St. John’s wort

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

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

People utilize st. John’s wort to treat depression and menopausal signs.


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

Anxiety. A number of research studies support the healing benefit of st. John’s wort in dealing with moderate to moderate anxiety. In fact, some research has actually revealed the supplement to be as efficient as a number of prescription antidepressants. It’s uncertain whether it’s useful in the treatment of severe depression. Because st. John’s wort interacts with numerous medications, it may not be a proper choice, especially if you take any prescription drugs.

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

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

Plant attributes

Duration: perennial.

Practice: shrub.

Leaf: green.

Size class: 1-3 ft.

Blossom details

Bloom color: yellow.

Flower 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 utilized for proliferation however softwood cuttings, which root easily, are the typical method.

Seed collection: not available.

Seed treatment: seeds require no special treatment.

Commercially get: yes (2 ).

Enjoyable realities:

St. John’s wort is a medical plant. Commercial tablet types of the plant extract is used to deal with depression. Nevertheless, it triggers increased sensitivity to the sun as well.

St. John’s wort also 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 various quantities of active component, so beware 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 three times a day for approximately six weeks;
  • 250 mg two times a day for 6 weeks;
  • 300 to 600 mg three times a day for six weeks;
  • 350 mg three times a day for eight weeks;
  • 300 to 600 mg 3 times a day for up to 26 weeks;
  • 400 mg twice a day for 6 weeks.

What should i keep an eye out for if I use St. John’s wort?

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

Increase in blood pressure.

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

St. John’s wort has been related to really serious and potentially hazardous interactions with numerous typical drugs. St. John’s wort can compromise how well other drugs work, including antidepressants, birth control pills, 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 trigger a hazardous increase in levels of serotonin, a hormonal agent that impacts mood. This condition is known as serotonin syndrome.

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

How does it work?

For a long time, private investigators thought a chemical in st. John’s wort called hypericin was accountable for its impacts versus anxiety. More current info recommends another chemical, hyperforin, in addition to adhyperforin, and numerous other comparable chemicals might play a larger function in depression. Hyperforin and adhyperforin act upon chemical messengers in the nerve system that regulate state of mind.

Uses & efficiency

Likely effective for …

Anxiety. Taking st. John’s wort extracts improves mood and reduces stress and anxiety and insomnia related to depression. It seems to be about as efficient in treating depression as lots of prescription drugs. In fact, scientific standards from the american college of physicians-american society of internal medication recommend that st. John’s wort can be considered an alternative in addition to antidepressant medications for short-term treatment of mild depression. However, since st. John’s wort does not appear to be more reliable or considerably much better endured than antidepressant medications, and because st. John’s wort causes numerous drug interactions, the standards recommend it might not be a proper option for many individuals, especially those who take other medications. St. John’s wort might not be as reliable for more serious cases of depression.

Perhaps efficient for …

Menopausal symptoms. Some evidence recommends that some particular mixes of st. John’s wort plus black cohosh (remifemin; gynoplus, jin-yan pharm) can help enhance menopausal symptoms such as hot flashes. The results of st. John’s wort alone on menopausal signs are inconsistent. Some, however not all, research recommends that st. John’s wort might lower hot flashes. Nevertheless, st. John’s wort does not appear to improve sleep, lifestyle, or other menopausal signs when used alone.

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

Wound recovery. Using an ointment containing st. John’s wort three times daily for 16 days appears to enhance injury recovery and reduce scar development after a cesarean area (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 virus (hcv) infection. Taking st. John’s wort by mouth does not appear to be effective for treating grownups with hepatitis c virus infection.

Hiv/aids. Taking st. John’s work by mouth does not appear to be effective for treating hiv-infected adults.

Irritable bowel syndrome (ibs). Early research reveals that taking a particular st. John’s wort extract (st. John’s wort extract extra strength, enzymatic treatment) twice everyday is not effective for reducing signs of ibs.

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

Social phobia. Taking st. John’s wort daily does not appear to improve social phobia or social stress and anxiety.

Inadequate evidence to rate efficiency for …

A procedure to widen obstructed arteries (angioplasty). Early research shows that taking st. John’s wort three times daily for 2 weeks after a treatment to widen blocked arteries enhances outcomes of the procedure in individuals who are also taking blood thinning medications. It is believed that st. John’s wort may help the blood thinning medications work much better in some individuals.

Stress and anxiety. Some reports recommend that taking st. John’s wort alone or together with valerian improves anxiety condition. Likewise, taking one pill of a particular item which contains st. John’s wort and valerian root (sedariston concentrate, aristo pharma gmbh) daily for one week, followed by a couple of capsules twice daily for another week, minimizes 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. But other research reveals that taking a st. John’s wort extract for 8 weeks does not improve adhd symptoms in kids ages 6-17 years.

Brain tumor (glioma). Early research shows that taking hypericin, a chemical in st. John’s wort, by mouth for up to 3 months may reduce tumor size and enhance the survival rate in people with brain tumors.

Herpes. Early research study suggests that using a particular combination of st. John’s wort and copper sulfate pentahydrate (dynamiclear) might help in reducing symptoms, consisting of stinging, burning and discomfort, in people with fever blisters or herpes.

Migraine headache. Early research recommends that taking a particular st. John’s wort product (perforan, godaru, iran) three times day-to-day improves the intensity of migraine pain but does not minimize how often migraines take place.

Obsessive-compulsive disorder (ocd). There is contrasting proof about the efficiency of st. John’s wort for ocd. The reason for contradictory findings could be due to differences in research study design, distinctions in the st. John’s wort products utilized, or other elements.

Skin redness and irritation (plaque psoriasis). Early research study suggests that applying st. John’s wort liquid or lotion to the skin reduces the severity and the size of psoriasis spots.

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

Seasonal depression (sad). Early studies suggest that st. John’s wort might help unfortunate. It appears to improve signs of anxiety, reduced sex drive, and sleep disruptions connected with sad. It is useful alone or in mix with light treatment.

Cigarette smoking cessation. Early research study suggests that taking a particular st. John’s wort extract (li-160, lichtwer pharma us) once or twice daily beginning one week before and continuing for 3 months after quitting cigarette smoking does not enhance long-lasting quit rates.

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

  • Stomach upset.
  • Skin problem.
  • Nerve pain.
  • Fatigue syndrome (cfs).
  • Muscle discomfort.
  • Weight loss. (5 )

St. John’s wort for weight control

Why do dieters utilize it? *

Some dieters say that st. John’s wort assists improve energy and alertness and eliminates tension and stress and anxiety.

What do the supporters state? *

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

* dieters and weight-management advocates may declare advantages for this supplement based on their personal or professional experience. These are private opinions and testimonials that might or may not be supported by regulated scientific studies or released scientific short articles. (6 ).


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

Negative results

If side effects do take place, they may consist of:.

  • Stress and anxiety
  • Dizziness
  • Dry mouth
  • Headache
  • Light level of sensitivity
  • Restlessness
  • Sedation
  • Sexual dysfunction
  • Skin responses
  • Indigestion
  • Fatigue or fatigue

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


A person with a diagnosis of anxiety must not use st. John’s wort as an option to therapies suggested by a doctor. If the herb is not effective, the anxiety may worsen.

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

  • Anticonvulsants
  • Cyclosporine
  • Digoxin
  • Oral contraceptives
  • Some anti-hiv drugs
  • Theophylline
  • Warfarin

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

Signs consist of:

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

In many cases, st. John’s wort can set off psychosis. Individuals with bipolar affective disorder or significant depression should not utilize it, as it may result in a mania.

It can likewise contribute 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 utilize during pregnancy or while breastfeeding.

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

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

When taken by mouth: st. John’s wort is likely safe when utilized in doses up to 900 mg daily for up to 12 weeks. It can trigger some adverse effects such as diarrhea, lightheadedness, trouble sleeping, uneasyness, and skin tingling. St. John’s wort engages with many drugs. Let your healthcare provider know if you want to take st. John’s wort.

St. John’s wort is perhaps unsafe when taken in large doses. It might cause extreme skin responses after sun direct exposure. Use sun block outside, especially if you are light-skinned. (9 ).

Possible interactions

St. John’s wort communicates with a large number of medications. In many cases, st. John’s wort makes the medication less efficient. In other cases, st. John’s wort may make the effects 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 may connect with many different medications, consisting of but not restricted to the following:.


St. John’s wort might engage with medications utilized to deal with anxiety or other state of mind conditions, including tricyclic antidepressants, ssris, and monoamine oxidase inhibitors (maois). Taking st. John’s wort with these medications tends to increase side 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 might reduce levels of these drugs in the body, making them less efficient:

  • Loratadine (claritin)
  • Cetirizine (zyrtec)
  • Fexofenadine (allegra)
  • Clopidogrel (plavix)

In theory, taking st. John’s wort together with clopidogrel might increase the threat of bleeding.

Dextromethorphan (cough medicine).

Taking st. John’s wort at the same time as dextromethorphan, a cough suppressant discovered in many over the counter cough and cold medicines, can increase the risk of adverse effects, consisting of serotonin syndrome.


St. John’s wort may lower levels of the medication and make it less effective. Do not take st. John’s wort if you take digoxin.

Drugs that reduce the immune system

St. John’s wort can reduce the effectiveness of these medications, which are taken after organ transplant, or to manage autoimmune diseases. There have been lots of 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 fight hiv

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

Birth control pills

There have been reports of advancement bleeding in ladies on birth control pills who were likewise taking st. John’s wort. It is possible that the herb might make birth control pills less effective, causing unexpected pregnancies.

Aminolevulinic acid

This medication makes your skin more sensitive to sunlight. St. John’s wort also increases skin sensitivity to light. Together, they may have a harmful effect on skin level of sensitivity to the sun.


Based upon animal studies, st. John’s wort might interfere with reserpine’s ability to treat hypertension.


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

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


  • Benzodiazepines, such as diazepam (valium)
  • Drugs to treat sleeping disorders, such as zolpidem (ambien), zaleplon (sonata), eszopiclone (lunesta), and ramelteon (rozerem)
  • Tricyclic antidepressants, such as amitriptyline (elavil)
  • Alcohol
  • Alprazolam (xanax)

St. John’s wort might accelerate the breakdown of xanax in the body, making it less effective.


St. John’s wort can lower levels of this medication in the blood. Theophylline is utilized to open the airways in people with asthma, emphysema, or chronic bronchitis.

Triptans (used to treat migraines)

St. John’s wort can increase the danger of adverse 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 efficiency of warfarin, an anticoagulant (blood thinner).

Other drugs

Because st. John’s wort is broken down by particular liver enzymes, it might engage with other drugs that are broken down by the 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 efficient
  • Some calcium channel blockers (taken to lower blood pressure)
  • Any medication broken down by the liver (10 )


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