• Adverse Reactions to Essential Oils in Australia

    Adverse Reactions to Essential Oils in Australia
    Author: Laura A’Bell, March 2018

    Background
    The purpose of this report was to discover adverse reactions to essential oils in Australia and to identify current reporting systems to determine future reporting with respect to aromatic use.

    A small survey was taken of 92 essential oil consumers who had experienced adverse reactions to essential oils.

    This survey was conducted online over a period of five days (20 September - 25 September 2017) with the purpose of identifying:

    • the type of adverse reaction
    • what oil or oils were involved in this adverse reaction
    • how the oil was used
    • who prescribed it
    • if it was reported, and to whom

    None of the respondents had noted that they had reported their adverse reactions to any reporting body / organisation or they did not know where or how to.

    Reactions to essential oils ranged from minor itching and headaches to kidney disease and death.

    A series of recommendations are surmised in this report including the need for a reporting system and the promotional tools to ensure consumers and health practitioners know where to report adverse reactions and for frontline health staff to advise on first aid and reporting.

    Purpose

    This survey was undertaken to find out how adverse reactions were occurring and to discover reporting methods of adverse reactions to essential oils in Australia.

    Variables

    • Health practitioners identified as prescribing - there is no evidence of their current training. This would need to be followed up with further surveys to identify if they are operating out of scope and against their own Association’s Code of Ethics
    • Multi-level-marketing (MLM) - no evidence of training levels of advocates who were prescribing/recommending usage
    • Quality of oil - no testing of any of the essential oils has been conducted. It is possible they could have been oxidised; not high quality oils
    • Products with multiple ingredients - respondent may have been sensitive to another ingredient rather than the essential oil

    Research Methodology
    A survey was created in Survey Monkey which was circulated to essential oil users in Australia. This survey was sent through social media channels only, mainly through aromatherapy groups and other natural medicine groups.

    This survey was open for approximately five days and garnered 92 responses.

    Given the large response in a matter of days, it is my opinion that there would be many more responses to a further study.

    Discussion

    Adverse reactions were reported for persons aged 2-73. However the majority were aged 24-40.

    Most of the reactions occurred in 2016 and 2017 however there were under five reported reactions that occurred prior to 2014.

    Whilst many single essential oils were listed, there were also a lot of blends. The blends would be difficult to identify which oil created the adverse reaction.

    There were a couple of products included which have been removed from this survey due to the variables of potential reaction with other ingredients found in the specific product.

    The most reported essential oils or blends in this survey for adverse reactions were:

    Oregano (origanum vulgare) - 6
    Lavender (not all identified species) - 11
    Peppermint - 6
    Tea Tree - 5
    Thyme (Thyumus Vulgaris) - 5
    Eucalyptus - 3
    Lemon - 3
    Clove - 3

    Thieves by Young Living was the highest reported blend for adverse reactions with 4.

    However, overall, blends with adverse reactions were highest for DoTerra, followed by Young Living. No other brands were mentioned in this survey.

    Citrus oils were responsible for a lot of internal adverse reactions where respondents were adding them to water. As were oils such as Cinnamon and Clove which were being used neat in water.


    Notable Reactions
    A lady who took DoTerra capsule products including Mit2Max, Deep Blue Polyphenol, xEO Mega and Alpha CRS+. This ongoing use results in her gallbladder being removed and she is still suffering chronic pancreatitis and poor spleen function as a result.

    “In all the research I’ve done I can’t see anything online about these being possible side effects. Also for the most part, DoTerra has swept this under the rug.”

    In another reported case - “Respondent suffered anaphylactic shock. Collapsed, stopped breathing, resuscitated and died several times in hospital, but brought back OK”.

    Q 4. How did you use the essential oil when this reaction occurred? (Topical, inhalation, diffuser, orally, internally via other method etc)

    Over 55% of reactions reported were from topical use. Most of these involved using the essential oil/oils neat.

    Around 40% suffered adverse reactions from internal use. These were either incorrect dosages or unsafe oils.

    There were around 5% of respondents who reported adverse reactions via inhalation either direct from bottle or via diffusion.

    From the topical use reactions, these varied from itching to blisters. Most common reports were from blisters, hives, redness, swelling and soreness.

    “Poured a twenty cent piece worth of oil straight on my hands - hundreds of blisters later and minutes later, I was doing everything to try and stop the reaction.”

    “After cleaning my face I applied a number of drops - I want to say 5, but it was whatever the bottle recommended - to my face and rubbed it in as directed”.

    “Topically 1 drop on each inner wrist, undiluted. Was given by a doTERRA practitioner”.

    “Topical - had been putting a few drops neat in my hair, but obviously too close to scalp”!

    “Dropped into ear canal. Undiluted”.
     
    “Topical, applied directly full strength with attached rollerball as per the seller's instructions”

    “I was instructed to use it topically (neat) on my face without dilution on some small spots; ultimately I burnt my face”.

    Respondents who suffered from internal use had reactions occur that ranged from burning, digestive issues, gallbladder removal and death.

    “Put a few drops in water and drank it and the oil "burnt" the edges of my lips “

    “Neat on gums”

    “Gargled undiluted in salt water”

    “Medicinally as prescribed by naturopath”

    “Was given drops of oil in a glass of water”

    “Ingested the capsules as per the recommended dosages”

    Most respondents either self prescribed or received information from an MLM Sales Representative.

    Around 10% of respondents suffered adverse reactions as a result of consultations or prescriptions from naturopaths, other health professionals or aromatherapist. It is not clear what qualifications these health professionals had and something which should be looked into with any further surveys.

    Most respondents indicated that the essential oil or blend was used undiluted or they were unsure of the dilution. Some reported it as diluted as it was placed into water (which for the purposes of this report we are counting as undiluted).

    As some respondents reported they were diluted, but they are unsure of ratios due to proprietary blends from companies.

    “The capsule contained 10-15 drops EO and 5-10 v6 oil”

    “No. Just put straight in the water”.

    “Yes, as per contents in pre made capsules - no idea on ratios”

    Adverse Reactions

    Adverse reactions ranged from headaches to death. There were some extremely serious adverse reactions reported in this survey. Most respondents who reported these reactions to companies did not receive any assistance, in fact some received bullying.

    “Respondent suffered anaphylactic shock. Collapsed, stopped breathing, resuscitated and died several times in hospital, but brought back OK”.

    Many reported burning and rashes from topical and internal use.

    “Burning, stinging in mouth, down the throat and burning discomfort in stomach for about 30 minutes.”

    “Burnt edges of my lips, experienced burning sensation for a while but recovered well”.

    “A dryness, irritations in the upper back of the throat. In the area if you breath in your nose where that air would interface with the throat. There was also for the lack of a better term the air seemed heavy or tick”.

    “Area became dark purple with hard sore lumps and a bit numb to the touch”.

    “Red prickly rash with heat”.

    “The itch got worse and developed into a rash that spread, up my arm, across to my chest and started going up my face”.

    “Skin welts”.

    “Repeated on me and indigestion, could taste for hours”.

    “It's burned so bad, had a chemical burn lasting 4 days, under dentist care I applied soft wax used for braces to protect it from food and spices”.

    “Headache, dizziness, sinus pain, nausea, irritability, sore eyes, asthma, feeling sad”.

    “Burping then heartburn. Was told it was detoxing so continued. Then burned my oesophagus (mildly). No complications now”.

    “Heart racing, panic attack, hyperventilation, nausea, fear, dry mouth. Nil sleep for around three days”.

    “Heart palpatations, blurry vision, vomiting”.

    “Stomach cramps, nausea, generally felt 'off' red cheeks hyperactivity running warm”.

    A number of people reported asthma attacks, headaches and migraines.

    “Adverse stomach reactions which got worse over time”.

    “Raw gums, felt like I'd burnt them. I stopped using it after two weeks”

    “My throat/chest infection cleared overnight but I coughed up blood during the evacuation. Also my feet got a little burned in the arches”.

    “UTI symptoms (burning upon urination and frequency) developing into back pain in kidney area. Symptoms remained for about 10 days. Urine culture found no sign of infection. I have had no further complications”.

    “Ingestion caused stage kidney disease, topical caused severe rashes that I wad told was detoxing”.

    “Immediate asthma attack. Repeated treatment to verify reaction. Each exposure became worse”.

    “Ended up with first degree burns”.

    “No initial reaction, felt fine in the skin. I went to the beach for the day. The area where I applied the oil started to feel sore on the drive home 6 -7 hours later and the area that was exposed to the sun through the car window on the drive home, became very painful. The armpits became increasingly sore and I realised when I got into the shower, it was incredibly painful to touch the armpits and the area exposed to through the car window. It was bright red and really painful. The next morning it was blistered, it subsequently peeled & the area was discoloured (like new scar tissue that's se posed to the sun - darker .... not like your armpits are usually a slightly darker colour, the discolouration extended onto the area on my back / u def the shoulder blade, which had been burned through the car window - it was quite dramatic) lasted for about a year after”.

    “Stomach pain, burning sensation and problems with digestion this has continued on to require treatment”

    “Partial seizure activity. Initially just tingling sensation in my elbow that travelled up my arm. I have walked into a patients room whose mother had used a very strong amount of lavender in the air and I had an absence seizure. I have applied diluted lavender oil to my children and I have suffered from stars in my eye sight which is a small misfire of electrical signals in my brain”.

    Recommendations

    1. Given the growing amount of misinformation around essential oils, it may be wise to consider recommendations for the future to minimise adverse reactions and to ensure that these are reported centrally in Australia for research and reporting purposes. There needs to be accountability for sales representatives in particular with recommending dosage or prescribing as well as ensuring minimum standards for all health professionals advising on essential oils.
    2. Minimum training standards in Aromatherapy for prescribing aromatics.
    3. Encourage aromatherapy training around Australia and including to regional areas. There are many who have barriers to the Advanced Diplomas by way of location and financial. There need to be more available certificates and diplomas by reputable companies to ensure good practice for consumers.
    4. Reporting of health practitioners to Associations who are prescribing or selling out-of-scope.
    5. Associations to remind their practitioners of their Code of Ethics with respect for out-of-scope and involvement with MLM schemes.
    6. Associations to fund a combination strategy to consumers and health care providers to ensure uptake of reporting on adverse reactions - not only for adverse reactions to essential oils, but to all forms of drugs.
    7. Given the lack of reporting in Australia, it is recommended that people report adverse reactions to the Therapeutic Goods Administration as well as the Atlantic Institute of Aromatherapy in the US. They have been contacted by the author of this paper and are updating their databases to include reporting from other countries.

     Photo image: credit unknown.

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