Sage is a well-known medicinal and culinary herb that has been used for many centuries in the Mediterranean region. It belongs to a widespread genus estimated to include somewhere between 500 and 900 species, which are, as one might surmise, taxonomically challenging. Some authorities include the closely related species S. lavandulifolia Vahl and S. tomentosa Mill. within S. officinalis. Sage is also chemically complex, with its chemical content varying in response to both genetic and environmental factors. It is widely cultivated and economically important. Its traditional uses were primarily medicinal; in culinary use it has become famous as a flavoring for poultry stuffing and Italian foods, and goes well with fatty meats and cheeses. For thousands of years, sage has had a particular reputation for improving memory. It has also been used to improve digestion, to treat liver diseases, and as a tonic and astringent for such symptoms as sore throat, bleeding gums, and excessive salivation, as well as fevers, colds, and excessive perspiration.

Like many members of the mint family, sage contains antibacterial and antiviral compounds, and it has been shown in animal studies to have significant antimutagenic, anti-inflammatory, and antioxidant activities. One small human trial in patients with mild to moderate Alzheimer?s disease showed that sage improved cognitive function compared to placebo and reduced agitation. Two other small trials of sage and the related S. lavandulifolia found that sage improved mood and mental performance in healthy people. Additionally, a human study found that a 15% sage extract spray was superior to placebo in treating sore throat. Animal studies suggest that sage?s ability to improve memory retention in rats may be related to cholinesterase inhibition; this effect has been found in several sage species and is attributable to multiple active compounds rather than just one chemical. One important active compound is rosmarinic acid, which is at least partly responsible for sage?s ability (in vitro) to protect cells from toxicity due to Alzheimer?s amyloid proteins. Rosmarinic acid is also found in rosemary, which is likewise traditionally believed to improve memory. Finally, two recent animal studies have found that sage improves liver antioxidant status and protects against drug-induced liver damage. As a widely used conventional food plant, sage is presumed to be safe at normal doses, and indeed human studies have reported no significant side effects.

Selected References

Afzal-Rafii, Z. 1976. Etude cytotaxonomique et phylogénétique de quelques Salvia de la région méditerranéenne: Groupe du Salvia officinalis L. Bull. Soc. Bot. Fr. 123:515-531.

Akhondzadeh, S., M. Noroozian, M. Mohammadi, S. Ohadinia, A. H. Jamshidi, and M. Khani. 2003. 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. 28:53-59.

Amin, A., and A. A. Hamza. 2005. Hepatoprotective effects of Hibiscus, Rosmarinus and Salvia on azathioprine-induced toxicity in rats. Life Sci. 77:266-278.

Eidi, M., A. Eidi, and M. Bahar. 2006. Effects of Salvia officinalis L. (sage) leaves on memory retention and its interaction with the cholinergic system in rats. Nutrition 22:321-326.

Figuerola, R., G. Stubing, and J. B. Peris. 1990. El complejo taxonomico de Salvia officinalis (sect. Salvia) en la region Mediterranea occidental: nomenclatura y nuevas combinaciones. Folia Bot. Misc. 7:81-86.

Hubber, M., H. Sievers, R. Lehnfeld, and W. Kehrl. 2006. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis ? a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur. J. Med. Res. 11:20-26.

Perry, N. B., R. E. Anderson, N. J. Brenna, M. H. Douglas, A. J. Heaney, J. A. McGimpsey, and B. M. Smallfield. 1999. Essential oils from dalmatian sage (Salvia officinalis L.): variations among individuals, plant parts, seasons, and sites. J. Agric. Food Chem. 47:2048-2054.

Rosua, J. L., and G. Blanca. 1986. Revision del genero Salvia (Lamiaceae) en el Mediterraneo Occidental: la seccion Salvia. Acta Bot. Malacitana 11:227-271.

St. Chakalova, E., E. M. Genova, and N. T. Thuy. 1993. Comparative anatomical investigations on leaves of Salvia officinalis L. and S. tomentosa Mill. Fitologija. 46:3-11.

Savelev, S. U., E. J. Okello, and E. K. Perry. 2004. Butyryl- and acetyl-cholinesterase inhibitory activities in essential oils of Salvia species and their constituents. Phytother. Res. 18:315-324.

Tildesley, N. T., D. O. Kennedy, E. K. Perry, C. G. Ballard, K. A. Wesnes, and A. B. Scholey. 2005. Positive modulation of mood and cognitive performance following administration of acute doses of Salvia lavandulaefolia essential oil to healthy young volunteers. Physiol. Behav. 83:699-709.

Tucker, A.O., M. J. Maciarello, and J. T. Howell. 1980. Botanical aspects of commercial sage. Econ. Bot. 34:16-19.