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Scientific Name(s): Santalum album L.
Common Name(s): East Indian sandalwood oil, Sandalwood, Santal oil, White or yellow sandalwood oil, White saunders oil
Medically reviewed by Holevn.org. Last updated on Jul 18, 2019.
Clinical Overview
Use
Sandalwood oil has been reported to have diuretic and urinary antiseptic properties, but clinical trial data are lacking. The oil has mainly been used as a fragrance enhancer.
Dosing
For the treatment of urological problems, a dose of 1 to 1.5 g daily is recommended for no more than 6 weeks. Sandalwood oil should be dosed in a resistant coating that protects against gastric secretions. The oil should not be ingested internally in its natural state.
Contraindications
None well documented.
Pregnancy/Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Interactions
None well documented.
Adverse Reactions
Sandalwood oil can cause dermatitis, although it is generally considered to be nonirritating to human skin.
Toxicology
Sandalwood oil has generally recognized as safe (GRAS) status as a flavoring agent in food by the Flavor and Extract Manufacturers’ Association, and the US Food and Drug Administration (FDA) also recognizes sandalwood oil as a natural flavoring.
Scientific Family
- Santalaceae
Botany
Indigenous to India and Indonesia, sandalwood is an evergreen tree that grows to 8 to 12 m in height and 2.5 m in girth.1 The bark is smooth and gray-brown in color, and the small flowers have numerous short stalks.
History
Sandalwood oil has a warm, woody odor and is commonly used as a fragrance in incense, cosmetics, perfumes, and soaps.1 It also is used as a flavoring for foods and beverages. The wood has been valued in carving because of its dense character.2, 3, 4
In traditional medicine, sandalwood oil has been used as an antiseptic and astringent, and for the treatment of headache, stomachache, and urogenital disorders. In India, the essential oil, emulsion, or paste of sandalwood is used in the treatment of inflammatory and eruptive skin diseases.5 The oil has been used in Ayurvedic medicinal system as a demulcent, diuretic, and mild stimulant.1 The leaves and bark of Santalum have been used by early Hawaiians to treat dandruff, lice, dermatitis, and sexually transmitted diseases.6 Sandalwood oil has also demonstrated repellency against the crop pest, Tetranychus urticae (two-spotted spider mite), with santalol suggested as the effective component.7
Chemistry
The essential oil of sandalwood is obtained from the heartwood of the tree.8 The light yellow, volatile oil contains about 90% santalols with 35% to 49% being alpha-santalol, 14% to 33% beta-santalol, 0% to 5% alpha-trans-bergamotol, and 1% to 7% epi-beta-santalol.9 The santalols are responsible for the pleasant odor of sandalwood, although 2-furfuryl pyrrole may also contribute an effect.2
The seeds yield about 50% of a viscid, dark red, fixed oil containing stearolic acid and santalbic acid. Gas chromatography “fingerprinting” of sandalwood oil has successfully analyzed the complex components.10
Uses and Pharmacology
Sandalwood is a fragrant wood from which an oil is derived for use in foods and cosmetics. The oil is rarely used medicinally today, but its widespread use as a popular fragrance continues. Reliable clinical studies are lacking in support of the effects of sandalwood oil. Tertiary resources document the oil as having diuretic and urinary antiseptic properties.11
Herpes simplex viruses 1 and 2
Animal and in vitro data
Sandalwood oil inhibited the replication of herpes simplex viruses (HSV) 1 and 2, with inhibition was more pronounced against HSV-1. The effect was dose dependent and the oil was not virucidal.12 Another in vitro study found sandalwood oil to exert inhibitory activity against HSV-2 (IC50 of 0.0015%).13
Sandalwood oil (along with the essential oils thyme, and hyssop) was found to exert virucidal activity against acyclovir-sensitive and resistant strains of HSV-1. The investigators suggested that mechanism of action must differ from that of acyclovir, given that it was effective against acyclovir-resistant strains and might be attributed to inactivation of the virus before it enters the cell.14
Clinical data
Research reveals no clinical data regarding the use of sandalwood oil for the treatment of herpes infections.
Antimicrobial effects
Animal and In vitro data
Some isolates of Santalum album were found to be active against Helicobacter pylori.15 S. album was also found to inhibit Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa, with the aqueous leaf extract showing a higher inhibition zone than with the stem extract.6
Beta-santalol was found to exert antiviral activity against influenza A/HK (H3N2), with a suggested mechanism of inhibition in late viral RNA synthesis.16
Clinical data
Research reveals no clinical data regarding the use of sandalwood oil for its antibacterial effects.
Chemopreventive activity
Alpha-santalol is believed to exert its chemopreventive effects, particularly against skin cancer, through the induction of apoptosis and tumor suppressor protein. It also inhibits cell proliferation through induction of G2/M phase arrest.8
Animal and in vitro data
Sandalwood oil may have chemoprophylactic effects on skin papillomas. Treatment (5% in acetone, w/v) on 7,12-dimethylbenz[a]anthracene-(DMBA)-initiated and 12-O-tetradecanoyl phorbol-13-acetate(TPA)-promoted skin papillomas and TPA-induced ornithine decarboxylase (ODC) activity in CD1 mice significantly decreased papilloma incidence by 67% and TPA-induced ODC activity by 70%.5
Daily oral feedings of sandalwood oil to adult male Swiss albino mice for 10 and 20 days led to a dose-dependent increase on glutathione S-transferase (GST) activity and acid soluble sulfhydryl (SH) levels. Although the mechanism of action is unclear, the enhancement of GST activity and acid-soluble SH levels may suggest a possible chemoprophylactic action on carcinogenesis.17
Similarly, alpha-santalol was found in a dose-response study to decrease DMBA-TPA–induced skin tumor incidence and multiplicity, ODC activity, and DNA synthesis in CD-1 mice. A superior effect was noted with a 5% application of alpha-santalol as opposed to 1.25% and 2.5%. Additionally, alpha-santalol in 2.5% and 5% concentrations as pretreatment reduced ultraviolet B UVB-initiated skin tumor development.8
Alpha-santalol activated caspase-3 activity, causing apoptosis in androgen-dependant and -independent human prostate cancer cells. The survival of these cells was affected by alpha-santalol in both a concentration- and time-dependent manner.18
Additionally, various lignans from S. album were found to exert cytotoxic effects against HL-60 human promyelocytic leukemia cells and A549 human lung adenocarcinoma cells.19
Clinical data
Research reveals no clinical data regarding the use of sandalwood oil for chemoprophylaxis.
Cardio-metabolic risk
Animal and in vitro data
In a study of streptozocin-induced diabetic rats, S. album petroleum ether fraction 10 mcg/kg given twice daily for 60 days was associated with a reduction in blood glucose, hemoglobin A1c. In addition, total cholesterol, triglycerides, and low-density lipoprotein cholesterol levels were reduced, while high-density lipoprotein cholesterol levels increased.20
Clinical data
Research reveals no clinical data regarding the use of sandalwood oil for cardio-metabolic risk.
Anxiety/Mood/Arousal/Central nervous system effects
Animal and in vitro data
Intraperitoneal administration of alpha- and beta-santalols in mice increased hexobarbital-induced sleeping time. Oral, intraperitoneal, and intracerebroventricular administration of alpha-santalol reduced rectal temperature and spontaneous motor activity more effectively than beta-santalol. However, beta-santalol was found to decrease acetic acid-induced writhing more effectively than alpha-santalol.21
Clinical data
Though not statistically significant, leg and foot massage with sandalwood oil reduced anxiety in patients.22 Topical administration of sandalwood oil produced “harmonizing” effects (ie, a reduction in the level of autonomic nervous system arousal but no behavioral level deactivation) in healthy volunteers, whereas alpha-santalol had relaxing/sedative effects.23 Inhalational sandalwood essential oil and alpha-santalol affected various physiological parameters and self-ratings of arousal in humans.24
Dosing
For the treatment of urological problems, a dose of 1 to 1.5 g daily is recommended for no more than 6 weeks. It should be dosed in a resistant coating that is protected against gastric secretions. The oil should not be ingested internally in its natural state.1, 25
Pregnancy / Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Interactions
None well documented.
Adverse Reactions
Sandalwood oil can cause dermatitis in sensitive persons, although it is generally considered to be nonirritating to human skin.2, 11, 26 A case report described a 65-year-old man with a scaly, hyperpigmented plaque on his forehead and fissuring of his fingers (markedly on the thumb and index finger). He reported daily use of sandalwood paste on the lesions for 8 years, and a patch test with sandalwood was positive. The lesions disappeared after discontinuation of sandalwood, although hyperpigmentation remained.27 Another case report described a photoallergic reaction resulting from exposure to a cosmetic product containing sandalwood oil.28
Toxicology
Sandalwood oil has GRAS status as a flavoring agent in food by the Flavor and Extract Manufacturers’ Association, and the FDA also recognizes sandalwood oil as a natural flavoring.1
The oral toxicity of sandalwood oil in rats was found to be 5.58 g/kg and 3.8 g/kg for alpha-santalol. The dermal toxicity of sandalwood oil and alpha-santalol in rabbits was reported as more than 5 g/kg.1
Sandalwood oil was found to be irritating in mouse and rabbit skin test models. The santalols and related compounds have been identified in the blood of mice that inhaled sandalwood fumes under experimental conditions, indicating that systemic absorption of these compounds can occur.29
References
1. Burdock GA, Carabin IG. Safety assessment of sandalwood oil (Sandalwood album L.). Food Chem Toxicol. 2008;46(2):421-432.179809482. Duke JA. Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press; 1985.3. Hongratanaworakit T, Heuberger E, Buchbauer G. Evaluation of the effects of East Indian sandalwood oil and alpha-santalol on humans after transdermal absorption. Planta Med. 2004;70(1):3-7. 147652844. Fox JED. Sandalwood: the royal tree. Biologist. 2000;47(1):31-34.93701045. Dwivedi C, Abu-Ghazaleh A. Chemopreventive effects of sandalwood oil on skin papillomas in mice. Eur J Cancer Prev. 1997;6(4):399-401.93701046. Kumar G, Jeyraaj IA, Jeyaraaj R, Loganathan P. Antimicrobial activity of aqueous extract of leaf and stem extract of Santalum album. Anc Sci Life. 2006;25(3-4):6-9.103742517. Roh HS, Park KC, Park CG. Repellent effect of santalol from sandalwood oil against Tetranychus urticae (Acari: Tetranychidae). J Econ Entomol. 2012;105(2):379-385.84437828. Zhang X, Dwivedi C. Skin cancer chemoprevention by α-santalol. Front Biosci. 2011;S3:777-787.15254879. Setzer WN. Essential oils and anxiolytic aromatherapy. Nat Prod Commun. 2009;4(9):1305-1316.1983104810. Wang Z, Hong X. Comparative GC analysis of essential oil in imported sandalwood [in Chinese]. Zhongguo Zhong Yao Za Zhi. 1991;16(1):40-43, 64.206970211. Leung AY. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. New York, NY: J. Wiley and Sons; 1980.12. Benencia F, Courreges MC. Antiviral activity of sandalwood oil against herpes simplex viruses-1 and -2. Phytomedicine. 1999;6(2):119-123.1037425113. Koch C, Reichling J, Schneele J, Schnitzler P. Inhibitory effect of essential oils against herpes simplex virus type 2. Phytomedicine. 2008;15(1-2);15:71-78.14. Schnitzler P, Koch C, Reichling J. Susceptibility of drug-resistant clinical herpes simplex virus type 1 strains to essential oils of ginger, thyme, hyssop, and sandalwood. 2007;51(5):1859-1862.1735325015. Ochi T, Shibata H, Higuti T, Kodama K, Kusumi T, Takaishi Y. Anti-Helicobacter pylori compounds from Santalum album. J Nat Prod. 2005;68(6):819-824.1597460216. Paulpandi M, Kannan S, Thangam R, Kaveri K, Gunasekaran P, Rejeeth C. In vitro anti-viral effect of β-santalol against influenza viral replication. Phytomedicine. 2012;19(3-4):231-235.2219286717. Banerjee S, Ecavade A, Rao AR. Modulatory influence of sandalwood oil on mouse hepatic glutathione S-transferase activity and acid soluble sulphydryl level. Cancer Lett. 1993;68(2):105-109. 844378218. Bommareddy A, Rule B, VanWert AL, Santha S, Dwivedi C. α-santalol, a derivative of sandalwood oil, induces apoptosis in human prostate cancer cells by causing caspase-3 activation. Phytomedicine. 2012;19(8-9):804-811.2257197519. Matsuo Y, Mimaki Y. Lignans from Santalum album and their cytotoxic activities. Chem Pharm Bull. 2010;58(4):587-590.2041065020. Kulkarni CR, Joglekar MM, Patil SB, Arvindekar AU. Antihyperglycemic and antihyperlipidemic effect of Santalum album in streptozocin induced diabetic rats. Pharm Biol. 2012;50(3):360-365.2212931421. Okugawa H, Ueda R, Matsumoto K, Kawanishi K, Kato A. Effect of α-santalol and β-santalol from sandalwood on the central nervous system in mice. Phytomedicine. 1995;2:119-126.22. Kyle G, Evaluating the effectiveness of aromatherapy in reducing levels of anxiety in palliative care patients: results of a pilot study. Complement Ther Clin Pract. 2006;12(2):148-155.1664809323. Hongratanaworakit T, Heuberger E, Buchbauer G. Evaluation of the effects of East Indian sandalwood oil and α-santalol on humans after transdermal absorption. Planta Med. 2004;70(1):3-7.1476528424. Heuberger E, Hongratanaworakit T, Buchbauer G. East Indian sandalwood and α-santalol odor increase physiological and self-rated arousal in humans. Planta Med. 2006;72(9):792-800.1678369625. van Wyk BE, Wink M. Medicinal Plants of the World. Portland, OR: Timber Press, Inc; 2004.26. Uter W, Schmidt E, Geier J, Lessmann H, Schnuch A, Frosch P. Contact allergy to essential oils: current patch test results (2000-2008) from the Information Network of Departments of Dermatology (IVDK). Contact Derm. 2010;63(5):277-283.2094645627. Sharma R, Bajaj AK, Singh KG. Sandalwood dermatitis. Int J Dermatol. 1987;26(9):597.344353028. Starke JC. Photoallergy to sandalwood oil. Arch Derm. 1967;96(1):62-63.602868329. Jirovetz L, Buchbauer G, Jager W, Woidich A, Nikiforov A. Analysis of fragrance compounds in blood samples of mice by gas chromatography, mass spectrometry, GC/FTIR and GC/AES after inhalation of sandalwood oil. Biomed Chromatogr. 1992;6(3):133-134. 1525487
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