St John’s Wort

The ancient Greeks and Romans believed that this herb could deter evil spirits. Today, St John’s wort has found new and widespread popularity as a natural antidepressant – a gentle alternative to conventional medications, with far fewer side effects.

What it is

A shrubby perennial bearing bright yellow flowers, St John’s wort is cultivated worldwide. It was named for Saint John the Baptist because it blooms around June 24, the day celebrated as his birthday. ‘Wort’ is an old English world for plant. For centuries, St John’s wort was used to soothe the nerves and to heal wounds, burns and snakebites. Supplements are made from dried flowers, which contain a number of therapeutic substances, including a healing pigment called hypericin.

What it does

St John’s wort is most often used to treat mild depression. Scientists aren’t sure exactly how the herb works, though it’s believed to boost levels of the brain chemical serotonin, which is one of the keys to mood and emotions.

Major benefits

A recent analysis of 23 different studies of St John’s wort concluded that the herb was as effective as antidepressant drugs – and more effective than a placebo – in the treatment of mild to moderate depression. (Few studies have examined its usefulness for more serious depression, though it may prove beneficial for this as well.) St John’s wort may be helpful for many conditions associated with depression, too, such as anxiety, stress, premenstrual syndrome (PMS), fibromyalgia or chronic pain. It may even have some direct pain-relieving effects. This herb promotes sound sleep, and may be especially valuable when depression is marked by fatigue, sleepiness and low energy levels. It may also aid in treating ‘wintertime blues’ (seasonal affective disorder, or SAD), a type of depression that develops in autumn and winter an dissipates in the bright sunlight of spring and summer.

Some people are wary to conventional antidepressants because of their potential for causing undesirable side effects, especially reduced sexual function. St John’s wort has fewer troublesome side effects than these drugs. In addition, although St John’s wort mayinteract with antidepressant medications, it doesn’t appear to interact with most other conventional drugs, making it useful for older people who may be taking multiple medications.

Additional benefits

St John;s wort fights bacteria and viruses as well. Research indicates that it may play a key part in combating herpes simplex, influenza and Epstein-Barr virus (the cause of glandular fever), and preliminary laboratory studies reveal a possible role for the herb in the fights against AIDS. When an ointment made from St John’s wort is applied to haemorrhoids, it relieves burning and itching. Taken along with the herb ephedra, St John’s wort may also be useful as a weight-loss aid. Hypericum oil, applied to the skin, is very effective at relieving the pain of shingles.

Common uses

• Treats depression.
• Helps to fight off viral and bacterial infections.
• May help to treat premenstrual syndrome (PMS) and fibromyalgia.
• Helps to relieve chronic pain.
• Soothes haemorrhoids.
• May aid weight loss.

Forms

• Tablet.
• Capsule.
• Tincture
• Cream/Ointment.
• Oil.

How to take it

Dosage

The recommended dose is 300 mg of an extract standardised to contain 0.3% hypericin, taken three times a day. Supplements containing 450 mg are also available and can be taken twice a day.

Guidelines for use

Take St John’s wort close to mealtimes to reduce stomach irritation. In the past, people using the herb were advised not to eat certain foods, including aged cheese and red wine – the same foods best avoided by those taking MAO inhibitors (a type of anti-depressant). But recent studies suggest that these foods do not present a problem for those on St John’s wort.

Like a prescription antidepressant, the herb must build up in your blood before it becomes effective, so be sure to allow at least four weeks to six weeks to determine whether it works best for you. It can be used long term, as needed. Unless you are under the care of a health practitioner familiar with both conventional antidepressants and St John’s wort, the drug medication and the herb should be taken together with caution. St John’s Wort can alter the way in which some antidepressants work. Note that the modification in dose of any antidepressant can result in unwanted symptoms and issues with anxiety.

However, I have seen many patients who have been successfully able to wean themselves off drug antidepressants with the use of a good St John’s Wort natural medicine. I question whether the hype about using St John’s Wort and drugs is more about instilling fear in patients so that they stay on their drugs, rather than helping patient enjoy better outcomes.

Even though no adverse effects have been reported in pregnant or breast-feeding women using the herb, there have been few studies in this group of patients, so caution is advised.

Possible side effects

While uncommon, side effects can include constipation, upset stomach, fatigue, dry mouth and dizziness. Fair skinned people are advised to avoid prolonged exposure to sunlight while taking St John’s wort, but increased sensitivity to the sun doesn’t appear to be much of a problem at recommended doses.

Caution

If you’re taking conventional antidepressant drugs, be careful with adding or switching to St John’s wort. Wean yourself off the drug antidepressant over time, while at the same time allowing the St John’s wort natural medicine to build in your system. If you have been on drug medication for some time, you may need to allow 2 to 3 months for a complete transition. Do not stop your drug medication and then start St John’s wort, as it needs at least 4 to 6 weeks to build in your system. During that time you will still need to continue with some drug medication, albeit at a slowly reducing dose.

If you develop a rash or have difficulty breathing (rarely, people have allergic reactions), discontinue use or perhaps try another formulation.

Reminder: If you have a medical or psychiatric condition, talk to your health practitioner before taking natural medicine. Preferably one that actually uses natural medicines.