What are the main uses of St. John’s wort. How effective is it for treating depression. Can St. John’s wort interact with other medications. What are the potential side effects of taking St. John’s wort. Is St. John’s wort safe for long-term use.

The History and Origins of St. John’s Wort

St. John’s wort (Hypericum perforatum) boasts a rich history dating back to ancient Greece. This perennial herb, characterized by its vibrant yellow flowers, has been utilized for centuries to address various ailments, particularly nervous disorders. The plant’s name is derived from its peak blooming period, which typically occurs around June 24th, traditionally celebrated as John the Baptist’s birthday.

Native to Europe, parts of Asia and Africa, and the western United States, St. John’s wort has become one of the most popular herbal supplements in the United States. Its widespread use can be attributed to its diverse therapeutic properties, including antibacterial, antioxidant, and antiviral effects.

Understanding the Active Components of St. John’s Wort

The medicinal properties of St. John’s wort are primarily attributed to several key chemical compounds:

• Hypericin
• Pseudohypericin
• Hyperforin
• Flavonoids

These components work synergistically to produce the herb’s therapeutic effects. While initial research focused on hypericin as the primary active ingredient, recent studies suggest that other compounds, particularly hyperforin, may play a more significant role in the plant’s medicinal properties.

How does St. John’s wort work in the body?

The exact mechanism of action for St. John’s wort is not fully understood. However, researchers believe it may function similarly to selective serotonin reuptake inhibitors (SSRIs), a class of antidepressant medications. This herb is thought to increase the availability of neurotransmitters such as serotonin, dopamine, and norepinephrine in the brain, which can help improve mood and alleviate symptoms of depression.

St. John’s Wort for Depression: Efficacy and Comparison to Conventional Antidepressants

One of the most well-studied applications of St. John’s wort is its use in treating depression. Numerous clinical trials have investigated its efficacy, particularly for mild to moderate depression.

How effective is St. John’s wort in treating depression? Many studies have found that St. John’s wort may be as effective as conventional antidepressants, such as SSRIs, in treating mild to moderate depression. Some research suggests it may have fewer side effects than prescription antidepressants, particularly regarding sexual dysfunction, a common complaint associated with SSRI use.

Several studies have compared St. John’s wort to popular antidepressants like fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), and paroxetine (Paxil). In many cases, the herb demonstrated comparable efficacy to these medications.

Are there any limitations to using St. John’s wort for depression?

While St. John’s wort shows promise for mild to moderate depression, it’s important to note that it is not recommended for severe or major depression. In cases of severe depression, where daily functioning is significantly impaired or there are thoughts of self-harm, professional medical intervention is crucial.

It’s worth mentioning that not all studies have yielded positive results. Some research has found St. John’s wort to be no more effective than a placebo in treating depression. However, these studies are in the minority and should be weighed against the numerous positive findings.

Other Potential Uses of St. John’s Wort

Beyond its application in treating depression, St. John’s wort has shown potential benefits for several other conditions:

1. Premenstrual syndrome (PMS)
2. Menopausal symptoms
3. Seasonal affective disorder (SAD)
4. Skin conditions
5. Obsessive-compulsive disorder (OCD)
6. Social phobia

How effective is St. John’s wort for premenstrual syndrome?

Research suggests that St. John’s wort may help alleviate both physical and emotional symptoms of PMS. Some studies have reported a significant reduction in symptom severity, with one study noting a 50% improvement. Symptoms that may be relieved include cramps, irritability, food cravings, and breast tenderness.

Can St. John’s wort help with menopausal symptoms?

When combined with black cohosh, another herbal supplement, St. John’s wort has shown promise in improving mood and reducing anxiety during menopause. This combination may offer a natural alternative for women seeking relief from menopausal symptoms.

Is St. John’s wort effective for seasonal affective disorder?

St. John’s wort has demonstrated efficacy in improving mood for individuals with seasonal affective disorder (SAD), a type of depression that occurs during winter months due to lack of sunlight. When used in conjunction with phototherapy, the standard treatment for SAD, St. John’s wort appears to enhance the therapeutic effect.

Topical Applications of St. John’s Wort

St. John’s wort’s antibacterial and anti-inflammatory properties make it a potential candidate for topical applications. When applied to the skin, it may help alleviate symptoms associated with:

• Eczema
• Minor wounds
• Burns
• Hemorrhoids

These topical applications harness the herb’s ability to fight bacteria and reduce inflammation, potentially accelerating the healing process and providing relief from skin irritation.

Potential Side Effects and Interactions of St. John’s Wort

While St. John’s wort is generally well-tolerated, it’s crucial to be aware of potential side effects and interactions with other medications.

What are the common side effects of St. John’s wort?

Common side effects may include:

• Gastrointestinal upset
• Dizziness
• Skin reactions
• Fatigue
• Restlessness
• Headache

In rare cases, St. John’s wort may cause photosensitivity, making the skin more sensitive to sunlight.

Can St. John’s wort interact with other medications?

St. John’s wort is known to interact with numerous medications, which is one of the primary concerns associated with its use. It can affect the metabolism of many drugs, potentially reducing their effectiveness or increasing the risk of side effects. Some medications that may interact with St. John’s wort include:

• Antidepressants
• Birth control pills
• Blood thinners
• Some HIV medications
• Certain cancer drugs

Due to these potential interactions, it’s crucial to consult with a healthcare provider before starting St. John’s wort, especially if you’re taking other medications.

Safety Considerations and Precautions for Using St. John’s Wort

While St. John’s wort has shown promise in treating various conditions, it’s essential to approach its use with caution and under professional guidance.

Is St. John’s wort safe for everyone to use?

St. John’s wort may not be suitable for everyone. Certain groups should exercise particular caution or avoid its use altogether:

• Pregnant or breastfeeding women
• Children
• Individuals with bipolar disorder
• People with a history of psychosis
• Those scheduled for surgery (St. John’s wort may interact with anesthesia)

How should St. John’s wort be used safely?

To ensure safe use of St. John’s wort:

1. Consult with a healthcare provider before starting use, especially if you have a pre-existing medical condition or are taking other medications.
2. Start with a low dose and gradually increase if needed, under professional guidance.
3. Monitor for any adverse effects and report them to your healthcare provider.
4. Do not abruptly stop taking St. John’s wort, as this may lead to withdrawal symptoms.
5. Be aware that it may take several weeks to notice the full effects of St. John’s wort.

Remember, while St. John’s wort is a natural supplement, it can have potent effects on the body and should be treated with the same respect as conventional medications.

Current Research and Future Perspectives on St. John’s Wort

The scientific community continues to investigate the potential applications and mechanisms of action of St. John’s wort. Ongoing research aims to clarify its efficacy in treating various conditions and to better understand its interactions with other medications.

What are the current areas of research for St. John’s wort?

Current research on St. John’s wort focuses on several areas:

• Its potential role in treating anxiety disorders
• Its efficacy in managing symptoms of attention deficit hyperactivity disorder (ADHD)
• Its possible benefits for cognitive function and memory
• Its potential as an adjunct therapy in cancer treatment
• The development of standardized formulations to ensure consistent potency and effects

As research progresses, our understanding of St. John’s wort and its potential applications in healthcare continue to evolve. While it shows promise in several areas, particularly in the treatment of mild to moderate depression, more studies are needed to fully elucidate its benefits and risks.

What does the future hold for St. John’s wort in healthcare?

The future of St. John’s wort in healthcare looks promising, but it will likely involve a more nuanced and personalized approach to its use. As we gain a better understanding of its mechanisms of action and potential interactions, healthcare providers may be better equipped to recommend its use in specific situations.

Future developments may include:

• More targeted formulations of St. John’s wort for specific conditions
• Improved methods for standardizing its active components
• Better guidelines for its use in combination with conventional medications
• Increased integration of St. John’s wort into mainstream healthcare practices

As with any herbal supplement, the key to harnessing the potential benefits of St. John’s wort lies in responsible use, ongoing research, and open communication between patients and healthcare providers. While it offers a promising natural alternative for certain conditions, it’s crucial to approach its use with informed caution and professional guidance.

St. John’s wort Information | Mount Sinai

Hypericum perforatum; Klamathweed

St. John’s wort (Hypericum perforatum) has a history of use as a medicine dating back to ancient Greece, where it was used for a range of illnesses, including various nervous disorders. St. John’s wort also has antibacterial, antioxidant, and antiviral properties. Because of its anti-inflammatory properties, it has been applied to the skin to help heal wounds and burns. St. John’s wort is one of the most commonly purchased herbal products in the United States.

In recent years, St. John’s wort has been studied extensively as a treatment for depression. Most studies show that St. John’s wort may help treat mild-to-moderate depression, and has fewer side effects than most other prescription antidepressants. But it interacts with a number of medications, so it should be taken only under the guidance of a health care provider.

DO NOT use herbs to treat severe depression — where you have trouble functioning day to day, or have thoughts of harming yourself or others. Always see a doctor if your depression is making it hard for you to function (See “Precautions” section).

Depression

There is good evidence that St. John’s wort may reduce symptoms in people with mild-to-moderate, but not severe (or major) depression. In many studies it seems to work as well as selective serotonin reuptake inhibitors (SSRIs), a popular type of antidepressant often prescribed to treat depression. SSRIs include fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft). In addition, St. John’s wort doesn’t seem to cause loss of sex drive, one of the most common side effects of antidepressants.

St. John’s wort contains several chemicals, including hypericin, hyperforin, and flavonoids. Researchers aren’t exactly sure how St. John’s wort works. Some have suggested that the herb acts similar to an SSRI, increasing the availability of the brain chemicals serotonin, dopamine, and norepinephrine. These neurotransmitters help improve mood. Scientists thought that hypericin was responsible, but now they believe that other chemicals in St. John’s wort may help.

Not all studies agree, however. In one study, St. John’s wort was found to be no more effective than placebo for treating depression. But these studies should be weighed against the majority that have found St. John’s wort helps depression. For example, in the same study, Zoloft also failed to show any benefit in treating depression. Many other studies have compared St. John’s wort to Prozac, Celexa, paroxetine (Paxil), and Zoloft, and found that the herb works as well as the drugs. Other studies are ongoing.

Other Uses

St. John’s wort has also shown promise in treating the following conditions, a few of which are related to depression.

• Premenstrual syndrome (PMS). Research suggests that St. John’s wort may help relieve physical and emotional symptoms of PMS in some women, including cramps, irritability, food cravings, and breast tenderness. One study reported a 50% reduction in symptom severity.
• Menopause. There’s some evidence to suggest that St. John’s wort, combined with black cohosh, helps improve mood and anxiety during menopause.
• Seasonal affective disorder (SAD). Used alone, St. John’s wort has improved mood in people with SAD, a type of depression that occurs during the winter months because of lack of sunlight. SAD is usually treated with light therapy. Research shows that using St. John’s wort together with phototherapy works even better.
• Eczema, wounds, minor burns, hemorrhoids. St. John’s wort has antibacterial properties and may also help fight inflammation. Applied topically (to the skin), it may relieve symptoms associated with minor wounds and skin irritation.
• Obsessive compulsive disorder (OCD), social phobia. One early open-label study found that taking St. John’s wort 450 mg, 2 times a day for 12 weeks improved OCD symptoms. However, other studies show that St. John’s wort doesn’t improve OCD.

Plant Description

St. John’s wort is a shrubby plant with clusters of yellow flowers that have oval, elongated petals. Scientists believe it is native to Europe, parts of Asia and Africa, and the western United States. The plant gets its name because it is often in full bloom around June 24, the day traditionally celebrated as the birthday of John the Baptist. Both the flowers and leaves are used as medicine.

What’s It Made Of?

The best-studied active components are hypericin and pseudohypericin, found in both the leaves and flowers. However, researchers are not sure whether these components are responsible for St. John’s wort’s healing properties. Scientists are studying St. John’s wort’s essential oils and flavonoids.

Available Forms

St. John’s wort can be obtained in many forms: capsules, tablets, tinctures, teas, and oil-based skin lotions. Chopped or powdered forms of the dried herb are also available. Most products are standardized to contain 0.3% hypericin.

How to Take It

Pediatric

Most studies on St. John’s wort have been conducted in adults. However, one study (more than 100 children under age 12) indicated that St. John’s wort may be a safe and effective way of treating mild-to-moderate symptoms of depression in children. Never give your child St. John’s wort without medical supervision. Children who are being treated with St. John’s wort should be carefully monitored for side effects, such as allergic reactions or upset stomach. You should not try to treat depression in a child without a doctor’s help because depression can be a serious illness.

Adult

• Dry herb (in capsules or tablets). The usual dose for mild depression and mood disorders is 300 mg (standardized to 0.3% hypericin extract), 3 times per day, with meals. St. John’s wort is available in time-release capsules.
• St. John’s wort is also available as a liquid extract or tea. Ask your doctor to help you find the right dose.

It may take 3 to 6 weeks to feel any effects from St. John’s wort.

DO NOT stop taking St. John’s wort all at once because that may cause unpleasant side effects. Gradually lower the dose before stopping.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

St. John’s wort is often used to treat depression. If your depression is causing problems with your daily life, or you are having thoughts of suicide or of harming yourself or others, you need to see a doctor immediately. St. John’s wort should not be used to treat severe depression.

You should see a doctor to make sure you have the right diagnosis before taking St. John’s wort. Your doctor can help you determine the right dose and make sure you are not taking medications that might interact with St. John’s wort.

Side effects from St. John’s wort are generally mild and include stomach upset, hives or other skin rashes, fatigue, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion. St. John’s wort can also make the skin overly sensitive to sunlight, called photodermatitis. If you have light skin and are taking St. John’s wort, wear long sleeves and a hat when in the sun, and use a sunscreen with at least SPF 15 or higher. Avoid sunlamps, tanning booths, and tanning beds.

Other potential concerns about St. John’s wort are that it may interfere with getting pregnant or make infertility worse; that it may make symptoms of ADD and ADHD worse, especially among people taking methylphenidate; that it may increase the risk of psychosis in people with schizophrenia; and that it may contribute to dementia in people with Alzheimer disease. More research is needed.

Since St. John’s wort can interact with medications used during surgery, you should stop taking it at least 5 days or more before surgery. Make sure your doctor and surgeon know you are taking St. John’s wort.

DO NOT take St. John’s wort if you have bipolar disorder. For people with major depression, there’s some concern that taking St. John’s wort may increase the risk for mania.

Women who are pregnant, trying to become pregnant, or breastfeeding should not take St. John’s wort.

Possible Interactions

St. John’s wort interacts with a large number of medications. In most cases, St. John’s wort makes the medication less effective. In other cases, St. John’s wort may make the effects of a medication stronger.

If you are being treated with any medications, you should not use St. John’s wort without first talking to your doctor. St. John’s wort may interact with many different medications, including but not limited to the following:

Antidepressants

St. John’s wort may interact with medications used to treat depression or other mood disorders, including tricyclic antidepressants, SSRIs, and monoamine oxidase inhibitors (MAOIs). Taking St. John’s wort with these medications tends to increase side effects, and could lead to a dangerous condition called serotonin syndrome. DO NOT take St. John’s wort with other antidepressants, including:

• SSRIs: Citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft)
• Tricyclics: Amitriptyline (Elavil), nortriptyline (Pamelor), imipramine (Tofranil)
• MAOIs: Phenelzine, (Nardil), tranylcypromine (Parnate)
• Nefazodone (Serzone)

Allergy drugs (antihistamines)

St. John’s wort may reduce levels of these drugs in the body, making them less effective:

• Loratadine (Claritin)
• Cetirizine (Zyrtec)
• Fexofenadine (Allegra)

Clopidogrel (Plavix)

Theoretically, taking St. John’s wort along with clopidogrel may increase the risk of bleeding.

Dextromethorphan (cough medicine)

Taking St. John’s wort at the same time as dextromethorphan, a cough suppressant found in many over-the-counter cough and cold medicines, can increase the risk of side effects, including serotonin syndrome.

Digoxin

St. John’s wort may lower levels of the medication and make it less effective. DO NOT take St. John’s wort if you take digoxin.

Drugs that suppress the immune system

St. John’s wort can reduce the effectiveness of these medications, which are taken after organ transplant, or to control autoimmune diseases. There have been many reports of cyclosporin blood levels dropping in those with a heart or kidney transplant, even leading to rejection of the transplanted organ.

• Adalimumab (Humira)
• Azathioprine (Imuran)
• Cyclosporine
• Etanercept (Enbrel)
• Methotrexate
• Mycophenolate mofetil (CellCept)
• Tacrolimus (Prograf)

Drugs to fight HIV

St. John’s wort appears to interact with at least two kinds of medications used to treat HIV and AIDS: protease inhibitors and non-nucleoside reverse transcriptase inhibitors. The Food and Drug Administration recommends that St. John’s wort not be used with any type of antiretroviral medication used to treat HIV or AIDS.

Birth control pills

There have been reports of breakthrough bleeding in women on birth control pills who were also taking St. John’s wort. It is possible that the herb might make birth control pills less effective, leading to unplanned pregnancies.

Aminolevulinic acid

This medication makes your skin more sensitive to sunlight. St. John’s wort also increases skin sensitivity to light. Together, they may have a dangerous impact on skin sensitivity to the sun.

Reserpine

Based on animal studies, St. John’s wort may interfere with reserpine’s ability to treat high blood pressure.

Sedatives

St. John’s wort can increase the effect of drugs that have a sedating effect, including:

• Anticonvulsants, such as phenytoin (Dilantin) and valproic acid (Depakote)
• Barbiturates
• Benzodiazepines, such as diazepam (Valium)
• Drugs to treat insomnia, such as zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem)
• Tricyclic antidepressants, such as amitriptyline (Elavil)
• Alcohol

Alprazolam (Xanax)

St. John’s wort may speed up the breakdown of Xanax in the body, making it less effective.

Theophylline

St. John’s wort can lower levels of this medication in the blood. Theophylline is used to open the airways in people with asthma, emphysema, or chronic bronchitis.

Triptans (used to treat migraines)

St. John’s wort can increase the risk of side effects, including serotonin syndrome, when taken with these medications:

• Naratriptan (Amerge)
• Rizatriptan (Maxalt)
• Sumatriptan (Imitrex)
• Zolmitriptan (Zomig)

Warfarin (Coumadin)

St. John’s wort reduces the effectiveness of warfarin, an anticoagulant (blood thinner).

Other drugs

Because St. John’s wort is broken down by certain liver enzymes, it may interact with other drugs that are broken down by the same enzymes. Those drugs may include:

• Antifungal drugs, such as ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan)
• Statins (drugs taken to lower cholesterol), including atorvastatin (Lipitor), lovastatin (Mevacor), and simvastatin (Zocor)
• Imatinib (Gleevac) — may make Gleevac less effective
• Irinotecan (Camptosar) — may speed up the rate at which Camptosar is broken down by the body, making it less effective
• Some calcium channel blockers (taken to lower blood pressure)
• Any medication broken down by the liver

Supporting Research

Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. JAMA. 2001;286:208-216.

Apaydin EA, Maher AR, Shanman R, et al. A systematic review of St. John’s wort for major depressive disorder. Syst Rev. 2016;5(1):148.

Beaubrun G, Gray GE. A review of herbal medicines for psychiatric disorders. Psychiatr Serv. 2000;51:1130-1134.

Biffignandi PM, Bilia AR. The growing knowledge of St. John’s wort (Hypericum perforatum L) drug interactions and their clinical significance. Curr Ther Res. 2000;61:389-394.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:359-366.

Breidenbach T, Hoffmann MW, Becker T, Schlitt H, Klempnauer J. Drug interaction with St. John’s wort with cyclosporin. Lancet. 2000;355:576-577.

Breidenbach T, Kliem V, Burg M, Radermacher J, Hoffman MW, Klempnauer J. Profound drop of cyclosporin A whole blood trough levels caused by St. John’s wort (Hypericum perforatum) [letter]. Transplantation. 2000;69:2229-2230.

Brenner R, Azbel V, Madhusoodanan S, Pawlowska M. Comparison of an extract of hypericum (LI 160) and sertraline in the treatment of depression: a double-blind, randomized pilot study. Clin Ther. 2000;22:411-419.

Briese V, Stammwitz U, Friede M, Henneicke-von Zepelin HH. Black cohosh with or without St. John’s wort for symptom-specific climacteric treatment — results of a large-scale, controlled, observational study. Maturitas. 2007;57:405-414.

Carai MAM, Agabio R, Bombardelli E, et al. Potential use of medicinal plants in the treatment of alcoholism. Fitoterapia. 2000;71:538-542.

Caraci F, Crupi R, Drago F, Spina E. Metabolic drug interactions between antidepressants and anticancer drugs: focus on selective serotonin reuptake inhibitors and hypericum extract. Curr Drug Metab. 2011;12(6):570-577.

Carpenter DJ. St. John’s wort and S-adenosyl methionine as “natural” alternatives to conventional antidepressants in the era of the suicidality boxed warning: what is the evidence for clinically relevant benefit? Altern Med Rev. 2011;16:17-39.

Chung DJ, Kim HY, Park KH, et al. Black cohosh and St. John’s wort (GYNO-Plus) for climacteric symptoms. Yonsei Med J. 2007;48:289-294.

De Smet P, Touw D. Safety of St. John’s wort (Hypericum perforatum) [letter]. Lancet. 2000;355:575-576.

Food and Drug Administration. Risk of Drug Interactions with St John’s Wort and Indinavir and Other Drugs. Rockville, MD: National Press Office; February 10, 2000. Public Health Advisory.

Gaster B, Holroyd J. St. John’s wort for depression. Arch Intern Med. 2000;160:152-156.

Geller SE, Studee L. Botanical and dietary supplements for mood and anxiety in menopausal women. Menopause. 2007;14(3 Pt 1):541-549.

Harrer G. Hypericum and phototherapy. Schweiz Rundsch Med Prax. 2000;89:2123-2129. Review.

Hubner W-D, Kirste T. Experience with St John’s wort (Hypericum perforatum) in children under 12 years with symptoms of depression and psychovegetative disturbances. Phytother Res. 2001;15:367-370.

Hypericum Depression Trial Study Group. Effect of Hypericum perforatum (St. John’s wort) in major depressive disorder: a randomized controlled trial. JAMA. 2002;287:1807-1814.

Kasper S, Anghelescu IG, Szegedi A, Dienel A, Kieser M. Superior efficacy of St John’s wort extract WS 5570 compared to placebo in patients with major depression: a randomized, double-blind, placebo-controlled, multi-center trial. BMC Med. 2006;4:14.

Kobak KA, Taylor LV, Bystritsky A, et al. St John’s wort versus placebo in obsessive-compulsive disorder: results from a double-blind study. Int Clin Psychopharmacol. 2005;20:299-304.

Kobak KA, Taylor LV, Warner G, Futterer R. St. John’s wort versus placebo in social phobia: results from a placebo-controlled pilot study. J Clin Psychopharmacol. 2005;25:51-58.

Kumar A, Singh A. Protective effect of St. John’s wort (Hypericum perforatum) extract on 72-hour sleep deprivation-induced anxiety-like behavior and oxidative damage in mice. Planta Med. 2007;73:1358-1364.

Linde K, Mulrow CD. St. John’s wort for depression (Cochrane Review). In: The Cochrane Library. Issue 4, 2000. Oxford: Update Software.

Meinke MC, Schanzer S, Haag SF. In vivo photoprotective and anti-inflammatory effects of hyperforin is associated with high antioxidant activity in vitro and ex vivo. Eur J Pharm Biopharm. 2012;81:346-350.

Mischoulon D. Update and critique of natural remedies as antidepressant treatments. Psychiatr Clin North Am. 2007;30:51-68.

Morelli V, Zoorob RJ. Alternative therapies: Part 1. Depression, diabetes, obesity. Am Fam Phys. 2000;62:1051-1060.

Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John’s wort, an herbal preparation in the treatment of depression. J Pharmacol Exp Ther. 2000;294:88-95.

Piscitelli S, Burstein AH, Chaitt D, et al. Indinavir concentrations and St. John’s wort [letter]. Lancet. 2000;355:547-548.

Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia, Penn:Hanley & Belfus, Inc. 2002:315-321.

Ruschitzka F, Meier PJ, Turina M, et al. Acute heart transplant rejection due to Saint John’s wort [letter]. Lancet. 2000,355.

Sarino LV, Dang KH, Dianat N, et al. Drug interaction between oral contraceptives and St. John’s wort: appropriateness of advice received from community pharmacists and health food store clerks. J Am Pharm Assoc. 2007;47:42-47.

Sarrell EM, Mandelberg A, Cohen HA. Efficacy of naturopathic extracts in the management of ear pain associated with acute otitis media. Arch Pediatr Adolesc Med. 2001;155:796-799.

Sarris J. St. John’s wort for the treatment of psychiatric disorders. Psychiatr Clin North Am. 2013;36:65-72.

Schempp CM, Winghofer B, Ludtke R, Simon-Haarhaus B, Shopp E, Simon JC. Topical application of St John’s wort (Hypericum perforatum L) and of its metabolite hyperforin inhibits the allostimulatory capacity of epidermal cells. Br J Derm. 2000;142:979-984.

Schrader E. Equivalence of St John’s wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mild-moderate depression. Int Clin Psychopharmacol. 2000;15:61-68.

Shelton RC, Keller MB, Gelenberg A, et al. Effectiveness of St. John’s wort in major depression: a randomized controlled trial. JAMA. 2001;285:1978-1986.

Sood A, Sood R, Brinker FJ, Mann R, Loehrer LL, Wahner-Roedler DL. Potential for interactions between dietary supplements and prescription medications. Am J Med. 2008;121:207-211.

Stevinson C, Ernst E. A pilot study of Hypericum perforatum for the treatment of premenstrual syndrome. British Journal of Obstetrics and Gynaecology. 2000;107:870-876.

Volz HP, Laux P. Potential treatment for subthreshold and mild depression: a comparison of St. John’s wort extracts and fluoxetine. Comp Psych. 2000;41(2 Suppl 1):133-137.

Warshowsky A. Uterine fibroids (Leiomyomata). In: Rakel D. Integrative Medicine. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 55.

Woelk H, for the Remotiv/Imipramine Study Group. Comparison of St. John’s wort and imipramine for treating depression: randomized controlled trial. BMJ. 2000;321:536-539.

Yue Q, Bergquist C, Gerden B. Safety of St. John’s wort (Hypericum perforatum) [letter]. Lancet. 2000;355:576-577.

Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

St. John’s wort is a plant native to Europe with yellow, star-shaped flowers. It’s often used for depression but can cause serious interactions with some drugs.

St. John’s wort is named after John the Baptist. The plant usually begins to flower around the 24th of June, the feast day of St. John the Baptist. It contains many chemicals that act on messengers in the brain that regulate mood.

People most commonly use St. John’s wort for depression and mood disorders. There is some strong scientific evidence that it is effective for mild to moderate depression. St. John’s wort is also used for symptoms of menopause and many other conditions, but there is no good scientific evidence to support most of these other uses.

St. John’s wort is available in dietary supplements in the US. But France has banned its use in products because of drug interaction concerns. In other countries, St. John’s wort is only available with a prescription.

Uses & Effectiveness ?

Likely Effective for

• Depression. Taking specific St. John’s wort extracts by mouth is effective for mild or moderate depression. Certain St. John’s wort products might work as well as some prescription drugs and might cause fewer side effects.

Possibly Effective for

• Symptoms of menopause. Taking St. John’s wort by mouth seems to help reduce hot flashes and other symptoms of menopause.
• Emotional distress caused by extreme focus on a physical symptom (somatic symptom disorder). Taking a specific St. John’s wort product (LI 160, Lichtwer Pharma) seems to reduce symptoms of this condition.

Possibly Ineffective for

• Burning pain in the mouth. Taking St. John’s wort by mouth doesn’t seem to reduce pain from burning mouth syndrome.
• Swelling (inflammation) of the liver caused by the hepatitis C virus (hepatitis C). Taking hypericin, a chemical in St. John’s wort, by mouth, doesn’t seem to be effective for hepatitis C infection.
• HIV/AIDS. Taking hypericin, a chemical in St. John’s wort, by mouth or by IV, doesn’t seem to be effective for treating HIV in adults. IV products can only be given by a healthcare provider.
• A long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS). Taking St. John’s wort by mouth doesn’t seem to reduce symptoms of IBS.
• Nerve damage in the hands and feet (peripheral neuropathy). Taking St. John’s wort by mouth does not seem to relieve nerve pain due to diabetes or other causes.
• A type of anxiety marked by fear in some or all social settings (social anxiety disorder). Taking St. John’s wort by mouth does not seem to improve social anxiety.

There is interest in using St. John’s wort for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: St. John’s wort is likely safe when used in doses up to 900 mg daily for up to 12 weeks. It can cause some side effects such as diarrhea, dizziness, trouble sleeping, restlessness, and skin tingling. St. John’s wort interacts with many drugs. Let your healthcare provider know if you want to take St. John’s wort.

St. John’s wort is possibly unsafe when taken in large doses. It might cause severe skin reactions after sun exposure. Wear sun block outside, especially if you are light-skinned.

When applied to the skin: St. John’s wort is possibly safe when it is applied to the skin once a week for four weeks. However, St. John’s wort might cause severe skin reactions after sun exposure.

Special Precautions and Warnings

When taken by mouth: St. John’s wort is likely safe when used in doses up to 900 mg daily for up to 12 weeks. It can cause some side effects such as diarrhea, dizziness, trouble sleeping, restlessness, and skin tingling. St. John’s wort interacts with many drugs. Let your healthcare provider know if you want to take St. John’s wort.

St. John’s wort is possibly unsafe when taken in large doses. It might cause severe skin reactions after sun exposure. Wear sun block outside, especially if you are light-skinned.

When applied to the skin: St. John’s wort is possibly safe when it is applied to the skin once a week for four weeks. However, St. John’s wort might cause severe skin reactions after sun exposure.

Pregnancy: St. John’s wort is possibly unsafe when taken by mouth during pregnancy. Taking St. John’s wort while pregnant might cause birth defects in infants. Until more is known, don’t use St. John’s wort when pregnant.

Breast-feeding: St. John’s wort is possibly unsafe when taken by mouth while breast-feeding. Infants can experience colic, drowsiness, and fussiness. Until more is known, don’t use St. John’s wort when breast-feeding.

Children: St. John’s work is possibly safe when taken by mouth for up to 8 weeks in children 6-17 years-old.

Alzheimer disease: St. John’s wort might make dementia worse in people with Alzheimer disease.

Bipolar disorder: St. John’s wort can bring on mania in people with bipolar disorder, and can also speed up the cycling between depression and mania.

Depression: In people with major depression, St. John’s wort might bring on mania, which can involve impulsive behavior.

Schizophrenia: St. John’s wort might bring on psychosis in some people with schizophrenia.

Surgery: St. John’s wort might affect serotonin levels in the brain, which could interfere with surgical procedures. Also, in people who have used St. John’s wort, using anesthesia may lead to serious heart complications during surgery. Stop using St. John’s wort at least two weeks before a scheduled surgery.

Interactions ?

Major Interaction

Do not take this combination

• The body breaks down alprazolam to get rid of it. St. John’s wort can increase how fast the body gets rid of alprazolam. This might decrease the effects of alprazolam.

• Some birth control pills contain estrogen. The body breaks down the estrogen in birth control pills to get rid of it. St. John’s wort might increase the breakdown of estrogen. Taking St. John’s wort along with birth control pills might decrease the effects of birth control pills. If you take birth control pills along with St. John’s wort, use an additional form of birth control such as a condom.

• The body breaks down cyclosporine to get rid of it. St. John’s wort can increase how quickly the body breaks down cyclosporine. This might decrease how well cyclosporine works.

• St. John’s wort might decrease how much digoxin the body absorbs. By decreasing how much digoxin the body absorbs, St. John’s wort might decrease the effects of digoxin.

• The body breaks down imatinib to get rid of it. St. John’s wort might increase how quickly the body gets rid of imatinib. Taking St. John’s wort along with imatinib might decrease the effects of imatinib.

• The body breaks down irinotecan to get rid of it. St. John’s wort might increase how fast the body breaks down irinotecan. This might decrease the effects of irinotecan.

• Some medications are changed and broken down by the liver. St. John’s wort might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• The body breaks down medications used for HIV/AIDS to get rid of them. St. John’s wort can increase how quickly the body breaks down these medications. Taking St. John’s wort might decrease how well some of these medications work.

• The body breaks down medications used for HIV/AIDS to get rid of them. Taking St. John’s wort might increase how quickly the body breaks down these medications. Taking St. John’s wort might decrease how well some of these medications work.

• Some medications are moved in and out of cells by pumps. St. John’s wort might change how these pumps work and change how much medication stays in the body. In some cases, this might change the effects and side effects of a medication.

• The body breaks down phenobarbital to get rid of it. St. John’s wort might increase how quickly the body breaks down phenobarbital. This could decrease how well phenobarbital works and increase the risk of seizures.

• The body breaks down phenprocoumon to get rid of it. St. John’s wort increases how quickly the body breaks down phenprocoumon. This decreases the effects of phenprocoumon.

• The body breaks down phenytoin to get rid of it. St. John’s wort might increase how quickly the body breaks down phenytoin. This might decrease the effects of phenytoin and increase the possibility of seizures.

• The body breaks down rivaroxaban to get rid of it. St. John’s wort can increase how quickly the body breaks down rivaroxaban. This can decrease the effects of rivaroxaban.

• The body breaks down tacrolimus to get rid of it. St. John’s wort can increase how quickly the body breaks down tacrolimus. This can decrease the effects of tacrolimus.

• The body breaks down warfarin to get rid of it. St. John’s wort might increase how quickly the body gets rid of warfarin. This might decrease the effects of warfarin and increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin might need to be changed.

• Mephenytoin is changed and broken down by the body. St. John’s wort increases how quickly this medication is broken down by the body. This might decrease the effects of mephenytoin.

• The body breaks down omeprazole to get rid of it. St. John’s wort can increase how quickly the body breaks down omeprazole. This could decrease the effects of omeprazole.

• The body breaks down docetaxel to get rid of it. St. John’s wort can increase how quickly the body breaks down docetaxel. This might decrease how well docetaxel works.

• The body breaks down ketamine to get rid of it. St. John’s wort might increase how fast the body breaks down ketamine. This might decrease the effects of ketamine.

• The body breaks down oxycodone to get rid of it. St. John’s wort might increase how fast the body breaks down oxycodone. This might decrease the effects of oxycodone.

Moderate Interaction

Be cautious with this combination

• Aminolevulinic acid can make the skin sensitive to sunlight. St. John’s wort might also increase sensitivity to sunlight. Taking St. John’s wort along with aminolevulinic acid might increase the chances of sunburn, blistering or rashes on areas of skin exposed to sunlight. Be sure to wear sunblock and protective clothing when spending time in the sun.

• The body must convert clopidogrel to its active form. Taking St. John’s wort increases how quickly the body converts clopidogrel to the active form. This might increase the effects and side effects of clopidogrel, such as bruising and bleeding.

• The body breaks down fexofenadine to get rid of it. St. John’s wort might decrease how quickly the body gets rid of fexofenadine. This could increase the effects and side effects of fexofenadine.

• Some medications are changed and broken down by the liver. St. John’s wort might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• Some medications are changed and broken down by the liver. St. John’s wort might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• Some medications might make the skin more sensitive to sunlight. St. John’s wort might also make the skin more sensitive to sunlight. Using these products together might increase the risk of sunburn, blistering, or rashes when the skin is exposed to sunlight. Be sure to wear sunblock and protective clothing when spending time in the sun.

• St. John’s wort extract might increase how much procainamide the body absorbs. This could increase the effects and side effects of procainamide. But it’s not clear if this is a big concern.

• Taking St. John’s wort might decrease the effects of reserpine.

• The body breaks down tramadol to get rid of it. St. John’s wort might increase how fast the body breaks down tramadol. This might decrease the effects of tramadol.

• Some medications are changed and broken down by the liver. St. John’s wort might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• The body breaks down gliclazide to get rid of it. St. John’s wort might increase how quickly the body gets rid of gliclazide. This might decrease the effects of gliclazide.

• The body breaks down methadone to get rid of it. St. John’s wort might increase how fast the body breaks down methadone. This might decrease the effects of methadone.

• The body breaks down zolpidem to get rid of it. St. John’s wort might increase how quickly the body breaks down zolpidem. Taking St. John’s wort and taking zolpidem might decrease the effects of zolpidem.

• The body breaks down bupropion to get rid of it. St. John’s wort might increase how quickly the body breaks down bupropion. This might decrease the effects of bupropion.

• Some medications are changed and broken down by the liver. St. John’s wort might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

• The body breaks down voriconazole to get rid of it. St. John’s wort might increase how quickly the body gets rid of voriconazole. Taking St. John’s wort along with voriconazole might decrease its effects.

• The body breaks down fentanyl to get rid of it. St. John’s wort might increase how quickly the body gets rid of fentanyl. This might decrease the effects of fentanyl.

• The body breaks down finasteride to get rid of it. St. John’s wort might increase how quickly the body gets rid of finasteride. Taking St. John’s wort along with finasteride might decrease its effects.

• The body breaks down ivabradine to get rid of it. St. John’s wort might increase how fast the body breaks down ivabradine. This might decrease the effects of ivabradine.

• The body breaks down some medications to get rid of them. St. John’s wort can increase how fast the body gets rid of some medications used for lowering cholesterol. Taking St. John’s wort along with these medications might decrease their effects.

• The body breaks down clozapine to get rid of it. St. John’s wort might increase how quickly the body breaks down clozapine. This might decrease how well clozapine works.

• The body breaks down indinavir to get rid of it. St. John’s wort might increase how quickly the body breaks down indinavir. This might decrease the effects of indinavir.

• St. John’s wort might increase a brain chemical called serotonin. Some medications also have this effect. Taking St. John’s wort along with these medications might increase serotonin too much. This might cause serious side effects including heart problems, seizures, and vomiting.

Minor Interaction

Be watchful with this combination

• Taking St. John’s wort along with methylphenidate might decrease how well methylphenidate works. But it’s not clear if this is a big concern.

• The body breaks down theophylline to get rid of it. St. John’s wort might increase how quickly the body gets rid of theophylline. Taking St. John’s wort along with theophylline might decrease its effects in some people.

• The body breaks down ambrisentan to get rid of it. St. John’s wort might increase how quickly the body gets rid of ambrisentan. But this effect is probably not a big concern.

• St. John’s wort contains a chemical called hypericin. Taking St. John’s wort with boceprevir might increase the amount of hypericin in the body. This might increase the effects or side effects of St. John’s wort.

Dosing

Talk to your healthcare provider before taking St. John’s wort. It can interact with many different drugs.

St. John’s wort extract is most commonly used by adults in doses of 600-900 mg by mouth daily, taken in 2-3 divided doses, for up to 12 weeks. St. John’s wort is also available in ointments, creams, and gels. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

View References

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
© Therapeutic Research Faculty 2020.

medicinal properties, contraindications, application, reviews of doctors

St. John’s wort can rightfully be called one of the most popular and well-known plants in folk medicine and herbal medicine. Decoctions, infusions or added to tea are prepared from this herb. They help to eliminate unpleasant symptoms and normalize well-being.

St. John’s wort: what are the characteristics of the plant

This raw material is actively used in herbal medicine due to its unique means and special composition, which helps to normalize metabolic processes. The plant contains myrcene, a compound that has antimicrobial activity against many dangerous bacteria. Geraniol has a similar effect, it has a bactericidal effect on the coccal flora, inhibits the growth of pathogenic intestinal flora and parasites.

Cineol has a positive effect on the functioning of the nervous system, it helps to normalize sleep, fights insomnia, including during periods of stress and depression. It also has a general tonic effect, eliminates muscle spasms due to overexertion. Due to the content of hypericin, cell growth is stimulated, which is useful in wound healing and during the recovery period after illnesses, the same effect helps to prolong youth. Due to the content of plant alkaloids, St. John’s wort helps in the fight against neuroses and depressive disorders. The content of azulene enhances the positive effect of the herb on the nervous system, accelerates the healing of wounds.

The effects are complemented by the content of saponins, which have a metabolic and diuretic effect, hyperoside, with its anti-inflammatory properties, and rutin, which protects blood vessels.

The plant contains a lot of vitamins – ascorbic acid, B vitamins, which help in the normalization of metabolic processes. Due to its composition, it is widely used for both oral and external therapy. The plant is used both fresh and dried, it does not lose its healing properties when properly collected and stored.

Medicinal properties of St. John’s wort

In herbal medicine, St. John’s wort is used as a mono-component or as part of collections. It is typical of a number of therapeutic and prophylactic properties used in the complex treatment of a number of diseases.

Due to its multi-component composition St. John’s wort has a number of useful properties:

Antimicrobial. Reception of decoctions or infusions is recommended for microbial infections of various localization. The components of raw materials inhibit the reproduction of bacteria, destroy pathogenic microbes.

Sedative. Due to the high content of B vitamins and additional components, decoctions and infusions calm the nervous system, help in the fight against stress, depression and mental overload.

Wound healing. Due to the ability to enhance tissue regeneration, St. John’s wort helps in the treatment of burns and wounds, various skin lesions with erosions. It is mainly used in the form of ointments and lotions.

Pain reliever. Decoctions or infusions can help in the fight against pain that occurs with digestive problems, pathologies of the nervous system and joint damage.

Diuretic and choleretic. Due to the active components in the composition of the plant, decoctions or infusions help in removing excess fluid, normalize the outflow of bile from the liver.

Antiparasitic. Various herbal preparations with St. John’s wort help in the fight against intestinal parasites.

Antispasmodic. By relaxing smooth muscles and normalizing the functioning of the nervous system, phytopreparations with St. John’s wort help in the treatment of lesions of the digestive tract, accompanied by intestinal spasms.

Expectorant. Components of St. John’s wort help in thinning sputum and stimulating its removal from the bronchial lumen. The plant is actively used for respiratory pathologies, SARS and infections with a cough.

Plus, St. John’s wort has a positive effect on the heart and blood vessels, and also helps in the prevention of rheumatic diseases, stimulates the immune system, and improves overall tone.

St. John’s wort can help with stomach cramps. Photo: pexels/Sora Shimazaki

St. John’s wort 9 contraindications0005

Although St. John’s wort is very useful and widely used in herbal medicine, before starting treatment, you need to make sure that there are no contraindications to taking it. It is forbidden to use any products with St. John’s wort in the presence of:

• photosensitivity conditions with an increase in skin sensitivity to ultraviolet radiation, since St.
• hypertension, especially with crises – plant components increase the level of pressure due to vascular tone, therefore, for people with high blood pressure, oral preparations of St. John’s wort are prohibited at least until consultation with a specialist;
• after organ or tissue transplantation taking St. John’s wort may increase the risk of transplant rejection due to the content of immunostimulatory components in it;
• when taking contraceptives – one of the contraindications for treatment with St. John’s wort, it can completely block the effects of these drugs, leading to pregnancy;
• mental problems, especially with manic inclinations, may be aggravated by taking St. John’s wort, so it is forbidden to take it;
• during treatment with antidepressants The use of various St.

St. John’s wort by mouth may reduce the effectiveness of some antibiotics and increase the photosensitizing effect of some drugs. Therefore, the joint intake of these funds with decoctions and infusions of St. John’s wort is unacceptable.

St. John’s wort is contraindicated against the background of antiretroviral therapy for HIV infection, it inhibits the activity of drugs.

While taking non-steroidal drugs and painkillers, the use of St. John’s wort may threaten to change the effect of drugs. It is dangerous to use St. John’s wort before surgical interventions with anesthesia, which threatens to damage the peripheral nerves.

It is forbidden to take this plant in pregnant and lactating women, it can harm the development of the child and threatens with allergies. Against the background of taking St. John’s wort in men, potency may temporarily decrease, which should also be remembered when treating with this drug. Long-term use of various types of drugs with St. John’s wort can threaten with an increase in the liver.

If you take St. John’s wort without the doctor’s consent and without his approval, side effects from therapy are possible in the form of:

• various allergic skin rashes, redness and itching;
• severe headache;
• anxiety and fatigue;
• anemia;
• abdominal pain, diarrhea or constipation;
• decreased appetite, bitter taste in the mouth.

If you take St. John’s wort without consulting a doctor, you may experience allergic reactions on the skin, redness and itching. Photo: Pixabay

The use of St.

John’s wort

In women , St. John’s wort is used as an additional remedy in the treatment of gynecological pathologies. It relieves PMS and pain during menstruation, normalizes hormone levels against menopause. Helps to strengthen the female body in times of stress. It is widely used in cosmetology, eliminating signs of aging, helping to smooth wrinkles and improve complexion.

For men helps relieve tension and stress, reduces the risk of vascular and heart disease, stimulates immunity and endurance.

In children, St. John’s wort should be used with extreme caution and only after a doctor’s permission. It can strengthen the immune system, eliminate skin diseases, relieve coughs and calm the nervous system.

Various forms of herbal medicine with St. John’s wort

This phyto-material is used to prepare various formulations for oral and external use. Each type of medicine, when taken correctly, helps in eliminating certain health problems. Before using any form of phytopreparations, it is necessary to determine the absence of allergies and individual intolerance.

Infusion

Photo: BAO, Globallookpress

3 st. spoons of dry raw materials pour 1 cup of very hot water, leave warm for at least 2 hours. Then strain.

Take 1/3 cup twice a day.

Infusion is used in the treatment of digestive disorders, sleep disorders and the fight against cystitis. In addition, it helps in eliminating pain in the body, increasing emotional tone, improving sleep and relieving stress. Course reception can significantly improve the general condition.

Tincture

Photo: Рixabay

Pour 1 part of dry and crushed raw materials with 10 parts of alcohol (or 20 parts of vodka) and infuse for 21 days in a cool dark place, shaking every 2-3 days. After the expiration of this period, strain the tincture through a sieve and store in a dark glass container.

Apply 10 – 20 drops per glass of water orally or externally, swab wounds, abrasions.

For gargling, dilute a teaspoon of tincture in a glass of warm water (not for children!).

Alcohol tincture helps eliminate inflammatory processes in the oral cavity in case of gingivitis or stomatitis. It is also used as an antiseptic for the treatment of minor abrasions, cuts or wounds. A diluted tincture can be gargled with a cold. When taken orally, it has a general tonic and sedative effect.

Decoction

Photo: Globallookpress

2 tbsp. tablespoons of dry chopped grass pour 250 ml of boiling water. Cook this mixture over low heat for 30 minutes, stirring constantly. Cool the finished broth to room temperature and strain through a sieve.

Take 1/4 cup by mouth thrice daily as directed by a physician.

Externally – moisten a cotton pad with decoction and wipe the face in the morning and evening.

You can rinse the decoction on your hair and rub it into the hair roots.

The decoction can be used for microcirculation disorders, sleep problems and anxiety, to eliminate signs of aging, to treat various diseases on the recommendation of a doctor. Decoction can be wiped on the face and used as a healing mask.

H

ai

Photo: Globallookpress

1 tbsp. Add a spoonful of St. John’s wort, lemon balm, linden and rose hips to a teapot, pour 500 ml of boiling water, leave for 10 minutes, use instead of tea leaves. Add honey or lemon to taste.

Take 1 cup thrice daily.

St. John’s wort tea is one of the popular herbal drinks. It helps in the fight against insomnia, depression and chronic fatigue syndrome, protects against the negative effects of stress. Tea is no less useful for strengthening immunity and fighting colds, eliminates inflammation of the nasopharynx and gums, and the oral cavity.

Doctors’ comments about St. John’s wort

Olga Zorina, pharmacist, teacher of pharmacology, chief editor of MedCorr:

– St. Often combined in the latter with oregano. It has a fairly strong anti-inflammatory effect, therefore it is also used as a gastric remedy. Infusions are also used in dentistry as an anti-inflammatory agent for rinsing the mouth.

Important! Contraindicated under 12 years of age, during pregnancy. It cannot be used in conjunction with common antidepressants (MAO uptake inhibitors) – it can distort or enhance the effect of the latter, has a photosensitizing effect, that is, while taking St. John’s wort, skin pigmentation may occur (you can not sunbathe).

Elena Korsun, Ph.D. head Department of Phytotherapy, ICM RUDN University, Head of the Educational and Health Center at the National Academy of Sciences of Ukraine:

– St. John’s wort has pronounced antimicrobial, anti-inflammatory, regenerating, detoxifying properties. St. John’s wort is prescribed in collections for all inflammatory diseases of the gastrointestinal tract, liver and pancreas, urogenital area, joints, and vascular atherosclerosis.

Its healing effect on the nervous system in chronic stress, neurosis, anxiety, asthenia, with pronounced choleric and melancholic temperament has been noted. It is often prescribed together with chamomile, calendula, apricot, elecampane, yarrow. Contraindications – nonspecific ulcerative colitis in the acute stage. The instructions for antidepressants say that when they are used, the appointment of St. John’s wort is contraindicated.

St. John’s wort: benefits and harms, expert comments

There are more than 300 types of St. John’s wort, but St. John’s wort is most often used in herbal medicine. It is harvested in July-August, about 25–30 cm are cut for medicinal raw materials. It received an unusual name due to the leaves, on which there are many small dots. They seem to be really perforated.

• What is St. John’s wort
• Benefit
• Other uses
• Side effects
• How to brew St. John’s wort
• Expert commentary

The article was commented by Alevtina Fedina, therapist, medical director of Checkme health management service

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What is St. John’s wort

St. John’s wort is a perennial herb that is actively used in herbal medicine. From St. John’s wort, medicinal decoctions, teas and tinctures are prepared, and it is also added to medicines. It can reduce the effect of contraceptives [1] and some antibiotics. It is usually used for mild forms of depression, menopausal symptoms.

In pastures, St. John’s wort is exterminated as a weed that can harm animals. If it is ingested by horses, sheep, or cattle, it can cause central nervous system depression, photosensitivity, poisoning, and even death.

Benefits of St. John’s wort

St. John’s wort may reduce the effectiveness of other medications

© Artem Podrez/Pexels

St. John’s wort helps relieve symptoms of menopause and somatic disorders, may be effective for depression, but scientific evidence is still insufficient to draw definitive conclusions [2 ]. Another study showed that the plant promotes the healing of wounds, bruises, burns and ulcers [3].

St. John’s wort contains hypericin, a natural photosensitizer used in photodynamic therapy against cancer.

It also contains hyperforin. It activates a specific receptor in the liver that promotes the production of an enzyme that causes many prescription drugs to break down more quickly and can interfere with their effectiveness.

1. Reduces symptoms of depression

Although the benefits of St. John’s wort are still being studied, studies show that it can relieve symptoms of depression. Scientists have found that antidepressants and St. John’s wort extract are more effective in treating mild to moderate depression than placebo [4]. The specialists also noted that patients were more likely to stop drinking antidepressants due to side effects compared to St. John’s wort.

Studies comparing St. John’s wort with selective serotonin reuptake inhibitors are limited. But there is some evidence that St. John’s wort can help in the same way as these drugs, but with fewer side effects [5].

A review by Cochrane, an international non-profit organization that studies the effectiveness of evidence-based treatments, found that St. John’s wort may also be useful in the treatment of severe depression [6]. Hypericin and hyperforin contained in the plant, according to experts, can increase the level of serotonin, dopamine and norepinephrine, which are responsible for mood.

But the Food and Drug Administration (FDA) has not approved the use of the plant in the treatment of depression and other illnesses. They classify St. John’s wort as a dietary supplement and not as a drug [7].

2. May help with atopic dermatitis

A study of the effectiveness of St. John’s wort cream has shown that mild to moderate atopic dermatitis may respond well to topical treatment [8].

3. Reduces the symptoms of somatoform disorders

St. John’s wort may be useful in the treatment of some somatoform disorders, but more evidence is needed [9].

4. Relieves symptoms of menopause

Research has shown that taking St. John’s wort can help reduce hot flashes and other symptoms of menopause.

Contraindications

St. John’s wort may help with mild symptoms of depression, but should not be taken without medical advice

© Andrea Piacquadio/Pexels

Patients diagnosed with depression should not use St. It can enhance the effects of antidepressants and also lead to a dangerous increase in serotonin levels in the body.

Symptoms of this condition:

• tremor;
• diarrhea;
• confusion;
• low body temperature.

Patients are also advised not to use St. John’s wort if they are taking:

• anticonvulsants;
• oral contraceptives;
• anticoagulants;
• some HIV drugs.

Cytochrome 450 enzymes are used by the body to remove drugs and chemicals from the bloodstream. They are responsible for the breakdown of any products and elements that enter the bloodstream. St. John’s wort induces the body to produce more of these enzymes, and this greatly affects the absorption of drugs, reduces their effectiveness.

In some cases, St. John’s wort can provoke psychosis. People with bipolar disorder or major depression should not take it as it can lead to mania.

It may also increase the effect of triptan drugs used for migraine, such as sumatriptan.

Since St. John’s wort is similar in properties to fluoxetine (antidepressant), it can cause the same side effects. Serious harm to health is caused by the joint use of these drugs.

How to brew St. John’s wort

St. John’s wort is brewed in various ways. In pharmacies, you can purchase both a ready-made drink with the addition of this ingredient, and dried grass to prepare a decoction yourself.

Ingredients:

• 1 teaspoon dried St. John’s wort
• 250 ml water

Place water in a small saucepan and bring to a boil. Pour hot water over St. John’s wort and cover with a lid to infuse it. If you prefer a strong decoction, then leave it for 30 minutes. Then strain the liquid. St. John’s wort gives a bitter taste, so it is better to dilute it with water. You can add sugar or honey if you like. In order to make a less concentrated drink, it should be infused for three to ten minutes.

Expert comment

Alevtina Fedina, therapist, Medical Director of Checkme Health Management Service

Why is St. John’s wort useful and in what cases can it be taken? Does it really help with colds, does it have antiviral and healing properties?

St. John’s wort for colds is a myth: this plant does not have antiviral and healing properties. However, its effectiveness has been proven in the treatment of depression and anxiety, as well as disorders of the nervous system. This is due to the content of hypericin and hyperforin in the composition of St. John’s wort, which in moderate doses contribute to the treatment of depression. In excessive amounts, they are harmful to the body and can lead to allergies, problems with the gastrointestinal tract and increased anxiety.

Is there any dosage for daily use?

For each individual: when using St. John’s wort as an antidepressant, you should strictly follow the dosage prescribed by a specialist, since its excess is fraught with the appearance of allergies and problems with the gastrointestinal tract. The use of St. John’s wort simultaneously with some other antidepressants can weaken their effect, which should also be taken into account when prescribing a course of treatment.

Is St. John’s wort best taken as a decoction, tincture, or tablet/capsule?

The effectiveness of St. John’s wort does not depend on its form, but the problem is that St. John’s wort is an over-the-counter drug, the quality of which is not subject to high requirements. Therefore, pharmacies often sell not the best raw materials.

Who is absolutely contraindicated to take it?

St. John’s wort is contraindicated in pregnant and lactating women, children under 12 years of age, hypertensive patients, and patients who have undergone organ transplantation.

How to understand that an overdose has occurred and you need to stop taking it, in what cases should you run to the doctor?

Overdose is most often manifested by allergic reactions: urticaria, rash and swelling. There may also be disorders of the gastrointestinal tract: diarrhea, nausea and vomiting. One of the unusual effects is photosensitivity: the skin becomes sensitive to sunlight.

Can it be used as a remedy for any ailments, and if so, for which ones?

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