St. John’s Wort
(Hypericum perforatum)
Also know as Klamath Weed
Botanical Information
An upright perennial herb with thin, opposite eliptical leaves with translucent dots, bright yellow flowers. Crushing the yellow flowers yields a blood-red juice due to coloring pigments in the petals.
Working with St. John’s Wort
Part(s) Used
Flowers, Leaf
Herb Forms
Tincture, standardized extract in tablet, oil, capsule, bulk herb
Christopher Hobbs:
“St. John’s wort shows great promise as an antiviral and anti-inflammatory agent and is being researched for its potential benefit to AIDS patients. It has long been used as a remedy for uterine cramping, mild depression, bedwetting, and anxiety. St. John’s wort is used internally and externally for pain relief. One of its main active ingredients, hypericin, is a strong anti-inflammatory and can penetrate through the skin if applied locally as an oil. This warming and soothing oil is used externally for wounds, nerve pain, trauma due to tension or accidents, and burns. The oil or tincture applied locally is one of the most effective remedies available to help reduce the redness and itching of poison oak rashes and quickly reduce the pain of a scrape or burn.
Herbalists always think of St. John’s wort for healing nerve trauma due to injury or chronic disease. Modern research from Europe has shown the whole plant extract to be as effective as a popularly prescribed drug for mild depression.
To make an oil, grind enough fresh flowering tops (traditionally harvested on St. John’s day–June 24th) to nearly fill a given quantity of olive oil. Wait for 2 weeks, strain and filter the oil, bottle for use. A traditional way of making the oil and effectively increasing the intensity of its red color is to make the infusion in the direct sun.
St. John’s Wort has a taste of BITTER, SWEET and a temperature of COOL.”
Historical Uses
St. John’s Wort (Hypericum perforatum) has been used for centuries in traditional medicine. Historically, it was a remedy for wounds, burns, and nerve-related conditions. Ancient Greeks, including Hippocrates, used it for its purported anti-inflammatory and mood-enhancing effects. It was also believed to ward off evil spirits in medieval times.
Modern Clinical Uses
Today, herbalists and naturopaths primarily use St. John’s Wort for its antidepressant properties, particularly for mild to moderate depression. Other uses include managing anxiety, seasonal affective disorder (SAD), menopausal symptoms, and sleep disorders. Topical preparations are sometimes used for wound healing and minor burns.
Chemistry
St. John’s Wort contains several active compounds, including:
- Hypericin and pseudohypericin: Linked to its antidepressant and antiviral effects.
- Hyperforin: Plays a role in modulating neurotransmitters like serotonin, dopamine, and norepinephrine.
- Flavonoids and tannins: Contribute to antioxidant and anti-inflammatory properties.
Pharmacology
The antidepressant effects are believed to result from:
- Inhibition of neurotransmitter reuptake (serotonin, dopamine, norepinephrine).
- Modulation of gamma-aminobutyric acid (GABA) and glutamate pathways.
- Anti-inflammatory actions on the central nervous system.
However, St. John’s Wort also induces cytochrome P450 enzymes, particularly CYP3A4, which affects the metabolism of many drugs, leading to significant drug interactions.
Safety
While generally well-tolerated, common side effects include:
- Mild: Dry mouth, dizziness, gastrointestinal discomfort, and fatigue.
- Serious: Photosensitivity (sensitivity to sunlight) and risk of serotonin syndrome when combined with other serotonergic drugs.
- Drug Interactions: St. John’s Wort can reduce the efficacy of oral contraceptives, anticoagulants, antiretrovirals, and certain chemotherapeutic agents due to its enzyme-inducing effects.
It’s not recommended for use in severe depression, during pregnancy or lactation, or in combination with other antidepressants.
Clinical Trials
Numerous clinical trials have evaluated its efficacy:
- Depression: Studies show that St. John’s Wort is as effective as selective serotonin reuptake inhibitors (SSRIs) like fluoxetine for mild to moderate depression, with fewer side effects.
- Other conditions: Some evidence supports its use for anxiety, PMS, and somatic symptom disorders, but findings are inconsistent.
- Meta-analyses: A Cochrane review confirmed its benefit in mild to moderate depression but noted variability in extract quality and trial methodologies.
Summary
St. John’s Wort is a well-researched herbal remedy primarily used for mild to moderate depression. Its efficacy rivals some conventional antidepressants, but safety concerns, particularly drug interactions, limit its widespread use. Clinicians should assess patient medications carefully before recommending it.
Generated by ChatGPT; edited by Christopher Hobbs
Cautions
While generally well-tolerated, common side effects include:
Mild: Dry mouth, dizziness, gastrointestinal discomfort, and fatigue.
Serious: Photosensitivity (sensitivity to sunlight) and risk of serotonin syndrome when combined with other serotonergic drugs.
Drug Interactions: St. John’s Wort can reduce the efficacy of oral contraceptives, anticoagulants, antiretrovirals, and certain chemotherapeutic agents due to its enzyme-inducing effects.
It’s not recommended for use in severe depression, during pregnancy or lactation, or in combination with other antidepressants.
Conditions treated with St. John’s Wort
Condition
Treatment Support
Application
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Condition
Treatment Support
antidepressant, nerve tonic
Application
tincture, tablet
Condition
Treatment Support
antiviral, anti-inflammatory
Application
oil externally, tincture internally
Condition
Treatment Support
nervous system tonic
Application
tincture, tablet, capsule
Condition
Treatment Support
hormone tonic, mood regulator
Application
standardized extract in capsules or tablets, tincture
Condition
Treatment Support
anti-inflammatory
Application
oil externally, tincture internally
Condition
Treatment Support
anti-inflammatory
Application
oil externally, tincture internally
Condition
Treatment Support
anti-inflammatory
Application
tincture, tablet, capsule
Condition
Treatment Support
anti-inflammatory
Application
tincture internally, oil externally
Condition
Treatment Support
antiviral, anti-inflammatory
Application
tincture interally, oil externally
Condition
Treatment Support
anti-inflammatory
Application
oil externally, tincture internally
Dosages
Powdered Extract
(standardized extract) 300 mg 3 times daily
Ointment
use topically for skin issues
Tincture
2-3 dropperfuls twice daily
Infusion
1 cup 2-3 times daily
Capsules
follow label instructions
The information given here is designed to help you make informed choices about your health. The information is drawn from numerous sources—both traditional medicine practice, from the clinical experience of many herbalists currently practicing, and supported by decades of scientific research from the author. The research most consulted includes human clinical trials that help to determine the most effective and safe herbs for various needs, the best doses, and types of preparations.
The information offered in this database is not intended as a substitute for any that may have been prescribed by your health practitioner or physician.