German Chamomile Benefits: What the Research Actually Supports

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German chamomile (Matricaria chamomilla) is one of the most-studied calming herbs on the market — and one of the most oversold. The research holds up best for two things: mild-to-moderate generalized anxiety and menstrual cramps. It holds up less well for sleep, despite chamomile’s reputation as the bedtime tea. And a few of the claims attached to it in older herbal guides — that it’s “proven” against specific bacteria, that it cures jaundice, that a cup after every meal prevents digestive trouble — don’t have real trial data behind them.

None of that makes chamomile a bad choice. It’s inexpensive, pleasant to drink, and mild for most healthy adults. But if you’re using it expecting a specific result, it helps to know which results have evidence behind them and which are tradition dressed up as fact.

What’s Actually in the Flower

Chamomile flower heads contain more than 120 identified compounds, but three get most of the research attention. Chamazulene and alpha-bisabolol, concentrated in the plant’s blue-tinted essential oil, are behind most of its anti-inflammatory and antispasmodic reputation.

Apigenin, a flavonoid found in the flower itself, is the compound most closely tied to chamomile’s calming effects — in lab and animal studies, it binds to the same benzodiazepine-binding site on GABA-A receptors that drugs like diazepam act on, though far more weakly (Saadatmand et al., 2024). That mechanism is well established in preclinical research; it’s a reasonable explanation for chamomile’s mild sedative and anxiolytic effects in humans, not proof that tea works the way a prescription anxiolytic does.

German Chamomile vs. Roman Chamomile

“Chamomile” on a supermarket shelf usually means one of two unrelated-but-similar-looking plants. German chamomile (Matricaria chamomilla, also called Matricaria recutita) is the more widely used and more heavily studied of the two in the United States (NCCIH, 2024). Roman chamomile (Chamaemelum nobile) is used similarly in traditional practice but has a smaller research base. If you want a closer look at how the two compare, our guide to Roman chamomile covers it separately — this article sticks to German chamomile.

Anxiety — the Strongest Evidence

This is where chamomile’s research base is most convincing, with a real caveat about which kind of anxiety.

A 2019 systematic review and meta-analysis pooled 12 randomized trials covering 965 people and found that chamomile produced a meaningful improvement in generalized anxiety disorder (GAD) symptoms after two and four weeks of use, measured on the Hamilton Anxiety Rating Scale — though the effect weakened by eight weeks. The same analysis found no significant benefit for state anxiety, the short-term, situational kind (like pre-exam nerves), when pooled across trials (Hieu et al., 2019). A more recent systematic review reached a similar conclusion, and traced the plausible mechanism to apigenin’s action at GABA receptors (Saadatmand et al., 2024). NCCIH’s own summary is consistent with this: preliminary evidence, but real, for a standardized chamomile supplement in GAD (NCCIH, 2024).

The trials behind this used standardized extracts, commonly in the range of roughly 220 mg to 1,500 mg per day of an extract standardized to about 1.2% apigenin — not a strong cup of tea (Schwartz et al., 2023). If persistent worry is interfering with daily life, that’s worth raising with a clinician; chamomile isn’t positioned in the research as a substitute for therapy or medication in moderate-to-severe anxiety. For a broader comparison against other anxiety supplements, our evidence-based guide to anxiety supplements covers chamomile alongside ashwagandha, magnesium, and lemon balm.

Sleep — More Complicated Than the Reputation Suggests

Chamomile is marketed as the sleep tea, but the dedicated insomnia research doesn’t back that reputation as firmly as you’d expect. NCCIH is blunt about it: there’s very little direct evidence on chamomile and insomnia, and the one placebo-controlled pilot trial it highlights found no significant benefit for insomnia severity (NCCIH, 2024).

That’s not the whole picture, though. The same 2019 meta-analysis that found a GAD benefit also pooled six trials measuring subjective sleep quality (using the Pittsburgh Sleep Quality Index) across mixed populations — not people specifically diagnosed with insomnia — and found a real improvement compared with placebo (Hieu et al., 2019). In other words: chamomile may help some people feel their sleep was better, but it hasn’t been shown to fix a diagnosed sleep disorder. A cup as part of a wind-down routine is a reasonable, low-risk habit. It isn’t a treatment for chronic insomnia. If sleep problems are ongoing, our guide to natural remedies for insomnia covers options with a stronger evidence base for that specific condition.

Menstrual Cramps

This is the other area where chamomile’s evidence is genuinely encouraging. A 2021 systematic review examined seven clinical trials totaling 1,033 women and concluded that chamomile reduced both pain and menstrual bleeding volume in most of the studies reviewed, more than placebo and, in some trials, comparably to NSAIDs (Niazi & Moradi, 2021). The proposed mechanism is that chamomile compounds suppress the production of prostaglandins and leukotrienes, the same inflammatory signals NSAIDs target to relieve cramping.

The caveat: several of the underlying trials are small, and study quality varies. This evidence applies to primary dysmenorrhea (cramps without an underlying condition) — it isn’t a substitute for evaluation if pain is severe, worsening, or accompanied by heavy bleeding, which can point to endometriosis, fibroids, or other conditions that need a clinician’s attention. Our guide to herbs for menstrual cramps walks through chamomile alongside other options like ginger and cramp bark.

Skin Irritation and Mild Eczema

The evidence here is older, smaller, and tied mostly to one specific commercial German chamomile cream (Kamillosan), so it’s worth reading carefully rather than as a blanket endorsement.

A 1985 trial in 161 patients with various inflammatory skin conditions found the chamomile cream roughly matched 0.25% hydrocortisone in effectiveness during maintenance therapy, and outperformed a non-steroidal comparator (Aertgeerts et al., 1985). A follow-up trial in 2000 found the same cream showed a mild edge over 0.5% hydrocortisone for atopic eczema — but only a marginal difference compared with the plain moisturizing base used as a placebo, which suggests some of the apparent benefit may come from the cream itself rather than the chamomile in it (Patzelt-Wenczler & Ponce-Pöschl, 2000).

Read together, that’s reasonable support for chamomile cream as a gentle option for mild skin irritation — not strong enough evidence to replace a dermatologist-prescribed treatment for diagnosed eczema, and not evidence that chamomile tea or raw flowers applied at home will do the same thing as a formulated cream.

Digestion and Mouth Sores

Chamomile’s reputation as a stomach-settling tea is almost entirely traditional. NCCIH notes that when chamomile is studied on its own — not combined with other herbs — there isn’t good evidence it helps with indigestion, upset stomach, or related complaints. Combination products containing chamomile have shown some benefit for infant colic and diarrhea in children, but that’s a different claim from “chamomile alone helps digestion” (NCCIH, 2024).

Where there’s more direct support is an unexpected corner: small trials suggest chamomile mouthwashes or rinses may help prevent or ease mouth sores (oral mucositis) caused by chemotherapy or radiation therapy (NCCIH, 2024). If you’re going through cancer treatment and mouth sores are a concern, that’s worth raising with your oncology team rather than adding on your own.

Blood Sugar — Early-Stage Research

A newer line of research looks at chamomile and diabetes. A 2020 systematic review of 15 studies found that chamomile was associated with improved glycemic markers and reduced oxidative stress in several diabetes studies, though its effects on longer-term diabetic complications were inconsistent across the research, and the authors called for better-designed trials before drawing firm conclusions (Hajizadeh-Sharafabad et al., 2020). Treat this as an emerging, not established, benefit. If you take medication for diabetes, mention regular chamomile use to your prescriber — combining anything with a blood-sugar-lowering signal with diabetes medication is worth a conversation, not a guess.

How People Typically Use It

The most common way to use German chamomile is as a tea: about 3 grams of dried flower heads (roughly a heaping tablespoon) steeped covered in 150 ml of hot water for 5 to 10 minutes, taken up to three or four times a day — a preparation standard that traces back to the German Commission E monograph, the reference many herbal-medicine dosing recommendations are built on. Capsule and extract products used in the anxiety and sleep-quality trials described above typically supplied somewhere between 220 mg and 1,500 mg per day of a standardized extract.

This article isn’t a substitute for dosing guidance from a pharmacist or your doctor, especially for capsules and extracts, where potency varies a lot between brands and isn’t always accurately labeled.

Side Effects and Who Should Be Cautious

Chamomile is generally well tolerated. NCCIH rates it as likely safe when consumed in the amounts typical of tea and food, and possibly safe for short-term medicinal use in adults and children. Reported side effects are uncommon and include nausea, dizziness, and allergic reactions — including, in rare cases, severe hypersensitivity reactions and anaphylaxis. Getting chamomile near the eyes can cause irritation (NCCIH, 2024).

Allergies

Chamomile belongs to the same plant family as ragweed, chrysanthemums, marigolds, and daisies (Asteraceae/Compositae). People allergic to any of these are more likely to react to chamomile too, and reactions can range from mild to severe (NCCIH, 2024). If you have a known ragweed allergy, treat chamomile with the same caution.

Blood thinners and surgery

This is one area where the advice you’ll find online is more settled than the actual evidence. A widely cited 2006 case report described a 70-year-old woman on warfarin who developed serious internal bleeding after using chamomile tea and lotion heavily, with a very elevated INR (Segal & Pilote, 2006). That case is the main reason many patient-information sites — and some hospitals — advise stopping chamomile before surgery.

But a 2023 randomized, placebo-controlled trial in healthy volunteers not taking anticoagulants found that neither chamomile tea nor a standardized capsule changed standard coagulation test results (prothrombin time, INR, and others) after a week of regular use (Schwartz et al., 2023).

Read together, that’s genuinely mixed evidence: the case-report concern is real but based on a single patient who was also on other medications, while controlled testing in people not on blood thinners found no measurable effect. If you take warfarin or another anticoagulant, or you have surgery scheduled, tell your prescriber or surgical team that you use chamomile regularly and let them decide — this isn’t a judgment call to make alone. NCCIH also notes interactions with cyclosporine and other liver-metabolized drugs (NCCIH, 2024).

Pregnancy and breastfeeding

NCCIH states plainly that little is known about chamomile’s safety in pregnancy or while breastfeeding (NCCIH, 2024). A 2025 systematic review pulled together 23 studies (2,065 women) on chamomile use around pregnancy and childbirth and concluded the evidence is too inconsistent and too weak, overall, to support a clear recommendation either way — some studies flagged possible links between concentrated chamomile use, especially later in pregnancy, and preterm birth or lower birth weight, while others found no such link (Ferguson & Gordon, 2025). Given that uncertainty, the reasonable approach is to talk with your OB or midwife before using chamomile regularly during pregnancy, particularly capsules or extracts, which deliver a more concentrated dose than tea.

Other interactions

Chamomile may have mild estrogen-like activity; preliminary research suggests it could reduce the effectiveness of birth control pills and, theoretically, worsen conditions sensitive to estrogen exposure, such as breast or uterine cancer (NCCIH, 2024). If you take any prescription medication regularly, it’s worth a quick check with a pharmacist before adding daily chamomile — herbs and drugs can interact in ways that aren’t always obvious.

When to get care instead of waiting it out: facial swelling, difficulty breathing, or hives after chamomile need emergency care, not home treatment. And if you’re using chamomile for anxiety, sleep, or menstrual pain that’s moderate to severe, persistent beyond a few weeks, or getting worse, that’s the signal to bring in a clinician rather than increase the dose on your own.

Health Disclaimer: This article is for educational purposes and isn’t a substitute for medical advice, diagnosis, or treatment. Chamomile can interact with medications, including blood thinners, and its safety in pregnancy and breastfeeding hasn’t been well established. Talk with a doctor, pharmacist, or other licensed healthcare provider before starting chamomile regularly — especially if you are pregnant or breastfeeding, take prescription medication, have a scheduled surgery, or have a known allergy to ragweed or related plants.

Frequently Asked Questions

References

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12. Hajizadeh-Sharafabad F, Varshosaz P, Jafari-Vayghan H, Alizadeh M, Maleki V. Chamomile (Matricaria recutita L.) and diabetes mellitus, current knowledge and the way forward: A systematic review. Complementary Therapies in Medicine. 2020;48:102284. View source
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