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St. John's Wort (Hypericum perforatum)

St. John's Wort (Hypericum perforatum)

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

About

St. John's wort is a plant with yellow, star-shaped flowers and five petals that grows in Europe, North and South America, Australia, New Zealand, and Eastern Asia. The plant grows in sunny, well-drained areas. It grows to be 50-100 cm tall.

St. John's wort might cause serious interactions with some drugs. Because of this, France has banned the use of St. John's wort in products. Several other countries, including Japan, the United Kingdom, and Canada are in the process of updating warning labels on St. John's wort products.

St. John's wort is most commonly used for depression and conditions that sometimes go along with depression such as anxiety, tiredness, loss of appetite and trouble sleeping. There is some strong scientific evidence that it is effective for mild to moderate depression.

Other uses include heart palpitations, moodiness and other symptoms of menopause, mental disorders that present physical symptoms, premenstrual syndrome (PMS), attention deficit-hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), social phobia, and seasonal affective disorder (SAD).

St. John's wort has been tried to help quit smoking, for fibromyalgia, chronic fatigue syndrome (CFS), burning feelings in the mouth, migraine and other types of headaches, muscle pain, nerve pain and nerve damage throughout the body, pain that travels down the sciatic nerve in the leg, and irritable bowel syndrome. It is also used for cancer (including brain cancer), HIV/AIDS, hepatitis C, herpes simplex, to help with a procedure to unblock clogged arteries, weight loss, and to treat a disease that causes the skin to lose color.

An oil can be made from St. John's wort. Some people take this oil by mouth for indigestion. Some people apply this oil to their skin to treat bruises and scrapes, inflammation and muscle pain, scaly and itchy skin (psoriasis), first degree burns, wounds, tooth pulling, bug bites, hemorrhoids, nerve pain, and to treat a disease that causes the skin to lose color. But applying St. John's wort directly to the skin is risky. It can cause serious sensitivity to sunlight.

In manufacturing, St. John's wort extracts are also used in alcoholic beverages.

The active ingredients in St. John's wort can be deactivated by light. That's why you will find many products packaged in amber containers. The amber helps, but it doesn't offer total protection against the adverse effects of light.

How does it work?

For a long time, investigators thought a chemical in St. John's wort called hypericin was responsible for its effects against depression. More recent information suggests another chemical, hyperforin, as well as adhyperforin, and several other similar chemicals may play a larger role in depression. Hyperforin and adhyperforin act on chemical messengers in the nervous system that regulate mood.

Traditionally used for

Depression.
Menopausal symptoms.
The conversion of mental experiences or states into bodily symptoms (somatization disorder).
Wound healing.
A procedure to widen blocked arteries (angioplasty).
Anxiety.
Brain tumor (glioma).
Herpes.
Migraine headache.
Obsessive-compulsive disorder (OCD).
Skin redness and irritation (plaque psoriasis).
Seasonal affective disorder (SAD).
Stomach upset.
Bruises.
Skin conditions.
Nerve pain.
Sciatica.
Excitability.
Fibromyalgia.
Chronic fatigue syndrome (CFS).
Muscle pain.
Weight loss.

Dosage

By Mouth:

For mild to moderate depression: In most studies, St. John's wort extract was standardized to 0.3% hypericin content and used at doses of 300 mg three times daily. Some studies have used St. John's wort extract standardized to 0.2% hypericin at doses of 250 mg twice daily. St. John's wort extract standardized to 5% hyperforin has been used at doses of 300 mg three times daily.

For premenstrual syndrome (PMS): St. John's wort extract standardized to 0.3% hypericin dosed at 300 mg once daily has been used.

For body symptoms associated with depression: 300 mg three times daily of the standardized hypericin extract has been used.

For somatization disorder: a specific extract (LI 160, Lichtwer Pharma) 600 mg/day has been used.

By skin

For wound healing: An ointment containing a 5% St. John's wort extract applied three times daily beginning 24 hours after a C-section and continued for 16 days has been used.

For Children

For mild to moderate depression: 150-300 mg of St. John's wort three times daily for 8 weeks in children 6-17 years-old has been used. A specific St. John's wort extract (LI 160, Lichtwer, Pharma) 300-1800 mg in three divided doses daily for up to 6 weeks has been used.

Do not suddenly stop taking St. John's wort. This might cause unpleasant side effects. If you decide to stop taking St. John's wort, reduce the dose slowly over time.

Possible Side Effects

St. John's wort is SAFE when taken by mouth for up to 12 weeks. Some evidence suggests it can be used safely for over one year. It can cause some side effects such as trouble sleeping, vivid dreams, restlessness, anxiety, irritability, stomach upset, fatigue, dry mouth, dizziness, headache, skin rash, diarrhea, and tingling. Take St. John's wort in the morning or lower the dose if it seems to be causing sleep problems.

St. John's wort is POSSIBLY UNSAFE when taken by mouth in large doses. When taken by mouth in large doses, it might cause severe reactions to sun exposure. Wear sun block outside, especially if you are light-skinned.

St. John's wort interacts with many drugs (see the section below). Let your healthcare provider know if you want to take St. John's wort. Your healthcare provider will want to review your medications to see if there could be any problems.

There isn't enough reliable information available to know if St. John's wort is safe when it is applied to the skin. St. John's wort might cause severe reactions to sun exposure.

Special Precautions & Warnings

Pregnancy and breast-feeding: St. John's wort is POSSIBLY UNSAFE when taken by mouth during pregnancy. There is some evidence that it can cause birth defects in unborn rats. No one yet knows whether it has the same effect in unborn humans. Nursing infants of mothers who take St. John's wort can experience colic, drowsiness, and listlessness. Until more is known, do not use St. John's wort if you are pregnant or breast-feeding.

Children: St. John's work is SAFE when taken by mouth for up to 8 weeks in children 6-17 years-old.
Alzheimer's disease: There is concern that St. John's wort might contribute to dementia in people with Alzheimer's disease.

Anesthesia: Use of anesthesia in people who have used St. John's wort for 6 months may lead to serious heart complications during surgery. Stop using St. John's wort at least 2 weeks before a scheduled surgery.

Attention deficit-hyperactivity disorder (ADHD): There is some concern that St. John's wort might worsen symptoms of ADHD, especially in people taking the medication methylphenidate for ADHD. Until more is known, don't use St. John's wort if you are taking methylphenidate.

Bipolar disorder: People with bipolar disorder cycle between depression and mania, a state marked by excessive physical activity and impulsive behavior. St. John's wort can bring on mania in these individuals and can also speed up the cycling between depression and mania.

Depression: In people with major depression, St. John's wort might bring on mania, a state marked by excessive physical activity and impulsive behavior.

Infertility: There are some concerns that St. John's wort might interfere with conceiving a child. If you are trying to conceive, don't use St. John's wort, especially if you have known fertility problems.

Schizophrenia: St. John's wort might bring on psychosis in some people with schizophrenia.

Surgery: St. John's wort might affect serotonin levels in the brain and as a result interfere with surgical procedures. Stop using St. John's wort at least two weeks before a scheduled surgery.

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