St. John’s wort

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

The flowers and leaves of st. John’s wort contain 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 symptoms.


Research on st. John’s wort use for particular conditions reveals:.

Anxiety. A number of studies support the restorative benefit of st. John’s wort in treating mild to moderate anxiety. In fact, some research has revealed the supplement to be as reliable as a number of prescription antidepressants. It’s unclear whether it’s advantageous in the treatment of extreme depression. Due to the fact that st. John’s wort engages with numerous medications, it might not be a proper choice, particularly if you take any prescription drugs.

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

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

Plant qualities

Period: seasonal.

Practice: shrub.

Leaf: green.

Size class: 1-3 ft.

Bloom info

Flower color: yellow.

Blossom time: jun, jul, aug.

. Growing conditions

Water usage: high.

Light requirement: part shade, shade.

Soil moisture: dry, damp.

Soil ph: circumneutral (ph 6.8-7.2).

Caco3 tolerance: low.

Soil description: dry, rocky soils.


Description: seeds can be used for propagation but softwood cuttings, which root easily, are the normal approach.

Seed collection: not offered.

Seed treatment: seeds require no special treatment.

Commercially avail: yes (2 ).

Enjoyable realities:

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

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

This wildflower was introduced from europe. (3 ).

How do I take St. John’s wort?

Preparations in the u.s. Have various quantities of active component, so be careful to note just how much you’re getting in your tablets. Depending upon the preparation, st. John’s wort can be taken in any of the following ways:.

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

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

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

Boost in high blood pressure.

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

St. John’s wort has been associated with really serious and possibly hazardous interactions with numerous common drugs. St. John’s wort can compromise how well other drugs work, consisting of antidepressants, contraceptive pill, cyclosporine (an anti-rejection drug), digoxin (a heart drug), hiv drugs, cancer medications, and blood slimmers such as coumadin.

Taking st. John’s wort with antidepressants can trigger a harmful boost in levels of serotonin, a hormone 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 used in place of basic antidepressants. (4 ).

How does it work?

For a very long time, detectives thought a chemical in st. John’s wort called hypericin was accountable for its impacts against depression. More current info suggests another chemical, hyperforin, in addition to adhyperforin, and numerous other comparable chemicals may play a larger function in depression. Hyperforin and adhyperforin act on chemical messengers in the nervous system that regulate state of mind.

Uses & & efficiency Likely reliable for …

Depression. Taking st. John’s wort extracts improves state of mind and reduces anxiety and insomnia related to anxiety. It seems to be about as reliable in treating depression as many prescription drugs. In fact, clinical guidelines from the american college of physicians-american society of internal medicine suggest 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 seem more effective or substantially better tolerated than antidepressant medications, and given that st. John’s wort triggers numerous drug interactions, the guidelines recommend it may not be an appropriate option for many people, particularly those who take other medications. St. John’s wort may not be as reliable for more serious cases of depression.

Potentially reliable for …

Menopausal signs. Some evidence suggests that some particular combinations 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 symptoms are inconsistent. Some, however not all, research recommends that st. John’s wort might decrease hot flashes. Nevertheless, st. John’s wort does not seem to enhance sleep, quality of life, or other menopausal symptoms when utilized alone.

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

Wound healing. Applying an ointment including st. John’s wort 3 times daily for 16 days seems to improve wound healing and lower scar development after a cesarean section (c-section).

Possibly ineffective for …

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

Liver disease c infection (hcv) infection. Taking st. John’s wort by mouth does not seem to be reliable for treating adults 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 study reveals that taking a particular st. John’s wort extract (st. John’s wort extract extra strength, enzymatic therapy) twice everyday is ineffective for decreasing signs of ibs.

Nerve damage outside the brain or spinal cord (polyneuropathy). Taking st. John’s wort by mouth does not appear to alleviate pain 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 stress and anxiety.

Inadequate proof to rate effectiveness for …

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

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

Attention deficit-hyperactivity disorder (adhd). Some research suggests that taking st. John’s wort daily for 4 weeks may improve attention and activity in adolescents with adhd. But other research study reveals that taking a st. John’s wort extract for 8 weeks does not improve adhd symptoms in kids ages 6-17 years.

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

Herpes. Early research recommends that utilizing a particular mix of st. John’s wort and copper sulfate pentahydrate (dynamiclear) may help in reducing symptoms, including stinging, burning and discomfort, in people with fever blisters or genital herpes.

Migraine headache. Early research suggests that taking a specific st. John’s wort item (perforan, godaru, iran) 3 times everyday improves the seriousness of migraine pain however does not minimize how often migraines take place.

Obsessive-compulsive disorder (ocd). There is clashing evidence about the effectiveness of st. John’s wort for ocd. The reason for inconsistent findings could be due to differences in research study style, distinctions in the st. John’s wort products utilized, or other elements.

Skin soreness and irritation (plaque psoriasis). Early research study recommends that using st. John’s wort liquid or lotion to the skin reduces the intensity and the size of psoriasis patches.

Premenstrual syndrome (pms). There is contrasting proof about the use of st. John’s wort for dealing with pms. Some early research study recommends that st. John’s wort might help reduce pms symptoms, including sleeping problems, coordination, confusion, sobbing, headache, fatigue, food cravings and swelling, by even as much as 50% in some ladies. Nevertheless, other research shows that taking st. John’s wort does not decrease anxiety or other pms signs.

Seasonal affective disorder (sad). Early studies suggest that st. John’s wort may assist unfortunate. It appears to enhance signs of anxiety, reduced sex drive, and sleep disruptions related to unfortunate. It works alone or in combination with light treatment.

Smoking cessation. Early research 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 smoking does not improve long-lasting quit rates.

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

  • Stomach upset.
  • Skin conditions.
  • Nerve pain.
  • Chronic fatigue syndrome (cfs).
  • Muscle discomfort.
  • Weight reduction. (5 )

St. John’s wort for weight control

Why do dieters utilize it? *

Some dieters say that st. John’s wort helps improve energy and awareness and eliminates tension and anxiety.

What do the supporters state? *

St. John’s wort is well developed as a treatment for moderate to moderate depression. Because depression can result in weight gain, and because medications with actions similar to that of st. John’s wort have been utilized for weight-loss, some individuals have proposed that st. John’s wort can be useful for weight loss. Nevertheless, no research at all has actually examined whether st. John’s wort has any value for this function.

* dieters and weight-management supporters may declare advantages for this supplement based on their individual or professional experience. These are private viewpoints and reviews that may or might not be supported by controlled medical research studies or released clinical short articles. (6 ).


The typical dose in capsule or dry tablet kind, is 300 milligrams (mg) 3 times a day, with meals. This is for grownups. It is not advised for kids.

Negative results

If adverse effects do occur, they may consist of:.

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

It may take 3 to 6 weeks to experience any benefit. Stopping using st. John’s wort ought to be done slowly, to prevent side effects.


A person with a medical diagnosis of anxiety should not utilize st. John’s wort as an alternative to therapies suggested by a medical professional. If the herb is not effective, the depression may intensify.

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

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

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

Symptoms consist of:

  • 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 depression should not use it, as it may lead to a mania.

It can also contribute to the result 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.

Patients ought to always discuss with their doctor first prior to taking st. John’s wort or other supplements or alternative treatments, 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 also increase the 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 advantages of taking st. John’s wort with your medical professional or pharmacist. (8 ).

When taken by mouth: st. John’s wort is most likely safe when used in doses up to 900 mg daily for as much as 12 weeks. It can cause some adverse effects such as diarrhea, dizziness, problem sleeping, restlessness, and skin tingling. St. John’s wort connects with numerous drugs. Let your healthcare provider understand if you want to take st. John’s wort.

St. John’s wort is potentially risky when taken in large doses. It may cause severe skin reactions after sun direct exposure. Wear sun block outside, specifically if you are light-skinned. (9 ).

Possible interactions

St. John’s wort interacts with a great deal of medications. For the most part, st. John’s wort makes the medication less efficient. In other cases, st. John’s wort may make the results of a medication stronger.

If you are being treated with any medications, you ought to not use st. John’s wort without very first speaking to your doctor. St. John’s wort might connect with various medications, including however not limited to the following:.


St. John’s wort may connect with medications used to deal with anxiety or other state of mind conditions, consisting of tricyclic antidepressants, ssris, and monoamine oxidase inhibitors (maois). Taking st. John’s wort with these medications tends to increase negative effects, and might result in a harmful condition called serotonin syndrome. Do not take st. John’s wort with other antidepressants, consisting of:.

  • 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)
  • Allergic reaction drugs (antihistamines)

St. John’s wort might minimize levels of these drugs in the body, making them less effective:

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

In theory, taking st. John’s wort along with clopidogrel might increase the danger 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 medications, can increase the risk of negative effects, consisting of serotonin syndrome.


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

Drugs that reduce the body immune system

St. John’s wort can minimize the effectiveness of these medications, which are taken after organ transplant, or to control autoimmune illness. There have actually 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 two type of medications used to deal with hiv and help: protease inhibitors and non-nucleoside reverse transcriptase inhibitors. The fda suggests that st. John’s wort not be used with any kind of antiretroviral medication used to deal with hiv or help.

Contraceptive pill

There have actually been reports of advancement bleeding in females on birth control pills who were likewise taking st. John’s wort. It is possible that the herb might make contraceptive pill less effective, leading to unintended pregnancies.

Aminolevulinic acid

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


Based upon animal research studies, st. John’s wort may hinder reserpine’s ability to deal with high blood pressure.


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

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 reliable.


St. John’s wort can reduce levels of this medication in the blood. Theophylline is used to open the airways in individuals with asthma, emphysema, or persistent bronchitis.

Triptans (used to treat migraines)

St. John’s wort can increase the threat of side 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 certain liver enzymes, it may communicate with other drugs that are broken down by the very 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)– may accelerate the rate at which camptosar is broken down by the body, making it less reliable
  • Some calcium channel blockers (required to lower blood pressure)
  • Any medication broken down by the liver (10 )


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