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Most Sage studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from high-quality meta-analyses and randomised trials published 2003–2026 with a typical study size of 67 participants.
Based on 20 studies · 2 meta-analyses · 13 RCTs · 1,240 total participants
Confidence
High
What the studies found
2helped· 18 more without graded effect data
By outcome
Cognitive functionInhibits acetylcholinesterase to enhance memory consolidation and recall, with multiple RCTs showing significant improvements in cognitive performance · undefined
Mostly mechanism / observational18 studies
Women's healthReduces hot flash frequency and severity by up to 50% through estrogenic activity at ERα/ERβ receptors · undefined · Phytoestrogens bind ERα/ERβ to support estrogen balance during perimenopause and menopause · undefined
Mostly mechanism / observational7 studies
Glucose & metabolic
Mostly mechanism / observational6 studies
Cholesterol & lipids
Mostly mechanism / observational5 studies
Safety profile
Mostly mechanism / observational5 studies
InflammationInhibits COX-2 and NF-kB pathways via rosmarinic acid and carnosic acid · undefined
Mostly mechanism / observational4 studies
Anxiety & stressModulates GABAergic and serotonergic pathways to reduce mild anxiety symptoms · undefined
Mostly mechanism / observational3 studies
Therapeutic & clinical
Mostly mechanism / observational3 studies
Depression & moodSupports mood stability through cholinesterase inhibition and anti-inflammatory effects · undefined
8 studies in the last 5 years · Latest meta-analysis: 2023
200320142026
1Chronic inflammation and quality of lifeSystematic Reviewn=124 · medium study2026
This review provides up-to-date information for further basic and clinical research on herbal medicine in metabolic syndrome.
Winiarska A et al. · Nutrients (2026)
Incorporating spice herbs into the daily diet may represent a simple and safe approach to increasing the intake of anti-inflammatory bioactive compounds.
Conclusions: Future research should focus on the precise determination of optimal doses and combinations of spice herbs to maximise benefits while avoiding potential adverse effects resulting from excessive intake of certain compounds or inappropriate selection of spice herbs.
Long-term studies conducted in larger populations of women with metabolic syndrome are required, as physiological differences, particularly those related to oestrogens, may result in sex-specific effects.
2Ethnobotanical uses of Salvia speciesSystematic Review2025
Ethnopharmacological evidence revealed 187 Salvia species with documented uses across Asia (Middle East, China), America (Mesoamerica and South America), Africa (Saharan and southern regions), and Europe (Mediterranean and Balkan areas).
Nicolescu A et al. · Journal of ethnopharmacology (2025)
Ethnopharmacological evidence revealed 187 Salvia species with documented uses across Asia (Middle East, China), America (Mesoamerica and South America), Africa (Saharan and southern regions), and Europe (Mediterranean and Balkan areas).
The most frequently cited ailments in which Salvia species are used were gastrointestinal (127), respiratory (86), dermatological (82), and genitourinary (80).
Culinarily, the genus provides aromatic and nutritional properties, increasing the value of diverse dishes and beverages.
The available evidence from clinical trials suggests that Salvia species may improve cognitive performance in healthy subjects and patients with dementia, possibly through acetylcholinesterase inhibitory properties.
Miroddi M et al. · CNS Neuroscience & Therapeutics (2014)
Multiple clinical trials demonstrated improvements in memory and attention in healthy young adults following acute and chronic Salvia officinalis or Salvia lavandulaefolia administration.
Sage extracts exhibit dose-dependent acetylcholinesterase inhibitory activity, mirroring the mechanism of approved Alzheimer's medications.
A randomized controlled trial in patients with mild-to-moderate Alzheimer's disease showed significantly better cognitive outcomes with Salvia officinalis extract compared to placebo over 4 months.
4Lipid profiles and oxidative stress markersRCTCited 2×n=60 · small study2025
Salvia officinalis supplementation significantly improved lipid profiles and reduced oxidative stress markers in women with polycystic ovary syndrome compared to placebo.
Maleki-Hajiagha A et al. · BMC Complementary Medicine and Therapies (2025)
Women with PCOS receiving Salvia officinalis extract showed significant reductions in total cholesterol, LDL cholesterol, and triglycerides compared to the placebo group.
Oxidative stress markers including malondialdehyde (MDA) and total oxidant status (TOS) were significantly reduced in the sage supplementation group.
Total antioxidant capacity (TAC) was significantly increased in the Salvia officinalis group relative to placebo.