Orally, lemon balm is used for anxiety, insomnia, dyssomnia, restlessness, dyspepsia, bloating, flatulence, colic, and for attention deficit-hyperactivity disorder (ADHD). Lemon balm is also used for Graves' disease (overactive thyroid), painful periods, cramps and headache. It is also used orally for Alzheimer's disease, melancholia, nervous palpitations, vomiting, and high blood pressure.
Topically, lemon balm is used for cold sores (herpes labialis).
No concerns regarding safety when used orally in amounts commonly found in foods.
Possibly Safe when used orally or topically and appropriately, short-term. Lemon balm has been used with apparent safety for up to 4 months.76,77,78,79,80
There is insufficient scientific information to comment about the safety of lemon balm when used long-term.
Children: Possibly Safe when used orally and appropriate, short-term. A specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 1-2 tablets once or twice daily has been safely used in children under age 12 years for about a month.81 Preliminary clinical research also suggests that a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (Colimil) is safe in infants when used for up to a week.82
Pregnancy and Lactation: Refer to a Medical Herbalist
Alzheimer's disease. Taking a standardized extract of lemon balm orally, daily for 4 months, seems to reduce agitation and improve symptoms of mild to moderate Alzheimer's disease on standard Alzheimer's disease rating scales.77
Colic. A clinical trial shows that breast-fed infants with colic who are given a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (Colimil) twice daily for a week have reduced crying times compared to placebo.82
Dyspepsia. A specific combination product containing lemon balm (Iberogast, Medical Futures, Inc) seems to improve symptoms of dyspepsia. The combination includes lemon balm plus peppermint leaf, German chamomile, caraway, licorice, clown's mustard plant, celandine, angelica, and milk thistle.83, 80 A meta-analysis of studies using this combination product suggests that taking 1 mL orally three times daily over a period of 4 weeks significantly reduces severity of acid reflux, epigastric pain, cramping, nausea, and vomiting compared to placebo.84
Herpes labialis (cold sores). Applying a lip balm containing 1% lemon balm extract seems to shorten healing time, prevent infection spread, and reduce symptoms of recurring cold sores.76,79
Sleep. Taking a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) three times daily appears to improve the quality and quantity of sleep in healthy people.85
INSUFFICIENT RELIABLE EVIDENCE to RATE
Restless Sleep. Preliminary evidence suggests that a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg
(Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 1-2 tablets once or twice daily might decrease symptoms in children under age 12 years who have pathological restlessness.81 More evidence is needed to rate lemon balm for this use.
Mechanism of Action:
The applicable part of lemon balm is the leaf. Lemon balm seems to have sedative, antioxidant, and antiviral effects.76,77,78,79 Lemon balm contains citronellal, neral, and geranial aldehydes; flavonoids and polyphenolic compounds; and monoterpene glycosides. These substances may contribute to the behavioral effects of lemon balm leaf and essential oil.78 Clinical research suggests that lemon balm induces a calming effect and reduces alertness.78
Orally, lemon balm is well tolerated. Rarely it may cause nausea, vomiting, abdominal pain, dizziness, and wheezing.77
Topically, there is one report of irritation and one report of exacerbation of herpes symptoms when lemon balm was applied.76
Interactions with Herbs & Supplements:
Additive effect with other nervine (relaxing) herbs.
Interactions with Drugs:
CNS Depressants: Theoretically, concomitant use of lemon balm with drugs with sedative properties may cause additive effects and side effects.78
Interactions with Foods:
Interactions with Lab Tests:
Interactions with Diseases or Conditions:
Thyroid Disorders: In laboratory studies thyroid hormone release is affected by Lemonbalm. No reported clinical cases.
Glaucoma: Animal studies incicate there may be a problem. No reported clinical cases.
Surgery: Tell patients to discontinue lemon balm at least 2 weeks before elective surgical procedures.
Dr Clare’s Blends: 1 gm per day
Oral: For mild to moderate Alzheimer's disease, 60 drops per day of a standardized lemon balm extract, prepared 1:1 in 45% alcohol, has been used.77
For improving sleep in healthy adults, a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 3 times daily has been used for up to 30 days.85
For colic in infants, a specific multi-ingredient product containing fennel 164 mg, lemon balm 97 mg, and German chamomile 178 mg (Colimil) twice daily for a week has been used,82
For dyspepsia, a specific combination product containing lemon balm (Iberogast, Medical Futures, Inc) and several other herbs has been used in a dose of 1 mL three times daily.83,80,84
For dyssomnia in children, a specific combination product providing lemon balm leaf extract 80 mg and valerian root extract 160 mg (Euvegal forte, Dr. Willmar Schwabe Pharmaceuticals) 1-2 tablets once or twice daily has been used.81
Topical: For herpes labialis (cold sores), the cream or ointment containing 1% of a 70:1 lyophilized aqueous extract is usually applied two to four times daily from first symptom to a few days after the lesions have healed.76,79
Specific References: LEMON BALM
76. Wolbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine 1994;1:25-31.
77. Akhondzadeh S, Noroozian M, Mohammadi M, et al. Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: a double blind, randomised, placebo controlled trial. J Neurol Neurosurg Psychiatry 2003;74:863-6.
78. Kennedy DO, Scholey AB, Tildesley NT, et al. Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). Pharmacol Biochem Behav 2002;72:953-64.
79. Koytchev R, Alken RG, Dundarov S. Balm mint extract (Lo-701) for topical treatment of recurring herpes labialis. Phytomedicine 1999;6:225-30.
80. Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69:45-52.
81. Muller SF, Klement S. A combination of valerian and lemon balm is effective in the treatment of restlessness and dyssomnia in children. Phytomedicine 2006;13:383-7.
82. Savino F, Cresi F, Castagno E, et al. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res 2005;19:335-40.
83. Holtmann G, Madisch A, Juergen H, et al. A double-blind, randomized, placebo-controlled trial on the effects of an herbal preparation in patients with functional dyspepsia [Abstract]. Ann Mtg Digestive Disease Week 1999 May.
84. Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87.
85. Cerny A, Shmid K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers (a double blind, placebo-controlled, multicentre study). Fitoterapia 1999;70:221-8.