St. Johns Wort
Scientific Name: St. John's Wort
Other Names: Amber Touch-and-Heal, Hardhay, Hypericum, Hypericum perforatum, Klamath Weed, Millepertuis, Rosin Rose, SJW, Tipton Weed
Should I take it?

St. John's wort belongs to a large family of shrub-like weeds that spread rapidly and invade cultivated land unless they are controlled. Believed to be native to Europe, St. John's wort is now found in most temperate climates--especially in dry areas such as the edges of fields and along roadsides. Its name comes from a supposed association with the plant's first blooming and the saint day of St. John the Baptist, which is June 24. In reality, St. John's wort blooms from late May through September depending on the climate. Various parts of the plants produce dyes--ranging from bright yellow through reds to brown and purple. For use in medicine, the yellow flowers are collected in late summer along with the buds, stem tops, and young leaves around them. These so-called flowering tops should be dried quickly to avoid the loss of active chemicals.

St. John's wort has been used on-and-off for centuries to treat many different conditions. As early as the first century, records show that the flowers of St. John's wort were soaked in olive oil, which gradually turned to a reddish color and which was applied to burns, hemorrhoids, and skin injuries. Oil treated with St. John's wort was also taken by mouth for relief of "demonic possession"--possibly due to mood disorders including anxiety and depression. Dried St. John's wort may have mild diuretic (urine increasing) properties, so it has been used as a tea to relieve swelling. More recently, potential antidepressant effects have brought St. John's wort back into popularity. It is currently the most prescribed antidepressant medication in Germany, where it is approved by the German commission E, the German governmental agency that evaluates the safety and effectiveness of herbal products. The United States does not have a comparable agency to evaluate herbal products. Dosage and Administration

Orally, St. John's wort is available in a number of commercial dosage forms such as capsules, liquid extracts, and tablets. Extracts are concentrated liquid preparations usually made by soaking chopped or mashed plant parts in a liquid such as alcohol, and then straining out the solid parts. A tea may be brewed from the dried plant by soaking 2,000 mg to 4,000 mg (2 grams to 4 grams or about 2 teaspoons to 4 teaspoons) of dried St. John's wort in about 5 ounces of boiling water for 10 minutes to 15 minutes. After the solid particles are strained out, the resulting tea may be ingested up to three times a day. Oral St. John's wort may not exert its maximum effects until it has been taken regularly for 4 weeks or longer.

Commercial oral preparations of St. John's wort may be standardized to hypericin content between 0.2% and 0.3% or to a hyperforin content of 5%. Standardization by the manufacturer should assure the same amount of active ingredient in every batch of the commercial preparation. Standardization of herbal products is not required by the U.S. Food and Drug Administration (FDA), so not every St. John's wort product sold in this country will contain the same amounts of active ingredients. In addition, the amounts and proportions of active chemicals in St. John's wort plants will differ depending on which species was used, on where it was grown, and on how the plants were harvested, processed, and stored.

Recommended oral dosing varies with up to 1,800 mg (1.8 grams) of St. John's wort used in some studies. Some common oral doses used in clinical studies of St. John's wort are:

For topical use, creams that usually contain 1.5% hyperforin and transdermal patches containing 0.3% hypericin are marketed. The cooled tea may also be used as a skin wash or as a poultice, which is a soft cloth that has been soaked in a medication, possibly heated, and applied to an aching or injured area of skin surface. Transdermal patches are applied once a day. Generally, other topical St. John's wort preparations may be applied as often as needed. Individuals who decide to use one of them should follow the directions on the package that is purchased.

Summary

Currently, St. John's wort is best known for possible mildly antidepressant effects, but it is also being studied to treat other mood disorders such as anxiety and obsessive-compulsive disorder. It may have antiviral and antibacterial effects and it has been used topically for skin injuries.

St. John's wort may cause the rejection of transplanted organs, therefore transplant recipients should not take it. Alzheimer's patients, individuals with mental illnesses, couples trying to conceive a child, and pregnant or breast-feeding women should also avoid it.

Rarely, taking St. John's wort may be associated with "serotonin syndrome"--an excess of the neurotransmitter serotonin that may cause confusion, hallucinations, and seizures.

Both oral and topical forms of St. John's wort may make the skin more likely to sunburn. Other possible side effects are generally mild. They may include drowsiness, headache, rash, and upset stomach.

If St. John's wort is taken with psoralens or certain antibiotics, the chance of sunburn may increase.

St. John's wort may interfere with a large number of drugs and herbal products including: