What is German chamomile?

German chamomile is a small daisy-like herb with white petals and a yellow centre. The dried flowers are used for tea, tinctures and skin creams. It is one of the best known calming herbs in Europe.

Its botanical name is Matricaria chamomilla. German speakers call it Echte Kamille, meaning "true chamomile". It is a different plant from Roman chamomile, though people use the two in similar ways.

Here is the honest verdict on the evidence. Human trials exist, but most are small, short and mixed. Long traditional use is not proof that it works, and it is not proof that it is safe.

How does German chamomile work?

The short answer is that nobody has pinned down how chamomile works in people.

In lab studies, a compound called apigenin binds to brain receptors that some calming drugs also act on. Whether a cup of tea does this in your brain has not been shown.

In test tubes and in animals, chamomile extracts appear to damp down inflammation. They also seem to relax the smooth muscle of the gut in animal tissue.

That may explain the old use for cramps and wind. It is a plausible idea, not a proven one.

On skin, the flower oil has slowed some bacteria and fungi in test tubes. Small trials of chamomile creams have given mixed results. The gap between a lab dish and real skin is wide.

What forms does German chamomile come in?

Dried flower tea is by far the most common form.

Other forms you will see on shelves:

Tea bags and loose dried flowers.

Liquid tincture, usually in alcohol.

Capsules or tablets of dried extract.

Creams, ointments and gels for skin.

Mouthwash and gargle liquids.

Sachets for steam inhalation.

Blue essential oil, meant for diluted use on skin.

Tea and standard extracts are mild. The essential oil is very strong and is not a drink.

Strength differs hugely between these forms. A capsule of concentrated extract is not the same thing as a tea bag.

Where it comes from:

Chamomile has a long record in European folk medicine and in the German herbal tradition, where it is called Echte Kamille.

Old herbals listed it for upset stomach, wind, cramps and restless sleep. Steam from the hot flowers was breathed in for colds and blocked noses. Compresses were laid on sore, itchy or weeping skin.

It was also a nursery remedy. Weak tea was given to fretful or teething children, a practice that modern advice treats with more caution.

Monks and village healers grew it in kitchen gardens across central Europe. It reached the Americas with European settlers.

German health authorities later reviewed the herb and accepted several of these traditional uses. That acceptance rests mostly on long use and safety records, not on large modern trials.

What does German chamomile help with?

• Mild anxiety and nervous tension: This is the use with the best human evidence, and it is still modest. Two trials from one US research group tested a standard chamomile extract in adults with generalised anxiety disorder. Symptom scores fell more than with placebo over eight weeks. The trials were small and used a concentrated extract, not tea. Nobody has shown that a mug of chamomile tea does the same.
• Trouble falling asleep: Tradition treats chamomile as a bedtime drink for restless nights. Small trials in older adults and in new mothers found modest gains in sleep quality. Other trials found no clear effect. The studies are small and short. Chamomile is not a sleeping pill and should not replace treatment for insomnia that goes on for weeks.
• Upset stomach, wind and mild gut cramps: European folk use put chamomile tea first for a sour or crampy stomach. In animal tissue, chamomile extracts relax gut muscle. Human trials mostly test chamomile inside multi-herb mixtures, so its own share of any benefit is unclear. If stomach pain is severe, lasting or comes with fever, weight loss or blood, see a doctor instead.
• Mild skin irritation and minor wounds: Creams and compresses were a standard folk dressing for red, itchy skin. A few small trials suggest chamomile cream may ease eczema symptoms about as well as low-strength hydrocortisone cream (a mild steroid). The trials were small and not well blinded. Treat this as unsettled. It is not proof, and chamomile is a common cause of skin allergy.
• Mouth and throat soreness, used as a rinse: Chamomile rinses were used for sore gums and mouth ulcers. Trials of chamomile mouthwash for mouth sores caused by cancer treatment have given mixed results. Some found less pain, others found no clear gain. If you are having cancer treatment, ask your oncology team before using any mouth rinse.
• Infant colic, in traditional use: Weak chamomile tea was a classic folk answer to a crying baby. Some trials of multi-herb drinks containing chamomile reported less crying. Chamomile alone has not been tested properly in babies, and the herbal drinks also displaced milk feeds. Do not give herbal tea to a baby without asking your doctor or health visitor first.

Which foods are rich in German chamomile?

1. Chamomile tea
2. Mixed herbal and bedtime tea blends
3. Some flavoured sweets, syrups and desserts

Practical Tips:

Chamomile is a flavouring as well as a remedy. Food amounts are small and are not the same as supplement doses.

What are the side effects of German chamomile?

• Allergic rash, hives or itching
• Contact dermatitis (a red, itchy rash where the cream touched skin)
• Rare but serious allergic reactions, including anaphylaxis (a whole-body allergic reaction)
• Drowsiness, especially with large amounts
• Nausea or vomiting with very strong brews
• Eye stinging and irritation if used as an eye rinse

Good to know:

Most people drink chamomile tea with no trouble at all.

The main real risk is allergy. People allergic to ragweed, daisies, marigold or chrysanthemum are more likely to react, because these are all in the same plant family.

Serious reactions are rare but have been reported, including a few cases of anaphylaxis. Swelling of the lips, tongue or throat, or trouble breathing, is a medical emergency.

How much German chamomile should you take?

• Recommended daily: Chamomile is sold as an ordinary food and supplement, so labels differ. Tea labels commonly carry about 1 to 3 grams of dried flowers per cup, taken up to three or four times a day. Capsule labels of concentrated extract often sit in the 200 to 1,100 mg per day range. These are the amounts products carry, not advice for you. Follow the label on the product in your hand, and ask a pharmacist if you take prescription medicines.
• Best time of day: Timing depends on why you are using it. For sleep or evening calm, it is usually taken in the hour before bed. For stomach upset, it is usually taken after meals. For skin and mouth products, time of day does not matter.
• With or without food: Food does not seem to matter much for chamomile. Tea is often taken after meals when the goal is a settled stomach. Capsules can be taken with food if they feel harsh on an empty stomach.
• Time to effect: If tea helps you relax, you would expect to notice it within an hour. In the anxiety trials, the clearest changes took two to eight weeks of daily extract. Skin creams were used for two to four weeks before results were judged. It may also do nothing for you. That is a real and common outcome with mild herbal remedies.
• How long to take it: Short runs are the usual pattern for stomach and sleep use, often days to a few weeks. The anxiety trials ran for eight weeks and up to about a year in one follow-up study. Long-term daily use of strong extracts has not been well studied. If a symptom has not shifted after two to three weeks, that is a reason to see a doctor, not to raise the dose.