{"id":10911,"date":"2020-04-22T10:11:36","date_gmt":"2020-04-22T14:11:36","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=10911"},"modified":"2020-07-08T18:38:30","modified_gmt":"2020-07-08T22:38:30","slug":"st-johns-wort","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/st-johns-wort\/","title":{"rendered":"Everything you need to know about St. John\u2019s wort"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">St. John\u2019s wort<\/span><span style=\"font-weight: 400;\"> is a plant with yellow flowers that grows in a range of climates in the United States and Europe. Also known as hypericum perforatum or klamath weed, ancient Greeks used the plant to treat a range of ailments, from animal bites to depression. Its modern-day benefits fall within similar realms, but its scientific efficacy and safety remain largely unproven within the medical community. The potential side effects aren\u2019t widely understood.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.singlecare.com\/prescription\/st-johns-wort\">St. John\u2019s wort<\/a> primarily works through hypericin and hyperforin, the two biologically active compounds in the supplement that have been shown to have significant medical properties. \u201cAs in any plant, there are many other chemicals present, including flavonoids (quercetin, rutin, luteolin) and tannins, which may have independent health benefits,\u201d says Harrison Weed, MD, an internal medicine physician at <\/span><a href=\"https:\/\/wexnermedical.osu.edu\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">The Ohio State University Wexner Medical Center<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What does St. John\u2019s wort do? Uses and benefits<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">St. John\u2019s wort is a natural remedy often sold in tablet or capsule format or as an ingredient in a variety of wellness supplements and teas. The most common ailments St. John\u2019s wort treats are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Mild depression<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Menopausal symptoms<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Inflammatory diseases<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Minor cuts and burns<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">As a supplement, it\u2019s not regulated by the U.S. Food and Drug Administration (FDA) or <\/span><a href=\"https:\/\/www.fda.gov\/food\/information-consumers-using-dietary-supplements\/questions-and-answers-dietary-supplements\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">approved to treat<\/span><\/a><span style=\"font-weight: 400;\"> any of these conditions. Though, there is some research indicating its effectiveness.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Mild depression<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Of the known usages for St. John\u2019s wort, depression is the most widely studied and the most commonly cited. \u201cPatients with mild depression have been shown to benefit significantly more than placebo and [St. John\u2019s wort is] as effective as standard antidepressants,\u201d says Erin Nance, MD, a New York City\u2013based orthopedic surgeon, citing the <\/span><a href=\"https:\/\/www.cochrane.org\/CD000448\/DEPRESSN_st.-johns-wort-for-treating-depression.\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Cochrane Review\u2019s<\/span><\/a><span style=\"font-weight: 400;\"> systematic review on the subject, which is considered to be one of the most comprehensive. While the clinical trials for treating mild depression indicate positive results, when it comes to treating moderate depression, major depressive disorder, severe depression, or bipolar disorder, St. John\u2019s wort is not a recommended treatment.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The hyperforin found in St. John\u2019s wort acts on chemical messengers in the brain that can affect mood to treat mild depression, similar to the way <\/span><span style=\"font-weight: 400;\">selective serotonin reuptake inhibitors (<\/span><span style=\"font-weight: 400;\">SSRIs) work. \u201cHypericin used to be thought of as the active ingredient with regard to treating depression,\u201d explains Dr. Weed. \u201cCurrently it is thought that hyperforin is the active ingredient through effects on neurotransmitters in the brain similar to the effects of prescription antidepressants.\u201d<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Menopausal symptoms<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">When it comes to treating menopausal symptoms, the herbal supplement has been demonstrated to be effective at treating <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10623319\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">psychological symptoms<\/span><\/a><span style=\"font-weight: 400;\"> related to menopause, such as sadness, anxiety, and stress, as well as <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20216274\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">physical symptoms<\/span><\/a><span style=\"font-weight: 400;\"> such as hot flashes and night sweats. While the findings are statistically significant when St. John\u2019s wort is taken alone, when taken alongside black cohosh, a flowering herb, the research is even more compelling.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">St. John\u2019s wort\u2019s ability to treat psychological menopausal symptoms is thought to act similarly to its ability to treat mild depression and seasonal affective disorder, while its effects on physical symptoms such as hot flashes are less widely studied and understood. Because of the way St. John\u2019s wort affects the brain\u2019s serotonin levels, it may also be effective in treating premenstrual syndrome.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Inflammatory diseases<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">While this application of St. John\u2019s wort is not as widely studied as others, the supplement has been shown to act as an anti-inflammatory agent in <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK92750\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">mice and rats<\/span><\/a><span style=\"font-weight: 400;\"> by limiting the expression of inflammatory agents in the body.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A concert of extracts from St. John\u2019s wort extract work together to decrease the activity of or decrease the production of certain inflammatory agents.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Minor cuts and burns<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">According to Dr. Nance, the herbal supplement is also sometimes used as an antibacterial treatment for minor cuts and burns. While there are plenty of topical St. John\u2019s wort products on the market, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28107097\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">studies indicate<\/span><\/a><span style=\"font-weight: 400;\"> that oral formulations have a more positive impact on wound healing than topical treatments containing St. John\u2019s wort.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">St. John\u2019s wort is believed to be successful in treating small wounds due to hyperforin, the main antibacterial component in the herbal supplement. Hyperforin acts to slow the growth of certain types of microorganisms that are present within cuts and wounds. Further studies indicate that the hypericin in St. John\u2019s wort could be effective in inactivating certain types of viruses.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Dosages<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">A common St. John\u2019s wort dosage ranges from 300 mg to 900 mg a day taken in divided doses. It\u2019s important to consult your doctor about the right dosage for you; he or she will consider other medications you are taking and your medical history. St. John\u2019s wort is classified as a dietary supplement, meaning it, like other natural medicines, is not monitored by the FDA. It\u2019s important to do some research to find a quality product to treat your condition. Try to <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/diet-supplements-can-interact-medications\/\"><span style=\"font-weight: 400;\">avoid purchasing<\/span><\/a><span style=\"font-weight: 400;\"> the supplement from another country when buying online.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When taking St. John\u2019s wort to treat mild symptoms of depression, allow a few weeks for the hyperforin within the supplement to have an effect on neurotransmitters, similar to prescription antidepressant drugs. \u201cIt usually takes a few weeks for neurotransmitter-altering medications to have an impact on mood,\u201d says Weed. Also, like any antidepressant, when you stop taking St. John\u2019s wort, you should taper it slowly, rather than abruptly stopping it. Your healthcare provider can advise you on an appropriate tapering schedule.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The long-term effects of St. John\u2019s wort are less widely studied. Because of this, most health experts will recommend limiting its use to no more than six months. \u201cBecause there are many different compounds in St. John&#8217;s wort, each with its own half-life, and because the metabolism of each person is different, one should probably assume that the effects of St. John&#8217;s wort \u2018stay\u2019 in a person&#8217;s \u2018system\u2019 for a few weeks,\u201d Dr. Weed adds.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">St. John\u2019s wort side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most common side effects of taking St. John\u2019s wort include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Abdominal bloating<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Anorgasmia (difficulty reaching orgasm)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Constipation<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Dizziness\/confusion<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Dry mouth<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Headache\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Hypertension (increased blood pressure)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Photosensitivity (skin redness\/rash\/burn with sun exposure)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Tiredness\/sedation<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Urinary frequency (increased)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Vivid dreams<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">In addition to these adverse reactions, St. John\u2019s wort can cause a life-threatening reaction, called serotonin syndrome, when taken with some medications. Serotonin syndrome can occur due to the buildup of too much serotonin. Its symptoms include: agitation, hyperthermia (overheating), sweating, tachycardia (fast heartbeat), and neuromuscular disturbances, including rigidity. You should seek medical help immediately if you experience any of these symptoms.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Because St. John\u2019s wort has so many interactions with over-the-counter and prescription drugs, it\u2019s important to check with your healthcare provider to see if it\u2019s safe for you. \u201cSt. John\u2019s Wort is known to have interactions with multiple medications due to its effect on enzymatic breakdown of other medications,\u201d says Dr. Nance.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It\u2019s crucial to have a conversation with your doctor or pharmacist before beginning a St. John\u2019s wort regimen because of its potential for <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/diet-supplements-can-interact-medications\/\"><span style=\"font-weight: 400;\">drug-drug interactions<\/span><\/a><span style=\"font-weight: 400;\">. Some medical professionals believe that the risks outweigh the potential benefits, including Dr. Weed. \u201cTreatment failures caused by St. John&#8217;s wort have been reported for anticoagulation, HIV, fungal infections, glaucoma, transplanted organs, heart arrhythmias, and contraception,\u201d he says. \u201cThe more you take, the more adverse the effects.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The following drugs may not be as effective when taken with St. John\u2019s wort:<\/span><\/p>\n<ul>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/alprazolam\"><b>Alprazolam (Xanax)<\/b><\/a><\/li>\n<li><b>Anticonvulsants: <\/b><span style=\"font-weight: 400;\">The decrease in effectiveness can result in loss of seizure control.<\/span><\/li>\n<li><b>Antifungals<\/b><\/li>\n<li>Antiretrovirals<\/li>\n<li><b>Barbiturates<\/b><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/bupropion-hcl-er-sr\"><b>Bupropion (Wellbutrin)<\/b><\/a><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/lanoxin\"><b>Digoxin<\/b><\/a><\/li>\n<li><b>Hormonal birth control (birth control pills, patches, and rings):<\/b><span style=\"font-weight: 400;\"> Decreased effectiveness of birth control can result in irregular bleeding or unplanned pregnancy.<\/span><\/li>\n<li><b>Immunosuppressives (<\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/cyclosporine\"><b>Cyclosporine<\/b><\/a><b>)<\/b><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/irinotecan-hcl\"><b>Irinotecan<\/b><\/a><\/li>\n<li><b>Narcotics: <\/b><span style=\"font-weight: 400;\">The combination can increase risk for serotonin syndrome.<\/span><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/prilosec\"><b>Omeprazole (Prilosec)<\/b><\/a><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/simvastatin\"><b>Simvastatin (Zocor)<\/b><\/a><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/warfarin-sodium\"><b>Warfarin (Coumadin)<\/b><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The following drugs can cause life-threatening serotonin syndrome when taken with St. John\u2019s wort:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.singlecare.com\/prescription\/fluoxetine-hcl\"><b>Fluoxetine (Prozac)<\/b><\/a><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.singlecare.com\/prescription\/sertraline-hcl\"><b>Sertraline (Zoloft)<\/b><\/a><\/li>\n<li>All selective serotonin reuptake inhibitor (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)<\/li>\n<li style=\"font-weight: 400;\"><b>Triptans <\/b><span style=\"font-weight: 400;\">(a class of medications used for migraine, such as Imitrex, or sumatriptan)\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">When St. John\u2019s wort is taken with <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/allegra-allergy\"><b>fexofenadine (Allegra)<\/b><\/a><span style=\"font-weight: 400;\">, it <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12087344\"><span style=\"font-weight: 400;\">may cause buildup<\/span><\/a><span style=\"font-weight: 400;\"> and intensify normal side effects.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The above list is not a comprehensive list of drug interactions, but provides some examples. Be sure to consult with your healthcare provider to ensure St. John\u2019s wort is appropriate and safe to take with any other medications (prescription and over-the-counter, including other supplements) you currently use.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">3 considerations before taking St. John\u2019s wort<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">St. John\u2019s wort has been used for hundreds of years as an alternative medicine by a variety of cultures to treat ailments ranging from anxiety and depressive symptoms to wound and burn care. Determining whether the herbal medicine is right for you requires a few considerations.<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\"><b>The condition you want to treat:<\/b><span style=\"font-weight: 400;\"> St. John\u2019s wort is most promising for treating mild depression, menopausal symptoms, and minor cuts and burns. Treating major depression or serious wounds requires a different approach than St. John\u2019s wort. Additionally, it\u2019s not commonly recommended to treat depression without a doctor\u2019s involvement, so seek a medical opinion you respect before beginning your own St. John\u2019s wort regimen for these purposes.<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>How long you anticipate taking the supplement:<\/b><span style=\"font-weight: 400;\"> Because long-term consequences of taking St. John\u2019s wort aren\u2019t widely studied, it\u2019s recommended to treat conditions that can be resolved within six months<\/span><\/li>\n<li style=\"font-weight: 400;\"><b>Adverse effects and interactions:<\/b><span style=\"font-weight: 400;\"> Consider the side effects and drug interactions of St. John\u2019s wort before taking the herbal supplement.\u00a0<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400;\">No matter how you\u2019ll use it, never begin treatment with St. John\u2019s wort without consulting a healthcare provider, as many serious interactions can occur.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>St. John\u2019s wort is a plant with yellow flowers that grows in a range of climates in the United States and Europe. Also known as hypericum perforatum or klamath weed, ancient Greeks used the plant to treat a range of ailments, from animal bites to depression. Its modern-day benefits fall within similar realms, but its [&hellip;]<\/p>\n","protected":false},"author":85,"featured_media":10834,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[11],"tags":[814,812],"coauthors":[12463],"class_list":["post-10911","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-wellness","tag-drug-interactions","tag-supplements","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>St. John\u2019s wort: Benefits, side effects, and its many interactions<\/title>\n<meta name=\"description\" content=\"St. John\u2019s wort is a natural remedy for conditions including depression and menopause. But it\u2019s not risk free. 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