Introduction

St. John’s Wort (Hypericum perforatum) is a plant that can be found in growing in the wild. Its primary use for over the centuries has been for treating mental health conditions, more precisely, it has been widely prescribed and used as a treatment against depression. There have been many studies to evaluate the effectiveness of St. John’s Wort. As to why there is a lot of controversy in using this plant.

There have been a lot of mixed conclusions about its effectiveness. However, if you’re considering using St. John’s Wort be sure to read up on it and contact your doctor before using it, as St. John’s Wort can interact with many different kinds of medicine or supplements and can induce side effects. The common name St. John’s Wort derives from the traditional flowering and harvesting that occurs on 24th of June, or on St. John’s day. The genus name derived from the Greek words hyper (above) and eikon (picture), it is a reference to the tradition that hanging the plant over religious icons on St. John’s day, fights of any evil.

So how does St. John’s Wort look?

St. John’s Wort (Hypericum perforatum) is a herbaceous perennial plant. The stems of this plant are erect, branching in the upper section, and possible height growth of 1 meter, it has opposite, stalkless, narrow, and oblong leaves that are 1-2 cm long. The leaves mostly are green-yellow in color, with translucent dots of the glandular tissue which can are visible when held up to the light, from where the leaves get their ‘perforated’ appearance to which the plant’s Latin name refers. The flowers usually measure up to 2.5 cm across, with five petals, and are colored bright yellow with conspicuous black dots. The flower appears in broad cymes at the ends of the upper branches. The flowers appear late spring and early to mid-summer. Their pollen grains are ellipsoidal.

Scientific evidence about St. John’s Wort treatment against depression

As previously mentioned there has been a lot of studies and evaluations about St. John’s Wort as to why there is some scientific evidence about it treating mild depression and as to why it’s benefits are similar to those of antidepressants. However, there have been two major studies, that stated that the herb was no more than a placebo when it comes to treating depression of moderate severity, in these studies conventional drugs were studied and they did not score any better than a placebo, either.

A small introduction to what Depression is:

Depression (major depressive disorder or clinical depression) is very common these days, and it represents a serious mood disorder. It can cause severe symptoms that affect how you feel, think and handle oncoming tasks or daily activities, such as sleeping, eating, or working. In 2015, in the U.S. alone, 7 percent of adults had at least one episode of major or severe depression in just the past year. The symptoms of depression vary in different cases but mainly they are:

  • The feeling of sadness all the time
  • Feeling of anxiety constantly
  • Not wanting to do activities that you found amusing or fun
  • Being easily frustrated, irritated or restless
  • Having problems with sleep and constantly feeling tired
  • Bigger or smaller appetite than usually
  • Having trouble concentrating, making decisions or remembering details.
  • Constant feel of being guilty, Worthless, or helpless.
  • Having thoughts about suicide or hurting yourself.
    If you think you’re experiencing any of these symptoms, please contact your doctor or psychologist about bits of advice. Antidepressants and variety of psychotherapies help treat depression.
  • Depression can be a serious mental illness and can lead to an increased risk of suicide. If you or someone you know has depression, talk to a health care provider, as it is not recommended to treat depression on your own.

So what precisely does science say about the safety and side effects for St. John’s Wort for depression?

It has been proven that combining St. John’s Wort and certain antidepressants have lead to potential life-threatening increased levels of serotonin, which is a brain chemical targeted by antidepressants. The signs of danger can occur within minutes to hours, and may include agitation, diarrhea, high blood pressure, in extreme cases hallucinations, increased body temperature and more.

There have been cases where St. John’s Wort having extremely dangerous side effects, as in worsening of psychotic symptoms in people with bipolar disorder or schizophrenia.

It is known that St. John’s Wort weakens the effect of a big number of prescription medicine, such as:

  • Antidepressants
  • Birth control pills
  • Certain chemotherapy drugs, like irinotecan
  • Digoxin, a heart medication
  • HIV drugs, like indinavir
      • Barbiturates
      • Ketamine
      • Narcotics, like methadone
      • Alprazolam (Xanax)
      • It is not recommended to use St. John’s Wort to replace already prescribed drugs and to postpone seeing a health care provider about a serious mental health problem.
      • Herbal therapies are not recommended for pregnant women, elderly people, children or people with certain medical conditions and people taking certain medicines.

Other minor and uncommon side effects of St. John’s Wort can usually be:

  • Upset stomach
  • Dry mouth
  • Headache
  • Fatigue
  • Confusion
  • Dizziness
  • Sexual dysfunction
  • Higher sensitivity to light
  • St. John’s Wort is considered as a stimulant and can worsen feelings of anxiety in some people.

Precautions to take when using herbal remedies:

We list some precautions that we recommend taking before using herbal remedies to ensure your safety:

  • Previously discussing with your doctor about the usage of drugs or supplements or even herbal products.
  • Notifying your health care provider if you’re experiencing side effects such as nausea, vomiting, anxiety, insomnia, skin rashes or even rapid heartbeat.
  • Being beware of commercial claims of what herbal products can do.
    Be sure to look for scientific-based sources of information.

Where to find St. John’s Wort (Hypericum perforatum)?

Hypericum perforatum is considered native to certain parts of Europe and Asia, but over the decades it has spread to temperate regions worldwide as a cosmopolitan invasive weed. These days St. John’s Wort is usually found in most pharmacies.

Other uses of St. John’s Wort

St. John’s Wort

St. John’s Wort (Hypericum perforatum) contains an active ingredient called hyperforin, which has been used in treatment for alcoholism, although the correct dosage, safety, and efficacy have not been studied. Hyperforin has displayed antibacterial properties against the bacteria called Gram-positive. A lipophilic extract from St. John’s Wort has been used in Herbal medicine as a topical remedy for wounds, abrasion, cuts, burns, muscle spasm and muscle pain. The positive effects on this herb are generally associated with the ingredient hyperforin, because of its antibacterial and anti-inflammatory properties, as to why hyperforin is used to treat some inflammatory skin diseases and infected wounds. St. John’s Wort as a herbal remedy has been used in treating insomnia, fluid retention and even hemorrhoids, as in the treatment of nerve pain too. On rare occasions St. John’s Wort has been used in treating menopausal symptoms when combined with a particular form of black cohosh extract.

Recommendations for taking St. John’s Wort

If you are planning on starting to use St. John’s Wort, you must not eat or drink certain foods and drinks that are high in tyramine. Alcohol is strictly prohibited since it can increase the nervous system side effects of St. John’s Wort, such as difficulty concentrating, dizziness, impairment in thinking and proper judgment and making decisions. St. John’s Wort can be used as an appetite suppressant since it can decrease starch and sugar intake and can cause ‘early fullness’ and can help weight loss in short terms, it has not been tested in long-term managing of obesity.

The recommended dosage for St. John’s Wort has a range of 300mg to 1200mg per day, which are usually taken in a dosage of 300mg three times a day or 600mg twice in a day. The dosage varies because of non-standardized manufacturing. The effects of St. John’s Wort have not been fully understood, although there have been many studies on it.

Summary

This plant has not been approved by the FDA (Food and Drug Administration) for being over-the-counter(OTC) or prescription usage in the United States, since FDA regulations for dietary supplements are different than those for drug products. Unless a new dietary ingredient is added, the firm does not have to provide evidence to the FDA officials about the safety or effectiveness before or after marketing the products. Also, the three active ingredients (hypericin, pseudohypericin, and hyperforin) may be quantitated in plasma as a confirmation of usage and an estimate of the dosage, which means they have plasma elimination half-lives in a range of 15-60 hours in humans. None of these three have been detected in urine specimens. The taste (and smell) of StJohn’s Wort is characteristically slightly sweet, bitter, and astringent. A commercial oil or tincture of Hypericum should be vivid, almost fluorescent red. Beware If the preparation is pale red and/or slightly pink, the hypericin content and the quality of the product is of a possible lower quality.

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