About Sage
Sage (Salvia officinalis and S. lavandulifolia) contains rosmarinic acid, carnosic acid, ursolic acid, and 1,8-cineole. Mechanistically a reversible acetylcholinesterase inhibitor — same target class as donepezil. Strongest evidence: short-term cognitive improvement in healthy adults (Tildesley 2003 PMID 12895688, Scholey 2008 — improvements in word recall and mood at 300–600 mg standardized extract), modest Alzheimer's cognitive improvement (Akhondzadeh 2003, n=42 RCT, 4 months at 60 drops fixed extract showed cognitive benefit), and menopausal hot flashes (Bommer 2011 open-label n=71 showed ~50% reduction in hot flashes at 280 mg/day fresh leaf extract; smaller RCT replications since). Also moderate evidence for oral health (sage mouthwash reduces plaque/gingivitis). SAFETY: S. officinalis contains thujone (similar to wormwood) — chronic high-dose use is contraindicated. EMA caps continuous use at 2 weeks. Avoid in epilepsy, pregnancy, and breastfeeding. S. lavandulifolia (Spanish sage) is thujone-poor and preferred for chronic cognitive use.
What Sage supports
- Improves short-term memory and mood in healthy adults — reversible cholinesterase inhibition
- Reduces menopausal hot flashes (open-label and small RCTs)
- S. officinalis contains thujone — limit continuous use to 2 weeks per EMA
How much Sage to take
The RDA prevents deficiency. The effective range is what clinical trials used to actually move the outcome.
Effective
300–900
mg
Cognition/memory RCTs (Tildesley 2003, Scholey 2008, Kennedy 2011) used standardized S. officinalis or S. lavandulifolia extracts at 300–900 mg single dose. Menopausal hot-flash trials used 280 mg fresh-leaf extract daily. Below 300 mg, acetylcholinesterase inhibition is unlikely to be clinically meaningful.
Clinical evidence
Moderate clinical evidence. Multiple cognition RCTs (Tildesley 2003, Akhondzadeh 2003, Scholey 2008) and menopausal hot-flash trials (Bommer 2011); acetylcholinesterase mechanism is well characterized.
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