Lemon Balm — Melissa officinalis

Common & Latin Names

Common names: Lemon balm, Balm, Sweet balm, Melissa, Bee balm (not to be confused with Monarda), Cure-all Latin name: Melissa officinalis L. Arabic: Badranjbuyeh TCM name: Not a classical TCM herb; referenced as Xiang Feng Hua (香蜂花) in modern Chinese integrative texts The genus name Melissa comes from the Greek word for “honey bee” — the plant is a powerful bee attractant

Plant Family & Parts Used

Family: Lamiaceae (mint family) Parts used: Leaves (primary), aerial parts. Fresh leaves preferred for essential oil content (volatile compounds diminish with drying). Both fresh and dried preparations are used. Habitat: Native to southern Europe, the Mediterranean region, and western Asia. Naturalized throughout Europe and North America. A hardy perennial growing 30-90cm, with opposite, serrated leaves that release a strong lemon fragrance when crushed. Thrives in full sun to partial shade in temperate climates.

Traditional Uses

Greco-Roman Medicine

Dioscorides (1st century CE) recommended lemon balm for scorpion stings and dog bites. Pliny recommended it for wounds and as a bee-attracting garden plant. Paracelsus (16th century) called it the “elixir of life” and believed it could revitalize the body completely. The medieval Arab physicians Avicenna and Rhazes used it for melancholy and cardiac conditions — Avicenna specifically noted it “maketh the heart merry.”

European Herbal Tradition

Lemon balm has been cultivated in European monastery gardens since the 7th century. Carmelite nuns created “Carmelite Water” (Eau de Mélisse des Carmes) in 1611 — a lemon balm-based preparation used for nervous headache, neuralgia, and digestive complaints that remained in use for over 300 years. Nicholas Culpeper (17th century) wrote that lemon balm “causeth the mind and heart to become merry… and driveth away all troublesome cares and thoughts out of the mind, arising from melancholy and black choler.”

Ayurvedic Medicine

While not a classical Ayurvedic herb (it’s not native to India), lemon balm has been integrated into modern Ayurvedic practice as a nervine and digestive herb, particularly for Pitta-type conditions.

Active Compounds & Pharmacology

Primary Phytochemicals

Rosmarinic acid: The primary phenolic compound (2-5% of dried leaf). Potent antioxidant, anti-inflammatory, and antiviral. Inhibits thyroid-stimulating immunoglobulins (relevant for Graves’ disease). Inhibits GABA transaminase (the enzyme that degrades GABA), thereby increasing GABA levels in the brain.

Hydroxycinnamic acid derivatives: Caffeic acid, chlorogenic acid — antioxidant and anti-inflammatory.

Flavonoids: Luteolin, apigenin, quercetin — anxiolytic (GABA-A modulation), anti-inflammatory, neuroprotective.

Volatile oils (0.05-0.3% — relatively low compared to other aromatic Lamiaceae):

• Citral (geranial + neral): Primary aromatic compound, responsible for lemon fragrance. Antimicrobial.
• Citronellal: Insect-repellent, antimicrobial.
• Geraniol, linalool, beta-caryophyllene: Various bioactive terpenes.

Tannins: Condensed tannins with astringent and antiviral properties.

Mechanisms of Action

1. GABAergic Enhancement: Rosmarinic acid inhibits GABA transaminase, increasing GABA availability in the brain. Flavonoids (apigenin, luteolin) directly modulate GABA-A receptors. The combined effect produces anxiolysis and mental calming.

2. Cholinergic Enhancement: Lemon balm inhibits acetylcholinesterase (AChE), increasing acetylcholine availability. This mechanism is shared with pharmaceutical Alzheimer’s treatments (donepezil, rivastigmine) and explains lemon balm’s cognitive-enhancing effects — particularly memory improvement.

3. Antiviral (Anti-HSV): Rosmarinic acid and other phenolics demonstrate potent activity against herpes simplex virus (HSV-1 and HSV-2) by interfering with viral attachment to host cells. This has been confirmed in multiple in vitro studies and clinical topical application trials.

4. Thyroid Modulation: Rosmarinic acid inhibits the binding of thyroid-stimulating immunoglobulins (TSI) to TSH receptors and blocks the peripheral conversion of T4 to T3. This makes lemon balm useful in hyperthyroid conditions but a consideration in hypothyroid patients.

5. Digestive Support: Carminative volatile oils reduce smooth muscle spasm (antispasmodic), enhance bile flow (cholagogue), and reduce gas formation. The spasmolytic effect is mediated through calcium channel antagonism and direct smooth muscle relaxation.

6. Antioxidant and Anti-inflammatory: Rosmarinic acid is one of the most potent natural antioxidants — it scavenges superoxide, hydroxyl radicals, and peroxynitrite. It also inhibits complement cascade activation and NF-kB.

Clinical Evidence

Key Clinical Trials

Cases, J., Ibarra, A., Feuillere, N., et al. (2011). “Pilot trial of Melissa officinalis L. leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances.” Mediterranean Journal of Nutrition and Metabolism, 4(3), 211-218.

• 20 volunteers with mild anxiety and insomnia, standardized lemon balm extract (Cyracos) 600mg daily for 15 days
• Results: 18% reduction in anxiety manifestations (p<0.01), 42% reduction in insomnia (p<0.01), 15% reduction in anxiety-associated symptoms (p<0.01). Significant improvement on HAM-A, PSQI, and free-text symptom reporting.
• Notable: Both anxiolytic and sleep-promoting effects achieved with a single herb.

Kennedy, D.O., Scholey, A.B., Tildesley, N.T.J., et al. (2002). “Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm).” Pharmacology, Biochemistry and Behavior, 72(4), 953-964.

• 20 healthy young volunteers, single doses of 300mg, 600mg, or 900mg lemon balm extract vs placebo
• Results: The 600mg dose significantly improved calmness and reduced alertness (indicating sedation). Surprisingly, the 300mg dose improved mathematical processing speed and accuracy without sedation. Dose-response was non-linear — lower dose enhanced cognition, higher doses promoted calmness.
• This dose-dependent bidirectional effect (cognitive enhancement at lower doses, calming at higher doses) is clinically important.

Kennedy, D.O., Wake, G., Savelev, S., et al. (2003). “Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (Lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties.” Neuropsychopharmacology, 28(10), 1871-1881.

• Confirmed cholinergic receptor binding in vitro and cognitive enhancement in vivo
• Memory improvement correlated with acetylcholinesterase inhibition

Akhondzadeh, S., Noroozian, M., Mohammadi, M., et al. (2003). “Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer’s disease: a double blind, randomised, placebo controlled trial.” Journal of Neurology, Neurosurgery & Psychiatry, 74(7), 863-866.

• 42 patients with mild-moderate Alzheimer’s, lemon balm extract 60 drops/day for 4 months
• Results: Significant improvement in cognitive function (ADAS-cog, p<0.01) and agitation (CDR, p<0.01) compared to placebo. No side effects.
• Landmark study demonstrating lemon balm’s potential in neurodegenerative disease.

Koytchev, R., Alken, R.G., & Dundarov, S. (1999). “Balm mint extract (Lo-701) for topical treatment of recurring herpes labialis.” Phytomedicine, 6(4), 225-230.

• 66 patients with recurrent herpes labialis, topical lemon balm cream vs placebo
• Results: Significant reduction in healing time and symptom severity. When applied within the first 4 hours of outbreak, healing time was markedly reduced.

Therapeutic Applications

Conditions

• Anxiety and stress (mild to moderate — particularly without need for sedation)
• Insomnia (sleep quality improvement)
• Cognitive decline and Alzheimer’s disease (adjunctive)
• Herpes simplex (topical treatment of cold sores and genital herpes outbreaks)
• Digestive complaints (bloating, gas, cramping, IBS-related spasm)
• Hyperthyroidism/Graves’ disease (adjunctive — TSI inhibition)
• ADHD (cognitive enhancement without stimulation)
• Pediatric anxiety and colic (gentle enough for children)
• Tension headaches (nervine and antispasmodic)

Dosage Ranges

• Dried leaf tea: 1.5-4.5g steeped in hot water for 10-15 minutes, 2-4 cups daily. This is the most common and pleasant form — lemon balm makes a delicious tea.
• Standardized extract (Cyracos or similar, min 7% rosmarinic acid): 300-600mg daily
• Tincture (1:5 in 45% alcohol): 2-6mL, 3 times daily
• Fresh plant tincture (1:2 in 75% alcohol): 2-3mL, 3 times daily
• Essential oil: Aromatherapy (diffusion) for calming. NOT for internal use.
• Topical cream (1% concentrated extract): Applied 2-4 times daily for HSV outbreaks
• For children (6+): Tea (half adult strength), or glycerite preparations

Safety & Contraindications

Extremely Safe

Lemon balm is one of the safest medicinal herbs, with GRAS status and centuries of safe use including in children and elderly. No serious adverse events in clinical trials.

Contraindications

• Hypothyroidism: Lemon balm’s inhibition of TSH receptor binding and T4-to-T3 conversion could theoretically worsen hypothyroidism. Patients on thyroid replacement should be monitored. This risk is most relevant with high-dose, long-term use of concentrated extracts — occasional tea is unlikely to be clinically significant.
• Glaucoma: Animal studies suggest lemon balm may raise intraocular pressure. Caution in glaucoma patients.
• Pregnancy: Generally considered safe (long history of use in pregnancy for nausea and anxiety), but concentrated extracts should be used with caution due to thyroid effects.

Drug Interactions

• Thyroid medications: May interfere with levothyroxine efficacy. Monitor thyroid function.
• Sedatives: Mild additive effects — usually beneficial rather than problematic.
• Glaucoma medications: May counteract intraocular pressure-lowering drugs.
• HIV medications: Theoretical — rosmarinic acid may affect some drug metabolism pathways.

Energetics

Western Herbal Energetics

• Temperature: Cool
• Moisture: Slightly drying (astringent tannins) but generating fluids (aromatic)
• Tissue State: Excitation (primary), Heat (secondary)
• Taste: Sour-sweet (the lemony flavor), mildly bitter, aromatic
• Organ Affinity: Nervous system, heart, digestive system

Ayurvedic Classification (Modern Integration)

• Rasa: Amla (sour), Madhura (sweet), Tikta (bitter)
• Virya: Shita (cooling)
• Vipaka: Madhura (sweet)
• Dosha effects: Primarily pacifies Pitta and Vata. One of the best herbs for Pitta-type anxiety (irritable, hot, intense) — cooling, calming, clarifying. Also soothes Vata-type nervousness without aggravating Pitta.

TCM Classification (Modern Integration)

• Temperature: Cool
• Flavor: Sour, slightly sweet, aromatic
• Meridian entry: Heart, Liver, Stomach
• Actions: Calms Shen, soothes Liver Qi, harmonizes Stomach, clears mild Heat
• TCM pattern correspondence: Liver Qi stagnation with Heart Shen disturbance — the patient with stress-related anxiety, irritability, digestive upset, and difficulty sleeping. The classic “stress hits the gut” pattern.

Functional Medicine Integration

HPA Axis Protocol

Lemon balm serves as a gentle nervine in all stages of HPA dysfunction. In Stage 1, it calms the “wired” nervous system without sedation (particularly at lower doses). Its cognitive-enhancing properties mean patients can use it during the day without impairment. The thyroid-modulating effect is relevant when HPA dysfunction coexists with subclinical hyperthyroidism or Hashimoto’s thyrotoxicosis flares.

Cognitive Protocol

The acetylcholinesterase inhibition mechanism positions lemon balm alongside lion’s mane, bacopa, and ginkgo in cognitive preservation protocols. The Akhondzadeh 2003 Alzheimer’s study provides clinical justification. Unique advantage: cognitive enhancement combined with anxiety reduction — useful for patients whose cognitive decline is partly driven by anxiety and stress.

Gut-Brain Axis

Lemon balm addresses both ends of the gut-brain axis simultaneously: calming the nervous system (reducing stress-driven gut dysfunction) while directly soothing the digestive tract (antispasmodic, carminative). This makes it a bridge herb in gut-brain protocols.

Viral Protocols

Topical application for HSV provides an evidence-based botanical option for a condition that conventional medicine manages only with antivirals. In FM practice, HSV reactivation often signals immune suppression from chronic stress — lemon balm treats both the local outbreak and the systemic stress driving it.

Four Directions Connection

Primary Direction: Hummingbird (North — Soul Journey)

Lemon balm is the Hummingbird’s gentle messenger. The Hummingbird brings sweetness — the ability to extract nectar from life even in difficult circumstances. Lemon balm’s very name (Melissa, the honey bee) and its capacity to bring cheerfulness to the melancholy heart reflect this energy. Paracelsus called it the “elixir of life” — not because it cures all diseases, but because it restores the capacity to find joy. The Hummingbird’s journey requires not only endurance (rhodiola’s gift) but also the ability to find sweetness along the way. Lemon balm is that sweetness — in a cup of tea, in a moment of calm, in the simple fragrance of crushed leaves between the fingers.

Secondary Direction: Eagle (East — Mental Clarity)

Cognitive enhancement and memory improvement serve the Eagle’s domain. The acetylcholinesterase inhibition that preserves memory is the Eagle’s gift — the ability to see and remember clearly.

Tertiary: Serpent (South — Physical Body)

Digestive healing, antiviral activity, and physical calming serve the Serpent’s domain of embodied, instinctual wellness.

References

1. Cases, J., Ibarra, A., Feuillere, N., et al. (2011). Pilot trial of Melissa officinalis L. leaf extract in volunteers with mild-to-moderate anxiety and sleep disturbances. Mediterranean Journal of Nutrition and Metabolism, 4(3), 211-218.

2. Kennedy, D.O., Scholey, A.B., Tildesley, N.T.J., et al. (2002). Modulation of mood and cognitive performance following acute administration of Melissa officinalis. Pharmacology, Biochemistry and Behavior, 72(4), 953-964.

3. Kennedy, D.O., Wake, G., Savelev, S., et al. (2003). Modulation of mood and cognitive performance following acute administration of Melissa officinalis with human CNS nicotinic and muscarinic receptor-binding properties. Neuropsychopharmacology, 28(10), 1871-1881.

4. Akhondzadeh, S., et al. (2003). Melissa officinalis extract in patients with mild to moderate Alzheimer’s disease. Journal of Neurology, Neurosurgery & Psychiatry, 74(7), 863-866.

5. Koytchev, R., Alken, R.G., & Dundarov, S. (1999). Balm mint extract for topical treatment of recurring herpes labialis. Phytomedicine, 6(4), 225-230.

6. Scholey, A., Gibbs, A., Neale, C., et al. (2014). Anti-stress effects of lemon balm-containing foods. Nutrients, 6(11), 4805-4821.

7. Shakeri, A., Sahebkar, A., & Javadi, B. (2016). Melissa officinalis L. — A review of its traditional uses, phytochemistry and pharmacology. Journal of Ethnopharmacology, 188, 204-228.

8. Miraj, S., Rafieian-Kopaei, M., & Kiani, S. (2017). Melissa officinalis L: A Review Study With an Antioxidant Prospective. Journal of Evidence-Based Complementary & Alternative Medicine, 22(3), 385-394.