When Listening to Your Body is Not Enough

If you read my blog or follow me on social media, you know that I am keenly aware of essential oil safety issues and misinformation and love to research and write about the topic. When safety concerns come up pertaining to essential oils and aromatherapy practices, it goes beyond "listen to your body." Self-awareness is a crucial component, but not the be all end all good advice. No one will be able to tell if they are damaging their liver and kidneys by ingesting improperly diluted essential oils on a regular basis. It would take routine blood tests to ascertain that type of issue. 

It takes a lot to keenly "listen to your body" because we encounter so many different things on a daily basis from what we eat, drink, breathe, allergens, pollutants, fragrances, etc. It is an obvious sign that if I put an essential oil product on my skin and I get a rash that most likely that was the cause... or was it a combination of different factors? Will it happen all the time? This can happen with anything. I realized rather shockingly that while I have never had a problem consuming anything using baking soda as an ingredient that I cannot use natural deodorants that contain baking soda as it turns my armpits into itchy, red, fiery, painful pits of agony. There is a lot of gray area when some signs might not be obvious.

Recently, I discovered that German Chamomile should be avoided all routes with the blood pressure medication that I take -- I did not notice any issues, but I do not use German Chamomile regularly, but it is something to be cognizant about. I switched out the two things that I occasionally use with German Chamomile in it with another oil with similar therapeutic properties. Knowing this, I will have to be careful when preparing blends for clients and customers so that I don't accidentally cause myself to have issues by incidental exposure.

According to Tisserand & Young: German Chamomile is to be avoid all routes (topical, internal, and inhalation) due to drug interactions with German Chamomile for drugs that are metabolized by the enzymes CYP2D6, CYP1A2, CYP2C9, and CYP3A4.

• CYP2D6: Donezepil, Alprenolol, Carvedilol, Propranolol, Codeine, Lidocaine, Mexiletine, Sparteine, Amitriptaline, Clomipramine, Imipramine, Haloperidol, Thiordazine, Domoperidone, Tamoxifen, Promethazine, Chlorpheniramine, Amphetamine, Ondansetron, Tropisetron, Flyoextine, Fluvoxamine, Paroxitine.
• CYP1A2: Tacrine, Tizanidine, Propranolol, Acetaminophen, Phenacetin, Flutamide, Mexiletine, Warfarin, Amitriptaline, Clomipramine, Imipramine, Mirtazapine, Clozapine, Haloperidol, Diazepam, Theophylline, Verapamil, Triamterene, Ropinirole, Estradiol, Tamoxifen, Zileuton, Ramelteon, Rasagiline, Caffeine, Naproxen, Frovatriptan (5-HT 18 D), Zolmitriptan (5-HT 18 D), Fluvoxamine
• CYP2C9: Irbesartan, Losartan, Amitriptyline, Glibenclamide, Nateglinide, Rosiglitazone, Tolbutamide, Terbinafine, Torasemide, Tamoxifen, Fluvastatin, Diclofenac, Ibuprofen, Naproxen, Piroxicam, Sildenafil, Fluoxetine
• CYP3A4: Donezepil, Carvedilol, Propranolol, Affentanil, Codeine, Fentanyl, Methadone, Losartan, Amiodarone, Lidocaine, Quinidine, Amitriptaline, Clomipramine, Imipramine, Mirtazapine, Glibenclamide, Itraconazole, Ketoconazole, Haloperidol, Ketoconazole, Diazepam, Midazolam, Triazolam, Ditiazem, Felodipine, Nicardipine, Nitrendipine, Verapamil, Cyclophosphamide, Doxorubicin, Vinblastine, Vincristine, Domperidone, Estradiol, Ethinyl estradiol, Tamoxifen, Budenoside, Dexamethasone, Hydrocortisone, Prednisolone, Astemizole, Chlorpheniramine, Terfenadine, Atorvastatin, Lovastatin, Simvastatin, Caffeine, Codeine, Cilostazol, Sildenafil, Nevirapine, Buspirone (5-HT 1A), Cisapride (5-HT 4), Ondansetron, Citalopram, Sertraline.

To explain what this means, a chemical component or multiple components in German Chamomile and other essential oils inhibit the way that drugs are metabolized by the aforementioned enzymes. Enzymes function works is different for everyone. Some people are ultra rapid metabolizers and others are slow metabolizers. The risk is that if a drug is metabolized too quickly, it may decrease the efficacy conversely if the drug is metabolized too slowly, toxicity could result. This is probably why there is a general precaution for drugs metabolized by this enzyme since it would be hard to know if you are an ultra rapid metabolizer or a slow metabolizer simply by listening to your body if not obvious symptoms emerge. Safety warnings are just that, they are there to provide us with the necessary information to make an informed decision about our health.

This is another case where "listen to your body" doesn't cover all bases. Some will argue that there are no documented cases of anyone having major issues. While that may be the case, everyone has a different physiology, so while 10 people on the same blood pressure medication may not have had an issue, you do have to take into account the 1 person who did have an issue. It all comes down to evaluating risks and knowing what those possible risks were. It is also important to note that not everyone reports injuries due to essential oils as it may not be obviously the culprit.

As an aromatherapist, I could not in good ethical practice, encourage someone to use a product that is contraindicated with their medications or a health issue. What if they were that one person who had a negative reaction? Their health and well being is not worth the risk. There are other essential oils that have the same therapeutic benefits that could be used in place of the problematic one. Besides which, this would be a huge liability issue. The mantra of anyone practicing in traditional Western medical fields or complementary alternative medical fields is "first, do no harm." 

​I urge you to read "The Unspoken Truth About Essential Oils" by Stacey Haluka and Kayla Fioravanti. It drastically changed my perspective on how safety issues are handled in the aromatherapy world especially when you have numerous people without any formal training selling essential oils and espousing dangerous myths and potentially dangerous misinformation. Stacey's story is a must read for anyone who uses essential oils personally or professionally -- even aromatherapists and other industry professionals need to read her story so they know what is at risk and how to avoid the pain and suffering Stacey had to endure. 

References:

• Tisserand, Robert, et al. Essential Oil Safety: a Guide for Health Care Professionals. 2nd ed., Churchill Livingstone/Elsevier, 2014.​