Chamomile Tea

📜 Historical Use

Chamomile was described in ancient medical writings and was an important medicinal herb in ancient China, Egypt, Greece and Rome, which makes it one of the older continuously used remedies in the modern supplement aisle. It travels under a long list of names - German chamomile, blue chamomile, wild chamomile, true chamomile, manzanilla, matricaire - and the confusion between the German and Roman species runs through the historical literature as well as the retail one. Its regulatory position in the United States is worth stating precisely, because it is routinely overstated. Chamomile has not been approved for use in any medical condition here, yet LiverTox notes it is found in several hundred over-the-counter preparations. Separately, the FDA classifies chamomile as generally recognized as safe for use in food as a spice, seasoning or flavoring agent. That is a food-additive classification about culinary quantities: not a finding of efficacy, and not a safety clearance for concentrated medicinal doses. Most chamomile is drunk as tea, but it is also inhaled, applied topically, and taken as tablets or capsules, usually combined with other herbals such as passionflower, aloe or valerian, or with mild analgesics or antihistamines - which is precisely why combination-product trial results transfer so poorly. Its oils are common in aromatherapy and in lotions, creams, soaps and cosmetics. In breastfeeding traditions, herbal and homeopathic chamomile preparations have been used for mastitis and cracked nipples, and chamomile has been used as a galactogogue, though LactMed states no scientifically valid clinical trials support that use.

📊 What the Research Shows

NCCIH is unusually blunt here. Studies of chamomile for specific conditions have not produced sufficient reliable evidence to rate clinical usefulness, and because many test chamomile combined with other herbs, it is difficult to know chamomile's exact role. Condition by condition, the strongest signal is not the one on the box. For generalized anxiety disorder and associated depression, some preliminary studies suggest a chamomile supplement might be helpful - preliminary being NCCIH's word, not a hedge added here. For diarrhea in children and infant colic, some research has found benefit from products containing certain herb combinations that include chamomile, but chamomile alone has not been shown to be helpful. For swelling or irritation in the mouth caused by radiation therapy, chemotherapy or stem cell transplantation, small studies suggest chamomile mouthwashes might prevent or treat it. And for insomnia, which is what most chamomile tea is bought for: there is very little information, and a 2019 review found one insomnia study, which found no benefit for this sleep disorder. Independent reviews catalogued by LiverTox agree: a 2005 American Academy of Sleep Medicine practice review noted clinical efficacy studies are lacking, and a 2012 Medical Letter insomnia guideline lists chamomile tea among herbals claimed to induce sleep while stating there is no convincing evidence for their efficacy and that the purity of over-the-counter products is suspect. A 2011 review ranked chamomile at evidence level B for anxiety in humans. Anxiety is the better-supported use; sleep is the better-selling one.

Steep 2 tsp dried chamomile flowers for 5-7 min. Drink after meals or when anxious.

Avoid if allergic to ragweed family.

⚠️ What happens if taken in excess:

Chamomile has no serious organ-toxicity signal in the federal sources, and it is worth saying so plainly before the real hazard. LiverTox assigns it a likelihood score of E - an unlikely cause of clinically apparent liver injury - and states that despite widescale use it has not been convincingly linked to liver injury or to serum enzyme elevations. Three drug-induced liver injury registries agree: none of the 85 supplement cases in the U.S. DILI Network, none of the 32 herbal cases in the Spanish registry and none of the 29 in the Latin American network were attributed to chamomile. One case of sinusoidal obstruction syndrome appears in a 2021 review of 936 herb-induced injuries. The real risk is allergic. Side effects are uncommon and may include nausea and dizziness, but also allergic reactions including severe hypersensitivity and anaphylaxis. People allergic to ragweed, chrysanthemums, marigolds or daisies are likelier to react, and LactMed adds cross-reactivity with echinacea, feverfew and milk thistle. Topical chamomile is a known sensitizing agent even in homeopathic products: two women developed patch-test-confirmed contact dermatitis of the nipples and areolas from an ointment containing 10.5 percent Roman chamomile. In sensitized people, drinking the tea can exacerbate topical rashes and has caused anaphylaxis. Near the eyes it might cause irritation. Two further cautions: chamomile might worsen any estrogen-sensitive condition, such as breast or uterine cancer; and Clostridium botulinum spores have been found in some loose-leaf chamomile teas sold in health food stores, which matters for infants under one year. Little is known about whether chamomile is safe during pregnancy or breastfeeding.

Chamomile is one of only eight herbs NCCIH singled out in its December 2024 Clinical Digest on herb-drug interactions, alongside Asian ginseng, cat's claw, cranberry, ginkgo, goldenseal, green tea and St. John's wort. Three concerns are named. First, and most consequential for anyone drinking this daily, preliminary studies suggest that taking chamomile along with oral contraceptives might decrease the effects of oral contraceptives. Second, interactions between chamomile and warfarin have been reported - reported, note, not characterised: NCCIH states neither direction nor magnitude, so this is a flag to raise with a prescriber, not a dose adjustment. Third, interactions with some drugs metabolized by the liver have been reported, and here the informative detail is an absence. NCCIH names no cytochrome P450 enzyme for chamomile, while in the same digest it names CYP2D6 and CYP3A4 for goldenseal, CYP3A4 substrates for cat's claw, and potent induction of both cytochrome P-450 enzymes and intestinal P-glycoprotein for St. John's wort with documented interactions involving cyclosporine, indinavir, oral contraceptives, warfarin, digoxin and benzodiazepines. Any source telling you chamomile inhibits a specific CYP enzyme is going further than the federal fact sheet does. Beyond those three, NCCIH records only theoretical reasons to suspect interactions with other drugs, such as sedatives. The digest's own caveat applies throughout: most herb-drug interactions in current sources are hypothetical, inferred from animal studies or cellular assays, and the drugs warranting most attention are those with a narrow therapeutic index - chemotherapeutic agents, warfarin and digoxin. If you take any medicine, tell your prescriber you drink chamomile.

1. Chamomile: A herbal medicine of the past with bright future — Srivastava JK, Shankar E, Gupta S Mol Med Report (NIH PMC) (2010)[NIH ↗]
2. Long-term chamomile therapy for generalized anxiety disorder — Mao JJ et al Phytomedicine (Elsevier) (2016)[doi ↗]
3. Chamomile (Matricaria chamomilla L.): An overview — Singh O et al Pharmacogn Rev (Wolters Kluwer) (2011)[NIH ↗]