Those who know me well, both personally and professionally, know two things. The first is that everything is “my favourite”, and the second is that I love prescribing saffron clinically for mental health.
The story of my love affair with saffron began almost ten years ago. On a whim, I travelled interstate to Sydney to attend an informal fireside chat with two world leaders in herbal medicine, Professor Kerry Bone and Simon Mills, fresh off a plane from the UK.
Talking about the new additions to their seminal textbook “Principles of Phytotherapy,” the duo brought up their interactions with middle eastern universities conducting research that hadn’t been translated into English or simply missed altogether.
The most compelling herbs from those interactions were Nigella, commonly known as Black seed and the herb we’ll talk about in this article, saffron.
I remember walking out that night, blown away by one key point about the potential saffron had for mental health that night.
It solved a fundamental interaction problem. At the time, St John’s Wort was the only viable, evidence-based option for depression, but its potential, hypothetical interaction with SSRIs and antidepressant medication limited its use. Since then, saffron has been confirmed not to have this problem.[1]
When I returned to my hotel room that night, I ordered the liquid extract of saffron straight away so it would be waiting for me for my next clinic day when I returned, and the rest is history.
Fast forward to 2023; the hype is real at this point. I’ve seen multiple different applications of saffron in the clinic but let’s look at some of the evidence first.
A meta-analysis in 2020 assessing twenty-one randomised trials found saffron to benefit mild to moderate depression, sleep and anxiety.[2]
As with all forms of herbal medicine, especially when looking at singular herbs, it can help to know which active constituents within the herbs are being studied. In the case of saffron, the actives are crocin[3], picrocrocin, and safranal.[4]
If you were to look at most professional natural medicine formulas, you would most likely see the Crocin content mentioned as an indication of the formula’s strength. A pro tip is to look out for these things if you are considering using saffron medicinally without the help of a health professional.
Crocin, out of the three actives mentioned above, has shown promise in major depressive disorder when used with either sertraline, fluoxetine or citalopram, all commonly prescribed antidepressants.[5]
This particular study was a pilot and conducted over four weeks, considered to be half the minimum time for saffron in other studies on depression.[6]
In 2022, new research has identified crocin’s ability to affect the brain’s immune system in animal studies. Whilst we don’t get too excited with animal studies as they can sometimes not translate to humans, in this particular one, crocin reduced anxiety and depressive markers in rats experiencing unpredictable chronic mild stress. Immune markers measured, in this case, were inflammation and oxidative stress levels, which might be easier to think of as rust coming from cells’ interaction with oxygen.
Saffron’s ability to influence the internal immune system within the brain has another exciting application – Traumatic Brain Injury or TBI.
If you’re to this term, traumatic brain injury is as it sounds. It can occur during a car crash, contact sports such as Australian, European or American football or being knocked out accidentally.
To this in context, around one point seven million people survive a traumatic brain injury annually in the USA.[7] TBI is especially pertinent for men and women serving in their respective militaries.
Estimates show that eighty per cent of active service members and veterans experience a traumatic brain injury at some stage, even when not deployed in action.[8]
This quite unbelievable statistic goes some way to explaining the difficulties men and women can have adjusting to living post-deployment. This phenomenon doesn’t only apply, though, to those in the military.
In a more Hong Kong-centric way, young kids playing contact sports such as rugby are at risk of higher incidence of mild to moderate head trauma. Fortunately, concussion protocols are more and more common practice.
However, what is less known is the connection between TBI and long-term personality changes, including major depression and anxiety disorders.
Studies show saffron’s promise to reduce the damage caused by TBI.
Preliminary studies in mice show saffron blocking the cascade of long-term inflammatory insults that unfold to the longstanding damage caused by sustaining a head injury.[9]
Reiterating our statement above, we still have a long way to go to get human studies to confirm this. Still, it certainly underlines the potential that saffron can have in helping to prevent the unravelling of people’s mental health after even TBI.
The context of another animal study has shown results that I see in the clinic.
During a subsequent chat with Professor Bone (I accosted him during a break at a conference), I asked to follow up with him on his clinical feedback using saffron post-introducing it a few years previously at their fireside chat.
At the time, he mentioned that he had started to be able to recognise someone who would respond to saffron when they walked in almost immediately. I remember him saying, “anytime you see someone with heavy eyes, there’s a good chance saffron will work.”
It was like Gandolf the White giving me a prophecy that only I could decipher.
I’ll admit, at the time, I had no idea what he meant by “heavy eyes.” I thought this level of recognition was saved only for only Professor Bone.
Lo and behold, though, after a few weeks, I encountered a new patient who struggled to keep their eyes open and recounted that their mood was just as heavy.
My patient felt run down from a heavy period of stress.
To this day, I will never forget seeing my patient a fortnight later with bright eyes and a flushed face—a complete reversal of how they presented in their first session. A reversal I knew was down to the saffron prescription.
A study from 2021 echoed these results in a human study using thirty milligrams of saffron over eight weeks. Fifty-six people who used saffron or placebo were placed under acute stressful situations and monitored for their responses.
The participants who received the saffron reported reduced depression scores and improved social relationships at the end of the eight weeks.
Of particular note is the improvement in social interactions, which occurred after day 56 of the study. A lesser-known origin of depression is loneliness and isolation.[10]
One study has shown that people who have higher depressive symptoms have a more significant amount of negative social interactions and a lower sense of belonging in social interactions.[11]
This improved social interactions with saffron was an unexpected result in this study that needs further investigation. Still, it’s nice to see some of these broader changes occurring in people’s lives.
For my Oura ring users, one of the parameters measured in this study was heart rate variability changes.
Generally, we can measure stress levels and how they affect someone via heart rate variability decreases. In this case, the usual drops were blocked in the participants using the saffron extract.
The study concluded that saffron could improve subclinical depressive symptoms and resilience against stress-related mental health conditions.[12]
I can confirm that, at least for myself, taking saffron affected my HRV positively from day one. This benefit continued over the days I took it, and my reaction to acute stress improved, so it’s nice to see some of these facets in the studies present in realistic ways.
Can saffron have a positive effect on emotional eating?
Yes, it can. You heard it right.
And this is one of the more important benefits that saffron offers people from a clinical point of view.
Let me explain.
A Turkish study released in 2022 found a connection between perceived depression, anxiety and stress levels and emotional eating.[13]
This connection is crucial because diet can often be a limiting factor in helping mental health conditions such as depression.[14]
Saffron given as an extract over eight weeks saw benefits in appetite suppression, reductions in dietary intake and central obesity reduction.[15]
Another study found that a saffron extract reduced snacking frequency over eight weeks by fifty-five per cent compared with a placebo.[16]
Saffron can also assist with sexual dysfunction caused by SSRIs.
Here is another understated issue that I’ve seen saffron help.
SSRI-induced sexual impairment is a well-known side effect of prescriptions. For example, one study examined saffron’s ability to help women using fluoxetine over four weeks.[17]
At the end of the study, significant changes in sexual function occurred in women who had reported issues.
Interestingly the success of using saffron, in this case, was not reproduced in males with erectile dysfunction from SSRI prescriptions, which I’ve seen to be the case with men in the clinic too.
Saffron can play a multi-faceted role in mental health, helping with not only mild to moderate depression but other key ripple effects from it.
Such as the emotional eating and sexual dysfunction we’ve looked at in this article. I’m really looking forward to seeing the potential of saffron and its role in mental health and depression unfold with more human studies.
For now, the future is bright.
Hope this helps.
References
[1] Lopresti AL, Smith SJ, Hood SD, Drummond PD. Efficacy of a standardised saffron extract (affron®) as an add-on to antidepressant medication for the treatment of persistent depressive symptoms in adults: A randomised, double-blind, placebo-controlled study. J Psychopharmacol. 2019;33(11):1415-1427. doi:10.1177/0269881119867703
[2] Ghaderi A, Asbaghi O, Reiner Ž, et al. The effects of saffron (Crocus sativus L.) on mental health parameters and C-reactive protein: A meta-analysis of randomized clinical trials. Complement Ther Med. 2020;48:102250. doi:10.1016/j.ctim.2019.102250
[3] Talaei A, Hassanpour Moghadam M, Sajadi Tabassi SA, Mohajeri SA. Crocin, the main active saffron constituent, as an adjunctive treatment in major depressive disorder: a randomized, double-blind, placebo-controlled, pilot clinical trial. J Affect Disord. 2015;174:51-56. doi:10.1016/j.jad.2014.11.035
[4] Escribano J, Alonso GL, Coca-Prados M, Fernandez JA. Crocin, safranal and picrocrocin from saffron (Crocus sativus L.) inhibit the growth of human cancer cells in vitro. Cancer Lett. 1996;100(1-2):23-30. doi:10.1016/0304-3835(95)04067-6
[5] Talaei A, Hassanpour Moghadam M, Sajadi Tabassi SA, Mohajeri SA. Crocin, the main active saffron constituent, as an adjunctive treatment in major depressive disorder: a randomized, double-blind, placebo-controlled, pilot clinical trial. J Affect Disord. 2015;174:51-56. doi:10.1016/j.jad.2014.11.035
[6] Hausenblas HA, Saha D, Dubyak PJ, Anton SD. Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med. 2013;11(6):377-383. doi:10.3736/jintegrmed2013056
[7] Georges A, M Das J. Traumatic Brain Injury. [Updated 2022 Jan 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459300/
[8] Georges A, M Das J. Traumatic Brain Injury. [Updated 2022 Jan 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459300/
[9] Shaheen MJ, Bekdash AM, Itani HA, Borjac JM. Saffron extract attenuates neuroinflammation in rmTBI mouse model by suppressing NLRP3 inflammasome activation via SIRT1. PLoS One. 2021;16(9):e0257211. Published 2021 Sep 10. doi:10.1371/journal.pone.0257211
More references!
[10] Ge L, Yap CW, Ong R, Heng BH. Social isolation, loneliness and their relationships with depressive symptoms: A population-based study. PLoS One. 2017;12(8):e0182145. Published 2017 Aug 23. doi:10.1371/journal.pone.0182145
[11] Steger MF, Kashdan TB. Depression and Everyday Social Activity, Belonging, and Well-Being. J Couns Psychol. 2009;56(2):289-300. doi:10.1037/a0015416
[12] Jackson PA, Forster J, Khan J, et al. Effects of Saffron Extract Supplementation on Mood, Well-Being, and Response to a Psychosocial Stressor in Healthy Adults: A Randomized, Double-Blind, Parallel Group, Clinical Trial. Front Nutr. 2021;7:606124. Published 2021 Feb 1. doi:10.3389/fnut.2020.606124
[13] Kaner G, Yurtdaş-Depboylu G, Çalık G, Yalçın T, Nalçakan T. Evaluation of perceived depression, anxiety, stress levels and emotional eating behaviours and their predictors among adults during the COVID-19 pandemic [published online ahead of print, 2022 Dec 1]. Public Health Nutr. 2022;1-10. doi:10.1017/S1368980022002579
[14] Bayes J, Schloss J, Sibbritt D. The effect of a Mediterranean diet on the symptoms of depression in young males (the “AMMEND: A Mediterranean Diet in MEN with Depression” study): a randomized controlled trial. Am J Clin Nutr. 2022;116(2):572-580. doi:10.1093/ajcn/nqac106
[15] Abedimanesh N, Bathaie SZ, Abedimanesh S, Motlagh B, Separham A, Ostadrahimi A. Saffron and crocin improved appetite, dietary intakes and body composition in patients with coronary artery disease. J Cardiovasc Thorac Res. 2017;9(4):200-208. doi:10.15171/jcvtr.2017.35
[16] Gout B, Bourges C, Paineau-Dubreuil S. Satiereal, a Crocus sativus L extract, reduces snacking and increases satiety in a randomized placebo-controlled study of mildly overweight, healthy women. Nutr Res. 2010;30(5):305-313. doi:10.1016/j.nutres.2010.04.008
[17] Kashani L, Raisi F, Saroukhani S, et al. Saffron for treatment of fluoxetine-induced sexual dysfunction in women: randomized double-blind placebo-controlled study. Hum Psychopharmacol. 2013;28(1):54-60. doi:10.1002/hup.2282
