St. John's Wort Blog Post

St. John's Wort

BY THEASHEN MOODLEY

Key Definitions

Adaptogen – a natural substance considered to help the body adapt to stress.
Anxiolytic – a drug used to relieve anxiety.
Astringent – a substance that causes the contraction of skin cells and other body tissues
Constituent - a component part of something.
Contraindications – a condition or circumstance that suggests or indicates that a particular technique or drug should not be used in the case in question.
Emmenagogue – a substance that stimulates or increases menstrual flow.
Indications – A symptom that suggests certain medical treatment is necessary.
Nervine – a medicine used to calm the nerves.
Tonic – a medicinal substance taken to give a feeling of vigour or well-being.
Vulnerary – a medicine used in the healing of wounds.

Introduction

St. John’s Wort was touted as the “happy herb” of the 1990s as it was used to treat depression and anxiety. In recent years St. John’s Wort has also shown promise as a remedy for damaged nerve endings. If you suffer from nerve pain or damage, insomnia, stress, mild (to moderate) depression and anxiety, fibromyalgia, chronic fatigue or seasonal affective disorder then St. John’s Wort may be able to help (Gladstar, 2014) (Easley & Horne, 2016).

St. John’s Wort belongs to the Hypericaceae plant family and is a perennial that grows to 80 cm in height. St. John’s Wort has bright yellow flowers that appear in flat-topped clusters. St. John’s Wort thrives in temperate climates across the globe and is normally harvested in summer (Chevallier, 2016).

Tincture surrounded by St. John's Wort flowers

Constituents, Actions & Indications

Constituents

Phloroglucinols (hyperforin); polycyclic diones (hypericin, pseudohypericin); flavonoids (hyperoside, rutin); volatile oil (caryophyllene, methyl-2-octane, n-nonane, n-octanal, n-decanal, alpha- and beta-pinene); catechins; proanthocyanidins (Chevallier, 2016).

Actions

Antidepressant; antiseptic; antiviral; digestive tonic; nervine; vulnerary; anxiolytic; wound healer; anti-inflammatory; antimicrobial; astringent (Easley & Horne, 2016) (Chevallier, 2016) (Hoffmann, 2003).

Indications

Anxiety, depression and tension; back pain; bites and stings; cold sores, chicken pox and shingles; depression and decreased vitality due to menopause; neuralgia; stiff and aching joints; tired and aching muscles; fibrositis, sciatica and rheumatic pain; healing of wounds (Chevallier, 2016) (Hoffmann, 2003).

Scientific Research

Resources by Ng, et al., 2017 and Coppock & Dziwenka, 2016 present the findings of clinical studies completed on St. John’s Wort in humans. These findings are summarised below:

The results of numerous clinical studies suggest that St. John’s Wort could be considered a viable alternative to SSRIs for mild to moderate depression as it has similar results, fewer side effects and a lower risk of discontinuation (or dropout).
Clinical studies have suggested that St. John’s Wort may control postoperative pain.
St. John’s Wort was seen to increase the duration of deep sleep across numerous studies.
Meta-analyses have shown that St. John’s Wort is an effective treatment for menopausal discomfort with few side effects.
Topical preparations of St. John’s Wort have shown antimicrobial activity.

Aether Apothecary St. John's Wort tincture on grey background

Preparations & Dosage

Infused oil – apply topically to bruises, sprains, burns and injuries of all kinds. Infuse 70% St. John’s Wort flowers and 30% St. John’s Wort leaves in olive oil (in a 1:4 ratio) for 2 to 6 weeks (Gladstar, 2014) (Chevallier, 2016) (Easley & Horne, 2016).

Infusion – pour 1 cup of boiling water over 1-2 tsp of dried herb and infuse for 10-15 mins. Take 100-240 mL 1-4 times a day as a digestive tonic (Easley & Horne, 2016) (Chevallier, 2016).

Tincture – take 5 drops to 3 mL 3 times a day of a 1:2 ratio tincture (containing fresh plant material and 95% alcohol) (Easley & Horne, 2016) (Chevallier, 2016). Take 2-4 mL 3 times a day of a 1:5 ratio tincture (containing 40% alcohol) (Hoffmann, 2003).

Capsule – take 500-1 500 mg 3-4 times a day (Easley & Horne, 2016).

Cream – for cramps or neuralgia rub onto the affected part (Chevallier, 2016)

Note that tinctures and infusions prepared from fresh, good-quality herbs will turn a deep red. If the colour does not turn red then it is an indication that the plant material is old, of poor quality or the wrong species of St. John’s Wort (Easley & Horne, 2016).

Shop our St. John’s Wort extract here.

Nerve Formula for Depression

This recipe was taken from Herbs for Stress & Anxiety and can be used for depression and grief. You can adjust the proportions of herbs to best suit your needs and sweeten the formula with a bit of honey. Use only the flowers and leaves of St. John’s Wort in a ratio of 70% flowers and 30% leaves (Gladstar, 2014).

Ingredients

1 L water
4 tbsp Hawthorn (berries, flowers, and leaves)
4 tbsp lemon balm
4 tbsp oats (milky green tops)
4 tbsp St. John’s Wort

Instructions

Mix the herbs in a heat-resistant container, e.g., a teapot.
Boil water and pour over the herb mixture.
Allow mixture to steep for 30-60 minutes. If you desire a stronger blend, then allow the mixture to steep for several hours or overnight.
Drink 3-4 cups daily, or as often as needed.

Safety Considerations

In the past there were concerns that St. John’s Wort worked similarly to a monoamine oxidase (MAO) inhibitor, but recent findings have disproved this theory. This means that St. John’s Wort doesn’t have the same restrictions as MAO-inhibiting antidepressants (Gladstar, 2014) (Brinker, 1998) (Gardner & McGuffin, 2013).

Contraindications

Empirical evidence suggests that St. John’s wort should not be consumed during pregnancy due to its emmenagogue, abortifacient and uterine stimulant effects and actions (Brinker, 1998).
St. John’s Wort should not be used during phototherapy (laser or ultraviolet) by fair-skinned persons, or when taking photosensitizing drugs (Easley & Horne, 2016) (Gladstar, 2014) (Chevallier, 2016) (Hoffmann, 2003) (Brinker, 1998) (Gardner & McGuffin, 2013) (Hoffmann, 2003) (Brinker, 1998).

Drug Interactions

If taken internally St. John’s Wort may decrease the therapeutic activity of some immunosuppressants, anticoagulants, antiarrhythmics, calcium channel blockers, anti-anginal, hormonal contraceptives, anxiolytics, antidepressants (tricyclic), antivirals, statins, anti-cancer drugs, beta-adrenergic blockers, hypoglycemics, antiulcer agents, antifungals, anticonvulsants, skeletal muscle relaxants and antihistamines (Chevallier, 2016) (Hoffmann, 2003) (Gardner & McGuffin, 2013). It is strongly advised that you consult with a qualified healthcare practitioner if you intend on taking St. John’s Wort while on other medication.
Avoid using St. John’s Wort when taking selective serotonin syndrome reuptake inhibitors (SSRIs) as it may result in serotonin syndrome. If you are considering switching from SSRIs to St. John’s Wort, implement a 3-week wash-out period for the SSRI before switching to St. John’s Wort (Easley & Horne, 2016) (Chevallier, 2016).

Adverse Events

Based on evidence from clinical trials, St. John’s Wort has been well tolerated, with no serious adverse effects reported (Gardner & McGuffin, 2013).
Evidence obtained from clinical trials also suggests that phototoxicity concerns, when taking St. John’s Wort, are not an issue for the general population. Caution is however advised for fair-skinned persons who experience excessive sunlight exposure.

Disclaimer

The information presented in this post is intended as an informational guide. The remedies, approaches and techniques described herein are meant to supplement, and not to substitute for, professional medical care or treatment. They should not be used to treat a serious ailment without prior consultation with a qualified health care professional.

References

Brinker, F., 1998. Herb Contraindications and Drug Interactions. 2nd ed. Oregon: Eclectic Medical Publications.
Chevallier, A., 2016. Encyclopedia of Herbal Medicine. 3rd ed. New York: DK Publishing.
Coppock, R. W. & Dziwenka, M., 2016. St. John's Wort. In: Nutraceuticals. s.l.:Academic Press., pp. 619-631.
Easley, T. & Horne, S., 2016. The Modern Herbal Dispensatory: A Medicine-Making Guide. California: North Atlantic Books.
Gardner, Z. & McGuffin, M., 2013. Botanical Safety Handbook. 2nd ed. Boca Raton: CRC Press.
Gladstar, R., 2014. Herbs for Stress & Anxiety. 1 ed. North Adams: Storey Publishing.
Hoffmann, D., 2003. Medical Herbalism: The Science and Practice of Herbal Medicine. 1st ed. Vermont: Healing Arts Press.
Ng, Q. X., Venkatanarayanan, N. & Ho, C. Y. X., 2017. Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. Journal of Affective Disorders, Volume 210, pp. 211-221.

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