Should anyone take essential oils internally?

At the Complementary Health Professionals office we are receiving numerous calls and emails about internal use following the advocacy of such practices from certain multi-level marketing sales companies. To help all our members, we have produced a policy statement on the subject advising anyone who may be considering becoming such a sales advisor and we know that other professional associations have made similar announcements. But what are the consequences of taking oils internally and why is this such a big issue here in the UK? Another question we are being asked more and more frequently is "what is a therapeutic grade essential oil and how does this compare to 100% pure essential oils?” This article aims to put the myths to rest and give the aromatherapist and general consumer the clear facts. Let's take each issue separately and start with internal use.

Firstly, the Aromatherapy Council (AC), the lead body for Aromatherapy in the UK, states in its Core Curriculum that essential oils should only be applied topically (a copy of which can be found at http://www.aromatherapycouncil.org.uk/standards). This means that all aromatherapists who have undergone accredited aromatherapy training in the UK or followed the UK syllabus will not have studied the complex pharmacology of how essential oils interact with our internal systems. Therefore they are not qualified to administer essential oils internally without further medical training, nor are they insured. There is a possibility of essential oil molecules being changed by digestive enzymes, strong acids and metabolism in the gastrointestinal tract and potential for liver damage (Price 2012). As an aromatherapist, what you will have learned is that essential oils are complex natural chemicals, some of which contain harmful toxins and you will have studied essential oil chemistry in some depth. As a result, you will know that even topically, essential oils need to be diluted in a base product in the main as they can cause skin irritation and sensitisation. Therefore, it is my belief and that of the majority of highly trained aromatherapists I have the pleasure to call my colleagues, that only an aromatherapist who has had extensive training can advise on the correct use of essential oils on the skin, especially where the client is taking medication or may be pregnant.

One case in point is a recent posting on Facebook of a woman who applied essential oils neat on her skin and then went to a tanning salon, exposing herself to UV radiation. Aromatherapists are trained to know which oils are phototoxic and to advise clients accordingly, so this situation with terrible burns would not have occurred in trained hands. Additionally, we as aromatherapists would rarely advocate undiluted application of essential oils even onto the skin with a few exceptions.

Marguerite Maury, who was a trained nurse and surgical assistant, is affectionately known as the Mother of Modern Aromatherapy Practice. In the 1940's, she lectured on the subject and fundamentally developed the topical method we use in practice today because of concerns surrounding the internal use of essential oils by doctors in France and she advocated that aromatherapy should only be "performed by practitioners in the same way as acupuncture...." (Maury 1964). Her prodigy, Daniele Ryman, one of the world's leading authorities on aromatherapy and essential oils has given me a statement that she is against taking essential oils internally. She says that Marguerite Maury warned about the dangers and consequences of taking the oils internally, which is why she developed the topical application method where essential oils are diluted into base products, including vegetable oils, creams and lotions. The image aside is courtesy of www.danieleryman.com

In France, doctors and pharmacists do prescribe essential oils for some conditions that are taken internally in capsule form and it would be illegal for anyone other than a physician or registered pharmacist to do this. However, this is generally for the treatment of severe infectious diseases and not for daily everyday use. As you can see from the image below, this remedy, Urisanol is prescribed for

conditions such as cystitis and is offered as a natural remedy instead of pharmaceuticals. It is not essential oils alone though but also other herbal preparations including extract of cranberry, glycerol and peanut vegetable oil, all developed with extensive knowledge and research. Essentials oils taken internally should never be neat but always diluted in something and Shirley Price (2012) advocates a fixed oil or honey - in this capsule, the peanut oil is the fixed oil. This French remedy is not recommended for children or pregnant women and Price (2012) also agrees that "ingestion of essential oils should never be used on pregnant women and young children". According to Schnaubelt (1995) taking essential oils internally "makes most sense when we need them to interact with the kidneys..." and this is because research has shown potent effects in the urogenital tract. My point is that essential oils can be prescribed internally by someone who has trained medically in this practice and the important lesson here is that whatever method, it is vital that whoever is giving the advice on how to use the essential oils is adequately trained so as to be completely safe. The most common adverse effect from internal consumption of essential oils is stomach irritation therefore, taking essential oils in water is not a good idea as these oils sit on water and this makes it harder for the body to assimilate as the oil will sit on top of the fluid in your stomach, causing irritation of the mucous membranes (Tisserand 2014). Price (2012) agrees that the ingestion of essential oils should only be "left in the hands of a competent aromatologist". This is why the Aromatherapy Trade Council in the UK recognises that the supply of essential oils to professional users for internal use is justifiable as a responsible supplier whereas supply to the general public is not. This is especially important when you consider that members of the public may be taking medications that could interact with essential oils.

Similarly, an aromatherapist does not have the training to advise on internal use either but they are best placed to advise on the safe use of essential oils via topical application and inhalations. They will need to take a detailed medical history first in order to give the correct safe use and will have a detailed knowledge of the contraindications relevant to your needs. It is important to note that there is no such thing as "no contraindications"; some oils are just not suitable for certain people in certain circumstances. Another important fact is that there is no nutritional benefit to taking oils internally and it is much safer to apply them topically and this is what I recommend. Schnaubelt (1995) also confirms that essential oils are "highly lipophilic, penetrate tissue more readily" and in essence (pardon the pun) "rubbing them into the skin or via inhalation is in many cases is much more effective than oral delivery".

What is "Therapeutic Grade" relating to essential oils?

Next is the subject around the terminology "therapeutic grade" when referring to essential oils. I consulted the Aromatherapy Trade Council (ATC) on this in order to be able to convey the correct facts in this article. For those of you who do not know this organisation, they are the trade association for the specialist aromatherapy essential oil trade, and represent manufacturers and suppliers of aromatherapy products as well as the interest of consumers in the United Kingdom. Click here for their website: Aromatherapy Trade Council.

I would always recommend that you only buy essential oils from a reputable supplier who is a member of the ATC. They have a strict policy on what should be on the label of an essential oil for its members:

(a) Instructions for use

(b) keep away from children and eyes

(c) Do not take internally or apply undiluted to the skin

(d) The quantity supplied e.g. 10 ml

(e) The company name and address

(f) Post code

(g) Batch code number

(h) Botanical and common name of plant

The ATC does not support the supply of essential oils to the general public to be taken internally for any purpose including health and wellbeing. The ATC believes that the current practice of promoting to the general public the indiscriminate self-medication of essential oils to be taken internally for any purpose is both irresponsible and potentially dangerous to health and that given the lack of information available on the safe internal use of essential oils for health purposes, the general public are not able to make an informed evaluation of the risks involved. Additionally, the ATC does not support the practice of the so called "Raindrop Technique" (where essential oils are dropped undiluted onto the skin) or its promotion to the general public for the same reason. There are regulatory authorities such as the International Fragrance Association (IFRA) who give product manufacturers guidance on dilutions of essential oils. For example, Lemongrass needs to be diluted to 0.7% to avoid allergic reactions (Tisserand 2014). These bodies consist of experts whose remit and purpose is to promote safe use of essential oils; their opinions are formed in light of research and scientific analysis and so in our view are the most reliable source of guidance on this topic.

The ATC has also told me that there is no such thing as a therapeutic grade essential oil. Jade Shutes in her article on "The Quality of Essential Oils" clearly explains that the essential oil trade in the UK has been mainly practitioner driven and as such, the "essential oil quality was initially quite high". We are used to being able to purchase 100% pure essential oils in the UK, especially from ATC members since the early 1990's onwards. As the interest in aromatherapy has grown and spread into commercial products, this has changed things somewhat. Did you know that an essential oil can still be labelled such even if it is entirely manufactured in a laboratory? If the price seems too good to be true, then it probably is manmade, never having come from the naturally grown plant and these types of products are put into all sorts of products from washing powder to hand soaps (and often labelled as being "aromatherapy"). Shutes further explains that the term "therapeutic grade" first arose in the 1990's and was "invented by some clever marketers who wanted people to believe that there were somehow therapeutic grade essential oils". The effect of this marketing ploy has been to encourage other companies to advertise their essential oils as “therapeutic grade” leading to widespread use of the term and a lack of understanding as to what this really means.

Basically, it is just marketing jargon and what these companies want you to think is that only therapeutic grade is desirable and all the other oils are somehow inferior. As a result, lots of other companies have now got on the bandwagon and say that their oils are also therapeutic grade and now people think that this is what they need to be looking for when buying essential oils. This is all just nonsense and means that we have fallen victim to a marketing ploy as there is actually no system of grading oils. According to Burfield and Kirkham (2006) "no quality standards for the authentication of essential oils exist in aromatherapy". Aromaweb (2017) confirms this on its website that in the USA there is no governmental grade or certification for essential oils. If you are told that an oil has GRAS status or FDA approval, what this actually means is that it is safe to use in food flavourings and not for use as medicines (Tisserand 2014). It is the same in the UK. Consequently, where you see this on any brand of essential oils, know that it does not in any way guarantee the quality or purity of the contents. If you want to know about the chemical constituents of an oil you should ask the supplier for the material safety data sheet (MSDS) and batch number of the oil, which reputable suppliers will be only too happy to provide. Another test of quality as previously mentioned is price – both cheap and expensive – be wary of products which are at either end of the scale as one may be synthetically produced and the other more to do with the label than the quality (there are many parallels we could draw with the fashion industry!).

Conclusion

Many people who are new to aromatherapy tend to enter a kind of "aroma-euphoria" and try and cure everything with essential oils, including sales representatives whose rhetoric is verging on the evangelical. In my experience, they are in for a disappointment! With knowledge and study of aromatherapy we come to understand that essential oils are best for infectious illnesses, the nervous system, certain skin conditions and hormonal balance (Schnaubelt 1995). Just about every essential oil in Julia Lawless's book "The Encyclopedia of Essential Oils" is indicated for stress. In the trained hands of a properly trained aromatherapist you can be assured that essential oils are being administered safely and should something go wrong, you know that they are insured and most belong to a professional association such as Complementary Health Professionals. However, things rarely go wrong when they are well trained, as all our aromatherapy members are and they will not advocate internal use unless they are also a trained medical doctor. They all abide by a strict Code of Conduct and Ethics in order to keep you safe. If you do want to experience internal use of essential oils, you will need to seek the guidance of a trained medical practitioner in this area. Let's face it, you would not play around with medicines would you so why would you do this with essential oils?

When purchasing essential oils, choose a reputable supplier and get to know what quality oils smell like. You can find a list of Aromatherapy Trade Council members on their website with links to their web pages. Ask for the GC (gas chromatography) test for that batch as the batch number should be on the label. Do not be succumbed into thinking that there are grades of essential oils and that therapeutic grade means anything different - it does not!

I hope this article has made the issues much clearer for you and that you are able now to make an informed choice. However, if you have any questions, please do not hesitate to get in touch with me at enquiries@complementaryhealthprofessionals.co.uk

Reference List

Aromatherapy Council www.aromatherapycouncil.org.uk

Aromatherapy Trade Council www.a-t-c.org.uk

Aromaweb, "Therapeutic Grade Essential Oils is a Potentially Misleading Claim" <accessed from www.aromaweb.com/articles/therapeuticgradeessentialoils.asp on 27/04/2017>

Burfield, T. and Kirkham, K. (2006). “The ʻTherapeutic Gradeʼ Essential Oils Disinformation Campaign”. “Naked aromatherapy – the truth laid bare” Aromatherapy Today 36, 28-33, as further updated in Cropwatch Newsletter August 2007).

Maury M., (1964) Marguerite Maury's Guide to Aromatherapy - The Secret of Life and Youth, republished by Churchill Livingstone 1990.

Price S. and P., (2012, 4th Edition), "Aromatherapy for Health Professionals", Churchill Livingstone

Shudes J., "The Quality of Essential Oils" (n.d.)

Schnaubelt K., Ph.D (1995) "Advanced Aromatherapy - The Science of Essential Oil Therapy" Healing Arts Press

Tisserand R., (2014) "Interview on ingestion, dilution and other safety issues", <accessed on www.roberttisserand.com 27/04/2017>