St. John’s Wort: Dosage, Health Benefits, and Side Effects
February 08, 2022
Saint John’s Wort (Hypericum perforatum) is a flowering plant that has a long history of use as an herbal medicine. Typically, the yellow flowers of the plant are used for medicine and must be used fresh. Unlike many other plants, the active compounds in St. John’s Wort flowers are not effective when old or dried. In order to make St. John’s Wort into an herbal medicine for storage, it must be harvested fresh and quickly put into oil or alcohol to make an extract.
While this ancient herbal remedy offers some unique benefits, it also has some health risks that are important to be aware of. In this article, we’ll cover all you need to know about St. John’s wort.
What Is St. John’s Wort?
St. John’s Wort is a plant that is part of the genus Hypericum, which contains nearly 500 species. It is native to Europe, Western Asia, and Northern Africa—where it has long been used in traditional herbal medicine systems—but it has naturalized in many other parts of the world as well, including the United States. It prefers a temperate climate and is often considered to be a noxious weed.
This cheerful yellow flower received its name as a reference to Saint John the Baptist, as it blooms in late June around the time of the holiday of the Feast of St. John. St. John's Wort has been used in herbal medicine as far back as the time of the ancient Greek civilization where it was believed to keep away evil spirits. It has been widely used in traditional European and American herbalism for a variety of conditions.
What Is St. John’s Wort Used For?
According to NCCIH, St. John's wort has historically been used for a variety of conditions, including kidney and lung ailments, insomnia, and depression, and to aid wound healing. Today, it is used for depression, menopausal symptoms, attention-deficit hyperactivity disorder (ADHD), somatic symptom disorder, obsessive-compulsive disorder, and is promoted for various skin conditions, including wounds, bruises, and muscle pain.
What Are the Benefits of St John’s Wort?
St. John’s Wort has been used in many ways throughout history. Below, we discuss some of the most common St. John’s Wort benefits:
St. John’s Wort May Help Treat Depression
Perhaps the most well-known use of St. John’s Wort is its ability to boost one’s mood and aid with depression. Studies on St. John’s wort show it is more effective than a placebo, and as effective as standard antidepressant medications in many cases.
Exactly how St. John’s Wort helps with depression is not fully understood, although it is largely attributed to the active compounds found in St. John’s Wort’s yellow flowers—the primary active ingredients being hypericin, hyperforin and adhyperforin.
Studies have shown that these active compounds increase the levels of chemical messengers in the brain associated with feelings of happiness and well-being—namely serotonin, dopamine and noradrenaline. The increased levels of these neurotransmitters may help uplift and regulate one’s mood.
A review of over 30 studies published in the National Library of Medicine found that St. John Wort was as effective, and in some cases more effective than prescription antidepressants, and did not seem to have the same common side effects that prescription antidepressants often do.
A “depression score” is a psychiatric method of numerically measuring one’s severity of depression based on categories of:
- 0-4 none
- 5-9 mild
- 10-14 moderate
- 15-19 moderately severe
- 20-27 severe.
A study on people with depression found that taking 900-1,800 mg of St. John’s Wort over a period of six weeks caused a 56.6% decrease in their depression score, compared to a 44.8% decrease from those on antidepressants.
A common conclusion from many different studies is that St. John’s Wort is effective at relieving symptoms of depression in mild-moderate depression, but there is still a need for more research on people with severe depression to determine St. John’s Wort’s effectiveness for this condition.
Interestingly, in traditional herbal medicine systems, St. John’s Wort was also used for uplifting one’s mood, and this was attributed to the “essence” within the bright yellow color of the flowers. Many people today use St. John’s Wort as a tea or supplement to help with Seasonal Affective Disorder (SAD), which is a mood disorder that many people experience during the winter months in climates where there is limited sunshine.
St. John’s Wort May Help Treat Anxiety
Anxiety is another common mood disorder that St. John’s Wort may be able to alleviate. This is also attributed to its ability to influence the neurotransmitters serotonin, dopamine and noradrenaline, which are associated with feelings of happiness and well-being. In studies involving St. John’s Wort’s use in people with social anxiety disorder, it was found that people experienced significant improvements when taking a dosage of 600 to 1800 milligrams of St. John's Wort daily.
St. John’s Wort May Help Heal Wounds
St John’s Wort has long been used for healing wounds. In England, it was commonly referred to as the “balm of the warrior’s wound.” Many Native American tribes also used St. John’s Wort for wound healing and made an oil from the plant to heal both external and internal wounds.
Studies on St. John’s Wort have found that it is an effective topical remedy for treating wounds, bruises, burns, sores, and hemorrhoids. Again, this is attributed to the active compounds found within the plant, particularly its yellow flowers.
St. John’s Wort May Help Improve Immune Function
The immune system is your body’s natural defense system that protects you from pathogens like bacteria, viruses, fungi, and toxins. It is made up of different cells, organs, and proteins that work together to keep you healthy. Hypericin, one of the compounds in St. John’s Wort, has been shown to boost immunity and to inhibit human immunodeficiency virus (HIV).
St. John’s Wort May Help Relieve Symptoms of PMS & Menopause
Premenstrual Syndrome (PMS) is a group of symptoms that occur in women, typically between ovulation and a period, that is caused by changes in hormones during the menstrual cycle. These symptoms commonly include mood swings, irritability, fatigue, food cravings, tender breasts, and depression.
Studies on St. John’s Wort—as well as many years of traditional use—suggest that it may be an effective remedy for reducing the severity of PMS. One double blind placebo-controlled study concluded that St. John’s Wort was “statistically superior to placebo in improving physical and behavioral symptoms of PMS.
Menopause, another condition related to women’s hormones is the end of a woman’s reproductive cycle and occurs 12 months after a woman’s last period. Menopause often causes symptoms such as hot flashes, sleep disturbances, irritability, vaginal dryness, and often anxiety and depression.
Studies on St. John’s Wort have found that supplementing with the herb during menopause caused a significant reduction in menopause-related symptoms, as compared to taking a placebo.
What Are the Active Compounds in St. John’s Wort?
The medicinal benefits of plants are mostly attributed to their active compounds. According to research published in the National Library of Medicine: “Constituents that have stimulated the most interest include the naphthodianthrones hypericin and pseudohypericin, a broad range of flavonoids, and the phloroglucinols hyperforin and adhyperforin.”
What Are the Side Effects of St John’s Wort?
While St. John’s Wort offers incredible benefits related to mood, it does have some potential side effects that are important to be aware of. The majority of people do not experience side effects when taking St. John’s Wort, however, some report trouble sleeping, upset stomach, irritability, fatigue and skin rashes as St. John’s Wort side effects.
What is most important to be aware of before taking St. John’s Wort is its potential to interact with certain medications. In fact, it can even weaken the effectiveness of some medications. According to NCCIH: “St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as:
- Antidepressants
- Birth control pills
- Cyclosporine, which prevents the body from rejecting transplanted organs
- Some heart medications, including digoxin and ivabradine
- Some HIV drugs, including indinavir and nevirapine
- Warfarin, an anticoagulant (blood thinner)
- Certain statins, including simvastatin.”
NCCIH also mentions that “Taking St. John’s wort with certain antidepressants or other drugs that affect serotonin, a substance produced by nerve cells, may lead to increased serotonin-related side effects, which may be potentially serious.”
If you are taking any medications, it is recommended to consult with your doctor before taking St. John’s Wort to see if it is a good fit for you.
Furthermore, St. John’s Wort is not recommended for women that are pregnant or breastfeeding. A few small studies have stated that St. John’s Wort may increase the risk of malformations at birth, and that it can be transferred into breastmilk at low levels—though these did not appear to cause side effects. Still, it is recommended to avoid this herb while pregnant or breast-feeding due to a lack of safety information.
Additionally, some studies suggest that St. John’s Wort can reduce fertility by inhibiting sperm and preventing egg fertilization. It is therefore not recommended to take for those attempting to conceive.
Summary
Saint John’s Wort (Hypericum perforatum) is a flowering plant that has a long history of use as an herbal medicine. It is native to Europe, Western Asia, and Northern Africa—where it has long been used in traditional herbal medicine systems—but it has naturalized in many other parts of the world as well, including the United States.
According to NCCIH, St. John's wort has historically been used for a variety of conditions, including kidney and lung ailments, insomnia, and depression, and to aid wound healing. Today, it is used for depression, menopausal symptoms, attention-deficit hyperactivity disorder (ADHD), somatic symptom disorder, obsessive-compulsive disorder, and is promoted for various skin conditions, including wounds, bruises, and muscle pain.
Perhaps the most well-known use of St. John’s Wort is its ability to boost one’s mood and aid with depression. Studies on St. John’s wort show it is more effective than a placebo, and as effective as standard antidepressant medications in many cases.
Exactly how St. John’s Wort helps with depression is not fully understood, although it is largely attributed to the active compounds found in St. John’s Wort’s yellow flowers—the primary active ingredients being hypericin, hyperforin and adhyperforin
While St. John’s Wort offers incredible benefits related to mood, it does have some potential side effects that are important to be aware of. The majority of people do not experience side effects when taking St. John’s Wort, however, some report trouble sleeping, upset stomach, irritability, fatigue and skin rashes as St. John’s Wort side effects.
What is most important to be aware of before taking St. John’s Wort is its potential to interact with certain medications. Furthermore, St. John’s Wort is not recommended for women that are pregnant or breastfeeding, or for anyone attempting to conceive. It is recommended to consult with your doctor before taking St. John’s Wort to see if it is a good fit for you, especially if you are taking any medications.
References:
https://www.nccih.nih.gov/health/st-johns-wort
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010734/
https://pubmed.ncbi.nlm.nih.gov/28011162/
https://pubmed.ncbi.nlm.nih.gov/22205093/
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