St. John's Wort
St. John's Wort or Hypericum perforatum is a yellow flowering herb. The plant is native to Europe where it has a long history in herbal medicines. Over the centuries, St. John's wort has been used for a variety of conditions.
Oily preparations are applied to the skin to treat minor burns and wounds. Taken as tea or extract, the herb has a mood balancing effect on the body. Extracts are also used to treat premenstrual and menopause syndromes.
Hypericum perforatum has been introduced to North America as an ornamental and as medicinal herb. Nowadays, the perennial with its cheery flowers can be found in many temperate parts of the world.
Modern research supports the effectiveness of St. John's Wort for depression. Today, it is a popular treatment for anxiety and mild to moderate depression. Many people choose Hypericum perforatum preparations as a herbal alternative to synthetic antidepressants.
Hypericum perforatum is a member of the Hypericaceae family. This large plant family is also known as St. John’s wort family.
Several Hypericum species are cultivated for their attractive flowers. Hypericum perforatum is the only species used in official medicine. The herb top of the plant is used to make tea and dry extracts of the plant.
Hypericum perforatum has many common names such as common or perforated St. John’s Wort, Hypericum, Goatweed, or Klamath weed.
What does the plant look like?
St. John's wort is a shrubby herb that typically ranges from about 40 to 80 cm in height. Its leaves are covered with small translucent spots.
The star-shaped flowers grow in clusters. They are yellow with occasional black dots along the edges of the petals. The flowers bloom in June around the summer solstice. They produce capsules that contain dozens of tiny, dark-brown seeds.
Where does the name come from?
The genus name Hypericum is thought to come from the Greek words ‘hyper’, meaning over, and ‘eikon’, meaning picture or image. This might refer to the plant’s supposed ability to protect people by being hung above pictures. Perforatum is Latin, referring to the perforated appearance of the plant's leaves.
The plant is commonly named St. John's Wort since it often flowers around St. John's day on 24 June. ‘Wort’ comes from an Old English word for plant or herb.
Hypericum perforatum as a medicinal plant
St. John's wort has been used as a medical herb for several hundred years. It is a common herbal treatment for depression and depressive disorders. Multiple clinical trials suggest that Hypericum extract is effective in patients with mild-to-moderate depression.
Some studies compared the treatment with St. John’s Wort extract to placebo. The results showed an improvement in depression scores for the St. John's Wort group. No adverse effects were reported in either group. The extract appears to act similarly to selective serotonin reuptake inhibitors (SSRIs).
Other studies investigated how effective Hypericum extract is for mild-to-moderate depression compared to SSRIs. The results suggest that St. John's Wort benefits are similar to low-dose tricyclic antidepressants in these patients. Also, the treatment with Hypericum seems to be better tolerated.
However, St. John's wort does not seem to be effective in patients with major depression or major depressive disorder.
Mood disorders are also frequently reported in women with premenstrual syndrome (PMS). A small clinical study evaluated the daily use of Hypericum extract for PMS. The symptoms significantly decreased after two cycles of treatment. This suggests that Hypericum may be useful as a treatment for PMS, but more research is needed.
Medicinal Properties of Hypericum perforatum
St. John's wort extract acts
- mood balancing
- anti-inflammatory
- anti-microbial
- vulnerary (wound healing)
- neuroprotective
Hypericin, one of the herb’s active substances, also showed antiviral and anti-tumor activities in test-tube experiments.
How and what is it used for
The flowering aerial parts of the herb are used to make tea, extracts, and oil macerates.
H. perforatum oil is used on the skin to treat burns and wounds. St. John's wort extracts can be taken as tablets, capsules, or liquids.
St. John's wort has been traditionally used to help with many conditions, including
- Depression and depressive disorders
- Dysthymia
- Heart palpitations
- Mood disturbances
- Somatic Symptom Disorder
- Premenstrual Symptoms (PMS)
- Attention Deficit/Hyperactivity Disorder (ADHD)
- Obsessive-Compulsive Disorder (OCD)
- Seasonal Affective Disorder (SAD)
Health Canada approves its use in herbal medicine to help
- Relieve restlessness and/or nervousness (calmative)
- Promote healthy mood balance
- Relieve sleep disturbances associated with mood imbalance
St. John's wort takes time to build-up in the body. It should be used for at least 1 week to see beneficial effects. However, for some individuals it may take three to six weeks of consistent use to find relief.
How does it work?
St. John's Wort contains several different active components. Two principle active substances are hypericin and hyperforin. For a long time, hypericin was believed to be responsible for the herb's effects on improving mood. More recent research suggests that other compounds like hyperforin also play an important role.
The active components seem to act similarly to a certain type of antidepressant, the so-called selective serotonin reuptake inhibitors (SSRIs). However, they appear to impact multiple neurotransmitters including serotonin and dopamine.
These neurotransmitters are chemical messengers in the nervous system. They regulate mood and are known as happiness hormones. St. John's Wort reduces the uptake of serotonin, dopamine, and others in the brain. This causes increased levels of the neurotransmitters that make us feel good.
Various components of the herb seem to be essential for its antidepressant and mood-improving effects. However, most often Hypericum extracts and health products are standardized to the hypericin extract.
Hypericin can lead to increased sensitivity to sunlight, especially in light-skinned or photosensitive persons. This photosensitization as well as gastrointestinal symptoms seem to be the limiting factors for St. John's Wort dosage. Still, when used carefully, side effects are reported to be rare.
What makes St. John's wort different?
St. John's has been shown to increase the amount of serotonin present in the body similarly to pharmaceutical drugs. The main difference between pharmaceutical SSRIs and herbal St. John's Wort is that synthetic drugs only work by one mode of action.
St. John’s Wort on the contrary has multiple modes of action that come from using the whole plant. This is one of the most unique aspects of herbal medicine. They work on multiple pathways and systems to help balance the body and mind.
Also, the herbal mood balancer is usually well tolerated without the adverse effects of pharmaceutical antidepressants.
Cautions and drug interactions
St. John's wort is generally considered safe when taken orally for up to 12 weeks in appropriate doses. A study in patients with mild to moderate depression found that even a treatment for up to one year was safe and effective.
Although usually well tolerated, the herb may cause certain side effects. St. John's wort side effects include photosensitivity, gastrointestinal symptoms, allergic reactions, fatigue, or restlessness. Some people may experience headaches.
However, Hypericum perforatum preparations should be taken with caution as there are many known drug interactions with St. John's Wort. This is because the herb up-regulates specific enzymes in the liver that metabolize many medications. It means that some drugs are removed from the body faster than they normally would be. The effectiveness of these medications is decreased so that they may not work properly.
This includes important medications such as
- Birth control pill
- Certain oral blood thinner, including warfarin and phenprocoumon
- Certain drugs that suppress transplant rejection reactions, including cyclosporine
- Certain heart medications, including digoxin and ivabradine
- Certain HIV drugs, including indinavir and nevirapine
- Certain cancer medications, including irinotecan and imatinib
- Verapamil
- Certain statins, including simvastatin
- Various drugs for depression, including amitriptyline, nortriptyline, midazolam
- Theophylline
Hypericum preparations can increase the risk of sunburns because of the herb's phototoxic properties. It can make the skin more sensitive to the sun, especially in fair skinned people. This is more common when St. John's is used externally. However, phototherapy or excessive sunbathing should be avoided.
St. John's can have very severe side effects when taken with standard antidepressants. While serotonin is a very beneficial neurotransmitter, too much of it can be harmful. It can lead to the so-called serotonin syndrome or serotonin toxicity.
Symptoms of this condition include fever, irritation or confusion, increased reflexes, tremor, sweating or shivering, dilated pupils, diarrhea, seizures, muscle stiffness, increased heart rate or blood pressure.
Some cases of serotonin syndrome can be life-threatening and should be treated immediately. In general, St. John's should not be taken together with other natural or pharmaceutical remedies that increase serotonin in the body.
Also, St. John's wort should not be used during pregnancy or lactation.
Let your healthcare provider know if you want to take St. John's wort. This is particularly important if you take any medications. Together, you can find the best way to support your mood and well-being.
Disclaimer
Pascoe Canada does not offer health or medical advice as we are not a healthcare practitioner. Please speak with your healthcare practitioner before beginning any program related to nutrition, diet, exercise, fitness, medical, and/or wellness. All content published by Pascoe Canada is developed through collaborating with licensed medical professionals and contributors. This includes text, graphics, images, and other material on the website, newsletter, and products (“Content”). This content is for informational purposes only and does not constitute medical advice. The content does not substitute professional medical advice, diagnosis, or treatment. Please always do your own research on whether this is for you along with your healthcare practitioner advice. Always consult your healthcare practitioner prior to use specific herbs because you might have underlined conditions needs professional care. The content is general in nature and are subject to change. It is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
What can Hypericum Help with or is indicted for
- depression and depressive disorders
- dysthymia
- heart palpitations
- mood disturbances
- somatization disorder
- premenstrual symptoms (PMS)
- attention deficit hyperactivity disorder (ADHD)
- Obsessive-Compulsive Disorder (OCD)
- Seasonal Affective Disorder
What can Hypericum Help with or is indicted for
- depression and depressive disorders
- dysthymia
- heart palpitations
- mood disturbances
- somatization disorder
- premenstrual symptoms (PMS)
- attention deficit hyperactivity disorder (ADHD)
- Obsessive-Compulsive Disorder (OCD)
- Seasonal Affective Disorder
What can Hypericum Help with or is indicted for
- depression and depressive disorders
- dysthymia
- heart palpitations
- mood disturbances
- somatization disorder
- premenstrual symptoms (PMS)
- attention deficit hyperactivity disorder (ADHD)
- Obsessive-Compulsive Disorder (OCD)
- Seasonal Affective Disorder