Peppermint

Mentha x piperita · herb

Evidence tier: moderate

In plain terms

Relieves IBS symptoms, bloating, gas, and intestinal cramping

How it works

Menthol relaxes the smooth muscle of the gut wall, which is why the oil eases cramping; the enteric coating carries it past the stomach so it is released in the intestine.

What the evidence says

Moderate for the gut symptoms of irritable bowel syndrome, and only for enteric coated (gastro resistant) peppermint oil capsules. A 2022 meta analysis of 10 RCTs (1,030 people) found it better than placebo for overall symptoms and abdominal pain, with more side effects and very low quality evidence (PMID 35942669); NCCIH reports the same review and notes that the American College of Gastroenterology's 2021 guideline recommends it (PMID 33315591). The largest recent trial, 189 people on 182 mg capsules for 8 weeks, missed its main endpoint but improved pain (PMID 31470006). EMA accepts the capsules on well established use for minor gut spasms, wind and abdominal pain, and peppermint tea on traditional use for indigestion and wind.

Dose and timing

Enteric coated oil: 0.2 to 0.4 ml per dose, 0.6 to 1.2 ml a day in 2 or 3 doses for adults and adolescents (EMA); the NHS says 1 capsule 3 times a day, up to 2 capsules 3 times a day, 30 to 60 minutes before meals. Tea: 1.5 to 3 g of leaf in 100 to 150 ml of boiling water, 3 times a day (EMA).

Swallow capsules whole, 30 to 60 minutes before meals; a broken or chewed capsule releases oil in the stomach and causes heartburn (EMA, NHS). Leave 2 hours between the capsules and antacids or indigestion remedies, and avoid them with acid reducing medicines such as omeprazole (EMA, NHS). Most people feel the effect within 1 to 2 weeks; EMA allows courses of up to 3 months, and the NHS says see a doctor if over the counter use has not helped after 2 weeks. Stop if heartburn starts. Avoid alcohol with the capsules (NHS).

Onset: ~7 days

Dose by form

• leaf tincture: 2 to 3 ml 3 times a day for adults [EMA/HMPC/572705/2014]
• topical oil for tension headache: 10 percent oil in ethanol on the forehead and temples, adults only [EMA/HMPC/522410/2013]
• peppermint tea (children 4 to 11): 1 to 2 g of dried leaf in 100 to 150 ml of boiling water, 3 times a day [EMA/HMPC/572705/2014]
• peppermint tea (adults and over 12s): 1.5 to 3 g of dried leaf in 100 to 150 ml of boiling water, 3 times a day [EMA/HMPC/572705/2014]
• enteric coated capsule, mg per capsule: The largest recent trial used capsules of 182 mg of peppermint oil each [PMID 31470006]; products differ, so check the mg per capsule on the label. No authority converts the EMA ml dose into mg
• enteric coated capsule (children 8 to 11): 0.2 ml of oil 3 times a day, 0.6 ml a day [EMA/HMPC/522410/2013]; the NHS over the counter guidance is for ages 12 and over
• enteric coated peppermint oil capsule (adults and over 12s): 1 capsule 3 times a day, up to 2 capsules 3 times a day if needed, 30 to 60 minutes before meals, swallowed whole [NHS Peppermint oil]; EMA sets 0.2 to 0.4 ml of oil per dose, 0.6 to 1.2 ml a day in 2 or 3 doses [EMA/HMPC/522410/2013]

Preparation forms

• enteric coated capsule
• tea
• tincture
• topical oil

Safety

Excellent safety for topical and oral culinary use. High dose oral essential oil can cause mucosal irritation and heartburn. Never apply to face or near airways of young children (menthol can trigger bronchospasm). Enteric coated capsules generally well tolerated.

Pregnancy: caution

Breastfeeding: caution

Traditional use

Used in Egyptian, Greek, and Roman medicine for digestive complaints for thousands of years. One of the most widely documented herbs in the entire history of European medicine. Enteric coated peppermint oil capsules are a well studied modern form for IBS.

Active compounds: menthol, menthone, menthyl acetate, 1,8 cineole

Pairs well with

• Ginger
• Fennel
• Chamomile

Remedies using Peppermint · Browse by body system · Check it against what you take

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.