Bioclinic Naturals Peppermint Oil
Benefits: Bioclinic Naturals Peppermint Oil
- Promotes healthy digestion
- Alleviates symptoms of medically diagnosed irritable bowel syndrome
- Relief of indigestion and dyspepsia
- Decreases digestive spasms
- Reduces nausea and vomiting
- Potent peppermint oil and caraway oil combination for enhanced efficiency
- Highly concentrated active constituents of herbs – menthol and carvone
- Enteric-coated capsule improves efficacy and tolerance
Recommended Dosage: Bioclinic Naturals Peppermint Oil
1 softgel 3 times per day or as directed by a health care practitioner.
Medicinal Ingredients: Bioclinic Naturals Peppermint Oil
|Each Softgel Contains:|
|Peppermint oil (Mentha x Piperita) (aerial)||180mg|
Each capsule is enteric-coated for enhanced efficacy and tolerance.
Feature Summary: Bioclinic Naturals Peppermint Oil
Peppermint and caraway oils support healthy digestion and relieve symptoms of indigestion, digestive spasms, nausea, vomiting and medically diagnosed Irritable Bowel Syndrome. The combination of these highly concentrated oils, delivered in an enteric-coated capsule, may improve patient compliance as well as the efficacy of the active ingredients in gastric and upper intestinal tissues.
Peppermint (Mentha x Piperita)
Peppermint leaves contain a high concentration of the essential oil monoterpene menthol, along with phenolic acids and flavonoid constituents.1,2 With a long history of use in Western herbal medicine as a digestive aid, peppermint has demonstrated antispasmodic, analgesic, antibacterial, immune modulating and anti-inflammatory mechanisms.3,4
Caraway has a long history of use in Persian and Iranian paradigms for digestive support.5 Containing the essential oil compounds carvone and limonene, as well as phenolic acids and flavonoids, the antimicrobial, the antioxidant and anti-inflammatory activity of caraway may contribute to its promotion of healthy digestion.
Warnings: Bioclinic Naturals Peppermint Oil
If symptoms persist or worsen, talk to your health care practitioner.
181.6 mg 90.8 mg 30 mg The widespread clinical use and data from clinical trials assessing the efficacy of peppermint oil, caraway oil and the combination of both have documented the infrequent occurrence of adverse effects.1-3 Both peppermint and caraway oil are generally well tolerated when ingested at the recommended dosage and adverse effects are rare when delivered in the enteric-coated form.1,4
However, sensitisation to peppermint oil, caraway oil and their constituents have been observed. Side effects that have been documented with oral intake of peppermint and caraway oils, at high doses for prolonged periods, include: hypersensitivity responses; allergic contact dermatitis; digestive symptoms (abdominal pain, heartburn); bradycardia; perianal burning; muscle tremor and exacerbation of pre-existing gastroesophageal reflux disease (GERD).2,4-6
Consult a health practitioner prior to use if you are taking felodipine, simvastatin, proton pump inhibitors, antacids, histamine H2-receptor antagonists, nonsteroidal anti-inflammatories, lovastatin, amitriptyline, codeine or paracetamol. Do not take while on cyclosporine therapy without medical advice. Consult a health care practitioner prior to use if pregnant or breastfeeding. Keep out of reach of children.
Preliminary evidence (in vitro and animal methodology) has demonstrated that peppermint oil inhibits the activity of several cytochrome P450 isoenzymes including CYP1A2, CYP 2C19, CYP 2C9 and CYP 3A4. Consequently, concomitant use of peppermint oil with medications metabolised by these enzymes (i.e. proton pump inhibitors, nonsteroidal anti-inflammatories, lovastatin and amitriptyline) may increase the endogenous bioavailability and activity of such medications.5,7-9
Animal data has also shown that peppermint oil can increase the oral bioavailability of felodipine, simvastatin and cyclosporin when used concomitantly.5,9,10
Chronic ingestion of peppermint oil in animals significantly inhibited the analgesic properties of codeine; while chronic caraway oil use in mice significantly enhanced paracetamol levels.11,12
Medications that decrease stomach acid or increase gastric pH levels (i.e. antacids, histamine H2-receptor antagonists and proton pump inhibitors) may cause premature dissolution of enteric-coated peppermint oil capsules when ingested concurrently.7
- Not to be used by individuals with hypersensitivity to peppermint oil, caraway oil or their constituents.5,7
- Contraindicated in individuals hypersensitive to members of the Apiaceae or Lamiaceae families.5,7
- Not recommended for use by those with bile duct obstructions, gallbladder inflammation, biliary disorders, severe liver damage or achlorhydria.4,5,7,
- Safe oral doses in women who are pregnant or breastfeeding have not been established. Use is not recommended.5,7,13
Mechanism of Action: Bioclinic Naturals Peppermint Oil
- Functions as an antispasmodic by:
- inducing intestinal smooth muscle and proximal stomach relaxation via blocking of calcium ion (Ca2+) flux through sensory neurons of the transient receptor potential melstatin 8 (TRPM8) channel;1,4,5,14-17
- inhibiting small bowel colonic circular smooth muscle contraction by blocking Ca2+ influx through sarcolemma L-type channels;1
- influencing enteric nervous system activity by promoting membrane potential depolarisation of transient receptor potential cation channel subfamily A member 1 (TRPA1);1
- inhibiting acetylcholine- and serotonin-mediated contraction;1
- decreasing frequency and strength of migrating motor complex contractions;14
- suppressing intestinal enterocyte glucose uptake.14
- Acts as a carminative by:
- relaxing oesophageal spasms and sphincter pressure;2,5,7
- reducing gastric and intestinal foam, resulting in gastric gas release;18
- antimicrobial activity, decreasing intestinal gas.18
- Has choleretic effects by:
- inhibiting gallbladder contraction and emptying;1,5
- stimulating bile acid secretion;5
- upregulating bile acid synthesis-associated gene expression and activity (CYP7A1 and FXR).5
- Antimicrobial activity via:
- inhibition of gram-positive and gram-negative bacteria (Helicobacter pylori, Staphylococcus aureus, S. mutans, S. pyogenes, Escherichia coli, Listeria monocytogenes, Mycobacterium avium, Salmonella typhi, Klebsiella spp);1,4,5
- inhibition of gram-negative bacterial quorum sensing activity.1
- Fungicidal activity (Candida albicans, Aspergillus albus).4
- Virucidal against herpes simplex virus (HSV)-1 and -2 and influenza viruses.4,5
- Acting as an antioxidant and free radical scavenger.5,7,15
- Functions as an analgesic by:
- stimulating excitation of gamma-amino butyric acid (GABA) receptors and sodium ion channels;1,5,15
- mediating gastrointestinal TRPM8 and TRPA1 receptor potential activity.1
- Antimicrobial activity against S. aureus, S. typhi, C. albicans and Aspergillus niger.3,4,13
- Has anti-inflammatory effects including inhibition of interferon-c (IFN-c), interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α).13
- Promotes gastric acid and bile secretion.13
- Reduces gastric mucosal lesions.3
- Antioxidant activity.3
Pharmaceutical Commentary: Bioclinic Naturals Peppermint Oil
The current clinical use of peppermint and caraway for a wide range of digestive disorders and symptoms is based on traditional practice. Peppermint has a long history of use in Ancient Greek, Roman and Egyptian cultures as well as many eastern and western medicinal paradigms for gastrointestinal issues. This includes stomach and bowel spasmodic pain, flatulence and nausea. Caraway has been used in Persian, Northern European, Indian and Russian traditional medicine systems for digestive concerns including dyspepsia, bloating, flatulence, indigestion, stomach spasms and pain, constipation, nausea and worms.1,3,7,13,18,20
Peppermint is one of the most ancient therapeutic herbals, as reflected in its name. The Latin word ‘mentha’ comes from an ancient Greek mythological nymph called ‘Mintha’ who was turned into mint by Pluto’s wife Persephone following her learning of her husband’s affection for the nymph.4,21 The name ‘caraway’ and ‘carvi’ is derived from the ancient Arab word ‘karawya’ in reference to the seeds.20
Indigenous and cultivated in Europe, caraway and peppermint are also propagated in Asia and North America, respectively.7,20 Caraway is considered by herbalists to have stimulatory and antispasmodic effects, while peppermint is thought to possess antispasmodic, antiemetic, carminative, analgesic, antimicrobial, stimulatory, astringent and antiseptic properties.4,13
The active constituents in both peppermint and caraway are responsible for the herbs’ therapeutic effects. Of the 30 constituents or more present in peppermint leaf, the primary active compounds in its oil are menthol (comprising 35-55%) and methone (20-31%). Other constituents of peppermint oil include methyl acetate, isomenthone, menthofuran, isomenthone, carvone,1,8 cineole, limonene, eucalyptol, myrcene and pulegone.7,18,21 Caraway fruit contains the most significant concentrations of essential oil; carvone (50-65%) and limonene (up to 45%) are the predominant volatile compounds, with lower quantities (<1.5%) of β-myrcene, carveol and dihydrocarveol.3,13,20
The pharmacokinetics of peppermint oil is based primarily on animal data.1 Following rapid absorption after oral ingestion, the menthol constituent in peppermint oil undergoes hepatic metabolism via the CYP2A6, CYP3A4 and glucuronide pathways to form menthol glucuronide, which subsequently undergoes enterohepatic circulation. Approximately 50% of the glucuronic acid conjugate (based on 100 mg oral dose) is absorbed with the remainder excreted mainly via the urine.1,18 Further investigations are required to determine the specific pharmacokinetic metabolism of caraway oil in humans.3
Current evidence demonstrates significant efficacy of the combination of peppermint and caraway oils for symptoms associated with medically diagnosed irritable bowel (IBS) syndrome and dyspepsia.14,15,22,23
Irritable Bowel Syndrome:
Medically diagnosed IBS is a persistent functional gastrointestinal disorder with complex pathophysiology that includes altered gastrointestinal motility, immune activation, dysbiosis, intestinal permeability, bile acid malabsorption and gut-brain interactions. Finally, visceral hypersensitivity, food intolerance and psychosocial distress can also be contributing factors to IBS.15,22,23 The disorder is characterised by many symptoms including constipation, diarrhoea, bloating, abdominal pain and changes in bowel habits. However, there is heterogeneity in the specific clinical presentation both between and within individuals depending on the aetiological factors present.22,23
Oral ingestion of enteric-coated peppermint oil alone, and when combined with caraway oil, has demonstrated significant benefits by alleviating many of these symptoms in adults with the disorder.1,14,15
A number of randomised, double-blind, placebo-controlled clinical trials conducted over the last few decades have investigated the role of peppermint oil for the management of IBS symptoms in adult subjects.24-29 Two earlier clinical trials were conducted over 3 and 4 weeks in 29 and 110 subjects respectively, with the primary outcome for both trials being changes in IBS symptoms.24,25 When taken 3-4 times daily for the intervention period, peppermint oil resulted in significant improvements in the overall IBS symptom score (50% vs 12.5% in placebo group).24 In the other clinical trial peppermint oil compared to placebo resulted in significant reductions in the severity of abdominal pain (79% of subjects vs 43%), abdominal distension (85% vs 29%), stool frequency (83% vs 32%) and flatulence (79% vs 22%).25
Similar results were observed in trials that had longer intervention periods.26,27 In 178 subjects taking peppermint oil for 3 months, there were significant improvements in gastro-enteric symptoms (97% vs 33% of placebo) and physical discomfort (37% vs 18%),26 as well as abdominal pain and quality of life in 90 subjects over 8 weeks.27
These findings are also consistent with more recent investigations. Alam et al28 observed improvements in abdominal pain in 74 subjects over 6 weeks (4.94 +1.30 vs 6.15 +1.24, p>0.001), while 72 patients taking peppermint oil (180mg equivalent of 83mg menthol daily) for 4 weeks had significant reductions in total IBS symptoms scores (TIBSS) including abdominal pain and discomfort, bloating, distension and pain at evacuation (40% vs 24.3% of placebo subjects).
A 2019 meta-analysis that was conducted on 12 randomised controlled trials with 835 patients assessing the impact of peppermint oil for the treatment of IBS found that peppermint oil was effective for pain and global symptoms in adults with IBS.15
The combination of peppermint and caraway oil has also demonstrated significant efficacy for the relief of IBS symptoms.14 A meta-analysis of randomised controlled trials evaluated the effect of a daily dose of peppermint oil of 180-270mg and caraway oil 100-150mg in adults with functional dyspepsia with IBS over 4-weeks. The primary and secondary outcomes were changes in pain intensity, flatulence, abdominal pressure/heaviness and diarrhoea, respectively. Compared with placebo, peppermint and caraway oil resulted in significant improvements in IBS symptoms including pain and the intensity of flatulence, diarrhoea and feelings of pressure, heaviness, tension or fullness symptoms compared with placebo and baseline symptom severity
Overall the evidence demonstrates that peppermint and caraway can have significant benefits in many symptoms associated with medically diagnosed IBS.1,14,15
Functional dyspepsia (FD) is characterised by symptoms including postprandial fullness, early satiation, epigastric pain and burning and the absence of structural abnormalities.30 Aetiological factors contributing to the onset of FD are similar to IBS (i.e. gastrointestinal inflammation, dysmotility, dysbiosis, visceral hypersensitivity and psychosocial distress) and the two disorders often coexist, with approximately 37% of subjects with FD also presenting with IBS.31
Consequently, a substance that has been demonstrated to be effective for the clinical management of IBS symptoms, may also result in the improvement of FD symptoms. In the meta-analysis conducted by Madisch et al14 discussed earlier, a daily dose of 180-270 mg of peppermint oil and 100-150 mg of caraway oil in adults with FD and concomitant IBS over 4-weeks, was equally effective in alleviating symptoms of FD as it was for IBS. Specifically, peppermint and caraway reduced the intensity of epigastric pain at a rate of almost twice that experienced by placebo subjects.
A number of other clinical trials highlight the clinical benefit of the combination of peppermint and caraway oils in subjects with FD.2,13 Specific functional benefits observed in these studies included improvements in the quality of life, Global Overall Symptoms and Clinical Global Impressions scores, as well as reductions in the frequency of pain and dyspeptic symptoms, abdominal pain and discomfort and the number and strength of migrating motor complex contractions.2,13
These data show that when combined with caraway oil, peppermint is effective for alleviating symptoms associated with functional dyspepsia.1
Clinical Evidence: Bioclinic Naturals Peppermint Oil
Both peppermint oil and the combination of peppermint/caraway oils in enteric-coated capsules are effective for relieving symptoms associated with functional gastrointestinal conditions including medically diagnosed irritable bowel syndrome (IBS) and dyspepsia.4, 6-9
Irritable Bowel Syndrome
A 2019 meta-analysis assessed the efficacy and safety of peppermint oil and caraway oil for the global improvement of IBS symptoms and abdominal pain in adult patients with medically diagnosed IBS.4 The 12 randomised controlled trials (total n = 835) used a daily dose of 180 mg of peppermint oil and 100 mg caraway ranging from 3-12 weeks’ duration. This analysis found that compared with placebo, treatment with peppermint and caraway oils significantly improved global symptoms of IBS and abdominal pain and also exhibited a good safety profile.
Functional Dyspepsia (FD)
Several clinical trials have demonstrated the effectiveness of a fixed peppermint/ caraway oil combination for symptoms associated with functional dyspepsia (daily dose = 180 mg/90 mg, respectively).6-9
A 2017 prospective, double-blind, multicentre clinical trial tested the efficacy and tolerability of peppermint/caraway oil in 114 subjects with chronic or recurrent functional dyspepsia.6 Following a 1-week placebo run-in phase, subjects were randomised to either the treatment or placebo group (both groups n=53) for 4 weeks, taken with liquids in the morning and lunch before meals. The primary outcome measure was the interventional impact on dyspeptic complaints consistent with epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) (abdominal pain, discomfort, cramping or bloating), as assessed by the Nepean Dyspepsia Index (NDI). Following 4 weeks of treatment, peppermint/caraway oil was more effective than placebo for improving PDS and EPS symptoms and pain and discomfort scores (62.3 versus 26%). The active treatment also resulted in 86.2% of subjects experiencing clinically meaningful improvements of at least 10% compared with 57.1% of placebo subjects. Peppermint/caraway oil was concluded to be effective for improving pain, discomfort and quality of life in subjects with FD.
Similar results were observed in a separate prospective, double-blind, multicentre clinical trial using the same oil combination and daily dose in 114 adult subjects with FD for 4 weeks.7 The primary outcome was the effectiveness of active treatment versus placebo on EPS and PDS. After 4 weeks of treatment, subjects in the peppermint/caraway oil combination had more significant improvements than the placebo group in EPS (by 3.0 ± 2.6 vs 1.0 ± 2.1) and PDS (2.6 ± 2.3 vs 1.0 ± 2.4 points). The authors stated that the peppermint/caraway oil combination significantly improved EPS and PDS symptoms in FD subjects.
The fixed peppermint/caraway oil combination was also assessed for a 12-week period in a double-blind, randomised trial in adult subjects with FD with a history of chronic/relapsing symptoms.8 Compared with placebo, peppermint/caraway oil resulted in significant reductions in NDI pain (by 8.7 ± 4.9 vs 5.1 ± 4.9 points, p=005)) and discomfort (3.7 ± 2.5 and 1.3 ± 2.6 points, p=0.0014) scores. Peppermint/caraway also resulted in significant improvements in the quality of life of FD subjects.
A 2018 systematic literature search of randomised controlled trials was conducted to assess the effectiveness of the fixed peppermint/caraway oil combination for reducing concomitant IBS-associated symptoms in subjects with FD.9 The 3 clinical trials included used this combination for 4 weeks, with changes to pain intensity and IBSassociated symptoms (flatulence, feelings of pressure/heaviness/fullness, diarrhoea) as the primary and secondary outcomes. The active treatment was associated with significant reductions in pain intensity values (by 50-75% vs 45% of placebo subjects) and concomitant symptoms. The authors suggested that peppermint/ caraway oil is an effective treatment option for alleviating IBS symptoms.
References: Bioclinic Naturals Peppermint Oil
- World Health Organisation. WHO monographs on selected medicinal plants, volume 2. Geneva, 2004.
- Bone K. A clinical guide to blending liquid herbs: herbal formulations for the individual patients. Churchill Livingstone: Missouri, 2003.
- Chumpitazi BP, Kearns GL, Shulman RJ. Review article: the physiological effects and safety of peppermint oil and its efficacy in irritable bowel syndrome and other functional disorders. Aliment Pharmacol Ther 2018; 47: 738-752.
- Alammar N, Wang L, Saberi B, Nanavati J, Holtmann G, Shinohara RT, Mullin GE. The impact of peppermint oil on irritable bowel syndrome: a meta-analysis of the pool clinical data. BMC Comp Altern Med 2019; 19: 21.
- Mahboubi M. Carway is an important medicinal plant in the management of diseases. Natural Prod Bioprospecting 2019; 9: 1-11.
- Rich G, Shah A, Koloski N, Funk P, Stracke B, Kohler S, Holtmann G. A randomized placebo-controlled trial on the effects of Menthacarin, a proprietary peppermint- and caraway-oil-preparation, on symptoms and quality of life in patients with functional dyspepsia. Neurogastroenterology & Motility 2017; e131132.
- Holtmann G, Rich G, Wieland V, Funk P Keiser M, Koehler S. Menthacarin for the treatment of epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS): data of a placebo-controlled trial revisited. Z Gastroenterol 2015; 53 – KG253.
- Holtmann G, Stracke B. Effects of Menthacarin on symptoms and quality of life in patients with functional dyspepsia: results of an 8-week optional placebo-controlled follow up. Z Gastroenterol 2016; 54 – KV420.
- Madisch A, Miehlke S, Labenz J, Stracke B, Kohler S. Effectivenss of Menthacarin on symptoms of irritable bowel syndrome. Wien Med Wochenschr. https:// doi.org/10.1007/s10354-018-0635-1.