Does Aromatherapy Pass the Sniff Test? with Melissa Young, MD

Podcast Transcript

John Horton:

Hey there, and welcome to another Health Essentials Podcast. I'm John Horton, your host.

Do you ever smell something and feel more relaxed, energized or vibrant? Consider that our starting point for a conversation on aromatherapy. This form of complementary and alternative medicine has been around since the days of Hippocrates, but somehow, it's more popular now than ever before. The global market for aromatherapy is expected to reach $5 trillion — yes, trillion — by the year 2050. So what exactly are people getting for that investment?

That's what we are going to chat about today with Dr. Melissa Young, a functional medicine specialist and frequent podcast guest. She's one of the many experts at Cleveland Clinic who pop into our weekly show to talk about health trends and whether they're worth trying. Now, let's spend a few minutes with her to find out whether our aromatherapy passes the sniff test.

Dr. Young, thanks for answering our call yet again to come on the podcast.

Dr. Melissa Young:

Thank you so much for having me again.

John Horton:

I always feel like our conversations focus on topics that walk the line between what's scientifically proven and what's fueled by anecdotal tales. What general guidance do you give people when they're considering whether to try what's considered an alternative treatment method?

Dr. Melissa Young:

Talking with your medical provider about whether certain a modality is safe for you, certain things can be safe for one person, not another. And I think that trying to understand if there is science behind that, whether that's actually something that is effective, but also is safe is key. So your medical provider is probably your best bet in understanding that for a certain individual.

John Horton:

Well, we trust you as a medical advisor, which is why we have you on the podcast today and why we're tackling the subject of aromatherapy. Let's shift right into that and let's look at the long history of people using this method of treatment in search of better health.

Dr. Melissa Young:

Absolutely, and it's been used for thousands of years. Hippocrates, the father of modern medicine, felt that aromatherapy was beneficial to health in aromatherapy baths and massage. So I thought-

John Horton:

…Those are strong roots.

Dr. Melissa Young:

Strong roots, absolutely. But it goes back thousands of years, even for use in different countries. And so India and China, Iran, Iraq, Greece. So very broad history of use in baths and socialization, and even therapeutically for health reasons. And it's exciting to see that history and start to bring that into the use of medicine currently.

John Horton:

Yeah, it's amazing how many cultures it's really ingrained in.

Dr. Melissa Young:

Absolutely. And even France has this history of using aromatherapy. And we're now doing more studies trying to understand the science behind aromatherapy and where it may be most useful.

John Horton:

Well, and that leads right into our next question, which is looking at where we're at today with aromatherapy. How is it being used as a complementary or alternative treatment method?

Dr. Melissa Young:

I think I agree, right now, we're terming it “complementary and alternative medicine,” using it as a complementary modality with conventional medicine. And we're seeing it used actually in hospitals now. There's been some good evidence for use in helping with pre-procedure anxiety. So say someone has anxiety about going into an MRI machine for imaging, or even preoperatively … helps reduce anxiety. There was a good study of reducing anxiety in ICU patients. I think some of the best evidence is in anxiety, stress, but also decreasing menstrual cramps. We call that-

John Horton:

…Wow.

Dr. Melissa Young:

Yes, by using aromatherapy topically with abdominal massage for women with cramps. Also, good evidence for helping with sleep. We're seeing more and more of that evidence, but there's still a call for more studies and looking at it for additional issues related to medical problems.

John Horton:

I saw where it was even tied in with care for dementia and even cancer.

Dr. Melissa Young:

Yeah. It is used more in cancer care for perhaps decreasing nausea, perhaps vomiting, mostly nausea for patients undergoing chemotherapy. It's used in end-of-life care and palliative care for reducing anxiety. There have been mixed studies at this time for dementia, so I think we don't know yet. There's been studies that are positive, but also a lot of studies that have not shown benefit.

John Horton:

One of the terms that we mentioned just a minute or so ago was complementary or alternative treatment. Can you give us just a little bit of what that means?

Dr. Melissa Young:

Definitely. I've been practicing integrative and functional medicine now for over 20 years. When I first started practicing, really, most of what we were doing was complementary and alternative medicine, where we were using wonderful modalities in the allopathic or Western medicine model as a complement to support regular Western medicine. And as time has gone on and there's more research in this area, we also look into say the traditional use, meaning these hundreds and sometimes thousands of years of use of certain modalities. We think about traditional Chinese medicine and Ayurveda aromatherapy. And using some of that data of … we know in a clinical setting, something may be helpful where we don't have all the medical evidence yet.

So we're learning more and more. And we're finding as time goes on in integrative and functional medicine, we can use some of these things truly therapeutically. But when we think about something aromatherapy right now, it's complementary to conventional medicine.

John Horton:

It's so interesting how that's all meshing together and you take these things that have been used, like you said, for thousands of years and maybe without a lot of this research and science maybe behind it, but then, tying it into the modern medicine that we have and using them in conjunction with each other.

Dr. Melissa Young:

Definitely. I was just working on a talk that I'm going to be giving on migraine. And now, we know there are studies that show supplements — nutrients like CoQ10 and magnesium and vitamin B2 — have good science behind them for increasing prevention of headache. And many of the conventional-minded and trained neurologists are now actually recommending those things.

So I think we're in a wonderful transition in medicine where we're getting more of the medical support in the literature, and not everything that we used to think of as complementary and alternative, I think, will stay that way. It'll become more incorporated into mainstream.

John Horton:

With aromatherapy, too, then, how much of that is backed by scientific research versus just these glowing reviews that people give it?

Dr. Melissa Young:

I think there's more and more data, which is very exciting, so more studies showing benefit. Some of the studies, sure, are still mixed, but I think there's enough science now for certain things that we've been talking about, especially anxiety and mood, stress. We talked about menstrual cramps, sleep, this sort of pre-procedure reduction of anxiety.

So certain things have more science, and then, in the world of ... we want to ask, as long as this doesn't cause harm or we know how to guide patients to avoid harm, if it feels good and we see benefits in a clinical setting, I think there's still some support for using certain things.

John Horton:

And aromatherapy does have that stamp of approval from various organizations, too, right?

Dr. Melissa Young:

Yes. Certainly, many nursing organizations — and nurses are I think the front line of using therapeutic aromatherapy in the hospital. So absolutely we're seeing that gain traction.

John Horton:

Can you walk us through how aromatherapy works? I mean, it's fascinating to me how just breathing in a certain fragrance can trigger a bodily response like the ones that we've been talking about.

Dr. Melissa Young:

Absolutely. Aromatherapy is the use of essential oils for different conditions or for, as we talked about, lowering stress and anxiety. And they are concentrated plant essences, different parts of plants from leaves and flowers. And so the active chemicals in the essential oils, we can inhale them or put them on topically, but in terms of inhalation, it's going to go up our nose into the olfactory nerve, which then goes right into the brain, especially the area of the limbic system that controls emotion. And so that's one of the reasons we can see people feel calmer or seem to feel happy when they're inhaling certain of these essential oils.

But it also can go to other parts of the body like the gastrointestinal tract. And again, we can put it on the skin — which we'll talk about safe ways to do that — but it influences our brain and our nervous system, which is incredible.

John Horton:

It really is. It's wild to think that you just sniff in these molecules and they get up in your head and they trigger these hormone releases and these feelings and all of that. It's hard to believe it works that way.

Dr. Melissa Young:

Well, and I think what's exciting about trying to look at the science behind these modalities that have been used for so long is … it's so exciting when we find the mechanisms and something that you wouldn't necessarily have thought that you're going to be changing neurotransmitters and neurochemicals that affect our brain and affect different areas of the body … is incredibly exciting.

John Horton:

You had mentioned the inhalation, which is what I think a lot of people think of with aromatherapy. And that's just … you vaporize these essential oils and you can smell it, right?

Dr. Melissa Young:

Yes, it doesn't necessarily have to be vaporized in a diffuser, but yes, just smelling the essential oil. Whether you're opening the bottle or putting it on the skin, you can diffuse it as well, that those molecules just go right to that olfactory nerve into the brain and nervous system.

John Horton:

When you use it topically, like you had mentioned in massaging it, is it more that you're smelling it as it goes on, or is there something with it being on your skin?

Dr. Melissa Young:

It's a little of both, but primarily, it's the smell and that going to the olfactory nerve to the nervous system. I think, too, perhaps we'll see, I didn't see this necessarily in the studies, I was looking at menstrual cramps, but it makes sense to me that if you're using essential oils with abdominal massage, you're calming the nervous system in multiple different ways. Both by massage of the abdomen and the pelvis, but as well, those particular essential oils are very calming to the nervous system.

John Horton:

Now, when we're talking about essential oils, can you go over a few different things that people might be using there and what some specific, I guess … these herbs target?

Dr. Melissa Young:

Definitely. I think one of the top essential oils that we have, one — good data on but is used widely — is lavender oil. And that's frequently used for anxiety. I would say stress is a broader category. There's an epidemic of people feeling stressed these days.

And especially for sleep. Some people are putting a drop of lavender oil say on a cotton ball, and you can put that between your pillowcase and your pillow, or just diffuse it in the bedroom. I think those are some of the really key problems that people are using those for.

John Horton:

You just think of smelling lavender and you feel a little more relaxed. It's one of those things we're kind of programmed that way right now.

Dr. Melissa Young:

And it's interesting. We're programmed, yes, but now, we have more of the data of why that is relaxing, and so we also ... it can be a placebo effect on one hand, as you said, we all know in some ways that lavender is effective, so we get two benefits from lavender oil.

John Horton:

What are a few of the other, I guess, top-smelling items that are out there?

Dr. Melissa Young:

Well, especially for calming, clary sage, chamomile, geranium — those are all wonderful for the calming benefits of using the essential oils.

John Horton:

When we start talking about the essential oils, I know one thing that always comes up is whether those are regulated. And I think that's where some of the questionable aspects of this come into play, right?

Dr. Melissa Young:

I think, absolutely, essential oils, and we've talked about supplements, dietary supplements in the past, and so in particular, essential oils are considered cosmetic by the FDA, and so they're not regulated in a way that ... the patient still needs to do due diligence in making good decisions.

But it's important to know that not everything you see on a store shelf is actually going to be a true essential oil. It can be adulterated. If it has "fragrance" on the label, that means it's not a pure essential oil. There are manufacturers who don't do their due diligence in proper sourcing, making sure when we can, they're organic, so we're avoiding pesticides and herbicides. So it can be the Wild West out there, and it's important that patients know they need to really talk to their medical provider about how to choose wisely.

John Horton:

Are there any just quick tips people should use when they're looking at purchasing an essential oil, like something you should always want to see on that packaging?

Dr. Melissa Young:

I would look for a few things. One, generally, you want a dark bottle. So if it's in a clear bottle, that's not something you want to choose because it's going to deteriorate quickly. Ecosert is one organization you could look at. When possible, choose organic. It should actually have the Latin name on the label for the plant. And doing due diligence, looking for reputable companies. And also looking for third-party testing, that might be important as well, that you're looking for purity.

John Horton:

I like the idea of looking for the Latin name instead of just a plant we picked up somewhere.

Dr. Melissa Young:

Yes, for sure. Absolutely.

John Horton:

In looking at everything that we've covered here today, which has been a lot, help somebody work through the decision-making process on whether or not they're going to try aromatherapy and then how they might go about doing it.

Dr. Melissa Young:

I think for people who are looking to perhaps help with mild sleep difficulties, feeling stressed, maybe a bit anxious, we talked a bit about, say, menstrual cramps, I think that the aromatherapy might be actually very therapeutic. We, again, want to look for reputable companies. It is important … there are certain cautions that we want people to take that they may not be aware of, is most oils should not be applied to the skin without a carrier oil. There can be burns on the skin. Some also make you photosensitive, so you don't necessarily want to put on essential oils to the skin and then go out in the sun.

We could talk about a few more cautions as well. But I also … when we think about that drop of lavender oil on a cotton ball under your pillow for sleep, these are simple things that actually may have a wonderful therapeutic benefit. And we're in a very tumultuous time, people are stressed and anxious, and I think for the majority of people, if they're provided with those particular cautions, this can be a very safe and therapeutic modality for them.

John Horton:

And just in case people aren't familiar with the term, the carrier oil you had mentioned, that's just something that helps dissolve these essential oils down a little bit.

Dr. Melissa Young:

Correct. And yeah, coconut oil, grape seed oil — there's actually a whole host of them. But the essences of the essential oils are so concentrated that they really need to be diluted for application, whether that's you're going for a massage with use of essential oils or you're just wanting to apply it to the skin.

John Horton:

You had mentioned a few other maybe reasons to be cautious or some other risks. Can you go over a few of those?

Dr. Melissa Young:

Sure, absolutely. And so I'm always cautious about using essential oils around children and pets, especially in diffusers. I think it'd be fine for someone to use a little bit of that topically, but I wouldn't diffuse or use the diffusers around children and pets. We talked about photosensitivity. People can get severe burns going out in the sun after using a lot of essential oils.

John Horton:

I know one of the things I know we always emphasize here is if you have a medical condition and you're looking at aromatherapy to ease some of those symptoms, you should talk with your healthcare provider or whoever you're working with, just to go over what you're using and how to do it.

Dr. Melissa Young:

For sure. And you prompted my memory, thank you so much. People with seizure disorder and epilepsy would not be good candidates for using aromatherapy. I'm always also cautious in advising people … if you have migraine headaches, if you have asthma or breathing problems, aromatherapy may not be for you. That may be triggering as well.

John Horton:

From everything you've said, though, it sounds like aromatherapy is something that can be used just in little ways within your life to possibly, like you said, give you a little stress relief or just calm you down and make you feel a little better.

Dr. Melissa Young:

Yes. And I think that's the beauty of it, it's something you can do on your own after doing the little bit of research and maybe listening to this podcast to know the concerns and cautions. But it's simple. Most people do get therapeutic benefit, especially for lowering that stress response and helping with sleep and anxiety.

John Horton:

Well, you've summed everything up really well as you always do, Dr. Young. But we're nearing the end of our time here today, so before we say goodbye, is there anything else you'd like to add on aromatherapy and just getting into that world?

Dr. Melissa Young:

Always talk to your medical doctor first if you have medical conditions. I think it's an exciting area of research, and we're going to learn more in the future about additional conditions that it may be beneficial for. And I think that … go to a health food store, which is a good place to start, that's going to have a higher level of choice of good products, if you're not sure where to start. And it's a simple place to begin to try to reduce some of the stress people might be feeling.

John Horton:

Well, it's hard to argue with that, and I know we could all use a little stress relief, as we talk about frequently.

Dr. Melissa Young:

Absolutely.

John Horton:

Well, thank you again for coming on. It is always a delight.

Dr. Melissa Young:

Thank you so much. It's always fun.

John Horton:

Aromatherapy has been used for thousands of years and its popularity continues to grow given the belief in its potential powers. Do your research before starting a program though and talk to your healthcare provider about how you can do it smartly and safely.

If you liked what you heard today, please hit the Subscribe button and leave a comment to share your thoughts. Until next time, be well.

Speaker 3:

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