Chamomile

What is Chamomile?

Chamomile refers primarily to German chamomile (Matricaria chamomilla), one of the oldest and most widely used medicinal herbs in the world, prepared from dried flower heads as teas, capsules, or standardized extracts. Its therapeutic properties stem from a complex mixture of flavonoids, terpenoids, and volatile oils concentrated in the flower. Roman chamomile (Chamaemelum nobile) shares similar uses but has a smaller research base than its German counterpart.

How does Chamomile work?

The primary active flavonoid, apigenin, binds with moderate affinity to GABA-A benzodiazepine receptors in the brain, producing mild anxiolytic and sedative effects without the dependence risk of pharmaceutical benzodiazepines. Alpha-bisabolol and chamazulene contribute anti-inflammatory and antispasmodic activity relevant to GI and skin applications. Quercetin and luteolin provide additional antioxidant and anti-inflammatory effects through inhibition of pro-inflammatory cytokines and COX enzymes.

What forms does Chamomile come in?

Tea (1–3 g dried flowers per 250 mL water, steeped 5–10 minutes) is the most traditional and widely consumed form, though bioavailability of apigenin is relatively low from tea alone. Standardized capsule extracts (220–500 mg, 1.2% apigenin) provide more consistent dosing and have been used in clinical trials. Tinctures offer intermediate flexibility. Topical creams and essential oils are used for skin inflammation and wound healing but are not interchangeable with oral forms for systemic effects.

Where it comes from:

Chamomile has been used medicinally for over 5,000 years, documented in ancient Egyptian, Greek, and Roman traditions for fever, digestive ailments, and wound care. It remains one of the most consumed herbal teas globally and is listed in the pharmacopoeias of multiple countries including Germany, where it is formally approved for GI spasms and inflammatory skin conditions by Commission E.

What does Chamomile help with?

• Generalized Anxiety Disorder: Apigenin's partial agonism at GABA-A benzodiazepine receptor sites modulates GABAergic inhibitory neurotransmission, reducing neuronal excitability associated with anxiety states. A long-term RCT by Mao et al. (2016, Phytomedicine) in 93 participants with GAD demonstrated that chamomile extract significantly reduced relapse rate of GAD symptoms compared to placebo over 26 weeks of maintenance therapy following an initial open-label response phase. Earlier work by the same group (Mao et al., 2009, Journal of Clinical Psychopharmacology, n=57) showed significant reduction in Hamilton Anxiety Scale scores with 220–1100 mg/day standardized extract versus placebo over 8 weeks.
• Insomnia: Chamomile's apigenin binds to central benzodiazepine receptors, promoting sleep onset through GABAergic sedation without significant REM suppression at typical doses. A double-blind RCT by Zick et al. (2011, BMC Complementary and Alternative Medicine, n=34) in adults with chronic insomnia found that 270 mg standardized chamomile extract twice daily improved sleep diary measures of sleep quality and daytime functioning compared to placebo over 28 days, though effects on polysomnographic endpoints were more modest. A separate RCT in postpartum women showed chamomile tea reduced sleep-quality deficiency scores and depression symptoms over a 2-week period.
• Irritable Bowel Syndrome: Alpha-bisabolol and the flavonoid fraction of chamomile exert antispasmodic effects on intestinal smooth muscle by modulating calcium channel activity, reducing the visceral hypersensitivity and cramping characteristic of IBS. Chamomile is frequently studied as part of multi-herb preparations for functional GI disorders; clinical evidence for chamomile in isolation for IBS is limited, though combination products including chamomile (e.g., Iberogast) have demonstrated efficacy in well-designed RCTs. Commission E formally recognizes chamomile for GI spasm and inflammatory GI conditions based on accumulated clinical data.
• Dyspepsia: Chamomile's antispasmodic and anti-inflammatory properties—mediated by smooth muscle relaxation and inhibition of prostaglandin synthesis—help reduce gastric mucosal irritation and upper GI discomfort. The herb has been studied as a component of the multi-herb preparation Iberogast (STW 5), which includes chamomile flower extract and has been evaluated in multiple RCTs showing significant improvement in total dyspepsia symptom scores versus placebo. Chamomile's contribution as an isolated agent to dyspepsia management is supported by mechanistic and traditional evidence, though large standalone RCTs are lacking.
• Eczema / Inflammatory Skin Conditions: Topically applied chamomile—particularly standardized creams containing alpha-bisabolol and chamazulene—reduces cutaneous inflammation through COX-2 inhibition and suppression of inflammatory mediators including histamine, leukotrienes, and pro-inflammatory cytokines. A comparative trial by Patzelt-Wenczler and Ponce-Pöschl (2000, European Journal of Medical Research) found that a chamomile cream performed comparably to a low-potency hydrocortisone cream and was superior to placebo in reducing eczema severity, with good tolerability. Anti-inflammatory and wound-healing properties are formally recognized in the German Commission E monograph for topical chamomile use.

What can Chamomile help prevent?

• Relapse of Generalized Anxiety Disorder symptoms (long-term maintenance use supported by Mao et al., 2016 RCT data)

What are the side effects of Chamomile?

• Allergic reactions (contact dermatitis with topical use, urticaria, or anaphylaxis in Asteraceae-sensitive individuals)
• Mild nausea or GI upset at high oral doses
• Increased sedation when combined with other CNS depressants
• Eye irritation (with chamomile eye washes—not recommended due to risk of contamination)
• Theoretical estrogenic effects at very high doses (limited clinical evidence in humans)
• Rare: vomiting with very large doses of concentrated extract

Good to know:

Chamomile is generally recognized as safe (GRAS) by the FDA for food use and has a well-established tolerability profile at typical doses. The most clinically significant risk is allergic reaction in individuals sensitive to plants in the Asteraceae (Compositae) family, which includes ragweed, chrysanthemums, marigolds, and daisies. Anaphylaxis has been reported rarely, primarily in atopic individuals.

How much Chamomile should you take?

• Recommended daily: Anxiety/Sleep: 220–500 mg standardized extract (1.2% apigenin) once or twice daily; clinical trials have used up to 1,500 mg/day in divided doses. Tea: 1–3 g dried flower heads per cup, 1–4 cups daily. Topical (eczema/skin): chamomile cream applied 2–3 times daily to affected area.
• Best time of day: For sleep and acute relaxation: 30–60 minutes before bedtime. For anxiety management: may be divided into morning and evening doses. For GI use: 20–30 minutes before meals.
• With or without food: Can be taken with or without food; taking with a small amount of food may reduce GI sensitivity in those prone to nausea with herbal supplements.
• Time to effect: Acute sedation/relaxation: 30–60 minutes post-ingestion. Sustained anxiolytic or GI effects: 4–8 weeks of consistent daily use.
• How long to take it: Safe for long-term daily use based on available clinical trial data (up to 26 weeks demonstrated in RCTs with no significant safety concerns). No formal cycling requirement, though periodic reassessment of need is recommended. Discontinuation does not require tapering.