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Orange Aromatherapy for Anxiety

The smell of sweet orange essential oil may have anxiety-reducing properties without the potentially addictive, sedating, and adverse effects of Valium-type benzodiazepine drugs.

February 19, 2014 |
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Supplementary Info

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Sources Cited

R. S. Herz. Aromatherapy facts and fictions: A scientific analysis of olfactory effects on mood, physiology and behavior. Int. J. Neurosci. 2009 119(2):263 - 290.

S. Kaddu, H. Kerl, P. Wolf. Accidental bullous phototoxic reactions to bergamot aromatherapy oil. J. Am. Acad. Dermatol. 2001 45(3):458 - 461.

E. Ernst, J. Zhang. Cardiac tamponade caused by acupuncture: A review of the literature. Int. J. Cardiol. 2011 149(3):287 - 289.

J. Lehrner, C. Eckersberger, P. Walla, G. Pötsch, L. Deecke. Ambient odor of orange in a dental office reduces anxiety and improves mood in female patients. Physiol Behav. 2000 71(1):83 - 86.

T. C. Goes, F. D. Antunes, P. B. Alves, F. Teixeira-Silva. Effect of sweet orange aroma on experimental anxiety in humans. J Altern Complement Med. 2012 18(8):798 - 804.

P. Posadzki, A. Alotaibi, E. Ernst. Adverse effects of aromatherapy: A systematic review of case reports and case series. Int J Risk Saf Med 2012 24(3):147 - 161.

B. Cooke, E. Ernst. Aromatherapy: A systematic review. The British Journal of General Practice 2000 50(455):493.

Y.-L. Lee, Y. Wu, H. W. H. Tsang, A. Y. Leung, W. M. Cheung. A systematic review on the anxiolytic effects of aromatherapy in people with anxiety symptoms. J Altern Complement Med 2011 17(2):101 - 108.

P. H. Graham, L. Browne, H. Cox, J. Graham. Inhalation aromatherapy during radiotherapy: Results of a placebo-controlled double-blind randomized trial. J. Clin. Oncol. 2003 21(12):2372 - 2376.

Stevenson, C. (1994). The psychophysiological effects of aromatherapy massage following cardiac surgery. Complementary Therapies in Medicine, 2(1), 27-35.


Images thanks to Timpo and Ankara via Wikimedia Commons; and Dr. N. Jithendran. Thanks to Ellen Reid for her image-finding expertise and Jeff Thomas for his Keynote help.


Aromatherapy is the use of concentrated essential oils extracted from plants to treat disease, and is commonly used to treat anxiety symptoms. Anxiety disorders are the most prevalent class of psychiatric disorders in the general population. However, their treatment is still challenging, as the drugs used for the relief of anxiety symptoms can have important side effects.

Thankfully, double-blind, randomized, placebo-controlled clinical trials performed to evaluate the effect of essential oils on anxiety symptoms are gradually starting to appear in the medical literature. However, in most of these studies, exposure to the essential oil odor was accompanied by massage. This makes it difficult to draw firm conclusions about the effect of the aroma itself.

Here's a typical example. Patients in the intensive care unit the day after open-heart surgery getting foot massages with orange-scented oil. Why not back massages? Because they just had their chests cracked open so they have this huge sternotomy wound. Maybe a preventive plant-based diet, rather than a post-op plant-based massage oil might have been the better choice, but the massages felt great, restful, peaceful, and calming. You know it's a British study because one described the effect as “smashing.”

But how do we know the essential oil had anything to do with it? Maybe it was just the massage that was so bloody good; in which case, great—let's give people massages! I'm all for more ICU foot rubs. There is considerable evidence from randomized trials that massage alone reduces anxiety, so if massage is effective, then aromatherapy plus massage is also effective. So aromatherapy may work, even if it doesn’t. In fact one study where cancer patients got massaged during chemo and radiation even found that the massage without the fragrance may be better. They thought it might be like a negative pavlovian response, patients smell the citrus and their body is like “Oh no not another cancer treatment!”

More recently the ambient odor of orange was tested in a dental office to see if it reduces anxiety and improves mood. Ambient odor of orange was diffused in the waiting room and appeared to have a relaxant effect, less anxiety, better mood, and more calmness, compared to a control group where there was no odor in the air. No odor, that is, except the nasty dentist office smell—maybe the orange scent was just masking the unpleasant odors. Maybe it had nothing to do with any orange-specific molecules.More research was necessary.

The effect of sweet orange aroma on experimental anxiety in humans. They exposed some grad students to an anxiety-producing situation and tested the scent of orange, versus a non-orange aroma, versus no scent at all, and the orange did appear to have an anxiety reducing effect. Interestingly, the observed anxiety-reducing effects were not followed by physical or mental sedation. On the contrary, at the highest dose, the orange oil made the volunteers feel more energetic. So potentially less anxiety without the downer effect of Valium-type drugs. So does that mean we can get the benefits without the side effects? Well I've talked about the concerns of using scented consumer products, even ones based on natural fragrances, and there have been reports of adverse effects of aromatherapy, in fact some pretty serious reactions.

Alternative medicine isn't necessary risk-free. Like there're dozens of reported cases of people having their hearts ruptured by acupuncture. Ouch.

But the adverse effects of aromatherapy were mostly from skin irritation from essential oils being applied topically, or even worse swallowed. Certain citrus oils can make your skin sensitive to sunlight, though less of a problem in France, evidently, where they're known to stick them where the sun don't shine.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

To help out on the site please email

Dr. Michael Greger

Doctor's Note

Lavender may also help for both anxiety (Lavender for Generalized Anxiety Disorder) and migraines (Lavender for Migraine Headaches).

I think the other other aromathery-related video is Wake Up and Smell the Saffron, though I have others on natural ways do reduce anxiety, including:

 Natural, though, doesn’t always mean safe. See, for example:

Of course eating citrus is good too! I have videos on Reducing Muscle Fatigue With Citrus and Keeping Your Hands Warm With Citrus, but Tell Your Doctor If You Eat Grapefruit.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • HemoDynamic, M.D.

    Regarding the evidence of essential oils, I think I will stick with the whole plant food source (eg. Whole Oranges). Also I will refrain from sticking it where the sun doesn’t shine! And will continue with recommending massage, as well, to help reduce anxiety.

    • Thea

      re: recommending massage

      I want you as my doctor!!!

      • HemoDynamic, M.D.

        I sent five patients for massage and acupuncture this week! For some it really helps.

        • jlikedisqus

          HD, M.D.
          I’ve been considering acupuncture for a while, but some recent articles and studies have made me shy away. Do you have any good studies, research, or information that you used in determining it would be beneficial for your patients?

          • HemoDynamic, M.D.

            All my “research” is experiencial and annecdotal. But I have seen resolution of medial and lateral epicondylitis within a week (golfers and tennis elbow’s respectively). I can get resolution of these problems with eccentric tendon exercises as well but it takes about 3-4 months.

            Also neck and back tension and recurrent HA that showed no organic causes but had great results with a couple of visits.

            One lady I had was on narcotics for years because of chronic neck pain. In her words, “The first visit helped relieve so much tension and pain I signed up for six more visits that day.”

            I’m sure part of it is the practitioner. We have a traditional Chinese trained (in China) board certified acupuncturist and DO who gets great results. But like anything it’s not always a magic “needle” some get greater results than others but at least it’s an option. Just like massage and adjustment. In my opinion, eating healthy, exercise, stretching, massage, acupuncture, meditation, body adjustments, etc. should be our first choice of treatments for the human body. Sometimes medications work great, especially for acute infections, but for chronic problems lifestyle changes should be first line with medications playing an adjunctive role.

            Some may not agree but it is through my experience and the success of my patients with lifestyle changes that has driven me to this conclusion.

            Bottom line is if you are considering acupuncture ask around and see who your friends or acquaintances have tried and have had success with in your local area.

            Here are some recent studies for acupuncture:

            This last study I find interesting because it is a MetaAnalysis and compares multiple modalities of treatment for sciatia showing comparable outcomes between Acupuncture, spinal manipulation, epidural injections and disc surgery. For me I would chose the least invasive options first (eg spinal manipulation, acupuncture) and leave the most invasive for last.

            I hope this helps.

  • 7in1

    It seems very strange that 800+ health related videos had been created, and not even a tag #GMO ! Dr. Greger, is it true that your sponsors does not let you explore GMO subject?

    • Brandon Klinedinst

      I think he’s stated before that if one has the extra funds, to go organic, but that it’s more important to just focus on wholefoods, plant-based diet more than anything.

      • Toxins

        Well said Brandon, the health epidemic currently is not caused by gmo, but by the the copious amounts of animal products and refined foods.

        • Adrien

          I totally agree. But, health apart. I’m really concern about the patent take over of all the crop. Because make no mistake, that is the goal of gmo. A worldwide monopoly on food.

        • Adrien

          And by the way, there IS concern about health. But the study have been censured by monsanto. The field of gmo science is heavily polluted by private money. I’ve just finished a chapter from Colin Campbel “Whole”, about the subtile power of money in research and carreer making of scientist rather than daylight bribery. But here in France we have witnessed the censorship of honest and rigorous scientists, pure and simple.

          I always wanted to know what Dr Greger think of Seralini study, and the Monsanto takeover of the editorial board of Food and Chemical Toxicology to remove this study.

          Here’s study:

          • Susan

            These images of huge tumors in laboratory rats can be seen at:
   They are the first of many studies that come up at the web site.

            Recently, a young cat adopted me who has two very large tumors on her chest and abs. I suspect, but cannot prove. that the cat food she had been previously fed was the culprit. If it was Purina, it’s full of potential GMO’s, as its ingredients are soy, corn, cottonseed meal and livestock fed GMO and herbicide resistant corn and soy.

            She’s now eating Blue Buffalo and soon will be eating organic cat food. She’s the sweetest and most compliant cat I’ve ever adopted.

          • wideEyedPupil

            You know there is vegan cat food, much less moggy footprint :-)

          • Susan

            I did not know. Cats are definitely carnivorous. I tried making my own pet foods, but I don’t know all the ingredients which are safe for cats. I know some plant foods can kill or cause them severe harm.

            I am currently looking into: Pollux Organix
            But this uses organic meat and other organic ingredients.
            What is the brand of a vegan cat food?

          • tedster

            I’ve been feeding my cat Evolution cat food. She’s a picky eater, so I have to add some “standard” cat food to the mix so she’ll maintain her weight. My girlfriend has also been feeding her cats Evolution. Her cats are less picky eaters and like it just fine.

            Cats are carnivores, but Evolution claims to have all the proteins found in raw meat, poultry, and fish without the GMOs, growth hormones, antibiotics, etc.

          • Shannon

            P.S. Do wet food; I’m not sure why they even make dry cat food, as it
            causes GI impaction, mostly from fur, and hard to digest dry food
            building up in the intestines. Many people have taken their cats to the
            ER for unnecessary and deadly surgery for this. Just feed wet food,
            and you won’t have a problem. Also, pure, fresh water daily!!

          • Thea


            You may be interested in the following talk by veterinarian Dr. Armaiti May. The title is “Vegan Diets for Dogs and Cats – Risks and Benefits”


            Compared to dogs, it can be harder to feed a vegan diet correctly to cats. Where by correctly, I mean that they cat stays healthy. But it can be done for at least a certain percentage of cats.

            Hope this helps.

            FYI: My vegan dog is *thriving.* (But then again, he’s a dog and not a cat…)

          • Shannon

            PLEASE DON’T feed any feline vegan food! They are the absolute purest
            carnivores on the planet, and while dogs are omnis and do well with a
            quality vegan diet, cats will die. Please do your research. My dogs
            were vegan, but after doing much research from independent sites and
            experts in animal nutrition, I found unanimously that cats cannot
            survive a vegan diet. My cat has FIV and the very highest quality food
            I’ve found is Wellness for either dogs or cats. Blue Buffalo ranks
            further down the list, has had several recalls, not as high quality
            nutrition, etc. but they pay for advertising… No preservatives
            whatsoever in Wellness. Three years later and you cannot imagine a
            shinier, happier, more energetic and healthy cat. No, am not a schill,
            just very concerned with animals and what is best for them. I really
            hope this helps. :)

          • Thea

            Shannon: You are right that it is harder to successfully feed a cat a vegan diet, but it can be done and is done. My friend’s cat is doing great, and I have heard of others. So, at least some cats are very healthy eating that way. I bring this to your attention so that you don’t incorrectly claim that all cats will die on a vegan diet.

          • wideEyedPupil

            Our ocean “bait fish” (that’s fishing term for baby fish) are stripped from the shallows to produce cat food. Our animal factories are run to produce cat feed. Our last remaining rainforrests are being clear felled to grow grain to fuel animal factories.

          • SeedyCharacter

            I am in no way defending GMOs here but years back I raised rescued lab rats and they commonly had tumors like these because they are bred to be tumor-prone (for cancer research purposes).

          • Adrien

            I understand what you mean. But the study used the same rats than the study that allowed GMO to be marketed. And there is significant difference between the non gmo and the gmo group as well as with the Roundup pesticide compared to control group.

          • SeedyCharacter

            Ah, it would have been helpful to have shown photos of the non-GMO and GMO rodents to see the contrast!

        • wideEyedPupil

          What about pesticides/herbicides? Pretty clear correlation with cancer incidence is the cotton crop in USA (most sprayed crop in large scale production)

          And it’s way to early to make a call that GMO have no role in environmental health impacts.

          • Susan

            Pesticides, which include herbicides, were touched on as a source of carcinogen in the President’s Cancer Panel report. And all the studies collected prior to the Bush Administration on 2,4-D presented a pretty strong case that 2,4-D was a human carcinogen. This may be the reason the BushCheney administration allowed Dow and other corporations to eliminate any and all the studies from the EPA archives they did not like, so that when reauthorization came up, the corporation’s studies would be used as they were in the early days of the Obama Administration.
            My source was P.E.E.R. although the evidence is no longer online.

          • Toxins

            Yes, the pesticides are not healthful, but the public health message should be a plant based diet as a first priority.

        • jazzfeed

          The epidemic and climbing disease rates have more than one causal factor. To rule out the consumption of mutated plant products marinated in xenobiotic chemicals as one is utterly myopic.

    • Susan

      The developmental disorders of the rats can be seen immediately at

      If Monsanto flacks have not taken down the studies, all should be there.

      One study that is repeatedly missing was done by soil and plant pathologist and micrbiologist, Don Huber, Ph.D., retired professor and expert from Purdue University, who studied the effects of pesticides on bees, and uncovered that glyphosate was one of the causes of their demise.

      I have the document printed before presumably Monsanto flacks removed it, but do not have the computer or internet knowledge of posting it again.

  • Adrien

    There is plenty of sun in the south of France, Michael. You should take vacation some time and come here to see for yourself ;)

    • Julot Julott

      I think the doctor mean in the video by “where the sun doesnt shine” inside the body by mouth or even worse… because in France many peoples use essential oils inside the body…

      • Adrien

        Ohh.. ok ! I’m sorry, I got it wrong. Anyway, the idea is still valid :) Get plenty of sunshine for your vitamin D doc ! Saving the world on a treadmill in a basement close to a cupboard is.. still an amazing thing to do. :D

    • wideEyedPupil

      Where the sun don’t shine is a phrase that references the anus and bowel.

      • Adrien


  • wideEyedPupil

    I second the motion that Dr Greger produce a series of videos on GMO research and health impact studies.

    If he is sponsored by *anyone* other than individual donors with no commercial interests in pharma or agri and food industries I want to know about it please, on a About page with disclaimers as it is proper for this sort of PH resource.

    • Susan

      Monsanto will litigate immediately. That’s how they control what the public knows. I don’t think Dr. Greger can raise the amount of money needed to defend himself. This way he can still get healthful information out.
      Dr Oz is now promoting healthier eating and organic foods, but cannot say anything about gmo’s.

      • jazzfeed

        This forum would be then be crawling with biotech trolls. Many of them are professional misinformation artists and would splinter and sully any discussion with lies. One of their skills is creating divisiveness. There are myriad sites revealing GMO truth, many with contributions by MDs; let’s keep this one out of it. Dr Greger is well aware (and you should be too) of the resultant harrassment, and worse, that is STANDARD and pre-planned for any high-profile individual or forum even expressing doubts about the GMO plague worldwide. If you are already aware, DO something instead, such as educating your friends and loved ones what food products to boycott so as not feed this psychopathic enterprise. Here is a guide:

      • jazzfeed

        No surprise – neither can the President of the United States. But we can. If we do not do everything possible under the term “RESISTANCE” our grandchildren will be eating fake food exclusively. Use your imagination after that.

    • jazzfeed

      I don’t agree, in this case … more in my remark below

  • wideEyedPupil
    • Thea

      wideEyedPupil: NutritionFacts originally started with some grant money, but it is my understanding that the original seed money has run out. So, now the only sponsors of this site are people like you and me.

  • Rivka Freeman

    The only reason anyone gets an accidental bulbous phytotoxic reaction is cause she obviously put more than a drop on. If the oil feels too strong dilute it with extra virgin olive oil coconut oil baby oil or any oil will decrease the strong sensation and make it tolerable. Applying water to wash away oil that feels too strong will drive the oil in deeper; apply a hot wet cloth on the skin if you want to potentiate the oil(s). Using small amounts of unadulterated oils directly on mucous membranes feels good and works great for bioavailability, bypassing the liver. You only need a drop it will circulate to every cell in the body cause cell membranes are made of fat. Lavender is my favorite for migraines and it’s used for burns wound healing and scars. Check me out on where I try to teach nutrition therapy.