St. John’s Wort | NCCIH

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Common Names: St. John’s wort, hypericum, Klamath weed, goatweed

Latin Names: Hypericum perforatum

Background

• St. John’s wort is a plant with yellow flowers that has been used in traditional European medicine as far back as the ancient Greeks. The name St. John’s wort apparently refers to John the Baptist, as the plant blooms around the time of the feast of St. John the Baptist in late June.
• Historically, St. John’s wort has been used for a variety of conditions, including kidney and lung ailments, insomnia, and depression, and to aid wound healing.
• Currently, St. John’s wort is promoted for depression, menopausal symptoms, attention-deficit hyperactivity disorder (ADHD), somatic symptom disorder (a condition in which a person feels extreme, exaggerated anxiety about physical symptoms), obsessive-compulsive disorder, and other conditions. Topical use (applied to the skin) of St. John’s wort is promoted for various skin conditions, including wounds, bruises, and muscle pain.

How Much Do We Know?

• There has been extensive research on the use of St. John’s wort for depression and on its interactions with medications. It has been clearly shown that St. John’s wort can interact in dangerous, sometimes life-threatening ways with a variety of medicines.

What Have We Learned?

• St. John’s wort appears to be more effective than a placebo (an inactive substance) and as effective as standard antidepressant medications for mild and moderate depression. It’s uncertain whether this is true for severe depression and for time periods longer than 12 weeks.
• St. John’s wort has also been studied for conditions other than depression. For some, such as irritable bowel syndrome, chronic hepatitis C virus (HCV) infection, HIV infection, and social anxiety disorder, current evidence suggests that St. John’s wort isn’t helpful.
• St. John’s wort might be helpful for menopausal symptoms, wound healing, and somatic symptom disorder, but there’s not enough evidence to know for certain.
• There’s not enough reliable evidence to know whether St. John’s wort might be beneficial for quitting smoking or improving memory or for many conditions, including anxiety, ADHD, and seasonal affective disorder.

What Do We Know About Safety?

• In research studies, taking St. John’s wort by mouth for up to 12 weeks has seemed to be safe. But because St. John’s wort interacts with many drugs, it might not be safe for many people, especially those who take conventional medicines.
• St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as
  • Antidepressants
  • Birth control pills
  • Cyclosporine, which prevents the body from rejecting transplanted organs
  • Some heart medications, including digoxin and ivabradine
  • Some HIV drugs, including indinavir and nevirapine
  • Some cancer medications, including irinotecan and imatinib
  • Warfarin, an anticoagulant (blood thinner)
  • Certain statins, including simvastatin.
• Taking St. John’s wort with certain antidepressants or other drugs that affect serotonin, a substance produced by nerve cells, may lead to increased serotonin-related side effects, which may be potentially serious.
• St. John’s wort may cause increased sensitivity to sunlight, especially when taken in large doses. Other side effects can include insomnia, anxiety, dry mouth, dizziness, gastrointestinal symptoms, fatigue, headache, or sexual dysfunction.
• There isn’t enough reliable information available to know if St. John’s wort is safe when it’s used topically. It may cause severe skin reactions to sun exposure.
• It may not be safe to use St. John’s wort during pregnancy or while breastfeeding. It has caused birth defects in laboratory animals. Breastfeeding infants of mothers who take St. John’s wort can experience colic, drowsiness, and fussiness.

Keep in Mind

• Depression can be a serious illness. If you or someone in your family may have depression, consult a health care provider.
• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions. Although it is important to tell your health care providers about any complementary health approaches you use, this is especially crucial for St. John’s wort because this herb interacts with so many medicines. Interactions with St. John’s wort can weaken the effects of life-saving medicines or cause dangerous side effects.

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Key References

• Apaydin EA, Maher AR, Shanman R, et al. A systematic review of St. John’s wort for major depressive disorder. Systematic Reviews. 2016;5(1):148.
• Cott JM. St. John’s wort. In: Coates PM, Betz JM, Blackman MR, et al., eds. Encyclopedia of Dietary Supplements. 2nd ed. New York, NY: Informa Healthcare; 2010:727-737.
• Gurley BJ, Fifer EK, Gardner Z. Pharmacokinetic herb-drug interactions (part 2): drug interactions involving popular botanical dietary supplements and their clinical relevance. Planta Medica. 2012;78(13):1490-1514.
• Ng QX, Venkatanarayanan N, Ho CYX. Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. Journal of Affective Disorders. 2017;210:211-221.
• Qaseem A, Barry MJ, Kansagara D. Nonpharmacologic versus pharmacologic treatment of adult patients with major depressive disorder: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine. 2016;164:350-359.
• Soleymani S, Bahramsoltani R, Rahimi R, et al. Clinical risks of St John’s wort (Hypericum perforatum) co-administration. Expert Opinion on Drug Metabolism & Toxicology. 2017;13(10):1047-1062.
• St. John’s wort. In: Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:359-366.
• St. John’s wort. Natural Medicines website. Accessed at naturalmedicines.therapeuticresearch.com on May 10, 2020. [Database subscription].

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Last Updated: October 2020

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.

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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.

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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?

St.