Issue:
110
Page: 61-71
Saffron: The Salubrious Spice
Emerging Research Suggests Numerous Health Benefits
by Linda Woolven, Ted Snider
HerbalGram.
2016; American Botanical Council
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 β 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.
References
-
Ferrence S, Bendersky G. Therapy with saffron and the goddess at Thera. Perspect Biol Med. 2004;47(2):199-226.
- Glenn L. HerbClip News — Saffron: Crocus sativus. HerbClip. February 28, 2006. Austin, TX: American Botanical Council. Available at: http://cms.herbalgram.org/herbclip/299/news9.html. Accessed April 4, 2016.
- Hausenblas HA, Heekin K, Mutchie HL, Anton S. A systematic review of randomized controlled trials examining the effectiveness of saffron (Crocus sativus L.) on psychological and behavioral outcomes. J Integr Med. 2015;13(4):231-240.
- Broadhead GK, Chang A, Grigg J, McCluskey P. Efficacy and safety of saffron supplementation: Current clinical findings. Crit Rev Food Sci Nutr. 2015. doi: 10.1080/10408398.2013.879467.
- Akhondzadeh S, Shafiee Sabet M, Harirchian MH, et al. A 22-week, multicenter, randomized, double-blind controlled trial of Crocus sativus in the treatment of mild-to-moderate Alzheimer’s disease. Psychopharmacology. 2010;207(4):637-643.
- Akhondzadeh S, Sabet MS, Harirchian MH, et al. Saffron in the treatment of patients with mild to moderate Alzheimer’s disease: a 16-week, randomized and placebo-controlled trial. J Clin Pharm Ther. 2010;35(5):581-588.
- Akhondzadeh S, Tahmacebi-Pour N, Noorbala A-A, et al. Crocus sativus L. in the treatment of mild to moderate depression: a double-blind, randomized and placebo-controlled trial. Phytother Res. 2005;19(2):148-151.
- Moshiri E, Basti AA, Noorbala A-A, et al. Crocus sativus L. (petal) in the treatment of mild-to-moderate depression: a double-blind, randomized and placebo-controlled trial. Phytomedicine. 2006;13(9-10):607-611.
- Dwyer AV, Whitten DL, Hawrelak JA. Herbal medicines, other than St. John’s wort, in the treatment of depression: a systematic review. Altern Med Rev. 2011;16(1):40-49.
- Lopresti AL, Drummond PD. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol. 2014;29(6):517-527.
- Noorbala AA, Akhondzadeh S, Tahmacebi-Pour N, Jamshidi AH. Hydro-alcoholic extract of Crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: a double-blind, randomized pilot trial. J Ethnopharmacol. 2005;97(2):281-284.
- Akhondzadeh Basti A, Moshiri E, Noorbala A-A, Jamshidi A-H, Abbasi SH, Akhondzadeh S. Comparison of petal of Crocus sativus L. and fluoxetine in the treatment of depressed outpatients: A pilot double-blind randomized trial. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31(2):439-442.
- Shahmansouri N, Farokhnia M, Abbasi S-H, et al. A randomized, double-blind, clinical trial comparing the efficacy and safety of Crocus sativus L. with fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients. J Affect Disord. 2014;155:216-222.
- Hausenblas HA, Saha D, Dubyak PJ, Anton SD. Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med. 2013;11(6):377-383.
- Karimi GHR, Hosseinzadeh H, Khalegh Panah P.. Study of antidepressant effect of aqueous and ethanolic extract of Crocus sativus in mice. Iran J Basic Med Sci. 2001;4(3):11-15.
- Sidi H, Asmidar D, Hod R, Nik Jaafar NR, Guan NC. Hypoactive sexual desire among depressed female patients treated with selective serotonin reuptake inhibitors: A comparison between escitalopram and fluoxetine. Int J Psychiatry Clin Pract. 2012;16(1):41-47.
- Kashani L, Raisi F, Saroukhani S, et al. Saffron for treatment of fluoxetine-induced sexual dysfunction in women: randomized double-blind placebo-controlled study. Hum Psyschopharmacol. 2013;28(1):54-60.
- Modabbernia A, Sohrabi H, Nasehi A-A, et al. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology (Berl). 2012;223(4):381-388.
- Shamsa A, Hosseinzadeh H, Molaei M, Shakeri MT, Rajabi O. Evaluation of Crocus sativus L. (saffron) on male erectile dysfunction: a pilot study. Phytomedicine. 2009;16(8):690-693.
- Cai T, Morgia G, Carrieri G, et al. IDIProst® Gold Study Group. An improvement in sexual function is related to better quality of life, regardless of urinary function improvement: results from the IDIProst® Gold Study. Arch Ital Urol Androl. 2013;85(4):184-189.
- Duračková Z, Trebatický B, Novotný V, Žitňanová I, Breza J. Lipid metabolism and erectile function improvement by Pycnogenol®, extract from the bark of Pinus pinaster in patients suffering from erectile dysfunction–a pilot study. Nutr Res. 2003;23(9):1189-1198.
- Mohammadzadeh-Moghadam H, Nazari SM, Shamsa A, et al. Effects of a topical saffron (Crocus sativus L) gel on erectile dysfunction in diabetics: A randomized, parallel-group, double-blind, placebo-controlled trial. J Evid Based Complementary Altern Med. 2015;20(4):283-286.
- Agha-Hosseini M, Kashani L, Aleyaseen A, et al. Crocus sativus L. (saffron) in the treatment of premenstrual syndrome: a double-blind, randomised and placebo-controlled trial. BJOG. 2008;115(4):515-519.
- Nahid K, Fariborz M, Ataolah G, Solokian S. The effect of an Iranian herbal drug on primary dysmenorrhea: a clinical controlled trial. J Midwifery Womens Health. 2009;54(5):401-404.
- Jabbarpoor Bonyadi MH, Yazdani S, Saadat S. The ocular hypotensive effect of saffron extract in primary open angle glaucoma: a pilot study. BMC Complement Altern Med. 2014;14:399. doi: 10.1186/1472-6882-14-399.
- Piccardi M, Marangoni D, Minnella AM, et al. A longitudinal follow-up study of saffron supplementation in early age-related macular degeneration: sustained benefits to central retinal function. Evid Based Complement Alternat Med. 2012;2012:429124. doi: 10.1155/2012/429124.
- Falsini B, Piccardi M, Minnella A, et al. Influence of saffron supplementation on retinal flicker sensitivity in early age-related macular degeneration. Invest Ophthalmol Vis Sci. 2010;51(12):6118-6124.
- PLT Health Solutions. Satiereal®: Women taking Satiereal report decreased hunger. PLT Health Solutions website. Available at: www.plthealth.com/sites/plthomas.com/files/ckfinder/userfilesfiles/SATIEREAL%20Product%20Sheet_2016.pdf. Accessed May 10, 2016.
- Gout B, Bourges C, Paineau-Dubreuil S. Satiereal, a Crocus sativus L extract, reduces snacking and increases satiety in a randomized placebo-controlled study of mildly overweight, healthy women. Nutr Res. 2010;30(5):305-313.
- Meamarbashi A, Rajabi A. Preventive effects of 10-day supplementation with saffron and indomethacin on the delayed-onset muscle soreness. Clin J Sport Med. 2015;25(2):105-112.
- Moshiri M, Vahabzadeh M, Hosseinzadeh H. Clinical applications of saffron (Crocus sativus) and its constituents: A review. Drug Res (Stuttg). 2015;65(6):287-295.
- Safarinejad MR, Shafiei N, Safarinejad S. A prospective double-blind randomized placebo-controlled study of the effect of saffron (Crocus sativus Linn.) on semen parameters and seminal plasma antioxidant capacity in infertile men with idiopathic oligoasthenoteratozoospermia. Phytother Res. 2011;25(4):508-516.
- Kianbakht S, Ghazavi A. Immunomodulatory effects of saffron: a randomized double-blind placebo-controlled clinical trial. Phytother Res. 2011;25(12):1801-1805.
- Zheng S, Qian Z, Tang F, Sheng L. Suppression of vascular cell adhesion molecule-1 expression by crocetin contributes to attenuation of atherosclerosis in hypercholesterolemic rabbits. Biochem Pharmacol. 2005;70(8):1192-1199.
- Verma SK, Bordia A. Antioxidant property of saffron in man. Indian J Med Sci. 1998;52(5):205-207.
- Vyas LK, Tapar KK, Nema RK. Study of Crocus sativus as complexion promoter in skin care. IJPCR. 2010;2(2):76-79.
- Chatterjee S, Datta RN, Bhattacharyya D, Bandopadhyay SK. Emollient and antipruritic effect of itch cream in dermatological disorders: A randomized controlled trial. Indian J Pharmacol. 2005;37(4):253-254.
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