confirm these findings. 

  • Chamomile-infused Compress for Skin Peeling (interventional): Menêses et al (2022)24 used a chamomile-infused compress to treat skin peeling (dry desquamation) among 43 cancer patients undergoing radiation therapy. Participants were instructed to apply the compress to the affected area three times per day until the end of their therapy treatment, and all participants experienced a reduction in skin peeling. This study lacked a control group, though, so we do not know if the same results would have been produced using the same compress without the chamomile infusion. 
  • Chamomile Gel to Prevent Skin Damage (interventional): Ferreira et al (2020)25 investigated the effects of a topical chamomile gel, as compared to a cream made with a compound called urea, to prevent and treat radiation dermatitis (burns or skin damage from radiation therapy) among 48 head and neck cancer patients and found that the chamomile gel was more effective than the urea cream in delaying the onset of dermatitis and preventing itching, burning, and darkening of the skin.    

Diabetes
Chamomile is thought to have potential benefits for symptoms of diabetes and diabetic complications, but there is limited research to support these claims.26 

  • Chamomile and Diabetes (review): Hajizadeh-Sharafabad et al (2020)27 examined 15 studies that focused on the effects of chamomile supplementation on diabetic patients. Chamomile appeared to improve dyslipidemia (the imbalance of lipids or fatty compounds such as cholesterol and triglycerides) and blood sugar levels while also decreasing liver- and kidney-related diabetic complications. 
  • Chamomile Tea and Blood Sugar (interventional): Zemestani et al (2016)28 enrolled 64 men and women with type 2 diabetes in a study examining the effects of chamomile tea on blood sugar. Half the participants drank chamomile tea three times a day, after meals, for eight weeks, while the other half drank water. Compared to the control group, the chamomile tea drinkers had significantly decreased blood sugar and blood insulin levels, and improved antioxidant activity.  

Digestive Disorders/Stomach Upset

Some studies have shown benefits from chamomile consumption for gastrointestinal disorders including intestinal parasites, ulcerative colitis, and acute diarrhea, but more research, particularly in humans, is still needed.

  • Chamomile Polysaccharides and Giardia (in vitro): Sabatke et al (2022)29 conducted a laboratory study of the effects of chamomile tea on a diarrheal disease caused by the parasite Giardia. More specifically, they were looking at the polysaccharides – carbohydrates found in fruits and vegetables – in chamomile, because polysaccharides in general have been shown to have benefits for gastrointestinal conditions. The chamomile polysaccharides, when combined with a traditional Giardia medication, made the medication five times more effective in reducing the growth of parasites.
  • Chamomile Extract and Parasitic Worms (in vitro and animal study): Hajaji et al (2019)30 studied the use of chamomile extract to treat parasitic worms, both in a laboratory setting and in mice. They found that the chamomile extract had a similar effect to a drug commonly used to treat worms, and it also helped reduce oxidative stress associated with the parasitic infection. 
  • Chamomile Extract and Ulcerative Colitis (animal study): Menghini et al (2016)31 explored the impact of chamomile extract on ulcerative colitis – a disease causing inflammation and sores in the digestive tract – in rat colons. They found that the extract was as effective as an anti-inflammatory drug called sulfasalazine in preventing the production of various biomarkers that present with ulcerative colitis. 
  • Chamomile Extract and Diarrhea (animal study): Mehmood et al (2015)32 studied the effectiveness of chamomile extract for treating diarrhea in live mice and in isolated rabbit intestines. They found that the chamomile extract had protective effects against diarrhea, intestinal spasms, and excessive fluid secretions in the intestines. Sebai et al (2014)33 also investigated chamomile extract as a treatment for diarrhea in rats and saw that greater anti-diarrheal benefits resulted with higher doses of the extract. 
  • Combined Herbal Supplement and Diarrhea (observational): Albrecht et al (2015)34 examined 1,062 patients with acute diarrhea caused by gastrointestinal disorders. The patients were given a combination of myrrh, coffee charcoal, and chamomile extract as an anti-diarrheal treatment either alone or in combination with standard medical therapy. The herbal treatment was well-tolerated and, among patients with irritable bowel syndrome (IBS) specifically, it was as effective as traditional medicines for the treatment of acute diarrhea. 

Mental Health

Chamomile tea is often advertised as having a calming and relaxing effect. Although there are scientific studies exploring the influence of chamomile on anxiety and depression, many combine chamomile with other herbs or treatments, making it difficult to ascertain the specific effects of chamomile alone. 

  • Obesity-related Depression and Anxiety Treated with Chamomile (animal study): Jabri et al (2022)35 studied the effects of chamomile on rats fed a high-fat diet to induce obesity, which also induced neurobehavioral changes indicative of depression and anxiety. The neurobehavioral changes were reversed in the rats treated with chamomile, showing promising evidence for using chamomile to manage mental health issues related to obesity. 
  • Lavender and Chamomile Aromatherapy and Mental Health in Older Adults (interventional): Ebrahimi et al (2022)36 tested the effects of inhaling chamomile and lavender essential oils to alleviate depression, anxiety, and stress among 183 older adults. Participants were split into three groups – lavender treatment, chamomile treatment, or control. After 30 nights of treatment, the lavender and chamomile therapies resulted in significant improvements in mental health, both immediately and after one month, compared to the control group that did not use any essential oils.  
  • Chamomile Extract and Anxiety (interventional): Amsterdam et al (2020)37 conducted a study of 179 adults diagnosed with generalized anxiety disorder. All participants took 1,500 milligrams of chamomile orally every day for eight weeks. All participants, including 79 who had both anxiety and depression, reported improvements in mood,   indicating that chamomile extract may have both anxiolytic (anti-anxiety) and antidepressant effects. However, this study lacked a control group, so it is not clear if the beneficial effects were attributable solely to the chamomile extract or if participants may have experienced other psychological responses simply from participating in the study (a placebo effect). Another study from the same research group (Mao et al (2016)38) showed that the chamomile extract treatment did not reduce the rate of relapse compared to a control group. 
  • Chamomile-Lavender Aromatherapy for Anxiety (interventional): Zamanifar et al (2020)39 explored the effects of music therapy combined with chamomile-lavender aromatherapy on nurses experiencing anxiety. The cohort of 120 nurses were split into three groups: music therapy alone, music therapy plus aromatherapy, and a control group. The nurses receiving both music therapy and chamomile-lavender aromatherapy experienced a greater reduction in anxiety than those who received either music therapy alone or no treatment (the control group), indicating a potential benefit from chamomile and/or lavender essential oils. Rafii et al (2019)40 also examined aromatherapy with chamomile and lavender for the treatment of anxiety. In this study, the researchers studied 105 patients with burn injuries who received a massage without aromatherapy, a massage with chamomile-lavender aromatherapy, or no massage at all. Massage alone helped relieve anxiety, while massage with aromatherapy helped to reduce anxiety and also improved sleep quality. More research is needed to separate the effects of chamomile from those of lavender. 

Sleep 

In addition to being used to calm stress and anxiety, chamomile tea is often thought to promote sleep. Again, more research is needed to provide scientific evidence to back up these claims. 

  • Chamomile Supplement and Sleep in the Elderly (interventional): Adib-Hajbaghery and Mousavi (2017)41 studied 60 adults over 60 years old who were living in a nursing home to determine the effects of a chamomile supplement on their sleep quality. The treatment group received 200-milligram chamomile capsules twice daily for 28 days while the control group received placebo capsules filled with wheat. Chamomile treatment significantly improved participants’ sleep quality compared to the placebo. Abdullahzadeh et al (2017)42 studied 77 elderly individuals hospitalized in nursing homes who received either no treatment or 400-milligram chamomile capsules twice daily for four weeks. Again, sleep quality was significantly improved among the chamomile treatment group. 
  • Chamomile Tea and Sleep Quality Postpartum (interventional): Chang and Chen (2015)43 recruited 80 postnatal women to participate in a study testing the efficacy of chamomile tea for sleep quality and depression. Half the participants drank chamomile tea daily for two weeks, while the other half received only their regular postpartum care. The treatment group had significantly fewer sleep quality issues related to physical symptoms and fewer symptoms of depression compared to the control group.

Potential Negative Effects: Chamomile is generally considered safe for consumption in the amounts used in tea and when consumed short-term as a supplement.2 Side effects, while rare, may include nausea, dizziness, diarrhea, or skin rash.15

Some people who are allergic to similar plants such as ragweed, chrysanthemums, marigolds, or daisies, may also have an allergic reaction to chamomile.2,15,44 Allergic reactions may include difficulty breathing, rash, or even anaphylaxis.44 Consumption of chamomile may also trigger symptoms in individuals with asthma.5 

Individuals who take blood thinners such as warfarin or aspirin should not consume chamomile, because it may increase the risk of bruising or bleeding.2,5,15,44 

Negative interactions have also been reported between chamomile and cyclosporine, a medication taken by organ transplant recipients.2,5,15

Because it may induce drowsiness, chamomile can increase the effects of sedatives such as seizure medications, sleep aids, and alcohol.5

Chamomile may decrease the effectiveness of birth control pills.5,12,45

To date, there is little information available about the safety of taking chamomile while pregnant or breastfeeding.2

Cooking and storage tips: After harvesting, chamomile flowers should be dried before storing. This can be done by air drying them in a dark room or by using a food dehydrator on a very low temperature setting (110 degrees Fahrenheit) for 24 hours or more.46 Once dried, chamomile flowers should be stored in an airtight container in a cool, dry, dark location.46,47 They will keep for up to one year but will lose their flavor and scent if kept much longer.47

Recipes:

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References:

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25. Ferreira EB, Ciol MA, de Meneses AG, Bontempo P de SM, Hoffman JM, Reis PEDD. Chamomile Gel versus Urea Cream to Prevent Acute Radiation Dermatitis in Head and Neck Cancer Patients: Results from a Preliminary Clinical Trial. Integr Cancer Ther. 2020;19:1534735420962174. doi:10.1177/1534735420962174

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29. Sabatke B, Chaves PFP, Cordeiro LMC, Ramirez MI. Synergistic Effect of Polysaccharides from Chamomile Tea with Nitazoxanide Increases Treatment Efficacy against Giardia intestinalis. Life Basel Switz. 2022;12(12):2091. doi:10.3390/life12122091

30. Hajaji S, Jabri MA, Alimi D, Rekik M, Akkari H. Chamomile Methanolic Extract Mitigates Small Bowel Inflammation and ROS Overload Related to the Intestinal Nematodes Infection in Mice. Acta Parasitol. 2019;64(1):152-161. doi:10.2478/s11686-019-00027-x

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32. Mehmood MH, Munir S, Khalid UA, Asrar M, Gilani AH. Antidiarrhoeal, antisecretory and antispasmodic activities of Matricaria chamomilla are mediated predominantly through K(+)-channels activation. BMC Complement Altern Med. 2015;15:75. doi:10.1186/s12906-015-0595-6

33. Sebai H, Jabri MA, Souli A, et al. Antidiarrheal and antioxidant activities of chamomile (Matricaria recutita L.) decoction extract in rats. J Ethnopharmacol. 2014;152(2):327-332. doi:10.1016/j.jep.2014.01.015

34. Albrecht U, Müller V, Schneider B, Stange R. Efficacy and safety of a herbal medicinal product containing myrrh, chamomile and coffee charcoal for the treatment of gastrointestinal disorders: a non-interventional study. BMJ Open Gastroenterol. 2014;1(1):e000015. doi:10.1136/bmjgast-2014-000015

35. Jabri MA, Rtibi K, Sebai H. Chamomile decoction mitigates high fat diet-induced anxiety-like behavior, neuroinflammation and cerebral ROS overload. Nutr Neurosci. 2022;25(7):1350-1361. doi:10.1080/1028415X.2020.1859727

36. Ebrahimi H, Mardani A, Basirinezhad MH, Hamidzadeh A, Eskandari F. The effects of Lavender and Chamomile essential oil inhalation aromatherapy on depression, anxiety and stress in older community-dwelling people: A randomized controlled trial. Explore N Y N. 2022;18(3):272-278. doi:10.1016/j.explore.2020.12.012

37. Amsterdam JD, Li QS, Xie SX, Mao JJ. Putative Antidepressant Effect of Chamomile (Matricaria chamomilla L.) Oral Extract in Subjects with Comorbid Generalized Anxiety Disorder and Depression. J Altern Complement Med N Y N. 2020;26(9):813-819. doi:10.1089/acm.2019.0252

38. Mao JJ, Xie SX, Keefe JR, Soeller I, Li QS, Amsterdam JD. Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial. Phytomedicine. 2016;23(14):1735-1742. doi:10.1016/j.phymed.2016.10.012

39. Zamanifar S, Bagheri-Saveh MI, Nezakati A, Mohammadi R, Seidi J. The Effect of Music Therapy and Aromatherapy with Chamomile-Lavender Essential Oil on the Anxiety of Clinical Nurses: A Randomized and Double-Blind Clinical Trial. J Med Life. 2020;13(1):87-93. doi:10.25122/jml-2019-0105

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