Holy basil and perceived stress: grade B

Moderate evidence. Direction: Benefit.

B ModerateIndustry-fundedShort-term only

Educational guidance, not medical advice

Why this grade

Rubric condition met: One randomized, double-blind, placebo-controlled RCT with n >= 100, positive on its prespecified primary outcome (PSS) and with known funding (n = 100 randomized, 85 completed; the editor counts randomized n); a second RCT, tied to the same supplier, points the same way

In a preregistered 8-week trial that randomized 100 adults with stress and poor sleep (15 withdrew), 250 mg/day of the Holixer extract lowered Perceived Stress Scale scores more than placebo, with lower hair cortisol at week 8. A 6-week trial in 150 adults with stress symptoms found larger reductions in a symptom score, on a scale the paper does not describe as validated, with 1,200 mg/day of OciBest. Both extracts come from Natural Remedies, which funded the first trial and employed three authors of the second, so no independent trial supports the grade, and neither trial ran longer than 8 weeks. No meta-analysis was found (PubMed and Europe PMC searches, November 11, 2026).

How we grade evidence

Studies this grade rests on

each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.

Show the numbers

Study	Year	Design	Participants	Result
Saxena 2012	2012	RCT	150	result not recorded
Lopresti 2022	2022	RCT	100	result not recorded

Efficacy of an Extract of Ocimum tenuiflorum (OciBest) in the Management of General Stress: A Double-Blind, Placebo-Controlled Study.

Saxena RC, Singh R, Kumar P. Efficacy of an Extract of Ocimum tenuiflorum (OciBest) in the Management of General Stress: A Double-Blind, Placebo-Controlled Study Evid Based Complement Alternat Med, 2012. PMID 21977056

Result not recorded

Design: Randomized, double-blind, placebo-controlled trial (6 weeks)
Sample: n = 150
Population: Adults with symptoms of general stress (two centers in Lucknow, India)
Funding: Funding not stated in the paper; three co-authors are at the Research and Development Centre of Natural Remedies, which developed OciBest

A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum (Holy Basil) extract (Holixer(TM)) on stress, mood, and sleep in adults experiencing stress.

Lopresti AL, Smith SJ, Metse AP. A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum (Holy Basil) extract (Holixer(TM)) on stress, mood, and sleep in adults experiencing stress Front Nutr, 2022. PMID 36185698

Result not recorded

Design: Randomized, double-blind, placebo-controlled, two-arm parallel-group trial (8 weeks)
Sample: n = 100
Population: Adults aged 18-65 experiencing stress for over a month and current sleep problems (PSS 14 or higher)
Funding: Natural Remedies Pty Ltd (maker of the Holixer extract), which also supplied the capsules

Search and history

Search (November 11, 2026): (holy basil[tiab] OR tulsi[tiab] OR "Ocimum sanctum"[tiab] OR "Ocimum tenuiflorum"[tiab]) AND (stress[tiab] OR anxiety[tiab] OR mood[tiab]) AND (randomized[tiab] OR placebo[tiab])

November 12, 2026 Graded B (proposed): Proposed in the monograph draft
November 13, 2026 B to B (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page