Name: St. John's Wort - Standardized Extract
Scientific Name: Hypericum perforatum
Intro: St. John's wort (Hypericum perforatum), once thought to rid the body of evil spirits, has a history of medicinal use dating back to ancient Greece, where it was used to treat a range of illnesses, including various 'nervous conditions.' St. John's wort also has antibacterial and antiviral properties and, because of its anti-inflammatory properties, has been used to help heal wounds and burns.
In recent years, there has been renewed interest in St. John's wort as a treatment for depression and there has been a great deal of scientific research on this topic. St. John's wort is one of the most commonly purchased herbal products in the United States. Because St. John's wort interacts with a wide variety of medications, it is important to take it only under the guidance of a healthcare provider who is knowledgeable about herbal medicines.
Nutrient Content: The best-studied active components are hypericin and pseudohypericin, found in both the leaves and flowers. There has been recent research to suggest, though, that these best-studied components may not be the most active in the plant, which also contains essential oils and flavonoids.
Benefits:
Comments: The Dietary Supplement Information Bureau recommends a daily dosage of approximately 300mg (standardized extract), 3 times a day for optimal health.
Many people take St. John's wort for depression. It is important to bear in mind that depression can be a serious condition and may be accompanied by thoughts of suicide or homicide, both of which warrant immediate medical attention. Evaluation by a healthcare professional should always be sought before using St. John's wort.
Caution: Potential side effects from St. John's wort are generally mild. They include stomach upset, hives or other skin rash, fatigue, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion.
Although not common, St. John's wort can also make the skin overly sensitive to sunlight (called photodermatitis). Those with light skin who are taking St. John's wort in large doses or over a long period of time should be particularly careful about sun exposure. The use of sunscreen with a skin protection factor (SPF) of at least 15, and the avoidance of sunlamps, tanning booths, or tanning beds is recommended while taking St. John's wort.
Because of the potential for serious interaction with medications used during surgery, patients should discontinue the use of St. John's wort at least 5 days prior to surgery and should avoid taking it post surgery.
St. John's wort should not be taken by women who are pregnant, trying to become pregnant, or breastfeeding
Possible Interactions
St. John's wort interacts with a range of medications. In most cases, this interactions leads to reduced the effectiveness of the medication in question; in other cases, however, St. John's wort may increase the effects of a medication.
If you are currently being treated with any of the following medications, you should not use St. John's wort without first talking to your healthcare provider:
Antidepressants
St. John's wort may interact with antidepressant medications that are used to treat depression or other mood disorders, including tricyclics, SSRIs (see earlier discussion), and monoamine oxidase inhibitors (MAOIs) such as phenelzine. How St. John's wort works is not entirely clear, but is believed to be similar to how SSRIs work. Therefore, using St. John's wort with this class of antidepressants in particular can lead to exacerbation of side effects including headache, dizziness, nausea, agitation, anxiety, lethargy, and lack of coherence.
Digoxin
St. John's wort should not be taken by those on digoxin because the herb may decrease levels of the medication and reduce its effectiveness.
Immunosuppressive medications
St. John's wort should not be taken by those on immunosuppressive medications such as cyclosporine because it may reduce the effectiveness of these medications. In fact, 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.
Indinavir and other protease inhibitors
The Food and Drug Administration (FDA) issued a public health advisory in February 2000 concerning the probable interaction between indinavir and St. John's wort that resulted in significantly decreased blood levels of this protease inhibitor, a class of medications used to treat HIV or AIDS. The FDA recommends that St. John's wort not be used with any type of antiretroviral medication used to treat HIV or AIDS.
Loperamide
There has been a report of a possible interaction between St. John's wort and the antidiarrheal medication, loperamide leading to delirium in an otherwise healthy woman.
Oral contraceptives
There have been reports of breakthough bleeding in women on birth control pills who were also taking St. John's wort.
Reserpine
Based on animal studies, St. John's wort may interfere with the intended action of this medication used to treat high blood pressure.
Theophylline
St. John's wort can reduce levels of this medication in the blood leading. Theophylline is used to open the airways in those suffering from asthma, emphysema, or chronic bronchitis.
Warfarin
St. John's wort interferes with the anticoagulant medication, warfarin, by reducing blood levels as well as the effectiveness. This leads to the need to for adjustments in doses of this medication.