2014-04-09

Q: Dear 100 Hour Board,

Essential oils. Scam? pseudoscience? I feel like yes. Can you explain them to me? I really don't get it. How are these oils claiming to cure things like the cold, cancer, sleep apnea, insomnia, etc, etc. I feel like literally every single mommy blog I read (mostly mormon) are OBSESSED with essential oils and claim they cure illness, clean your house better than x, y, & z, and make your skin 10 years younger! Really? I am trying my best googling skills to learn more, but do any of you have experience with essential oils? I am really not trying to come across rude, so please don't take it that way. I am just very confused and don't know nearly enough about the subject to trust it or form a valid opinion yet.

thanks,

okmeowmeow

A:

Dear cat,

I, too am skeptical about the wilder claims regarding essential oils. But I have used some, and will now share my opinions and experiences. It should be noted that I bought the oils I have from Wegmans*. They are not the brand you hear about most often. Also, I do not consume the oils; I just put them on my skin.

1.) Soon after buying a few oils, I was soaking my feet in water with epsom salts and...apple cider vinegar? I forget why. I decided to add some orange oil to improve the smell. It smelled terrific, but when I was done, I found that I had chemical burns on the tops of my feet, where the oil had floated at the top and gathered around my feet. This scared me off of essential oils for a few months. (In retrospect, I probably should have diluted the oil by putting in some other kind of oil with it. Or maybe it was the combination of ingredients, which was untested and unresearched.)

2.) I have used lavender oil on a small first-degree burn, and was shocked that it actually did remove the pain. So that's nice. I also use some at night in an attempt to get its sleepy-making benefits. I'm not sure if this is working, but I do like the way my pillow tends to smell like lavender.

3.) I added some cinnamon oil to the baking soda I use to scrub my bathtub, and I can't quantify this, but it seems to be more effective with the oil than without.

4.) I have used eucalyptus oil for coughing. It seems to work okay, like a weaker version of Vick's Vapor Rub. 

5.) Recently, I used peppermint to relieve itching, and it definitely made a difference. Last summer, I would put it on to keep cool, which is also effective. It did not relieve tummy troubles when put on my abdominal area. And there was no place on my head where peppermint would make headaches go away.

6.) I put tea tree oil (melaleuca) in my homemade cleaning spray for its anti-fungal properties, and to improve on the smell of the vinegar. I also have added a few drops to a spray bottle of water, which I spray on my children's heads, hoping to ward off lice. And a member of my family may be having success using it on a fungally infected toenail.

7.) None of the oils I have tried (peppermint, lavender, Balance, Citrus Bliss***) have done anything to boost my mood or calm me down. 

So, my overall experience  with essential oils has been positive, or at least neutral. I don't feel particularly inclined to argue against any small claims I hear about them. A friend says lemon oil in a diffuser helps calm down the kids in his classroom, for instance. I'm cool with that. And I can't deny that lavender made my burn feel better.

But I just can't believe that they cure cancer, et cetera. A lady in my ward has said that lemon oil is curing her osteoporosis. This is tempting to believe, because I happen to have a couple of bones I'd love to regrow...but no. The same thing applies when I hear claims of "no side effects!" Sounds nice, because I've had some pretty bad ones. But, really, who is keeping track? I think essential oils probably can do some great stuff, but for anything serious, I need studies, not anecdotes.

- The Defenestrator

*Honestly, I originally bought them hoping to make perfume for myself** that didn't have lots of unknown chemicals it it. This was moderately successful, as I found that I really like how orange and lavender smell mixed together.

**I'm done with this. I've found some companies I trust, and I will let them mix the essential oils for me.

***Yes, those two are from doterra. A friend gave them to me in little roller bottles when I told her about my anxiety. It was very sweet of her. Unfortunately, I require medication to fix this. If I can ever find one that works.

A:

Dear okmeakwlkjdf,

As I've mentioned in a few previous responses, I am very active in the skeptical/consumer awareness community and have been working with lawmakers to try to rein in Big Alternative especially where unvalidated medical claims are being made.  Needless to say, I'm pretty stoked you asked this question.

You're intuition is mostly correct but, as the great Carl Sagan would point out, it's just as lazy to scoff alternative "medicine" as it is to religiously follow science-based medicine without the proper investigation.  So let's investigate a bit.

Let's first discuss what an essential oil is: you take an oil (a hydrophobic, fat-based liquid) and add a smell to it.  That's it.  Not much to it.  Methods of infusing the oil with scent vary from artificial (laboratory made) scents to distillation, expression (pressing really hard on something), or solvent extraction.  It should be widely noted that "essential" does not mean "essential for health" but rather "containing the essence of."  So, as you can see, we aren't dealing with anything terribly complicated here.  Oil + smelly stuff = essential oil.  

So the way I see it, we have two things we are dealing with: a fat and stuff suspended in the fat.  Can we prove that either of these components, or that these components put together, has medical benefit?

Well, yes we can!  Fats are hydrophobic and, when used topically, can create a barrier for your skin.  Moisture in your skin is repelled by the lipid barrier and remains in the skin.  Moisture (which may contain irritants) outside the skin cannot as effectively penetrate.  Here's a neat little study on this idea.  Here is another study showing the connection between various moisturizers and enhanced would healing.  I also called a couple MD and APRN friends who agreed that keeping minor wounds and burns moisturized enhances healing.  So I think we can safely say that, yes, essential oils do have benefit for healing minor skin wounds and protecting skin from irritants by creating a hydrophobic barrier on the skin.  But this benefit is more linked to them being oil-based and less to them being "essential."

As to house-hold cleaners, there is a basic chemical rule which states "like dissolves like."  Oil, not necessarily essential, has great cleansing properties when you are trying to clean away another non-polar substance.  Olive oil can clean caked-on candle wax or gunky sticker residue but not because of anything special or "natural" in olive oil.  It's just they are both non-polar substances.  I guess the benefit here of using an essential oil is that it will clean waxy build-up and leave your house smelling nice.

So now we are on to the "does the other stuff in the essential oil have clinical benefit" part of our journey.  I was able to see that many proponents of essential oils claim that they are homeopathic.  If you know the term "pseudoscience" you probably know that the homeopathic claim of* "infinitesimal bits of stuff are super great for you**" is complete*** rubbish and has been summarily disproven to the point where it's no longer**** worthy***** of comment.  And, for what it's worth, I happen to be somewhat of an expert on the mechanics of liquids and, while there is a such thing that could almost be considered "water memory" it lasts for approximately 1x10^{- at least two digit number} of a second (really, really, extremely short amount of time...if this weren't true, liquids wouldn't be liquids).  Little bits of lavender suspended in oil does not, necessarily, a super-potent remedy make.

Similarly, we are going to quickly disregard the appeal to nature argument.  Just because something is "natural" (what even is "natural" anyway??) doesn't make it good.  Cyanide is a naturally occurring substance.  Almonds which have been genetically modified through years of human cultivation so as to not contain cyanide are "unnatural."  Let that sink in for a minute.

I'll be frank and say that I have not found any properly conducted, peer-reviewed articles or other studies which have shown benefit, detriment, or zero effect of essential oils on things like cancer.  But keep in mind that "by the mouth of two or three witnesses" will the truth be known.  This holds true in scientific investigation as well.  If there is no theoretical or analytical reason to suspect that a suspension of cinnamon particles in oil becomes a cancer fighter, it's unlikely anyone would invest the money into conducting an experimental or observational study on such a thing.  And to the critics of the scientific method, I agree that lack of reason does not a strong argument make.  That being said, it is extremely unethical****** for Big Alt to make such claims without having done the proper investigation (and, in keeping with the scientific method, I agree that there are too many variables in anecdotal stories for them to be considered evidence).  

But what I was able to find, which I was surprised at myself, was possible evidence as to anti-bacterial properties of essential oils.  I've been sifting through journal articles (I am doing my best to find articles published in non-bias, reputable journals) on anti-microbial properties of essential oil.  Here is what I've found: 

Many articles showed a link between essential oils and inhibition of bacterial growth.  However, I am a touch skeptical as to their conclusions as it seems that the pH and hydrophobic properties of the oil itself are the two biggest factors in preventing bacterial (and in one study, fungal) growth.  I found no good studies on inhibition of viral reproduction.  Here's an article that studied this link.  

I found more articles which showed comparisons of various essential oils and their respective anti-bacterial properties.  I'm skeptical of these studies as they failed to demonstrate why certain essential oils seem to be more effective over others.  And until this link is made, I would be extremely hesitant on making a sweeping statement like, "essential thyme oil can be used effectively as an anti-biotic in favor of Neosporin."  Additionally, with so many different types of essential oils, it seems dangerous to make broad conclusions about them as a whole.  But judge for yourself - here's one of the better comparison articles.  The journal which published both of these articles seems to be legitimate as well.  Keep in mind that all of these articles were tested against placebo and not against any commonly used anti-bacterial topical gels.  There would be a much stronger case for essential oil use as an anti-septic if it could be shown they were as effective or more effective than leading anti-septic or anti-bacterial gels.  

So let's wrap up with a risk vs. benefit analysis.  Are there benefits to topical use of essential oils?  There certainly seem to be when compared to placebo - mostly due to the hydrophobic and non-polar properties of the oil itself and, on a lesser level, to the pH of the essential oil.  These benefits would be similar to OTC lotions.  There also seems to be some evidence to suggest that some essential oils may inhibit bacterial growth.  But, unlike topical antibiotics with which you would treat a wound, there is no evidence to suggest they kill bacteria.  There is no evidence thus far as to the bigger claims such as cancer treatment.  Final benefit: they smell nice!  While aroma therapy has little to no supportive evidence, who doesn't like to smell nice things?

Risks: they are expensive!  Seriously, with all the benefits, you can get a cheaper, likely more potent version of what you need in either a hand lotion or a tube of Neosporin.  But, whatever, if you have the money, who am I to tell you what to do with it.  Some of them can be mildly dangerous if ingested or applied to sensitive body parts (my husband who used to work in the ER told me a story of a man who used essential chili oil to enhance his love life...I don't think I need to go into detail about what went wrong here - and that's as close to anecdotal evidence as I'm going to get).  And, as with most alternative remedies, there is a secondary danger in distracting truly sick people from real cures - especially when unvalidated medical claims are made.  And, since there are so few regulations in this industry, there is no guarantee that what you see on the label is what you get in the jar.

As to all this, it seems both the risk and specific benefits are minimal.  If you like it and it makes you feel good, there is likely little danger.  Just don't expect them to be the snake oil they are all too often sold as.

As a final point, I have been reading about how the pharmacological industry uses essential oils by isolating and enhancing specific compounds in the oil.  I direct you to my most-starred footnote but will reiterate that many alternative remedies do have efficacy - the immorality in the industry lies in their abuse of consumer ignorance and refusal to treat their drugs as drugs.  Which is why I'm extremely skeptical of anything claiming medical benefit which has been able to skirt the appropriate FDA scrutiny.

Well, that was a long and likely boring way to say, "sure, there may be some benefits but likely not the miracle ones being claimed."

- Hypatia

The starred links in the homeopathy section are, in my opinion, the best and most enlightening:
* Ben Goldacre's overview of the homeopathy problem
** This one is just for fun :)
*** Jame's Randy's TED talk on the subject
**** Ben Goldacre giving a talk about the flaws of homeopathy
***** Peer reviewed meta analysis of the flaws of homeopathic trials and why the only ones which show clinical benefit of homeopathy are flawed 

****** I'd like to take a moment to explain why I am so adamant about fighting pseudoscience.  Do I believe that everything off the "holistic medicine" shelf is complete bunk?  Hardly!!  In fact, I will fully admit that many, many "alternative" cures have some efficacy.  What boils my blood is that Big Alternative has successfully lobbied in the US and elsewhere to avoid proper testing such that they may continue to make whatever claims they wish without providing security to the consumer.  We have Orrin Hatch and DSHEA to thank for that one.  If you claim your product is a drug, IT SHOULD BE TREATED AS A DRUG!!!  In the interest of full disclosure, my grandfather's death is a result of alternative medicine mislabeling so I am admittedly a touch sensitive on this subject.  Unfortunately, he isn't the only one to pay the ultimate price for lack of regulation on the alternative "medicine" industry.  Much of pharmacology is based on naturally occurring substances and I find it to be a crime of the first world that Big Alternative is allowed to sell drugs (mostly) without impunity or sell sugar pills which distract sick people from real cures.  Thankfully things are starting to turn around and many remedies which have not been properly tested and whose efficacies are not known are now made to bear a label which says as much.  Ideally, I would like to see Big Alt start participating in clinical trials to take some of the strain off the pharmaceutical industry as it is likely they could have some positive benefits on pharmacology.  (Big Pharma is hardly the ideal standard either.)  Let's get a little science in that pseudoscience!

A:

Dear okmeowmeow ~

As one of the resident naturalists, one who loves essential oils, I want to say... nothing cures everything. Not even essential oils. There is no miracle cure. For anything. And everything reacts differently to different people.

Some essential oils do work wonders for me. Others do nothing. A mix of peppermint, lavender, and frankincense can drastically reduce most of my headaches, which is fantastic when I'm pregnant and can't take ibuprofen (Tylenol doesn't touch my headaches). PastTense (a doTerra blend) does nothing for my headaches, but has been taking the edge off my sister's migraines and allowing her to function. Breathe (another doTerra blend) has been vital in helping me get through colds and excess mucus during pregnancies. Citrus oils do a great job of taking stickers off things without filling my house with fumes. My neighbor's daughter asks for Serenity every night to help her fall asleep, because she has always struggled with falling asleep until her mom found that oil and started using it.

Essential oils are not miracles. They sell them as such to get people to buy into them. Especially more expensive/higher quality companies. And yes, I've seen them do wonderful things. But I've also seen them fall flat and not do as promised.

Essential oils are tools, not miracles.

~ Dragon Lady

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