A Year of Legends: Best of 2024 at Dr. Kara Fitzgerald
My father recently asked me about black cumin seed oil. He emailed me (as I think so many of our friends and family do!): “Kara, I’m taking black cumin seed oil capsules daily. Should I?” I haven’t been using it in practice, and his question prompted a review of literature by me- which was immediately interesting- and then a good dialogue with our Clinical Development tribe. I was thrilled that Dr. Gereau not only had some experience using it in her functional otolaryngology practice, but wanted to dive into the literature around allergic disease- a focus at our clinic as well. We will be incorporating Nigella Sativa in conjunction with a full functional approach. Are you?
Thank you Sezelle, for this well thought-out and researched blog! DrKF
Sezelle Gereau MD, CDP participant
Allergy and allergic-related diseases are some of the most common conditions for which patients seek medical care. Starting early in life the allergic march can present as food allergy and progress to eczema. Soon after, patients develop seasonal and perennial allergies, which unfortunately can later lead to asthma. Thus, medical practitioners of all types require good treatment strategies for allergy. The most effective treatments are those that help to reverse the course or prevent progression of the disease, not just eliminate symptoms. It is also essential to start such therapies early so that children will not bear the lifelong burden of the atopic skin conditions and asthma.
The use of nutraceuticals in the allergic patient is tricky as patients can be allergic to the supplement itself, or be on a number of other medications that could cause interactions. Having a therapy that can easily be combined with medications, herbals, or used topically instead of taken orally, can minimize the risk of side effects and ultimately improve patient outcomes. Our goal should always be to reduce the use of antihistamines and steroids, and not to contribute to poly-pharmacy. Better yet if that herbal can be used as a food and still provide therapeutic effect.
It isn’t often that a powerhouse herb such as Nigella Sativa comes to our attention. In Arab countries it is widely used as a regular part of the diet for general wellness. There are many clinical studies that support its use as a dietary supplement to treat a variety of illnesses. This research looks especially promising for conditions such as eczema, asthma, and to enhance the effects of immunotherapy. The safety profile is impeccable, and many of its pharmacological properties suggest that it could be an ideal adjunct to other anti-allergy protocols. As an otolaryngologist, I believe it is worthy of a closer look.
A Plant with a Long, Esteemed History
Nigella sativa (NS), an annual flowering plant of the Ranunculaceae family, is native to South Asia. It is also cultivated and used in different parts of the Mediterranean, southern Europe, and Northern Africa. Also known as black cumin seed, nigella sativa has a long history of use in traditional foods and folk medicine.
While the seeds can be eaten plain, they are also heated or ground and mixed with honey, water or milk. They are often sprinkled on bread or pastries. Sometimes, they are burnt as incense. In Islamic medicine it has been touted as “a cure for all diseases except death” and the variety of ailments that it has been used for extend across many organ systems. A Pub Med literature search over the past 5 years revealed in vitro and in vivo research, examining NS for a number of disorders, including:
- Diabetes, hypertension and dyslipidemia
- Asthma, allergies and eczema
- Milk production in nursing mothers, mastitis and mastalgia
- Improvement in semen quality and production in infertile men
- Generalized oxidative stress
- Alcohol induced liver injury
- Neuropathic pain
- Mood, anxiety and cognition
- MRSA
- Cancer of various types, including cervical, lung, neuroblastoma, cholangiocarcinoma and leukemia
- Hashimoto’s thyroiditis
There was even one article that cited sero-conversion of an HIV+ patient who used a “concoction” containing NS. One might think that this “wonder herb” is just too good to be true!
Plant Pharmacology and Research Relevant to Atopic Disease
The seeds are the pharmacologically active portion of the plant. While NS has over 100 active constituents, 50% of the seed is composed of essential fatty acids (linoleic, oleic, palmitic, di-homolinoleic). Within this, thymoquinone (TQ) appears to be the active ingredient.
NS seeds are thought to exhibit anti-histaminic, anti-inflammatory and immune enhancing effects. TQ is believed to account for the antioxidant and anti-inflammatory properties, partially through inhibiting inducible nitric oxide in response to oxidative stress. TQ can inhibit 5-lipoxygenase (especially relevant to asthma), and works synergistically with glutathione, NAD and NADPH.
Animal studies have shown that TQ and other constituents of NS oil can alter cytokine production, inhibiting TNF-a, interleukin (IL)-6 and IL-1b. Nigellone, a polymer of TQ, has been shown to prevent the release of histamine from mast cells, thus having applications in asthma, bronchitis and allergies. Nigellone also appears to have antileukotriene effects .
Numerous studies have shown improvement in allergic disorders with the use of oral NS. When .5ml of oil was administered to allergic patients orally for 30 days there was a significant decrease in sneezing and itch, turbinate hypertrophy and congestion, and mucosal pallor.
It has also been shown to cause a decrease in blood eosinophils.
When administered alongside subcutaneous immunotherapy, NS helps to preserve polymorphonucleocyte (PMN) function. A very small study looked at 30 asthmatic children who were also sensitized to house dust mite and were receiving sublingual immunotherapy. When NS in powder form was administered with probiotics and multivitamins, there was a greater improvement in symptoms than with immunotherapy alone.
One study looked at 1 gram of NS oil administered topically twice daily for 4 weeks to patients with hand eczema. Subjects were 18-60 years old. The study found equivalence to betamethasone cream utilized similarly for an equivalent time. Eczema often heralds the start of the allergic march for many children and sometimes requires topical steroids for treatment. It would be interesting to see a similar study in a younger population, or even NS oil used alongside placebo without the betamethasone limb as it could offer a new, safe and effective alternative to topical steroid use in the pediatric population.
A double blind crossover study looked at topical use of NS oil for nasal symptoms in the elderly. They compared 2 weeks of NS oil to topical saline spray. Both were used as 3 sprays 3 times daily. While there was no difference in muco-ciliary transport there was a difference in patients’ reports of nasal obstruction, dryness and crusting. No difference was noted in burning and itch. One drop of NS oil used intranasally 3 times daily for 6 weeks alleviated symptoms of allergy. more effectively than placebo.
Koshak studied a group of 80 asthmatic patients. He found that 4 weeks of NS oil (.7% TQ, 500 mg twice daily) significantly decreased asthma symptoms. Improvement in FEV1 approached clinical significance. Blood eosinophils were reduced while there was no difference in total serum IgE.
Caveats for Clinical Use
Many of the studies had methodological constraints, including small sample sizes, unclear endpoints, and use of non-validated quality-of-life questionnaires. While most studies looked at skin testing results prior to administering the instrument, none looked at skin prick testing post. Despite these issues, overall the research looks promising – well worth recommending it to patients as an adjunct to our integrative protocols.
NS appears to be safe used in recommended dosages. It can inhibit cytochrome P450 and so should be used with caution in patients who are on drugs similarly metabolized. Side effects are rare. There are some reports of nasal dryness when used topically; nausea, headache and insomnia when taken orally.
Dosages vary from 40-80mg/kg a day with usual dosages at around 50 mg/kg/d. Many studies used 500mg of the oil taken 3 times daily. If taken as the whole seed, dosage is 1-3 grams daily. Intranasal use is 1-3 sprays 3 times daily. For eczema 1 gram should be used topically for 4 weeks. It is recommended to look for .7% or greater TQ content.
How I Use Nigella Sativa in Practice
I have used Nigella Sativa rarely in my practice, and only to augment the effectiveness of sublingual immunotherapy. Now, having reviewed the research and learned of the many other uses for this herb, I am eager to share this information with my patients. I am particularly interested in it for topical nasal use, as there are so few options for patients other than nasal steroids or nasal antihistamines. It’s nice to have new tricks up one’s sleeve for the allergically prone patient. I am hopeful that this will lead to better patient outcomes overall – truly the best use for integrative therapies that there is!
If you have clinical experience with using NS in your practice, please share in the comments below.
25 Comments
Related posts
Great information and research!
Thank you!
After using black cumin oil for my own asthma, and having the most profound results, I now prescribe it with huge success. I now take it only as needed instead of a pump, and have patients off all asthma meds, one after 30 years of chronic use… This oil literally saves me. It is such a gift, albeit an awful taste…
That is great, Elaine. Please share how you’re dosing it with asthmatics and what products you are using. DrKF
As a healing asthmatic, I loved reading of this new suggestion. I would also love to know the dosing recommendations so I could discuss it with my ND.
Doses typically range from 40-80 mg/kg, although dosage may depend on various factors including the form and administration. I’m sure your ND will have a great background on using Nigella sativa and if it’s appropriate for your needs.
Hello there…hope u doing very well. Just wanna ask u that how long it takes for black seeds oil to notice any improvement in asthma symptoms. Thanks
That will vary from person to person and depending on other factors like what other interventions someone is using, nutrient status, and severity of the symptoms.
I am not a Dr or have a practice, however I have been giving this oil to my daughter who has had severe asthma and allergies since birth, Her main allergies being dust mite, pine nuts and peanuts. She has been under hospital care for her asthma due to the severity and frequency of hospital admissions for asthma attacks. After some resesrch I decided to try Black seed oil. Within 2 months I saw she had less mucous, very occasional wheeze and 0 asthma attacks. She has now had around 6 months of the oil and has not used or needed any asthma pumps or any allergy relieving meds. You would not know this was a child that relied on medication daily to breathe and cope with allergies. It is truly an amazing oil.
Hi, at what dose did you give your daughter. How old was she and after how long you noticed some difference
Where can i get the seeds from like to plant it
What a great idea – you can find some sources online for purchasing organic seeds. Best of luck!
Hi Dr Fitzgerald,
This is a great article and I’m hoping you are still looking at comments.
I have a complicated, painful health situation involving an idiopathic autoimmune, MCAS/HIT, multiple toxicities and am tapering off several meds I let some reckless Drs put me on…….steroids, a very low dose benzo, and a tricyclic antidepressant (both use a CYP450 pathways).
I’m looking for a good natural anti-inflammatory and pain reliever that doesn’t aggravate an already overactive immune system. I also have terrible nerve pain from overuse of antibiotics for Lyme I prob didn’t have and damage from gabapentin I finally weaned off 3 months ago.
Please let me know if you think NS (Black Seed) may help with this complicated situation.
Thanks for your help,
Tod
Thank you for reading. Sounds like you’ve been doing some extensive research in addressing your health – that’s great. Unfortunately, due to the variables in your situation and without knowing the details of your case, we can’t make any recomendations here. As you know, each person is different and especially when dealing with MCAS and Lyme, we should be careful to approached with the full picture in mind. If accessible to you, I would suggest working with a provider trained in Functional Medicine who can walk this journey with you and provide safe and effective support. We do offer consultation services (remote or on person), contact us here: https://www.drkarafitzgerald.com/contact-2/ or you can find a local provider at http://IFM.org.
Hello, Dr. Fitzgerald:
I currently suffer from ABPA (Allergic Bronchopulmonary Aspergillosis). Right now I’m not sure if it’s allergies to some type of pollen (Spring here now, everything in bloom) or my lung fungus causing my asthma to worsen. >>>Taking steroids (prednisone) is something I never want to have to do again.<<< As I age, my lung capacity is less and less, and I am now trying Cresemba w/ Symbicort as an inhaler. Do you think ingesting black cumin seed oil would be okay for me to try? I can't consult my lung Dr., as I know full well he will only recommend more steroids. Any opinion on mixing cumin seed oil w/ Cresemba/Symbicort? Thank you.
Thanks for reading this article. Unfortunately, we’re unable to provide specific medical advice online. There are too many variables to consider. Working with a clinician trained in Functional Medicine who can guide and manage a comprehensive approach would be ideal.
I have searched all over for intranasal black seed spray, I have even looked for instruction on how to safely make it. Can you please help me with this. I have fallen in love with black seed for the anti-inflammatory effects and have hopes it will help with my sinus issues and this awful parosmia I have from covid. It has been almost a year.
The researchers in this study cited (https://www.aurisnasuslarynx.com/article/S0385-8146(13)00213-7/fulltext) in the blog above used the following formulation for the nasal spray: Cold press NS oil – one spray was 22 micrograms in 25 microliters per nostril. This was utilized as 3 sprays each nostril 3 times daily for 2 weeks. You could get in touch with a compounding pharmacy and ask that it be made to a similar spray formulation. Alternatively, you could also try taking it orally, which could perhaps give even better results without the difficulty of compounding it into a nasal spray. There’s also recent research on intranasal Vitamin A sprays for anosmia due to long-COVID. However, it’s best to work with practitioners trained in Functional Medicine who can tailor interventions to your specific needs. Thank you for reading & commenting!
Thank you for this most interesting post. I bought some organic NS seeds to give to my 8 year old son with asthma, however, he couldn’t tolerate the taste of the ground seeds. Do you think patients would have the same effect if given whole seeds?
Thanks!
Hi there. Happy you enjoyed this post. Currently research focuses on the benefits of the volatile oils found in those seeds, which would mean the seeds need to be crushed or chewed to release these beneficial compounds. Of course, nigella seeds have been used as food for a very long time and there may be some benefits to eating the whole seeds. Even with the whole seeds, there may still be taste issues and some people can get heartburn too, so please do take care.
Dear Doctor .Thjnak you very much for your compreensive explanations.For 100 years I was looking for for a good summary about NS as I suffer from histamines flair ups. One thing that I would ask for additional details is for ..It can inhibit cytochrome P450 and so should be used with caution in patients who are on drugs similarly metabolized,,,
What should be the level of caution ? Do you mean that eventually the inhibition of Cytochrome -p 450 would be a 100% descouraging/ disheartening, as it suprress the P450 which is a kind of filter for chemicals and we can be poisoned in longterm use? Thank you Gilson de Jesus/Brasil
Hi Gilson. Thank you for your thoughtful question. According to the Natural Medicines Database NS has not been shown to cause hepatotoxicity in humans. So we could say it is unlikely to decrease liver enzyme function a 100%. As always this would depend on the person’s health status and pre-existing conditions. Therefore, it is best to discuss this with your primary healthcare provider or functional medicine practitioner before initiating any supplementation.
Hello,
Have you used with children with allergies and asthma? I would like to use it with my teen daughter who is 14. I bought 500 mg capsules but not sure on dose to try.
Thank you
Hello Joanna, while we can’t give out specific advice online, we can point out that the study referenced in the blog above (Kardani et al., 2013) was performed in a pediatric population and used the following dosing:
“Nigella sativa used in this study was Nigella sativa in powder form and in capsules prepared and was given at a dose of 15 mg / kg / day [33]. Each capsule contains 150 mg of Nigella sativa. Each 10 kg of weight will receive 1 capsule Nigella sativa.”
– team DrKF