St. John’s Wort
hypericum perforatum
Main active constituents
Essential oil, containing caryophyllene,methyl-2-octane, n-nonane, n-decanal, a and b-pinene, and traces of limonene and myrcene. Hypericins, prenylated phloroglucin derivatives, hypericin, pseudohypericin and hyperforin, flavonoids, epicatechin.
Physiological Effects
Parts used: Tops and flowers
Traditional Use and Health Benefits The use of this herb dates back over 2,000 years to the Ancient Greeks, where their physicians recommended its use for a variety of nervous and mood disorders. Considered to be imbued with magical powers, St John’s Wort was used to fend off evil and to protect against disease. In more practical terms, it was used as a folk remedy to aid kidney infections, heal wounds and to alleviate nervous disorders – including insanity!
St John’s Wort Benefits
Antidepressant The most famous use of St John’s Wort is as a remedy for mild to moderate depression. It is perhaps the most studied herb for this complaint, with literally thousands of studies and clinical trials performed to assess its usefulness as an antidepressant.
It contains the active phytonutrient hypericin, which together with hyperforin, is one of the principal active constituents found in St John’s Wort. Many studies have found the herb to be equally as effective as traditional antidepressants, but with fewer side effects in mild to moderately depressed patients. Whilst researchers aren’t exactly sure how St John’s Wort actually works its magic, some have postulated that it acts in a similar way to SSRI’s (selective serotonin reuptake inhibitors), because it makes serotonin, dopamine and norepinephrine available to the brain.
Preliminary research suggests that St. John's Wort also lowers levels of the stress hormone cortisol and enhances the activity of gamma-aminobutyric acid (GABA), a naturally occurring tranquilizer in the brain. It is a very mild, clinically insignificant monoamine oxidase (MAO) inhibitor. MAO is responsible for the breakdown of two brain chemicals - serotonin and norepinephrine. By inhibiting MAO and increasing norepinephrine, St. John's Wort may exert a mild anti-depressive action. The antidepressant or mood elevating effects of St. John's Wort were originally thought to be due solely to hypericin, but hypericin does not act alone. St. John's Wort relies on the complex interplay of many constituents such as xanthones and flavonoids for its antidepressant actions. St. John's Wort may also block the receptors that bind serotonin.
It is important to note that St John’s Wort is useful in treating mild to moderate depression – day to day blues which can still be debilitating and affect your life in a negative way. For major, suicidal depression it is recommended that you speak to your health care professional.
SAD (Seasonal Affective Disorder) This type of depression that only occurs in the winter due to lack of sunlight, has also been found to respond favorably to St John’s Wort. Whilst one of the most effective treatments for SAD is to spend time every day in full spectrum light, research has found that using this herb in combination with phototherapy works even better. Whilst one of the side effects of this plant can be increased photosensitivity, lightbox therapy can be safely combined with St John's Wort because lightboxes do not produce ultraviolet light.
OCD (Obsessive Compulsive Disorder) Recent research has found that SSRI’s are effective against OCD, leading researchers to speculate about the potential of St John’s Wort as a natural alternative. A small clinical study was done where 13 people with OCD received St John’s Wort, twice daily, for 12 weeks. At the end of the study, clinicians rated 42% of the participants as “much” or “very much improved”, 50% as “minimally improved” and 8% (one person), as “unchanged”. It was concluded that at the very least, St John’s Wort warrants further study as a treatment for this debilitating condition.
PMS Symptoms A 2010 study by S Canning and N Orsi et al at the Institute of Psychological Sciences, University of Leeds, looked at the efficacy of St John’s Wort for the treatment of PMS. The results of this randomized, double blind, placebo controlled trial found that: “St John’s Wort was statistically more beneficial than the placebo for food cravings, swelling, poor co-ordination, insomnia, confusion, headaches, crying and fatigue”.
Contraindications/Precautions
This product may cause your skin to be more sensitive to sunlight, leading to sunburn, rash, or redness of the skin.
St. John’s wort may reduce the effectiveness of chemotherapy, and also increase the adverse skin effects of radiation therapy.
Patients should discontinue use of this product well before surgery, chemotherapy, or radiation therapy.
Avoid use of St. John’s wort in addition to other prescription antidepressants as it may create a serious condition of excess serotonin in the body.
Use of this supplement should also be avoided if taking other supplements such as 5-HTP or SAM-e because these products may also affect serotonin levels.
Contact your doctor if you experience pain or tingling in the extremities, wounds that will not heal, yellowing of the eyes or skin, or any other unusual symptoms while taking this herb.
Do Not Take St. John’s Wort If:
You are pregnant or nursing.
You are taking birth control pills: St. John’s wort can increase the risk of pregnancy.
You are undergoing treatment with UV light: Skin may become more sensitive to light.
You are undergoing radiation therapy: St. John’s wort may increase adverse skin effects.
You are undergoing chemotherapy: St. John’s wort can reduce its effectiveness.
You are receiving methotrexate: St. John’s wort may increase toxic effects.
You are scheduled for surgery: St. John’s wort should be discontinued well before surgery.
You are taking blood thinners or undergoing other anticoagulant therapy: St. John’s wort may increase or decrease their effect.
You are taking medication to treat congestive heart failure or heart rhythm problems: St. John’s wort might lessen their effects.
You are taking medications for depression and/or anxiety: St. John’s wort may have additive effects and lead to serotonin excess, a serious condition.
You have bipolar disorder: This herb has caused mania in a few patients with bipolar disorder.
You are taking medications for migraines or cluster headaches: St. John’s wort may have additive effects and lead to serotonin excess, a serious condition.
You are taking drugs for high or low blood pressure: St. John’s wort may decrease or increase their effects.
You are taking drugs for diabetes: St. John’s wort can decrease their effectiveness.
You are undergoing immunosuppressive therapy, antiretroviral therapy, or therapy for respiratory diseases: St. John’s wort can decrease their effectiveness.
You are taking cholesterol lowering drugs: St. John’s wort can decrease their effectiveness.
You are taking cough suppressants or allergy medications: St. John’s wort can decrease their effectiveness.
You are taking pain killers: St. John’s wort can decrease their effectiveness and increase side effects.
You regularly consume alcohol: St. John’s wort may result in increased sedation.
You are taking clozapine: St. John’s wort can decrease its effectiveness.
You are taking SAM-e: Because SAME-e may also affect serotonin levels, the use of multiple herbs that do this should be avoided to reduce risks for excess serotonin in the body, a serious condition.
You are taking 5-HTP : Because 5-HTP may also affect serotonin levels, the use of multiple herbs that do this should be avoided to reduce risks for excess serotonin in the body, a serious condition.
Disclaimer
This information is intended only as a general reference for further exploration, and is not a replacement for professional health advice. This content does not provide dosage information, format recommendations, toxicity levels, or possible interactions with prescription drugs. Accordingly, this information should be used only under the direct supervision of a qualified health practitioner such as a naturopathic physician.