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Medicine: Toxicology Start‑class Low‑importance

This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Wikipedia talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine articles Start This article has been rated as Start-class on Wikipedia's content assessment scale. Low This article has been rated as Low-importance on the project's importance scale. This article is supported by the Toxicology task force (assessed as Low-importance).

Added properties from "Grant & Hackh's Chemical Dictionary" (5th Edition) McGraw Hill 1987.

Oil of ANY kind should not be applied to sunburn. The oil acts as a barrier for sweat and can cause more pain than the original intention of lavendar oil to relieve pain. Water based ointments only. It would be preferred to use very strong black tea (black, no sugar) after it has cooled down to room temperature which then should be sponged onto the affected area. Do not rub. For best effect, have a fan blowly softly onto the wet tea to further drop the skin temperature. If blisters form after a few hours, seek medical assistance due to second degree burns. (uncopyrighted text - anon.) —Preceding unsigned comment added by 220.236.188.225 (talk) 05:28, 21 November 2007 (UTC)[reply]

It is not true that no oil should be used against sunburn - coconut oil is a very effective healer of sunburn - and also very effectively prevents it in the first place. — Preceding unsigned comment added by Elmgrove33 (talk • contribs) 17:22, 2 February 2015 (UTC)[reply]

Oppose There are many other articles on essential oils, apart from the main plant articles. I see no reason to delete this one. Waitak 11:27, 4 June 2006 (UTC)[reply]

Oppose There's enough information here to justify a separate article. Kyleberk 20:10, 26 July 2006 (UTC)[reply]

Science News July 1, 2006 Vol. 170 page 6 indicates that products containing lavender oil or tea tree oil can cause enlarged breast in young boys.

FROM CHRISTINE LEEDS: I was in your pharmacy recently and the saleslady asked me about lavender oil. I looked up the website http://cottageessentialoils.com/shop/categories/Medicinal-Oils/. I have used Cottage Lavender Oil since approximately 1990 and have had no problems with it. However, I don’t know how the new mix compares with the old mix. For example, I used to buy 80%+20% pure Lavender oils, in 200ml bottles for approximately $13.00. I don’t understand their new labeling saying each ml contains 50mcl for 50 mls at $4.95 and I think the bottle contains other ingredients. I am still using my stockpile of 200ml bottles, however I haven’t seen the pure oils on the supermarket shelves for ages. Thus, I can’t say if it is better, or possible, to stay with this brand.

Eureka has a nice product advertised at http://eurekaoils.com.au/product/Lavender-Oil They don’t make it easy to compare prices though. I know you can still buy this brand at supermarkets and because you can get it with your groceries, it probably costs less.

Both oils work well for my purpose, which is to use it for feminine hygiene. I purchased a 50ml spray applicator bottle and filled it half with water and half with 100% lavender oil. The spray bottle is suitable for oil, and one application in the morning lasts all day. After using the product, I notice I don’t have to wash my pajamas every day and I don’t get thrush and bacterial infections anymore. It is especially good for your ears. I often get dry cracked skin in and around my ears and ear infections if I don’t use it regularly. The oil also stops itching, excoriation, dryness and leaves you feeling fresh and clean, with peace of mind that you are not polluting the environment too much.

I also buy a 450ml selecta multipurpose spray bottle and fill it with 100mls lavender oil, 100mls QV ego water dispersible oil, and 250mls water. This mix is perfect to keep in the toilet for when I get my period. I would use it for changing baby’s nappies as well,although I would probably use it at half strength for babies.

It is common knowledge Lavender oil is approved by drug standards for external use. The internet infers this knowledge can give the consumer a false sense of security because there are some serious problems if you ingest lavender oil like breast enlargement and birth defects [1].

Lots of people use lavender oil as an antidepressant. I have concerns regarding the use of inhalants and vaporizers because some have propellants and toxins in them and the lungs are very absorbent. The habit is dangerous as well. The manufacturer can change the ingredients at a drop of a hat and the consumer can keep on using the product, unawares. Your saleslady said she sprayed Bosistos lavender spray from an aerosol can on her pillow at night. I would not recommend the product for that use, although I have sprayed it on sheets and blankets to freshen them up.[2]. I have enclosed a printout of Bosisto’s Lavender Oil ‘FGB’ Material Safety Data Sheet. Note it says the poison schedule is “not scheduled”. They also say the recommended use is therapeutic active, flavor, fragrance and raw material. I think all the sites advertising the use of lavender oils/blends, as well as the Data Sheet, need to be reviewed and the safety information made more specific. For example, if you use it for your feet, make sure you don’t slip.If the consumer is informed regarding the pros and cons of the product, and uses the oil for external use, lavender oil is an excellent product. P.S. I have just found a website that says tree nuts can cause severe allergies. Cottage massage lavender oil has almond oil in it. Take care if you buy blended products and do a small patch test on the skin first.“Cottage Lavender Massage Oil contains pure essential oil of Lavender in a base of Sweet Almond Oil” http://cottageessentialoils.com/shop/search.php?search_query=LAVENDER+OIL&x=0&y=0]. — Preceding unsigned comment added by 220.237.89.125 (talk) 23:12, 3 June 2012 (UTC)[reply]

Some quotes:

"Lavender oil and tea tree oil contain compounds that act like female sex hormones and interfere with male hormones,"

"Bloch recommended that the boys stop using lavender-containing products. When they followed his advise, gynecomastia disappeared within a few months."

"These oils possess both estrogenic and anti-androgenic properties," Henley reported at the Endocrine Society meeting in Boston this week.

"Young boys should avoid the oils, Bloch advises. Many personal-care products contain them."

"-B. Harder"

Somitcw 02:24, 6 July 2006 (UTC)[reply]

Full article is only available to subscribers: http://www.sciencenews.org/articles/20060701/fob8.asp

Non-subscribers can get to the table of contents: http://www.sciencenews.org/articles/20060701/toc.asp

Non-subscribers can also see the references and sources: http://www.sciencenews.org/articles/20060701/fob8ref.asp

Somitcw 07:52, 22 August 2006 (UTC)[reply]

The main problem with this study is that it only involves 3 cases. This certainly does not mean it should be ignored but it certainly isn't significant enough to devote much space to either. After reading the actual study, all 3 cases involved products containing Lavender Oil and one case involved lavender oil AND tea tree oil. For this reason it's strange that someone devoted a lot of space to this issue on the tea tree oil page when tea tree oil was never isolated. So it's good that this issue is being discussed here at the appropriate page.Imaginenow (talk) 22:02, 31 January 2008 (UTC)[reply]

No sale, Imaginenow. Three cases involving adverse affects upon children is certainly sufficient to warrant space on both pages. The essential oils industry may have a vested industry in fudging these findings, but it doesn't alter the facts: A. Gynecomastia occurred following topical application; B. It quickly resolved upon discontinuation; C. Separate research positively identified estrogenic/anti-androgenic compounds in both lavender and tea tree oil. One of those researchers Kenneth Korach wrote in the New England Journal of Medicine that pure lavender AND tea tree oils can simultaneously mimic the effects of estrogens and inhibit those of androgens: "This combinatorial activity makes them somewhat unique as endocrine disruptors." An ancient and general priniciple of medicine is "first do no harm." Until and unless, the industry can demonstrate some therapeutic value which could outweigh the detriment of such a known side-effect (and possibly other effects unknown) to a child unable to consent to medication, it should be removed from products sold for topical use, or at the very least labeled with the appropriate warning. In the meantime, Wikipedia is providing information that most young parents considering such a product would be interested to have! Un Mundo (talk) 20:04, 20 May 2009 (UTC)[reply]

The article previously stated that Bloch was an "endrocrinologist." I changed this to "endocrinologist," but I'm not absolutely certain that endrocrinology isn't a medical term. IrisWings 23:00, 1 November 2006 (UTC)[reply]

Could we get a photo of an actual bottle of the essential oil? It seems misleading to have the only picture be of a body oil product only containing a small amount of the EO. This could confuse people into believing that that is what is meant by 'lavender oil' throughout the article. Dforest (talk) 08:50, 2 August 2008 (UTC)[reply]

Photo is also used on the page "essential oil" and identified as sandalwood oil. If it is in fact sandalwood oil, the photo is false. If it is lavender oil, then edits need to be made to the "essential oil" page to change the caption on the photo. Shadymilkman22 (talk) 7:07, 6 March 2011 (UTC)

The sentence about kashmirian oil doesn't have any meaning, kashmir is a region on the base of himalias, so the oil produce there is produced on the base of himailas. It's like saying Russian oil is famous to be from Russia..? :) Gatheringwithin (talk) 13:35, 17 July 2011 (UTC)[reply]

I recently reverted a change by an IP user which was mainly about recent research into the safety of lavender oil [3]. While unsuitable content for Aromatherapy it occurred to me that other editors might find something of use in the reverted change for this article. --Salimfadhley (talk) 13:28, 28 July 2014 (UTC)[reply]

"Lavender oil is an essential oil obtained by distillation from the flower spikes of certain species of lavender. Two forms are distinguished, lavender flower oil, a colorless oil, insoluble in water, having a density of 0.885 g/mL; and lavender spike oil, a distillate from the herb Lavandula latifolia, having density 0.905 g/mL."

Are both oils from Lavandula latifolia? If lavender flower oil is not, what species is it from? If it is, please rewrite these sentences to clearly say that.

Partridgefoot (talk) 22:55, 27 October 2014 (UTC)[reply]

One of the qualities of lavender essential oil that is hardly discussed is the fact that it is a strong healing agent for cuts and burns. Healing starts immediately and is not accompanied later by any inflammation or sepsis. I have also used it with good effect against cellulitis. — Preceding unsigned comment added by Elmgrove33 (talk • contribs) 17:20, 2 February 2015 (UTC)[reply]

Would need WP:MEDRS-compliant sources. Alexbrn ^{talk|contribs|COI} 18:40, 2 February 2015 (UTC)[reply]

I understand that the page on Eucalyptol (a significant component of the Lavandula latifolia variant of lavender oil) has a source from NCBI claiming anti-inflammatory effects. "Eucalyptol has anti-inflammatory properties, which may be mediated by the ion channel TRPM8." I don't know how much this really contributes to the talk, though. Forgive me, new to wikipedia page editting. NCBI link- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387001/ Eucalyptol Wikipedia page- https://en.wikipedia.org/wiki/Eucalyptol Rule Breaking God (talk) 21:28, 12 December 2020 (UTC)[reply]

The link between lavender oil and gynecomastia / estrogenic effects (primarily the Henley study) has been thoroughly disproven. This claim should be removed. https://roberttisserand.com/2013/02/lavender-oil-is-not-estrogenic/ — Preceding unsigned comment added by 50.206.151.164 (talk • contribs)

We need a reliable source, and some random WP:SPS isn't that. Alexbrn (talk) 06:31, 25 October 2018 (UTC)[reply]

I made this edit to indicate that the gynecomastia effect is rare, and - as of 2016 - is still being reported, PMID 26353172. In the new edit, I limited "adverse effects" to sedation and contact dermatitis which are generally well-documented. The journal Cosmetics is an MDPI publication (on the WP:SOURCEWATCH list), so may be disqualified and removed, but is a review and presents data credibly. --Zefr (talk) 14:43, 13 May 2019 (UTC)[reply]

No Alex, we need a WP:MEDRS source for the claim that lavender oil causes gynecomastia, and as you know quite well, just a primary source, a study of a mere three individuals no less, more than ten years old no less, isn't going to cut it. MarshallKe (talk) 12:48, 3 October 2021 (UTC)[reply]

It was trivially sourceable, did you look? Better to upgrade the reference than water-down the adverse effects section (it looks like a cross-article pattern is emerging). Alexbrn (talk) 07:36, 4 October 2021 (UTC)[reply]

How about you stop making point-of-view edits in violation of Wikipedia's most sacred principles? MarshallKe (talk) 23:15, 5 October 2021 (UTC)[reply]

• Now MarshallKe is edit-warring to remove the replacement MEDRS source. What is going on? Alexbrn (talk) 02:00, 6 October 2021 (UTC)[reply]

Content in violation of WP:MEDRS removed. MarshallKe (talk) 02:14, 6 October 2021 (UTC)[reply]

pmid:33109161 is a recent secondary source in a reputable journal. Alexbrn (talk) 02:20, 6 October 2021 (UTC)[reply]

Can someone verify what exact oil is in this image? This article claims it is lavender, but in the essential oil article it claims to be sandalwood instead, the latter of which I assume to be true. If possible the image should be switched with an actual representation of lavender oil. Christiaanp (talk) 06:54, 3 September 2020 (UTC)[reply]

The photo in this article and the photo in the essential oils article are actually different photos, if you look at the bottom of the container you can see the biggest difference. As for verifying its contents, it looks about the right colour (I have some myself and it is a slightly darker yellow, but that could be down to the uploaders camera, my monitor, or just different plants in a different area). 102% Yield (talk) 11:28, 10 September 2020 (UTC)[reply]

The image came from Itineranttrader, apparently a graphics specialist, who uploaded the image as "own work" to Wikimedia Commons in 2009 (searched the image name on Commons). When an editor chooses an image from Commons to use in a Wikipedia article, the information provided by the contributor is all we have to trust. 102% Yield provided an image of a home distillation apparatus, which I removed as a good faith edit, as the apparatus could be used for any oil distillation, and so is not informative specifically about lavender oil, which - in industry - would be produced using manufacturing distillation. Zefr (talk) 13:44, 10 September 2020 (UTC)[reply]

The Adverse Effects section was recently edited by Reba16 to include the sentence "Lavender oil is poisonous, due to the components linalyl acetate and linalool, and should not be ingested." Given that the source cited even includes the line, "Lavender oil is generally not poisonous in adults when breathed in during aromatherapy or swallowed in smaller amounts. It may cause a reaction in children who swallow small amounts. The major effects are due to allergic reactions of the skin.", this seems somewhat disingenuous as a blanket statement. As with all essential oils, and literally any other substance, classification as a poison is completely dose dependent. Lavender oil is considered GRAS by the FDA, and is sold and used as a flavoring in many foods with no issues to speak of, and more recently has been studied as a supplement in the 80-160mg range with few reported adverse effects. Browsing through the literature most of the poisoning cases seem to be in children/infants ingesting large amounts of the stuff, which is obviously a concern, but I don't think any sane person is suggesting going out and drinking an entire bottle of the stuff. Is it appropriate to keep this sort of blanket statement in the article, or would it make sense to at least tweak it to provide some more context? — Preceding unsigned comment added by 65.96.39.147 (talk) 02:38, 27 May 2021 (UTC)[reply]

I am in complete agreement that the blanket statement "Lavender oil is poisonous" is not only inaccurate but does a disservice to the many readers who may benefit from lavender oil, and especially from the anxiolytic impact, corroborated by many recent studies as well as systematic reviews. I wish I had the time to write something up but the "poison paragraph" should be heavily edited or removed. Kim99 (talk) 01:51, 25 May 2022 (UTC)[reply]

I changed the subhead and content with this edit to clarify the toxicity concern about ingestion. In a PubMed search for what you say is "corroboration by many recent studies as well as systematic reviews", I didn't see any usable sources, as the studies were of poor quality and published in weak journals that do not meet WP:MEDRS. Zefr (talk) 02:46, 25 May 2022 (UTC)[reply]

I agree that we don't have enough systematic reviews purely focused on toxicity. My main focus is on systematic reviews on the anxiolytic impact, eliminating the reviews on essential oils in general (and many exist). If you examine the discussions on prophylactic dosages, it seems entirely safe. Reports of poisoning seem to result from ingestion of quantities far above medicinal efficacy. Too much of anything is poisonous :-) Kim99 (talk) 17:54, 5 June 2022 (UTC)[reply]

I include the systematic reviews mentioned: https://pubmed.ncbi.nlm.nih.gov/31655395/

https://pubmed.ncbi.nlm.nih.gov/34775136/ https://pubmed.ncbi.nlm.nih.gov/31792285/

https://pubmed.ncbi.nlm.nih.gov/31743795/

https://pubmed.ncbi.nlm.nih.gov/22464012/

Kim99 (talk) 17:56, 5 June 2022 (UTC)[reply]

@Alexbrn: Do you mean to say that the fact that it comes from the National Institute of Environmental Health Sciences overrides the fact that the article is based on an in-vitro study? MarshallKe (talk) 19:38, 6 March 2022 (UTC)[reply]

The NIEHS is concerned about the possibility of endocrine disruption. We relay that concern since it is due. It's for them to analyse the import of research, not you. If you like, quote their news piece too[4] - it would improve the article. Alexbrn (talk) 19:42, 6 March 2022 (UTC)[reply]

So, since NIEHS is considered a high quality source on its own, we will generally trust what it says. However, the cited source is the Endocrine Society. Questions: 1) How would you compare Endocrine Society to NIEHS as far as quality/reliability for MEDRS purposes? and 2) Do you think it would be more appropriate to use the NIEHS source rather than the ES source? MarshallKe (talk) 19:48, 6 March 2022 (UTC)[reply]

Both good sources, esp. for matters related to endocrine disruption and the environment. And the claim (that the endocrine disrupting nature of certain chemicals is a potential cause of concern) is not weighty. Alexbrn (talk) 20:32, 6 March 2022 (UTC)[reply]

@Alexbrn: See this reply per User:Zefr. In short, Zefr argues that rejecting the article because it's based on an in-vitro study is a normal part of assessing the quality of evidence and does not run afoul of "Editors should not perform detailed academic peer review." MarshallKe (talk) 15:48, 7 March 2022 (UTC)[reply]

If other editors have something to contribute to this here, I await their contribution with interest. Alexbrn (talk) 16:28, 7 March 2022 (UTC)[reply]

The issue in this case is more about assessing toxicity in an essential oil with significant potential for human poisoning. In toxicology assessment, in vitro methods are preferred as screens over lab animal testing, and certainly over the typical process of human clinical research. Including the section under Environmental impact is justified. Zefr (talk) 17:17, 7 March 2022 (UTC)[reply]

I can see how an in-vitro study might be allowed into an article if it's a toxicology study. Are you also willing to overlook the fact that this article is based on only a single study plus a few case reports? I wouldn't think the fact that this is a toxicology study would allow us to skip the principles of MEDASSESS altogether. MarshallKe (talk) 01:19, 8 March 2022 (UTC)[reply]

We are not here citing "an in-vitro study" (though primary sources are sometimes used about toxicity) and are heeding the "the principles of MEDASSESS" in that the sourcing for merely stating there is a concern about lavender oil toxicology is fine and this knowledge is due. Alexbrn (talk) 02:37, 8 March 2022 (UTC)[reply]

Maybe that's fine. If a statement about toxicological concern can be supported by such a low quality source, I see no reason for a similar quality source to support a statement of medical interest for, say white button mushrooms in prostate cancer research, or a statement that there is a lack of toxicological concern, for example, in this article on a supplement popularly taken for anxiety. If toxicology has such a low bar for evidence, there are so many studies that support the safety (but not efficacy) of fringe folk medicine substances. Or, are you saying the low bar of evidence only applies when the toxicological studies come to certain "approved" conclusions? MarshallKe (talk) 13:05, 8 March 2022 (UTC)[reply]

It's not "such a low quality source". It shows this concern is on the radars of the most relevant major medical orgs. I'm not sure about your other reasoning but if it means you're going to keep deleting "negative" MEDRS sources (e.g.[5]) here or pushing weak sources then it's not good. Probably better to make concrete proposals about Lavender oil here, about button mushrooms there, and about MEDRS itself at the relevant guidelines Talk page or WT:MED. Alexbrn (talk) 13:21, 8 March 2022 (UTC)[reply]

I think we now have enough systematic reviews to devote a sizable section on this topic: https://pubmed.ncbi.nlm.nih.gov/31655395/ https://pubmed.ncbi.nlm.nih.gov/34775136/ https://pubmed.ncbi.nlm.nih.gov/31792285/ https://pubmed.ncbi.nlm.nih.gov/31743795/ https://pubmed.ncbi.nlm.nih.gov/22464012/ Kim99 (talk) 18:00, 5 June 2022 (UTC)[reply]

Maybe a sentence. Looks like "no good evidence of benefit" would be a reasonable summary. Alexbrn (talk) 18:05, 5 June 2022 (UTC)[reply]

I'm a little confused by your response. Are you saying that in the 5 minutes between my message and yours you looked through the five systematic reviews and came to that conclusion? What sources do you base at opinion on? Do you have stronger evidence than the five systematic reviews I submitted? Kim99 (talk) 18:19, 5 June 2022 (UTC)[reply]

Enough to see they're not five systematic reviews, and some are too old, and none is in a stellar journal considering the WP:EXCEPTIONAL topic area. And from the abstracts/conclusions I looked at this seemed to be the upshot. Alexbrn (talk) 18:28, 5 June 2022 (UTC)[reply]

Okay let's respond point by point. 1. One is a network meta analysis, the rest are clearly systematic reviews. 2. What do you mean by old? It's a relative term. Many "old" studies are still extremely relevant. 3. Try actually reading stuff before talking about it. After that let's try to have an intelligent exchange. Kim99 (talk) 21:04, 5 June 2022 (UTC)[reply]

None of those sources is reliable, as they are not high-quality clinical publications, and there are too many deficiencies of research in conducting the studies. Neither is there any medical organization recommending lavender oil to treat anxiety, failing WP:MEDSCI. I revised the Uses section using the Drugs.com review to include treatment of anxiety as having "no good evidence." Zefr (talk) 21:27, 5 June 2022 (UTC)[reply]

@Kim99: It's generally useful to know what one is looking at beforehand, because Wikipedia has preferences for sourcing. Five years is generally a cut off in actively researched fields. On the three remaining, Phytomedicine seems a reasonable, relevant journal (impact factor ~5). Considering the caveats on offer in the 2019 article ("The most important limitation of this review is the low average quality of available studies on the topic. The majority of included RCTs were characterized by a high overall risk of bias") the most this would support is "weak evidence of benefit", or "no good evidence" as suggested. Alexbrn (talk) 21:29, 5 June 2022 (UTC)[reply]

Appreciate the detailed reply. You mention that neither is there any medical organization recommending lavender oil to treat anxiety." As a self-described skeptic, could I suggest you apply your skepticism to cover medical organizations as well as wacky naturopaths. As you may know major funders of pharmaceuticals are very reluctant to fund studies on natural products. You can't sell a bottle of lavender oil or probiotics for $1,000. That's a major reason why we don't have many reviews of traditional medicines. And of course many naturopaths have no clue about how to apply the scientific method. It's a sad story. As a result I think two or three systematic reviews of traditional medicines should be acceptable. Kim99 (talk) 02:37, 6 June 2022 (UTC)[reply]

So you think the NHS (say) isn't keen on low-cost healthcare and wants expensive "$1000/bottle" drugs? That is bonkers, as well as nearly 180° wrong, and not a good basis for interpreting disappointing results wrt lavender oil in a more positive light. Incidentally, the lavender oil market is worth ~ $100 million pa, with some large companies involved:[6] big suppla is a thing too. I'm not sure who the "self-described skeptic" is? Alexbrn (talk) 06:24, 6 June 2022 (UTC)[reply]

You use the word "bonkers" so I guess you are from the UK or one of the ex-colonies. Perhaps you you are not fully aware of the situation in the United States. The FDA is in bed with Big Pharma, and the naturopaths are in bed with fairies in their back gardens. Nobody really applies the scientific method anymore. Big Pharma still buries the studies that fail (publication bias) so we have no idea who is telling us bigger lies. Producers of plant-based medicines are actually very tightly controlled behind the scenes. For example, no matter how effective or scientifically solid a plant-based product may be for depression and anxiety, the manufacturers are not allowed to use the words "depression" or "anxiety" in their marketing. Those words are completely monopolized by Big Pharma. This is not a free country. Kim99 (talk) 23:51, 7 June 2022 (UTC)[reply]

PS I'm throwing in the towel.. I can't deal with someone who dismisses multiple systematic reviews based on the abstracts and the relative respectability of journals. Of course it's the Western Europeans and Americans who control the parameters of respectability. The usual eurocentric crap. Kim99 (talk) 00:02, 8 June 2022 (UTC)[reply]

For some reason user User:Alexbrn believes the meta-analysis published in Scientific Reports (peer-reviewed open access scientific mega journal published by Nature Portfolio) https://www.nature.com/articles/s41598-019-54529-9 findings should not be included in this wikipedia article. I would like to know why. It is a more recent than any of the articles mentioned in the "drugs.com" article that is also cited in this article, as well as being a more reliable source than "drugs.com". I'm fine with keeping the "drugs.com" citation around as long as it is made clear that it does not include studies newer than 2018 and as long as the actual claims made in the "drugs.com" article are made clear rather than interpreted in a biased way.

Similar HAM-A change findings are found in a separate review of clinical trials as well https://pubmed.ncbi.nlm.nih.gov/28511598/ — Preceding unsigned comment added by 50.45.170.185 (talk) 16:51, 26 June 2022 (UTC)[reply]

Diff reference https://en.wikipedia.org/w/index.php?title=Lavender_oil&type=revision&diff=1095131761&oldid=1095130792

"Weak source for exceptional claim."

The source is not weak and the claim is not "exceptional" nor is it even a claim, it is just the exact findings of the meta-analysis. 50.45.170.185 (talk) 17:28, 26 June 2022 (UTC)[reply]

Any claim about drug benefit is exceptional. And Scientific Reports (not "Nature" NB) is rather notorious. Alexbrn (talk) 17:36, 26 June 2022 (UTC)[reply]

This is not a claim about a "drug benefit". This is a description of the findings of meta-analysis. Review wording of above diff.

Peer reviewed papers published "Scientific Reports" are used as a source in many Wikipedia articles, so I don't see how your claim of "notorious" holds any weight beyond simple name-calling. It's the 7th most cited journal in the world and the largest journal in the world. There are only a handful of controversial articles published to it that were later removed out of the millions of peer-reviewed articles published there.

Other analysis's exist as well with similar findings: "A total of 697 patients were assessed for efficacy. Silexan was superior to placebo in reducing the HAMA total score during 10 weeks' treatment [mean value difference, 95% confidence interval: 3.83 (1.28; 6.37) points]. Superiority was comparably pronounced for psychic and somatic anxiety as well as for observer- and self-rated anxiety. Silexan had a beneficial effect on sleep (secondary to the anxiolytic effect) without causing sedation and improved the patients' health-related quality of life. Adverse event incidence in both treatment groups was comparable [risk ratio: 1.06 (0.85; 1.33)]. Silexan has a significant and clinically meaningful anxiolytic effect in subthreshold anxiety. The results cannot be generalised to other lavender oil products." https://pubmed.ncbi.nlm.nih.gov/29150713/ 50.45.170.185 (talk) 17:47, 26 June 2022 (UTC)[reply]

Maybe get some better source then? Wikipedia wants good ones. Alexbrn (talk) 17:50, 26 June 2022 (UTC)[reply]

What is your reasoning that the anonymously authored article on drugs.com article is a better source than the 3 papers I linked? Of course I can link more if you want but your criteria for what is a "good" source is inconsistent with what hundreds of other editors on wikipedia think, considering the widespread usage of Scientific Reports citations.

If not I can request an uninterested third-party to mediate. 50.45.170.185 (talk) 17:58, 26 June 2022 (UTC)[reply]

I'm not super-keen on drugs.com either. Alexbrn (talk) 18:00, 26 June 2022 (UTC)[reply]

I'll take your lack of engaging with the conversation as request for DRN. 50.45.170.185 (talk) 18:04, 26 June 2022 (UTC)[reply]

Scientific Reports is indeed not sufficient. IRT "conflicting results", it's like "more research is needed", "There is no good evidence to support [...]" is a good description for it... —PaleoNeonate – 09:02, 27 June 2022 (UTC)[reply]

• PMID:33638614 is a better, if still not stellar, source with similar conclusion, but which mentions as a limitation that all the data comes from one research group. Not sure how to handle this, if at all. May need more thoughts from WT:MED. Alexbrn (talk) 11:00, 27 June 2022 (UTC)[reply]

  It is not an encyclopedia's job to do a peer-review of research. If you don't think the conclusion of these papers are correct because of bad methodology then you should reach out to the journal itself to see if you can have it removed.

  In any case, at least the methodology and findings are clear and the publishers' names are known for these papers. The "conclusion" of the drugs.com article is simply anonymous and not peer reviewed, and many many papers are missing from their page in the first place.

  Perhaps a middle-ground: find all relevant papers published in the last 5 years on the topic, no matter what their findings are, and write up a summary of what was found. Example, "Some studies show effectiveness[1][2], while others do not[3][4][5]" or "There is some evidence of effectives[1][2][3]", etc etc whatever we find gets summarized. 50.45.170.185 (talk) 19:10, 27 June 2022 (UTC)[reply]

  It is an enyclopedia's job to evaluate sourcing strength and summarize whole papers accurately, including caveats. Just selecting everything in a time window, no matter how strong/weak, would seem dumb. Alexbrn (talk) 19:23, 27 June 2022 (UTC)[reply]

  I agree that would be dumb. That's why my proposal is all *relevant* papers published in the last 5 years. So I'm sure we'd both agree that alternative medicine journals and other such crackpottery are out of the question. But perhaps we will still need a volunteer to help us come to a conclusion about which journals should be considered relevant. As I am still currently of the opinion that every journal I've linked thus far is still worth being mentioned 50.45.170.185 (talk) 19:58, 27 June 2022 (UTC)[reply]

I made this edit to provide a succinct statement about the meta-analysis in question. First, I don't see any consensus here that this source and the content were agreed among several editors, so adding it back into the article was premature both for this talk page and the incomplete DRN discussion here. Accordingly, the entry in the article is temporary and may be removed. Second, the meta-analysis and the 5 trials included in the review were all by the same Vienna-based Kasper group, giving concern about bias and conflict of interest, which is revealed further by the numerous potential COI issues of corporate funding sources for the authors of the meta-analysis (end of publication). Third, there is confusion about dosing and effect on anxiety in the two meta-analysis studies the IP proposed: this one concluded that 160 mg/day of oral silexan was needed for effect, whereas this one said the effective dose was 80 mg/day. Fourth, until yesterday, the only edits by IP 50.45.170.185 were on promoting this anxiety topic, raising concerns about the motivation and potential COI of this editor. Fifth, contrary to the IP's wish to include several other weak publications about using lavender oil for anxiety, there is no justification or consensus for using them. I retain the position of our previous article conclusion: There is no good evidence to support the use of lavender oil for treating dementia or anxiety, and the Drugs.com review is a superior source over a meta-analysis of weak research. Zefr (talk) 15:11, 28 June 2022 (UTC)[reply]

Thanks Zefr.

By the way, are you familiar with this image on MEDRS? https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)#/media/File:Research_design_and_evidence.svg

I'm still curious though why "drugs.com" is being pushed as superior to a meta-analysis of randomized placebo-controlled trials. From my understanding, the new source would be considered "2nd best" and "drugs.com" would be considered "2nd worst". I feel it has no place on this article, and all instances of it being used for medical claims should be replaced by secondary sources from reputable peer-reviewed journals. 50.45.170.185 (talk) 15:36, 28 June 2022 (UTC)[reply]

I think you misunderstand WP:MEDASSESS and perhaps are too easily persuaded (or mesmerized) by the word, meta-analysis. As in the case of this report, a meta-analysis of poor-quality research is a poor-quality encyclopedia source, especially for medical content. When good reviews are absent - as in this case - we rely on academic or clinical guidelines with summaries of evidence. Drugs.com reviews are used across Wikipedia in articles where journal reviews are inadequate. Drugs.com is published by a reputable organization (American Society of Health-System Pharmacists) (see here). Its review on lavender is the most thorough overall coverage available on material that is difficult to standardize and finance for long-term clinical research. It also offers critical assessment of the state of research, such as in the case of using oral lavender oil for anxiety: trials often included healthy volunteers, and most were considered to be of poor quality and displayed inconsistent results and significant heterogeneity, lack of blinding, small sample sizes, and small number of studies. Better to side with skepticism about research quality than put misleading content and poor sources into the encyclopedia. Zefr (talk) 16:31, 28 June 2022 (UTC)[reply]

Thanks for clarifying Zefr, it does sound like you agree with me that "drugs.com" is not a better or equivalent source to a meta-analysis of randomized controlled trials from a reputable, peer-reviewed journal.

I know I have not been responding to your various criticisms of the paper(s), that is because I still think this stance is the correct one and the only way to avoid bias: It is not an encyclopedia's job to do a peer-review of research. If you don't think the conclusion of these papers are correct because of bad methodology then you should reach out to the journal itself to see if you can have it removed.

The article as it stands now accurately summarizes the findings of the most recent, highest quality secondary sources on the subject matter. Reverting now would be a strict downgrade from this position, and I feel like people in this position that want to move away from peer-reviewed secondary sources to something that is not peer-reviewed are usually motivated by bias... (at least looking around on some wikipedia talk pages that seems to be the case usually) 50.45.170.185 (talk) 16:43, 28 June 2022 (UTC)[reply]