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Saffron: The Salubrious Spice

Emerging Research Suggests Numerous Health Benefits

ISSUE:
Page:
61-71

Introduction

Since ancient times, saffron (Crocus sativus, Iridaceae) has been valued in the medical traditions of Persia, Greece, Egypt, and India. Strangely, though, it has largely been ignored by scientists and by the West — until now. The past dozen years has brought a flowering of research on this versatile and intriguing herb.

Saffron is the world’s most expensive culinary botanical, and it may soon become known for its medicinal value as well. Perhaps the most interesting research on saffron has examined its effects on depression and Alzheimer’s disease (AD). However, there has also been promising research on a host of other conditions, from erectile dysfunction (ED), premenstrual syndrome (PMS), and dysmenorrhea, to glaucoma, weight loss, and exercise.

The plant part used as a medicine and spice is the dried stigma from the flower. Saffron is expensive because each flower contains only three red, yellow, or golden yellow-orange stigmas, which are collected in the field and used. A small, but growing, body of research is exploring the possibility of using saffron extracts made not from the stigma, but from the petal. (The potency of stigma extracts and petal extracts is relatively similar, and both preparations have been shown to produce antidepressant effects.) With more usable plant material to produce extracts, saffron could become a more readily available, and more affordable, medicinal herb.

The purpose of this review is to summarize the available evidence from clinical trials on the internal and topical uses of saffron. Together, these studies form an impressive and exciting body of research that suggests that saffron is a safe, effective, and multipurpose herb.

Saffron as Food and Medicine

Saffron’s history as a culinary and medicinal plant stretches back to ancient times. It first appeared in a seventh century BCE Assyrian botanical dictionary in which it was indicated for breathing difficulties, painful urination, menstrual disorders, and “diseases of the brain” — the last two uses corresponding to some of the best-researched modern applications.1 Though saffron is best known for its use in traditional Persian medicine, it also was used by the ancient Greeks and Egyptians, as well as in the Ayurvedic tradition of India.2 Its traditional medical indications were many, and included cramps, asthma, menstrual conditions, liver disease, and pain.3

Iran is the world’s largest producer of saffron, and much of the modern pharmacological and clinical research on the herb has been conducted there in a number of research facilities, including major universities and hospitals.

Saffron’s mechanisms of action are not yet well understood, but they likely involve a number of compounds, such as safranal, crocin, and crocetin — carotenoids that are structurally similar to zeaxanthin, a carotenoid found in many plants, as well as in the eye. (Carotenoids are photosynthetic pigments with strong antioxidant properties.)4

Despite the broad traditional uses of saffron, modern research has been scarce. Few studies have evaluated its traditional uses, and few modern herbal books have included saffron. However, this has changed in the past dozen years with recent clinical research focusing on Alzheimer’s disease, depression, reproductive health, eye health, weight loss, exercise, and other areas.*

Alzheimer’s Disease

A group of researchers in Iran has published two small studies on saffron and AD. The first was a double-blind, randomized, controlled phase 2 study comparing a saffron extract to donepezil. Donepezil is one of the most recently approved cholinesterase inhibitors, the leading class of Alzheimer’s drugs.

The dose of donepezil was 5 mg for four weeks, then 5 mg twice a day for 18 weeks; the dose of saffron extract was 15 mg a day for four weeks, then 15 mg twice a day for 18 weeks. The saffron (Green Plants of Life, IMPIRAN Co., Ltd.; Tehran, Iran) was prepared by extracting dried and milled stigmas with 80% ethanol at a 1:15 ratio. The extract was then dried. It contained 0.13-0.15 mg of safranal and 1.65-1.75 mg of crocin per 15 mg. Study participants had experienced cognitive decline for at least six months before the start of the study. Forty-seven people completed the study (24 in the saffron group; 23 in the donepezil group). The mean age was 72.7 in the saffron group and 73.9 in the donepezil group.

In this study, saffron was found to be as effective as donepezil. Scores on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-CS) improved by 3.96 points in the saffron group and by 3.77 points in the donepezil group. The improvement was not significantly different between the two groups. Scores on the Clinical Dementia Rating Scale-Sums of Boxes (CDRS-SB) improved by 0.77 points in the saffron group and by 0.83 points in the donepezil group. Again, the improvement was not significantly different between the two groups. The changes in scores from baseline to 22 weeks were not statistically significant for either scale in either group, but the authors state that a three-point change in the ADAS-CS score, which both groups experienced, is clinically meaningful. While there was no statistical difference between saffron and donepezil, saffron did have an advantage in adverse events (AEs). Frequency of AEs was similar, but there was significantly more vomiting in the donepezil group.5

In another study, the beneficial effect of the saffron preparation did reach statistical significance. In this randomized, double-blind, placebo-controlled study of 46 people with probable AD, each person was given either a placebo or 15 mg of saffron extract (Green Plants of Life, IMPIRAN) twice a day for 16 weeks. Saffron stigmas were extracted in 80% ethanol, then dried. ADAS-CS and CDRS-SB scores improved significantly in the saffron group compared to placebo (P = 0.04 on both scales). On both scales, subjects improved in the saffron group, while those in the placebo group continued to worsen (−3.69 and +4.08, respectively, on the ADAS-CS, and −0.67 and +0.63, respectively, on the CDRS-SB). There was no significant difference between saffron and placebo in AEs. The researchers said that saffron’s mechanism in benefiting AD may be the inhibition of aggregation and deposition of amyloid  plaque in the brain.6

Depression

Saffron was used in traditional Persian medicine for treating depression, and depression is the condition for which saffron has the strongest scientific support in Iran.7 The initial evidence was provided by two small, double-blind studies. The first was a six-week, randomized, double-blind, placebo-controlled trial of 35 people with mild to moderate depression who were given either a placebo or 30 mg of saffron stigma extract (produced in 80% ethanol, then dried). The saffron extract used (Novin Zaferan Co.; Mashhad, Iran) was not standardized. At the end of the six-week study, the saffron group had a significantly greater improvement on the Hamilton Rating Scale for Depression (HAMD) (P < 0.001). The saffron was well-tolerated, and there was no significant difference in AEs between the saffron and the placebo groups.7

The second study was also a six-week, randomized, double-blind, placebo-controlled study of 40 people with mild to moderate depression that compared 30 mg of saffron petal extract to a placebo. The saffron was an 80% ethanol extract (identified by the Department of Cultivation and Development of the Institute of Medicinal Plants [DCDIMP]; Tehran, Iran). Once again, the saffron group’s HAMD scores improved significantly more than those of the placebo group (P < 0.001). As in the first study, AEs were the same in both groups.8 An intriguing feature of this study is that it is one of the few to use saffron petal instead of saffron stigma. One systematic review has shown that saffron petal is as effective as saffron stigma for depression.9 Though saffron petal does not contain crocin, it does contain kaempferol, a flavonoid with antidepressant effects.10

The next studies on saffron and depression compared the herb to various antidepressant drugs. The first small study was a randomized, double-blind trial that compared saffron extract (Novin Zaferan Co.) to the pharmaceutical tricyclic antidepressant imipramine. The study lasted six weeks and included 30 people, aged 18-55, with mild to moderate depression. The dose of imipramine was 100 mg per day; the dose of saffron was 30 mg per day. The saffron preparation was an 80% ethanol extract of dried and milled stigmas that was then dried. Improvement on the HAMD was significant in both groups (P < 0.0001) and there was no significant difference between groups (P = 0.33). Though saffron was not more effective than imipramine, it had fewer AEs, because dry mouth and sedation were significant in the imipramine group.9

In the next study, saffron was compared to a selective serotonin reuptake inhibitor (SSRI). In a six-week, randomized, double-blind study, 40 people, aged 18-55, with mild to moderate depression were given either 10 mg of fluoxetine twice a day, or 15 mg of saffron twice a day. The saffron extract was made from dried and milled stigmas extracted with 80% ethanol, and it was then dried. Each 15-mg capsule was standardized to 0.30-0.35 mg of safranal. Both fluoxetine and saffron led to significant improvement on the HAMD. The 54% improvement with saffron was similar to the 65% improvement with fluoxetine (P = 0.71). While saffron was not more effective than fluoxetine, it trended toward a decreased incidence of sexual dysfunction (P = 0.10) and tremor (P = 0.10), but this was not statistically significant.11

Saffron was compared to fluoxetine again in an eight-week, randomized, double-blind study of 38 people, aged 18-55, with mild to moderate depression who were given either 10 mg of fluoxetine twice a day or 15 mg of an 80% ethanol extract of saffron petals twice a day (morning and evening). The extract was standardized to 0.30-0.35 mg of safranal. The saffron had a significant effect (P < 0.0001) on HAMD scores compared to baseline values, which was equal to the effect of fluoxetine (−12, or 54%, in the saffron group and −13.5, or 59%, in the fluoxetine group). In both groups, the remission rate was 25%, and there was no significant difference in the response rate to treatment (defined as at least a 50% decrease on the HAMD) between the two groups: 75% in the saffron group and 85% in the fluoxetine group responded to treatment.12 The study was limited by the lack of a placebo control.

A third study, with a different population, compared saffron to fluoxetine. This study included people with mild to moderate depression who had undergone percutaneous coronary intervention (angioplasty) for coronary artery disease. This population was investigated because coronary artery disease is often associated with depression, and the procedure of percutaneous coronary intervention may also be associated with depression. In this small, randomized, double-blind, placebo-controlled study, 40 people were given either 40 mg of fluoxetine or 30 mg of saffron extract (SaffroMood; Green Plants of Life, IMPIRAN) each day for six weeks. The saffron extract was a dried 80% ethanol extract of stigmas. Each 15-mg capsule contained 0.13-0.15 mg of safranal and 1.65-1.75 mg of crocin. The two treatments were found to be equally effective (P = 0.62), according to the HAMD. In both groups, the remission rate was 70%. A complete response was counted if the decrease on the HAMD was 50% or more; 85% of the saffron group had a complete response versus 80% of the fluoxetine group. There was no significant difference in the frequency of AEs, but two people in the fluoxetine group had to be excluded due to severe anxiety and suicidal thoughts.13

There have been two reviews of saffron preparations for the treatment of depression. The first was a meta-analysis of five randomized, controlled studies. The meta-analysis does not identify the preparations used, but a check of the references reveals that four of the studies used ethanol extracts of saffron stigmas and one used an ethanol extract of the petals. Two of the studies used placebos in the control arms, and three used antidepressant drugs. An antidepressant effect was found for saffron preparations compared to placebo, and saffron was shown to be as effective as the antidepressant drugs. Saffron was as safe as placebo and safer than imipramine.14

A systematic review of six high-quality clinical trials included the five studies mentioned in the previous paragraph and one additional study that had been conducted since publication of the first meta-analysis. This systematic review included 230 people with major depression. Two studies were randomized, double-blind, and placebo-controlled, and four were randomized, double-blind comparisons to antidepressant medications. Four of the studies used saffron stigma extract and two used saffron petal extract. In all six studies, the dose of saffron extract was 15 mg twice a day. In three of the studies, the saffron extract was standardized for crocin and/or safranal; in the other three studies, there was no reported standardization. This review also found a large treatment effect for saffron preparations, compared to placebo, which was similar to the effect for antidepressant drugs. Interestingly, the review found that saffron stigma extracts and petal extracts had similar efficacy, according to HAMD scores (stigma extracts: reduction of 11.7-12.2; petal extracts: reduction of 12-14).10

The authors of the systematic review suggested that saffron’s mechanism of action in treating depression may be due to its serotonergic, antioxidant, anti-inflammatory, neuroendocrine, and neuroprotective effects. It has been suggested that the serotonergic effect is due to saffron’s ability to act like an SSRI. Saffron may also inhibit the reuptake of dopamine and norepinephrine.15

Reproductive Health

Saffron may be able to attenuate some of the sexual dysfunctions caused by SSRI antidepressants when the two are used conjunctively.11 This is according to at least two studies, which found that subjects taking saffron preparations had significantly greater improvements in certain symptoms compared to those taking a placebo.

Many SSRIs can cause sexual dysfunction, such as decreased desire and arousal. In particular, fluoxetine is associated with reduced sexual desire: 64.3% of women on fluoxetine reportedly experience this symptom.16

A randomized, double-blind, placebo-controlled study found that saffron can help women suffering from sexual dysfunction induced by fluoxetine. The study included 34 women, aged 18-45, who were suffering from major depression. All the women were taking 40 mg of fluoxetine a day and were experiencing various sexual dysfunctions. None of the women had experienced any sexual dysfunction before initiating fluoxetine treatment. Each subject added to her current treatment either 30 mg a day of saffron petal extract (Green Plants of Life, IMPIRAN) or a placebo for four weeks. The saffron was prepared by extracting dried and milled petal in 80% ethanol, then drying it. Each 15-mg capsule was standardized to 1.65-1.75mg of crocin. Though the intervention section of the article first refers to the saffron material as “the stigma’s extract,” it later refers to it as “dried and milled petal” and “extract of petal.” So, this could be the third study to use the less expensive saffron petals, instead of the more expensive stigmas, although it is unclear. Compared to the placebo group, the women taking the saffron extract experienced significantly greater improvements in total Female Sexual Function Index (FSFI) (P < 0.001), and in the arousal (P = 0.028), lubrication (P = 0.035), and pain (P = 0.016) domains of the FSFI, but not in the desire (P = 0.196), satisfaction (P = 0.206), or orgasm (P = 0.354) domains. Frequency of side effects was similar between the two groups, but less frequent in the saffron group. This study suggests that saffron extract may be able to improve some of the sexual dysfunction symptoms caused by fluoxetine.17

Saffron can also help men suffering from sexual dysfunction caused by SSRIs. In a randomized, double-blind, placebo-controlled study, 30 men, aged 18-45, with major depression who were taking fluoxetine and experiencing sexual impairment were given either 15 mg of saffron stigma extract (Green Plants of Life, IMPIRAN) or a placebo twice a day for four weeks. The saffron was extracted in 80% ethanol, then dried. Each capsule was standardized to 1.65-1.75 mg of crocin. Researchers used the International Index of Erectile Function (IIEF-5) scale to gauge sexual function. After four weeks, the saffron group had significantly greater improvements in ED (P < 0.001), intercourse satisfaction (P < 0.001), and total IIEF-5 scores (P < 0.001) compared to the placebo group. Saffron did not significantly improve orgasm, overall satisfaction, or sexual desire compared to placebo. Impressively, 60% of the men taking saffron achieved a normal erectile function score on the IIEF-5 versus only 7% of those taking the placebo. The frequency of AEs was similar between the two groups.18

Saffron preparations may also be effective for sexual dysfunction not caused by antidepressant drugs. In an open-label study, 20 men with ED were given 200 mg of saffron for nine days and then 400 mg on the 10th day. The saffron used was an aqueous extract (plant part not specified) containing 19.7 mg/g of crocin and 0.25 mg/g of safranal (Novin Zaferan Co.). After 10 days of saffron treatment, subjects had significant improvements in rigidity (P < 0.0001) and size (P < 0.0001) compared to baseline scores, as measured by the Nocturnal Penile Tumescence (NPT) test. Total IIEF-5 scores also improved significantly after saffron treatment (P < 0.001). Mean IIEF-5 scores for erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction increased significantly after saffron treatment (P < 0.0001). Saffron led to more frequent (P < 0.0001) and longer-lasting erections (p-value not reported). There were no major AEs.19 These are impressive results after only 10 days of treatment, but the study was small, there was no control, and it was not blinded.

A second study looked at men suffering from ED and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). The study was randomized, but it is not clear if it was blinded. One hundred twenty-nine men over the age of 50 were given either 320 mg of saw palmetto (Serenoa repens, Arecaceae) berry extract alone or in combination with 120 mg Masson’s pine (Pinus massoniana, Pinaceae) bark extract and 100 mg of saffron extract (IDIProst Gold; idiPharma; Aci Bonaccorsi, Italy), for three months. Additional details about the extracts were not provided. The combination product produced a significantly greater improvement in the International Prostate Symptom Score (IPSS) compared to saw palmetto alone (P < 0.001). The combination also produced greater improvement in ED, as evidenced by significantly greater improvement on the IIEF-5 (P < 0.003). Saw palmetto berry extract alone did not improve ED. Quality of life, as measured by the Short Form Health Survey (SF-36), also improved significantly more in the combination group (P < 0.001). There were few AEs.20 The inclusion of the pine bark extract in this study makes it difficult to establish the role of the saffron, because the patented extract of French maritime pine (P. pinaster) bark, which is known commercially as Pycnogenol (Horphag Research; Geneva, Switzerland), also has been reported to improve ED.21

Diabetes is a major risk factor for ED. In a novel study, saffron was shown to help ED when applied topically. This one-month, double-blind, placebo-controlled study asked 50 diabetic men with ED to apply a “pea-sized” amount of either a topical saffron gel or a placebo gel 30 minutes before intercourse for one month. The saffron gel consisted of 1% saffron (the paper does not specify the plant part used, or if it was an extract) in a starch-based gel (School of Pharmacy, Shahid Beheshti University of Medical Sciences; Tehran, Iran). The saffron gel significantly improved ED compared to placebo on the IIEF-5 (P < 0.001).22

Saffron can help other aspects of reproductive health as well. At least two studies have explored saffron’s efficacy for menstrual conditions. A randomized, double-blind, placebo-controlled study investigated saffron’s ability to alleviate symptoms of PMS. The study included 47 women, aged 20 to 45, who suffered from PMS. They were given either a placebo or 15 mg of saffron extract twice a day (morning and evening) for two menstrual cycles. The saffron was made from dried and milled stigma that was extracted with 80% ethanol and then dried (identified by the DCDIMP). Compared to placebo, the saffron significantly improved the symptoms of PMS, according to the Total Premenstrual Daily Symptoms Rating (TPDSM) scores (P < 0.0001). In the saffron group, 76% of participants responded to treatment, compared to 8% in the placebo group, a significant difference (P < 0.0001). Not surprisingly, given the research on saffron and depression, the saffron preparation also significantly decreased depression on the HAMD (P < 0.0001) — the secondary endpoint of the study — and did so significantly better than the placebo (P < 0.001). In addition, 60% of the saffron group responded to treatment, according to HAMD scores, compared to only 4% of the placebo group (P < 0.0001). There was no significant difference in AEs between groups.23

The second study related to female reproductive health used a combination saffron product. One hundred eighty students, aged 18-27, who suffered from dysmenorrhea (painful menstruation), were given either a placebo, 500 mg of highly purified saffron combined with celery (Apium graveolens, Apiaceae) seed and anise (Pimpinella anisum, Apiaceae; presumably the seed), or mefenamic acid three times a day, for three days, starting from the onset of bleeding or pain. (Mefenamic acid is a nonsteroidal anti-inflammatory drug [NSAID] commonly used for dysmenorrhea.) The women were followed for two to three menstrual cycles. There was a statistically significant reduction in pain and duration of pain in the herbal combination group (P < 0.001) and the mefenamic acid group (P < 0.01) compared to baseline, but the improvement was significantly greater in the herbal combination group.24 Given that saffron was administered in combination with two other herbs, it is difficult to isolate the effectiveness of saffron in this study.

Eye Health

Another promising area of saffron research is eye health. A leading cause of blindness, glaucoma is caused by increased pressure within the eye, known as intraocular pressure. In this randomized, double-blind, placebo-controlled study, 34 people with primary open-angle glaucoma, who were being treated with timolol and dorzolamide eye drops, added either an oral aqueous extract of saffron stigma (East Sorkhfam Saffron Co.; Gonabad, Razavi Khorasan, Iran) or a placebo. The saffron capsule contained 30 mg of concentrated powdered extract, and was taken once a day. After three weeks, there was a significantly greater improvement in the saffron group (P = 0.013) compared to placebo. At the end of the four-week study, intraocular pressure was virtually unchanged in the placebo group, but, in the saffron group, intraocular pressure dropped significantly (P = 0.001). There were no AEs for either group.25

Saffron has also been shown to help age-related macular degeneration (AMD). In an open-label study, researchers gave 20 mg a day of saffron stigma to 29 people with AMD for 15 months (Zaffit; Hortus Novus; L’Aquila, Italy). At this dose, the supplement was presumably an extract. Compared to baseline, the saffron preparation led to a significant increase (P < 0.01) in focal electroretinogram (fERG), an assessment of macular function, and a significant improvement in mean visual acuity (P < 0.01). All 29 participants reported improved vision, especially contrast and color perception, reading ability, and vision at low light.26

A second study on saffron and AMD was randomized, double-blind, and placebo-controlled. It included 25 people, aged 54 to 85, with AMD who were given either a placebo or 20 mg of saffron for three months. No information is provided about the saffron supplement; though, at a dose of 20 mg, it is presumably an extract. fERG improved significantly in the saffron group (P < 0.001) but not in the placebo group. The difference between the two groups was significant (P < 0.01). Visual acuity improved in 80% of the saffron group but in 0% of the placebo group. The improvement in visual acuity was significant (P < 0.01). There were no AEs.27

Weight Loss

In a less-explored area of research, saffron has demonstrated the ability to reduce snacking and promote weight loss. One study included 60 healthy, mildly overweight women. It was randomized, double-blind, placebo-controlled, and lasted eight weeks. Subjects took either a placebo or Satiereal (Inoreal Ltd.; Plérin, France), which the manufacturer describes as a novel patented extract of saffron stigma.28 The saffron supplement contained 176.5 mg of saffron taken in two doses: one at breakfast and one at dinner. Subjects’ caloric intake and exercise frequency were not restricted. The women in the saffron group lost significantly more weight than those in the placebo group: 2.19 lbs versus 0 lbs (P < 0.01). The women in the saffron group had their snacking reduced by 55% compared to a 28% reduction in the placebo group, a significant difference (P < 0.05). Feelings of satiety increased in the saffron group. On the General Index of Food Craving, the saffron group experienced an improvement in the “hunger” and “snacking” dimensions, compared with the placebo group (P < 0.05). The saffron supplement was well-tolerated.29

Exercise

Delayed onset muscle soreness (DOMS) is the pain and discomfort that may be felt for a few days after strenuous exercise. It is experienced as stiffness, tenderness, and pain during physical activity. DOMS is problematic for people in training because, aside from the discomfort, it can limit exercise and training. In a randomized, double-blind, placebo-controlled trial, 39 sedentary men were given a placebo, 300 mg of dried saffron powder (plant part not specified), or 75 mg of the NSAID indomethacin for 10 days, starting one week before exercise and continuing for three days. The placebo group experienced severe pain for three days after the exercise, but pain in the saffron group was 11.2 times lower than baseline scores after 24 hours. Pain in the indomethacin group took three days to disappear, but the saffron group had no pain after 48 hours (P < 0.001). The researchers concluded that dried saffron is more effective than indomethacin for DOMS.30

Systematic Reviews

There have been three recent reviews of saffron research. One is a systematic review of 12 randomized, controlled trials of saffron or saffron combination products. Six of the studies were on depression, one was on PMS, four were on sexual dysfunction and infertility, and one was on weight loss and snacking behavior. The review does not provide details about the preparations used, but an analysis of the references reveals that numerous preparations were used: seven studies used saffron stigma extracts; two depression studies used saffron petal extracts; one study on fluoxetine-induced sexual dysfunction did not specify whether the extract was of stigmas or petals; one used a standardized, but unspecified, extract; and the other also was unspecified. The reviewers conclude that the data from these studies support the efficacy of saffron for depression, PMS, sexual dysfunction, and excessive snacking. They say that the strongest clinical evidence exists for saffron as a treatment for depression. They also note that, in the studies comparing saffron to antidepressants, the pharmaceutical drugs caused more sedation/drowsiness, headaches, dry mouth, constipation, and sexual dysfunction compared to saffron. The reviewers conclude that the data support saffron’s efficacy for ED, despite their inclusion of one negative open-label study that compared a dried 80% ethanolic extract of saffron petal with the ED drug sildenafil.3

A second review article concluded that saffron can improve cognition (comparable to donepezil), can help treat mild to moderate depression (comparable to imipramine) and AMD, can significantly improve symptoms of PMS, improve fluoxetine-induced sexual dysfunction in men and women, and can significantly decrease lipoprotein oxidation.4

The third review concluded that saffron is effective for depression, and is more effective than placebo and as effective as donepezil for AD.31 It found evidence that saffron can help with weight loss and reduce snacking, and that it is superior to placebo and similar to standard treatments for PMS. The review included two studies on AD, six on depression, one on ED, one each on PMS and dysmenorrhea, and one on weight loss, all of which are discussed above. It also identified one study that suggested that saffron does not help male infertility caused by idiopathic low sperm count.32 Another study included in the review found that saffron may have short-term immunomodulating effects.33

The review included two promising studies on saffron for cardiovascular health. The first was a double-blind, placebo-controlled trial that concluded 400 mg of saffron stigma (at this dose, presumably not an extract) produced a statistically significant lowering of standing systolic blood pressure and arterial blood pressure. However, according to the authors, the improvements were not clinically significant.34 The second cardiovascular study found that 50 mg of saffron dissolved in milk, when administered twice a day to a group of 20 people (10 of whom had heart disease), decreased susceptibility to lipoprotein oxidation.35

Two studies provided limited evidence that saffron can benefit the skin. The first showed that a 0.3% dry extract of saffron stigma in a cream, lotion, or face powder can lighten skin via shining and depigmentation. However, the methodology of the study was not adequately reported.36 The second study was an open-label, randomized, controlled trial that found improvement in itching with a topical application that included saffron. However, the 0.025% saffron extract is one of 11 ingredients in the formula, so it is not possible to make any conclusions about the efficacy of saffron itself.37 Finally, the review concluded that saffron has a “high safety level.”

Conclusion

The recent research from Iran on this traditionally used plant strongly suggests that saffron, the most expensive spice on the market, may also have significant medicinal value. Additional research on the efficacy of petal extracts, compared to the more commonly used stigma extracts, may lead to more of the botanical being used in medicinal preparations, thus making it more accessible and possibly decreasing the historically high price. If replicated and confirmed by researchers in other countries, this growing body of research could lay the foundation for saffron to take a place among other important medicinal plants used for a variety of physical and psychological conditions.

Linda Woolven is a master herbalist, registered acupuncturist, and solution-focused counselor with a practice in Toronto. She is the author of several books, including Smart Woman’s Guide to PMS and Pain-free Periods (John Wiley & Sons, 2008) and The All-New Vegetarian Passport (Whitecap Books, 2013).

Ted Snider is a natural health researcher and writer. Snider and Woolven have co-authored Healthy Herbs: Your Everyday Guide to Medicinal Herbs and Their Use (2006), The Family Naturopathic Encyclopedia (2011), and Sex & Fertility: Natural Solutions (2012), all published by Fitzhenry and Whiteside Limited. They also publish The Natural Path newsletter. Woolven and Snider can be reached on their blog at www.thenaturalpathnewsletter.com

* See Table e1, available at http://cms.herbalgram.org/herbalgram/index.html, for additional details about the studies mentioned in this article.

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