St. John's wort (Hypericum perforatum) is a medicinal plant that grows in many parts of the world. It has many medicinal properties and is widely used to treat various ailments, including depression, phobias, PMS, hemorrhoids, and skin problems.

St. John's wort (Hypericum perforatum): What is St. John's wort? | Depression, Stress and Anxiety | Menopause | Preparations | SIDE EFFECTS | Common Interactions | Questions and Answers | Sources/references

St. John's wort, botanically known as Hypericum perforatum, is a leafy plant that grows in open, uncultivated areas, mostly in regions of Europe, western Asia, and southern Africa. It is a plant with yellow flowers used in traditional European medicine by the ancient Greeks. The name St. John's wort refers to John the Baptist, as the plant blooms around the feast of St. John the Baptist at the end of June. St. John's wort flowers are widely used - they are used to prepare liquid extracts, tablets/capsules, and teas.

St. John's wort is one of the most famous medicinal plants in Slovenia, the properties of which are confirmed by numerous studies and research. The plant is a perennial with a spindle-shaped rhizome. Its upright two-sided stem can grow up to 70 cm in height and branches in the upper third. The leaves of the plant are oval-ovate, elliptic in shape, and almost without stalks, oppositely placed and slightly translucent dotted on the surface.

The flowers of St. John's wort are golden yellow in color and star-shaped and consist of dense panicle inflorescences. The plant bears five green sepals and five yellow petals. When the yellow flowers are macerated between the fingers, only these turn red, which indicates that we have picked the right plant.

St. John's wort: when fighting depression, stress, and anxiety

In recent years, St. John's wort has been extensively studied as a treatment for depression and anxiety (more in a reputable journal: https://www.sciencedirect.com/topics/medicine-and-dentistry/hypericum-perforatum).

Most studies show that St. John's wort can help treat mild to moderate depression, which is why pharmaceutical companies often incorporate its extract into herbal medicines and nutritional supplements. As such, it usually has fewer side effects than most other synthetic antidepressants prescribed by prescription. However, like any medicine, St. John's wort extract medicine has effects and interactions with each other, so it makes sense to consult with an experienced pharmacist before using this type of medicine/supplement.

So there is convincing evidence that St. John's wort can reduce the symptoms of mild depression - especially in people with mild to moderate depression. In many studies, it appears to work as well as selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed class of antidepressants mainly prescribed to treat moderate to severe depression. In addition, St. John's wort products do not appear to cause loss of libido, another common side effect of synthetic antidepressants.

Many clinical studies (https://pubmed.ncbi.nlm.nih.gov/12153829/) have compared the effectiveness of St. John's wort with a placebo and antidepressants. Most of the findings are that the herbal remedy containing St. John's wort is more effective than a placebo and is often equivalent to standard antidepressants for treating mild to moderate depression.

A lot of research on St. John's wort concerns its use in the treatment of depression, but one thing we should not ignore is that depression and anxiety are closely related. According to a trusted source (https://adaa.org/ understanding-anxiety/facts-statistics), about 50% of people with depression also suffer from an anxiety disorder.

If you are dealing with anxiety and worry, taking St. John's wort could benefit you, as it has a beneficial effect on your psychological state, mood, and emotional balance.

St. John's wort and menopausal symptoms

Some evidence suggests that taking St. John's wort alone or combined with the herb Cimicifuga Racemosa may reduce menopausal symptoms such as hot flashes.

We know several forms of St. John's wort preparations

St. John's wort is most often consumed in the form of drops or capsules, by the instructions for use. The dried herb can also be used as tea.

Traditionally, tea is used as a nervous system tonic to relieve anxiety, bad mood, and neuralgia.

Saint John's wort, due to its effectiveness, often affects other drugs (side effects), so it is essential to carefully read the instructions for using the medicinal tea.

If you are pregnant, breastfeeding, or taking other medications, consult your doctor before using St. John's wort preparation.

Side effects of St. John's wort extracts

The herbal medicine or the extract obtained from the Hypericum perforatum plant is a preparation that is extremely useful for depression and anxiety.

Taking St. John's wort alone is often not problematic for the health of your liver. Still, when taken in combination with other drugs, it can significantly increase the hepatotoxicity of other medicinal agents, as St. John's wort affects the cytochrome P450 system (induction of CYP 3A4 and 2C9) and the main drug transport proteins.

St. John's wort and its use can have many side effects, as it interacts with coagulation inhibitors, anticoagulants, and some psychotropic substances. Therefore, when using St. John's wort, a great deal of caution and verification of specific interactions is required.

It has been demonstrated that using St. John's wort can be dangerous, sometimes even fatal, especially in interactions with other drugs. If you are unsure about taking it, ask your doctor or pharmacist.

Possible warnings and instructions before starting to use St. John's wort

St. John's wort is generally considered safe when taken orally for up to 12 weeks in appropriate prescribed doses, without concomitant use of other medications. Although the herb is usually well tolerated in proper doses, it can cause side effects. Side effects of St. John's wort include photosensitivity (phototoxic reaction), gastrointestinal problems, allergic reactions, fatigue, or restlessness. Some people may also experience headaches.

Hypericum perforatum preparations should be taken with caution, as many interactions with active ingredients are known - some of them are listed below.

Common St. John's wort interactions

• Contraceptive pills
• Certain oral blood thinners, including warfarin and phenprocoumon
• Certain medicines that inhibit transplant rejection reactions, including cyclosporins
• Certain heart medicines, including digoxin and ivabradine
• Some HIV medicines, including indinavir and nevirapine
• Certain cancer medicines, including irinotecan and imatinib
• Verapamil
• Some statins, including simvastatin
• Various medications for depression, including amitriptyline, nortriptyline, midazolam
• Theophylline

St. John's wort preparations often increase the risk of sunburn due to its phototoxic properties, which can make the skin more sensitive to the sun, especially in fair-skinned people, so intensive skin protection with a high protection factor is in order. Such side effects are even more familiar with dermal use of St. John's wort - for this purpose, it makes sense to avoid solariums and excessive sunbathing.

Tell your doctor if you want to take St. John's wort, which is especially important if you are also taking any other medicine. Talking to a doctor and choosing the proper preparation is often the best and safest way to support your mood and well-being.

Questions and answers

What is St. John's wort good for?

St. John's wort is especially effective for depression, menopause symptoms, and attention deficit hyperactivity disorder (ADHD).

Is St. John's wort more effective than antidepressants?

St. John's wort can help treat mild to moderate depression, and the effects appear similar to those of antidepressants designed to treat mild to moderate depression. However, St. John's wort extract is also known to be ineffective in treating severe forms of depression.

How toxic can it take St. John's wort to be?

In large enough quantities, St. John's wort can be very toxic to humans. The main danger is the ingredient hypericin, which causes photosensitivity of the skin, resulting in a severe rash and, in the worst cases, even death of the skin (necrosis). Other potentially toxic effects are also known, mainly due to interactions of St. John's wort with other active ingredients.

Sources and references

1. https://www.mayoclinic.org

2. https://www.nccih.nih.gov/health/st-johns-wort