Overview

St. John's wort is a plant with yellow, star-shaped flowers and five petals that grows in Europe, North and South America, Australia, New Zealand, and Eastern Asia. The plant grows in sunny, well-drained areas. It grows to be 50-100 cm tall.

St. John's wort might cause serious interactions with some medications. Because of this, France has banned the use of St. John's wort in products. In other countries St. John's wort is only available with a prescription.

St. John's wort is most commonly used for "the blues" or depression and symptoms that sometimes go along with mood such as nervousness, tiredness, poor appetite, and trouble sleeping. 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 these uses.

An oil can be made from St. John's wort. Some people apply this oil to their skin to treat wounds. Applying St. John's wort directly to the skin might be risky. It may cause serious sensitivity to sunlight.

Classification

Is a Form of:

Plant

Primary Functions:

Depression

Also Known As:

Amber, Amber Touch-and-Heal, Barbe de Saint-Jean,  Hypericum perforatum

How Does It Work?

For a long time, scientists thought a chemical in St. John's wort called hypericin was responsible for its effects on improving mood. More recent information suggests other chemicals like hyperforin may play a larger role. These chemicals act on messengers in the nervous system that regulate mood.

Uses

• Taking St. John's wort extracts by mouth improves mood and decreases nervousness and tiredness related to depression. It seems to be about as effective as many prescription drugs. The American College of Physicians-American Society of Internal Medicine guidelines show that St. John's wort can be considered an option along with prescription medications for short-term treatment of mild depression. However, since St. John's wort causes many drug interactions, the guidelines show it might not be a good choice for many people. St. John's wort might not be as effective for more severe cases of depression.

• Symptoms of menopause. Most research shows that taking St. John's wort by mouth can help reduce hot flashes and other symptoms of menopause. Some evidence shows that specific combinations of St. John's wort plus black cohosh (Remifemin; Remifemin Plus; Gynoplus) can also improve some symptoms of menopause such as hot flashes and mood changes. But not all St. John's wort combination products seem to be beneficial.
• Emotional distressed caused by extreme focus on a physical symptom (somatic symptom disorder). Treatment with a specific St. John's wort product (LI 160, Lichtwer Pharma) daily for 6 weeks seems to reduce symptoms of somatization disorder.
• Wound healing. Applying an ointment containing St. John's wort three times daily for 16 days seems to improve wound healing and reduce scar formation after a Cesarean section (C-section).

Recommended Dosing

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

• For mild to moderate low mood or depression:
• In most studies, St. John's wort extract was standardized to 0.3% hypericin content and used at doses of 300 mg 3 times daily.
• Some studies have used St. John's wort extract standardized to 0.2% hypericin at doses of 250 mg twice daily.
• St. John's wort extract standardized to 5% hyperforin has been used at doses of 300 mg 3 times daily.

• For symptoms of menopause:
• St. John's wort extract (Hypiran, Poursina Pharmaceutical Mfg. Co., Tehran, Iran) containing 0.2 mg/mL hypericin, taken in doses of 20 drops 3 times daily for 2 months has been used.
• St. John's wort 300mg 3 times daily for 3-4 months has been used.

• For emotional distressed caused by extreme focus on a physical symptom (somatic symptom disorder): a specific extract (LI 160, Lichtwer Pharma) 600 mg/day has been used.

APPLIED TO THE SKIN:

• For wound healing: An ointment containing a 5% St. John's wort extract applied three times daily beginning 24 hours after a C-section and continued for 16 days has been used.

CHILDREN

BY MOUTH:

• For mild to moderate depression: 150-300 mg of St. John's wort three times daily for 8 weeks in children 6-17 years-old has been used. A specific St. John's wort extract (LI 160, Lichtwer, Pharma) 300-1800 mg in three divided doses daily for up to 6 weeks has been used.

Do not suddenly stop taking St. John's wort. This might cause unpleasant side effects. If you decide to stop taking St. John's wort, reduce the dose slowly over time.

St. John’s Wort Supplements Frequently Asked Questions

What are the benefits of St John's wort?

John's wort is most commonly used for "the blues" or depression and symptoms that sometimes go along with mood such as nervousness, tiredness, poor appetite, and trouble sleeping. There is some strong scientific evidence that it is effective for mild to moderate depression.

What are the side effects of St John's wort?

John's wort are usually minor and uncommon. They may include upset stomach, dry mouth, headache, fatigue, dizziness, confusion, sexual dysfunction, or sensitivity to sunlight. Also, St. John's wort is a stimulant and may worsen feelings of anxiety in some people.

Is St John's wort safe to take?

Safety and side effects

St. John's wort is generally considered safe when used orally in appropriate doses.

Is St John's Wort good for anxiety?

Two recent major studies showed that St. John's wort worked no better than a placebo for moderate depression. St. John's wort has also been studied in the treatment of other mood disorders, such as severe depression, anxiety disorders, obsessive compulsive disorder (OCD), and seasonal affective disorder (SAD.)

Does St John's wort make you gain weight?

John's wort is well established as a remedy for mild to moderate depression. Since depression can lead to weight gain, and since medications with actions similar to that of St. John's wort have been used for weight loss.

Should I take St John's wort in the morning or night?

Dosage as an Antidepressant

St John's wort is usually available in 300 mg capsules. Approximately 900-1200 mg is needed to reduce the symptoms of depression. (St John's wort works best if taken twice a day.) In the third and fourth week, take 300 mg morning and 600 mg evening.

How long does it take for St John's wort to kick in?

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.

Why is St John's Wort banned in Ireland?

The herb was classified as a prescription-only medicine in 2000 by the Irish Medicines Board, which is now known as the Health Products Regulatory Authority (HPRA). This was due to concerns over the quality of products available.

When should you not take St John's wort?

Antidepressants – you should not take St John's wort at the same time as any other antidepressant. Combining the two medications can make your depression worse and can lead to serotonin syndrome. Sleeping pills and anaesthetics – St John's wort may prolong the effects of some sleeping pills and anaesthetics.

Can St John's wort damage the liver?

St. John's wort has not been implicated convincingly in cases of clinically apparent, acute liver injury, although it may increase the hepatotoxicity of other agents by herb-drug interactions that alter drug metabolism.

Does St John's wort give you energy?

St. John's wort (Hypericum perforatum) is used in traditional herbalism as a nerve tonic and antidepressant. It is said to be helpful in revitalizing those who are tired, low in energy, or simply fed up.

Does St John's wort work immediately?

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.

Who shouldn't take St John's wort?

Who shouldn't take St. John's wort? Herbal therapies aren't recommended for pregnant women, children, the elderly, or those with certain medical condition.

Does St John's wort make you happy?

The most popular herbal treatment for depression right now is St. John's wort. It's considered the natural alternative to Prozac. It is classified as a thymoleptic, or mood-lifter, and is both calming to those who feel anxious and stimulating to those who feel lethargic (a common symptom of depression).

Does St John's wort speed up metabolism?

John's wort increases the activity of an enzyme in the body that metabolizes lovastatin . Consequently, supplementation with St. John's wort may increase the metabolism of, and therefore reduce the activity of, lovastatin. Studies have shown that taking indinavir together with St. John’s wort.

What time of day should you take St John's wort?

(St John's wort works best if taken twice a day.) In the third and fourth week, take 300 mg morning and 600 mg evening. In the fifth week consider increasing the dose to 600 mg twice a day. Like all antidepressants, it can take four to six weeks before you feel any benefits.

Does St John Wort make you sleepy?

Likely Effective for. Depression. Taking St. John's wort extracts by mouth improves mood and decreases nervousness and tiredness related to depression.

What is the best way to take St John Wort?

It's usually taken in divided doses (300 mg three times daily or 600 mg twice daily). The effects of St. John's wort on the body are not fully understood. A number of the supplement's active ingredients, including hypericin, hyperforin, and adhyperforin, may be responsible for its medicinal benefits.

What does St John's wort do to the brain?

These ingredients appear to increase the levels of chemical messengers in the brain, such as serotonin, dopamine and noradrenaline. These then act to lift and regulate your mood. Interestingly, St. John's wort doesn't have some of the common side effects of prescription antidepressants, such as loss of sex drive.

Can you drink with St John's wort?

You should avoid or limit the use of alcohol while being treated with St. John's wort. Alcohol can increase the nervous system side effects of St. John's wort such as dizziness, drowsiness, and difficulty concentrating.

Can you stop taking St John's wort suddenly?

Some people report symptoms like sickness, dizziness and anxiety after they stop taking it abruptly. To be safe, it's generally recommended to slowly reduce your dosage before discontinuing your use of St. John's wort. Summary: Some side effects have been reported with the use of St. John’s wort.

Which brand of St John Wort is the best?

Nature's Way St. John's Wort is the perfect natural remedy to help fight depression. We recommend them to anyone who is living with depression and doesn't want to take prescription medications. Nature's Way sources from Chili and Europe where the product grows best.

Can St John's wort cause panic attacks?

John's wort can cause serious side effects. Those side effects included anxiety, panic attacks, dizziness, nausea and spikes in blood pressure, the researchers reported in the July issue of Clinical and Experimental Pharmacology and Physiology.

Clinical Studies

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• ^ Jakobs D1, et al. Downregulation of β1 -adrenergic receptors in rat C6 glioblastoma cells by hyperforin and hyperoside from St John's wort. J Pharm Pharmacol. (2013)
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• ^ The Ham D6 is more homogenous and as sensitive as the Ham D17.
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