Lemon balm—mildly sedating, antiviral, and carminative—is used commonly as tea, tincture, and ointment throughout western Europe, where it was named Europe's plant of the year in 1988. In the United States, herbalists recommend lemon balm for a broad range of indications, including insomnia, dyspepsia, infant colic, anxiety, depression, and chronic fatigue syndrome.

Lemon balm is also used to reduce the pain and swelling of arthritis; to alleviate headaches; to desensitize individuals prone to allergy, eczema, and asthma; to relax uterine smooth muscle tissue during premenstrual syndrome; and to regulate hot flashes during menopause. While many of these uses have not been corroborated with controlled trials, studies with laboratory animals and tissue cultures have supported the empirical results of traditional uses of lemon balm.

In the 1970s, lemon balm volatile oil was demonstrated to exact nonspecific sedative actions. Its effects on the gastrointestinal tract are apparently due to smooth muscle relaxation. Studies also demonstrate modulation of thyroid stimulating in relation to lemon balm administration. And current research supports its use for cold sores or lesions due to herpesvirus types 1 and 2.

Lemon balm has been used for thousands of years. The Greek physician Dioscorides used it for dog and scorpion bites. In the Middle Ages, Eau de Melissa was commonly used as a sedative. The 17th century English herbalist, Nicholas Culpepper, claimed that lemon balm could lift spirits, prevent fainting, stimulate clear thinking, and precipitate menstruation. American eclectic physicians used lemon balm during the 19th century as a mild stimulant. European colonists used it to sweat out fevers. Lemon balm's scientific name, Melissa, is derived from the Greek word for bee: bees are attracted to its odor. It is added to cosmetics, furniture polish, insect repellant, and food.

Erect perennial, growing up to two feet in height, with branching, hairy, square stems. Oval/heart shaped leaves, wrinkled, opposite, broad, toothed, grow one to three inches long, and smell like lemon. White-yellow flower clusters bloom at leaf axils July through September and sometimes become light blue. Native to Southern Europe and North Africa. Cultivated around the world.

• Leaves

Leaves contain a minimum of 0.05% volatile oil, with citronellal, citral a and b, geraniol, neral, caryophyllene, linalool, and limonene primary terpenoid constituents; also, phenol carboxylic acids and estimated 4% rosmarinic acid; and bitter principles, flavonoids, and tannins.

Dried leaf, tea, capsules, extracts, creams, and oil, and combined with other sedative or carminative botanical preparations.

Traditional: carminative, diaphoretic, febrifuge; essential oil is sedative, spasmolytic, antibacterial; poultices used for sores, tumors, headaches, stomach and menstrual complaints, insect bites

Conditions: catarrh, influenza, painful or delayed menstruation, nervous unrest or insomnia, gastrointestinal discomfort (internal administration); wounds or lesions (topical application)

Clinical applications: Lemon balm leaf preparations are approved in Germany as treatment for nervous sleep disorders, appetite loss, and for symptoms of functional gastrointestinal disorders (flatulence, abdominal bloating). There is promise of potential usefulness in treatment of cold sore/herpes simplex symptoms.

Components in lemon balm essential oil cause mild, nonspecific sedation when given at dosage ranges of 3 to 100 mg/kg (laboratory animals). Citronellal, a terpene in the volatile oil, may be the primary sedating constituent. In a study to determine the effects of 178 herbal extracts on herpes, influenza, and polio viruses, lemon balm's phenol constituents showed significant antiviral effects. The oil also has antibacterial activity, and tannins are currently considered the antiviral agents that speed healing from cold sores and herpes.

A multicenter, double-blind study showed that a concentrated ointment (700 mg crude drug per gram of ointment), applied bid to qid for 5 to 10 days, began to relieve symptoms by the second day of treatment. By the fifth day, 50% more participants applying lemon balm versus placebo noted full symptom relief, and recovery involved less scabbing than with placebo. Both patients and their doctors preferred the lemon balm treatment. Lemon balm ointment at this level of concentration is not currently available in the United States. Tea can be used when cooled and applied topically.

Freeze-dried liquid extracts are both antithyrotropic and antigonadotropic in laboratory tests. Lemon balm extract interferes with thyroid stimulating hormone binding with Graves' immunoglobulin (Graves'-specific IgG), and consequent thyroid activation, a finding that supports lemon balm's use in the treatment of Grave's disease.

Eugenol, geraniol, and nerol, constituents in many plant volatile oils in addition to lemon balm's, have been evaluated individually. Eugenol, which is used in dentistry as an antiseptic and anesthetic, has convulsant, antioxidant, hypothermic, spasmolytic, central nervous system depressant, and platelet aggregation suppressant actions. Spasmolytic actions pertained to general smooth muscle activity in both human and animal experimental models; platelet aggregation provoked by arachidonate, adrenaline, and collagen was blocked in vitro. Geraniol's antiseptic actions are seven times more potent than phenol. Antibacterial actions of both geraniol and nerol are under investigation.

• For difficulty in sleeping, or to reduce symptoms of gastrointestinal distress: 1.5 to 4.5 g dried herb as tea several times daily or as directed by physician, or tincture, 2 to 5 ml tid, or equivalent in fluid extract or encapsulated form.
• For cold/herpes sores: Steep 2 to 4 tsp. dried leaf in 1 cup boiling water for 10 to 15 minutes, cool, apply topically throughout the day.

The American Herbal Products Association safety rating for lemon balm is class 1, safe with appropriate use. The German Commission E cites no associated toxicity or side effects.

Emmenagogue; do not use during pregnancy.

No specific interactions between lemon balm and conventional medications are known to have been reported in the literature to date, including the German Commission E monograph (Blumenthal 1998). However, because of the ability of lemon balm to inhibit binding of bovine thyrotropin to human thyroid plasma membranes in a potent, dose-related fashion in vitro, systemic use of lemon balm with other thyroid medications may influence their action, although this has not been tested (Auf'mkolk et al. 1984).

Dietary supplement in U.S.; leaf preparations are approved for use as tea in the treatment of functional digestive distress and insomnia by the German Commission E.

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