St. John’s Wort: Everything You Need to Know

Uses of St. John’s Wort

St. John’s wort is an herb used in dietary supplements to relieve symptoms of depression. Research shows that St. John’s wort works as well as some antidepressants for the short-term treatment of depression. Be aware that taking supplements with antidepressants can cause a severe interaction.

St. John’s wort is also touted for treating skin conditions and reducing menopause symptoms. However, more scientific research is needed to back these benefits. It’s essential to consult your healthcare provider before taking St. John’s wort because it makes many medications less effective, including birth control pills and medicines for treating heart conditions.

Depression

Depression is the most common mental illness, affecting close to 4% of people worldwide. It is characterized by symptoms like sadness, anxiety, decreased appetite, and anhedonia (the loss of pleasure in activities).

St. John’s wort is prescribed for depression in some European countries and is commonly used as an OTC supplement in the United States.

Studies show that around 56% of people who use St. John’s wort respond positively to treatment vs. 35% of people treated with a placebo (sugar pill without active medicine).

St. John’s wort is as effective as a common class of prescription antidepressants called selective serotonin reuptake inhibitors (SSRIs) for mild to moderate depression.

It’s mainly been studied short-term for up to twelve weeks. This means that long-term effects are uncertain. And it’s unclear if St. John’s wort benefits severe depression or suicidality.

Supplement Facts

• Active Ingredients: Hypericin, hyperforin, flavonoids, proanthocyanidins, procyanidines, tannins, essential oil, amino acids, phenylpropanes, xantones
• Alternate Names: Hypericum, Klamath weed, goatweed, Hypericum perforated
• Legal Status: Over-the-counter (OTC) dietary supplement (United States)
• Suggested Dose: 300 milligram (mg) capsule containing 0.3% hypericin three times a day for depression
• Safety Considerations: Not recommended during pregnancy or breastfeeding, and it may interact with many prescription medications, herbs, and supplements

Skin Disorders

St. John’s wort has a long history of use for various skin conditions, such as acne, eczema, and wounds.

The component hyperforin in the herb is believed to be responsible for St. John’s wort’s antibacterial effects and wound care benefits.

Clinical trials are rare, however. It has been researched in small human trials for the following:

• Although it may benefit these conditions, larger trials are needed before it can be recommended for routine use.

Menopausal Symptoms

A study of 80 postmenopausal women found that St. John’s wort improved symptoms of depression, anxiety, and sleep disturbances.

St. John’s Wort Supplements

St. John’s wort is widely available as a supplement in health food stores, groceries, pharmacies, and online. It can be purchased in many forms, such as:

• Tablets
• Capsules
• Tea
• Oil
• Tinctures
• Extracts
• Topical products

Look for products that have been independently tested by one of the following agencies:

• U.S. Pharmacopeia (USP)
• ConsumerLab.com
• NSF.org

Summary

St. John’s wort is a flowering herb that may be an alternative to conventional antidepressants for mild to moderate depression, particularly for people not taking other medications.

It’s essential to keep in mind, though, that just because some substances are natural doesn’t mean it’s safe. Do involve a healthcare provider in any treatment plan for depression.

St. John’s wort can decrease the effects of many prescription medications, from birth control pills to heart medicines. Your provider can help you monitor for side effects and interactions.

Frequently Asked Questions

1. What medications interact with St. John’s wort?
   St. John’s wort decreases the effect of many other medicines. Some examples include antidepressants, birth control pills, blood thinners, and medications for cancer, HIV, blood pressure, and cholesterol.
2. Is St. John’s wort safe during pregnancy and breastfeeding?
   Although St. John’s wort has been used in clinical trials of pregnant and nursing women, it is typically not recommended for these groups due to the possibility of congenital disabilities or side effects in nursing infants.
3. What are some nonmedication approaches that may help depression?
   Psychotherapy and behavioral therapy are common treatment modes for depression. Exercise, light therapy, yoga, and acupuncture may also be beneficial.
4. Does St. John’s wort interact with any foods?
   Theoretically, St. John’s wort may interact with foods or drinks that contain tyramine, such as aged cheese or wine, to cause high blood pressure. Although one case report exists of an interaction happening, there’s no evidence to prohibit eating certain foods while taking St. John’s wort.