St. John’s wort

St. John’s wort (hypericum perforatum) is a flowering shrub belonging to europe. It gets its name from the fact that it frequently flowers on the birthday of the biblical john the baptist.

The flowers and leaves of st. John’s wort contain active ingredients such as hyperforin. St. John’s wort is available as a supplement in teas, tablets, liquids and topical preparations.

Individuals utilize st. John’s wort to deal with depression and menopausal symptoms.


Research study on st. John’s wort usage for particular conditions shows:.

Depression. Numerous studies support the therapeutic advantage of st. John’s wort in dealing with moderate to moderate depression. In fact, some research study has actually revealed the supplement to be as reliable as a number of prescription antidepressants. It’s uncertain whether it’s useful in the treatment of extreme depression. Because st. John’s wort connects with lots of medications, it may not be an appropriate choice, especially if you take any prescription drugs.

Menopausal symptoms. Some evidence suggests that taking st. John’s wort alone or in mix with black cohosh or other herbs may reduce menopausal signs such as hot flashes.

Somatic symptom disorder. Some research studies indicate that st. John’s wort might be helpful for the treatment of this condition that causes serious stress and anxiety about physical symptoms such as pain, weak point or shortness of breath. (1 ).

Plant attributes

Period: perennial.

Habit: shrub.

Leaf: green.

Size class: 1-3 ft.

Blossom details

Blossom color: yellow.

Bloom time: jun, jul, aug.

. Growing conditions

Water use: high.

Light requirement: part shade, shade.

Soil wetness: dry, moist.

Soil ph: circumneutral (ph 6.8-7.2).

Caco3 tolerance: low.

Soil description: dry, rocky soils.


Description: seeds can be used for proliferation but softwood cuttings, which root easily, are the typical method.

Seed collection: not available.

Seed treatment: seeds require no special treatment.

Commercially avail: yes (2 ).

Enjoyable facts:

St. John’s wort is a medical plant. Industrial pill forms of the plant extract is utilized to deal with anxiety. However, it causes increased level of sensitivity to the sun also.

St. John’s wort likewise triggers photodermatitis in grazing animals.

This wildflower was presented from europe. (3 ).

How do I take St. John’s wort?

Preparations in the u.s. Have different quantities of active component, so take care to note just how much you’re getting in your tablets. Depending on the preparation, st. John’s wort can be taken in any of the following methods:.

  • 300 mg 3 times a day for approximately six weeks;
  • 250 mg twice a day for 6 weeks;
  • 300 to 600 mg three times a day for 6 weeks;
  • 350 mg three times a day for 8 weeks;
  • 300 to 600 mg three times a day for as much as 26 weeks;
  • 400 mg two times a day for 6 weeks.

What should i watch out for if I utilize St. John’s wort?

Increased level of sensitivity to the sun, particularly if you are fair-skinned and taking big doses.

Increase in blood pressure.

Do not take st. John’s wort during pregnancy or while you are breastfeeding.

St. John’s wort has actually been related to extremely serious and potentially harmful interactions with numerous common drugs. St. John’s wort can weaken how well other drugs work, including antidepressants, contraceptive pill, cyclosporine (an anti-rejection drug), digoxin (a heart drug), hiv drugs, cancer medications, and blood thinners such as coumadin.

Taking st. John’s wort with antidepressants can cause a dangerous increase in levels of serotonin, a hormonal agent that affects state of mind. This condition is known as serotonin syndrome.

Always inform your doctor or pharmacist if you are taking st. John’s wort or any other organic product. St. John’s wort must not be utilized in place of basic antidepressants. (4 ).

How does it work?

For a very long time, private investigators thought a chemical in st. John’s wort called hypericin was accountable for its effects versus anxiety. More current info suggests another chemical, hyperforin, along with adhyperforin, and several other comparable chemicals might play a larger function in anxiety. Hyperforin and adhyperforin act on chemical messengers in the nerve system that manage state of mind.

Uses & effectiveness

Likely efficient for …

Anxiety. Taking st. John’s wort extracts improves mood and reduces anxiety and sleeping disorders related to depression. It appears to be about as reliable in dealing with anxiety as numerous prescription drugs. In fact, medical standards from the american college of physicians-american society of internal medicine suggest that st. John’s wort can be considered an option along with antidepressant medications for short-term treatment of mild depression. Nevertheless, given that st. John’s wort does not seem more reliable or significantly much better tolerated than antidepressant medications, and because st. John’s wort causes numerous drug interactions, the guidelines recommend it may not be an appropriate option for many people, especially those who take other medications. St. John’s wort may not be as efficient for more extreme cases of depression.

Potentially efficient for …

Menopausal symptoms. Some evidence suggests that some particular mixes of st. John’s wort plus black cohosh (remifemin; gynoplus, jin-yan pharm) can help improve menopausal symptoms such as hot flashes. The impacts of st. John’s wort alone on menopausal symptoms are inconsistent. Some, but not all, research suggests that st. John’s wort may minimize hot flashes. However, st. John’s wort does not seem to enhance sleep, lifestyle, or other menopausal symptoms when used alone.

The conversion of psychological experiences or states into physical symptoms (somatization disorder). Treatment with a particular st. John’s wort product (li 160, lichtwer pharma) daily for 6 weeks appears to lower symptoms of somatization condition.

Wound healing. Using a lotion consisting of st. John’s wort 3 times daily for 16 days seems to improve injury recovery and reduce scar formation after a cesarean section (c-section).

Potentially ineffective for …

Burning mouth syndrome. Taking st. John’s wort 3 times daily for 12 weeks does not decrease pain from burning mouth syndrome.

Hepatitis c infection (hcv) infection. Taking st. John’s wort by mouth does not seem to be efficient for dealing with grownups with liver disease c virus infection.

Hiv/aids. Taking st. John’s work by mouth does not seem to be efficient for dealing with hiv-infected grownups.

Irritable bowel syndrome (ibs). Early research study reveals that taking a particular st. John’s wort extract (st. John’s wort extract extra strength, enzymatic treatment) two times day-to-day is not effective for minimizing symptoms of ibs.

Nerve damage outside the brain or spinal cord (polyneuropathy). Taking st. John’s wort by mouth does not seem to relieve discomfort in diabetic or non-diabetic individuals with polyneuropathy.

Social phobia. Taking st. John’s wort daily does not seem to enhance social phobia or social anxiety.

Insufficient evidence to rate effectiveness for …

A treatment to broaden obstructed arteries (angioplasty). Early research study reveals that taking st. John’s wort 3 times daily for 2 weeks after a treatment to broaden blocked arteries enhances outcomes of the treatment in people who are likewise taking blood thinning medications. It is believed that st. John’s wort may help the blood thinning medications work better in some individuals.

Anxiety. Some reports recommend that taking st. John’s wort alone or together with valerian enhances anxiety condition. Also, taking one pill of a particular product which contains st. John’s wort and valerian root (sedariston concentrate, aristo pharma gmbh) daily for one week, followed by one or two pills twice daily for another week, minimizes stress and anxiety more than the medication diazepam.

Attention deficit-hyperactivity disorder (adhd). Some research study recommends that taking st. John’s wort daily for 4 weeks might improve attention and activity in teenagers with adhd. However other research study reveals that taking a st. John’s wort extract for 8 weeks does not enhance adhd signs in children ages 6-17 years.

Brain tumor (glioma). Early research study reveals that taking hypericin, a chemical in st. John’s wort, by mouth for up to 3 months may lower growth size and enhance the survival rate in individuals with brain growths.

Herpes. Early research recommends that using a particular mix of st. John’s wort and copper sulfate pentahydrate (dynamiclear) may help reduce symptoms, consisting of stinging, burning and pain, in individuals with fever blisters or herpes.

Migraine headache. Early research recommends that taking a particular st. John’s wort product (perforan, godaru, iran) 3 times daily improves the intensity of migraine pain however does not decrease how often migraines take place.

Obsessive-compulsive condition (ocd). There is conflicting proof about the efficiency of st. John’s wort for ocd. The reason for inconsistent findings could be due to distinctions in research study style, differences in the st. John’s wort products used, or other aspects.

Skin soreness and irritation (plaque psoriasis). Early research recommends that using st. John’s wort liquid or lotion to the skin decreases the seriousness and the size of psoriasis spots.

Premenstrual syndrome (pms). There is clashing proof about the use of st. John’s wort for treating pms. Some early research study recommends that st. John’s wort may help reduce pms signs, consisting of sleeping issues, coordination, confusion, weeping, headache, tiredness, food yearnings and swelling, by even as much as 50% in some women. Nevertheless, other research study reveals that taking st. John’s wort does not minimize anxiety or other pms signs.

Seasonal affective disorder (sad). Early research studies suggest that st. John’s wort might assist unfortunate. It appears to enhance symptoms of anxiety, reduced sex drive, and sleep disruptions related to sad. It is useful alone or in mix with light treatment.

Smoking cigarettes cessation. Early research study recommends that taking a specific st. John’s wort extract (li-160, lichtwer pharma us) one or two times everyday beginning one week before and continuing for 3 months after giving up smoking cigarettes does not enhance long-lasting stopped rates.

Tooth pulling. Early research study suggests that applying a homeopathic st. John’s wort preparation does not improve dental pain after a tooth is pulled or after dental surgery.

  • Indigestion.
  • Skin conditions.
  • Nerve discomfort.
  • Fatigue syndrome (cfs).
  • Muscle pain.
  • Weight-loss. (5 )

St. John’s wort for weight control

Why do dieters utilize it? *

Some dieters state that st. John’s wort assists improve energy and awareness and eliminates stress and anxiety.

What do the advocates state? *

St. John’s wort is well established as a remedy for mild to moderate depression. Considering that anxiety can lead to weight gain, and because medications with actions similar to that of st. John’s wort have actually been utilized for weight reduction, some individuals have proposed that st. John’s wort can be beneficial for weight reduction. However, no research study at all has investigated whether st. John’s wort has any worth for this purpose.

* dieters and weight-management advocates might claim benefits for this supplement based upon their personal or professional experience. These are private opinions and reviews that may or might not be supported by controlled scientific research studies or released clinical short articles. (6 ).


The normal dose in pill or dry tablet kind, is 300 milligrams (mg) 3 times a day, with meals. This is for adults. It is not recommended for children.

Negative impacts

If adverse effects do occur, they may include:.

  • Stress and anxiety
  • Lightheadedness
  • Dry mouth
  • Headache
  • Light level of sensitivity
  • Restlessness
  • Sedation
  • Sexual dysfunction
  • Skin reactions
  • Stomach upset
  • Exhaustion or fatigue

It may take 3 to 6 weeks to experience any advantage. Stopping the use of st. John’s wort must be done slowly, to prevent negative effects.


An individual with a diagnosis of anxiety ought to not use st. John’s wort as an alternative to treatments advised by a medical professional. If the herb is ineffective, the depression might worsen.

Patients ought to not take st. John’s wort if they are taking the following medications, as its use might make them less effective:.

  • Anticonvulsants
  • Cyclosporine
  • Digoxin
  • Contraceptive pills
  • Some anti-hiv drugs
  • Theophylline
  • Warfarin

St. John’s wort might increase the impact of ssri antidepressants. This can result in a dangerous increase in serotonin in the body.

Symptoms include:

  • Trembling
  • Diarrhea
  • Confusion
  • Muscle tightness
  • Low body temperature level
  • It can be fatal.

In some cases, st. John’s wort can set off psychosis. Individuals with bipolar illness or major anxiety must not utilize it, as it may result in a mania.

It can likewise add to the impact of triptan drugs used for migraine, such as sumatriptan.

It is not yet clear whether st. John’s wort is safe to use during pregnancy or while breastfeeding.

Clients must always discuss with their doctor initially prior to taking st. John’s wort or other supplements or alternative therapies, specifically if they are currently taking medications. (7 ).

When used topically, st. John’s wort might cause a skin rash. St. John’s wort (both oral and topical) can likewise increase the level of sensitivity of your skin and eyes to sunshine. If you have a condition such as lupus or are taking medication that can trigger photosensitivity (such as some acne medications), evaluate the risks and benefits of taking st. John’s wort with your physician or pharmacist. (8 ).

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

St. John’s wort is potentially hazardous when taken in big doses. It might trigger severe skin responses after sun exposure. Use sun block outside, specifically if you are light-skinned. (9 ).

Possible interactions

St. John’s wort engages with a large number of medications. Most of the times, st. John’s wort makes the medication less effective. In other cases, st. John’s wort may make the impacts of a medication more powerful.

If you are being treated with any medications, you should not use st. John’s wort without very first speaking to your physician. St. John’s wort might interact with many different medications, including however not limited to the following:.


St. John’s wort may communicate with medications utilized to treat depression or other state of mind disorders, including tricyclic antidepressants, ssris, and monoamine oxidase inhibitors (maois). Taking st. John’s wort with these medications tends to increase negative effects, and might lead to a harmful 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 minimize 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 might increase the risk of bleeding.

Dextromethorphan (cough medicine).

Taking st. John’s wort at the same time as dextromethorphan, a cough suppressant discovered in numerous non-prescription cough and cold medicines, can increase the threat of negative effects, consisting of serotonin syndrome.


St. John’s wort might reduce levels of the medication and make it less efficient. Do not take st. John’s wort if you take digoxin.

Drugs that suppress the immune system

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

  • Adalimumab (humira)
  • Azathioprine (imuran)
  • Cyclosporine
  • Etanercept (enbrel)
  • Methotrexate
  • Mycophenolate mofetil (cellcept)
  • Tacrolimus (prograf)

Drugs to combat hiv

St. John’s wort appears to engage with at least 2 type of medications utilized to deal with hiv and help: protease inhibitors and non-nucleoside reverse transcriptase inhibitors. The food and drug administration suggests that st. John’s wort not be utilized with any kind of antiretroviral medication utilized to deal with hiv or help.

Birth control pills

There have been reports of development bleeding in females on birth control pills who were likewise taking st. John’s wort. It is possible that the herb may make contraceptive pill less effective, resulting in unplanned pregnancies.

Aminolevulinic acid

This medication makes your skin more conscious sunshine. St. John’s wort also increases skin sensitivity to light. Together, they might have a harmful influence on skin level of sensitivity to the sun.


Based on animal research studies, st. John’s wort might interfere with reserpine’s ability to deal with high blood pressure.


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

Anticonvulsants, such as phenytoin (dilantin) and valproic acid (depakote).


  • 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 accelerate the breakdown of xanax in the body, making it less effective.


St. John’s wort can decrease levels of this medication in the blood. Theophylline is used to open the respiratory tracts in people with asthma, emphysema, or persistent bronchitis.

Triptans (utilized to treat migraines)

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

  • Naratriptan (amerge)
  • Rizatriptan (maxalt)
  • Sumatriptan (imitrex)
  • Zolmitriptan (zomig)
  • Warfarin (coumadin)

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

Other drugs

Since st. John’s wort is broken down by particular liver enzymes, it may engage with other drugs that are broken down by the exact same enzymes. Those drugs may include:.

  • Antifungal drugs, such as ketoconazole (nizoral), itraconazole (sporanox), fluconazole (diflucan)
  • Statins (drugs taken to lower cholesterol), consisting of atorvastatin (lipitor), lovastatin (mevacor), and simvastatin (zocor)
  • Imatinib (gleevac)– might make gleevac less reliable
  • Irinotecan (camptosar)– might accelerate the rate at which camptosar is broken down by the body, making it less reliable
  • Some calcium channel blockers (taken to lower blood pressure)
  • Any medication broken down by the liver (10 )


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