What Is St. John's Wort?

<p>Madeleine_Steinbach / Getty Images</p>

Madeleine_Steinbach / Getty Images

Medically reviewed by Arno Kroner, DAOM

St. John's wort (Hypericum perforatum) is a yellow-flowered plant with roots tracing back to ancient Greece. This flower often blooms around late June, close to the feast of St. John the Baptist, from whom it draws its name.

St. John’s wort was historically a go-to remedy for a variety of health issues ranging from kidney and lung conditions to sleep challenges. Today, many people turn to St. John's wort as a natural remedy for conditions like depression, anxiety, and ADHD. When used topically (applied directly to the skin), St. John's wort is believed to help with various skin issues such as wounds, bruises, and sore muscles.

Benefits of St. John's Wort

St. John's wort is often used to reduce symptoms of depression. Several large reviews of over 20 studies found that St. John’s wort was reported to be as effective or more effective than selective serotonin reuptake inhibitors (SSRIs)—a class of drugs commonly used to treat depression.

One of the reviews found similar effects compared to tricyclic antidepressants. It also found that St. John’s wort might reduce depression after menopause.

St. John's wort may also be beneficial for conditions like:

  • Premenstrual syndrome (PMS): Physical and emotional symptoms that generally occur 1-2 weeks before your menstrual period

  • Psoriasis: An autoimmune skin condition that causes inflamed skin patches

  • Somatic symptom disorder: An extreme focus on physical symptoms that leads to significant anxiety

  • Obsessive-compulsive disorder (OCD): A mental health condition that causes uncontrollable, intrusive, and continuous thoughts (obsessions) that lead to repetitive activities and behaviors (compulsions)

  • Attention-deficit/hyperactivity disorder (ADHD): A condition characterized by inattention (not being able to focus), hyperactivity (feeling restless), and impulsivity (making decisions without thinking)

  • Seasonal affective disorder: Depression that occurs due to seasonal changes

It might also improve memory and wound healing and help you quit smoking. However, most possible benefits are unclear. More research is needed to confirm possible connections.

How To Use St. John's Wort

St. John's wort is made from ground flowers and dried leaves of the plant. People most commonly consume it in capsule form, as a natural supplement. Other methods of use include:

  • Tea: The dried herb is usually steeped in hot water for several minutes before drinking.

  • Tincture: Tinctures are liquid extracts. They can be taken directly or added to water or juice.

  • Skin cream: St. John's wort is sometimes used in creams that can be used topically (applied to the skin) to reduce inflammation or support wound healing. These creams can increase your skin's sensitivity to sunlight, so you might be advised to use them at night.

  • Oil: St. John's wort oil might be infused in a carrier oil like olive oil. It can be used topically to help treat contusions (bruises), inflammation, and mild burns.

Always consult with a healthcare professional before trying St. John's wort or any other herbal supplement to ensure it's safe for you to use. Strength and dosage can differ widely among products and might not always match the information on the label.

Adults might take one 300 milligram (mg) capsule containing 0.3% hypericin (an active chemical in St. John's wort) three times daily. Typically, 1-3 capsules are taken daily with meals or as your healthcare professional advises. Store this herbal supplement in a cool and dry place, out of direct sunlight.

Is St. John's Wort safe?

St. John's wort has been taken by many people as a natural remedy. Research suggests that consuming it for up to 12 weeks seems to be safe. However, there are several key safety considerations.

For example, it may not be safe for pregnant or breastfeeding people and may cause symptoms like fussiness and sleepiness in breastfed infants. There are also many possibly dangerous drug interactions.

Potential Drug Interactions

St. John's wort can affect how drugs work. This can make the drugs less effective and may even be life-threatening.

One concerning effect is a dangerous increase in serotonin, a substance in your body that helps nerve cells communicate with one another. This effect is more likely when St. John's wort is mixed with certain antidepressants or other mood-enhancing drugs. It can lead to a condition known as serotonin syndrome (SS)—a potentially life-threatening that occurs when serotonin levels get too high.

Symptoms of serotonin syndrome include raised blood pressure, tachycardia (heart palpitations), and dilated pupils. Severe cases can lead to fevers as high as 106°F. Treatments might involve using specific drugs to counteract the effects of serotonin and help calm the body.

Other medications that St. John's wort can affect include:

  • Birth control pills

  • Medications that help prevent the rejection of transplanted organs

  • Certain heart medications, including digoxin (brand names include Digitek and Lanoxin)

  • Human immunodeficiency virus (HIV) drugs like Crixivan (indinavir) and Viramune (nevirapine)

  • Some cancer medications, including Campto (irinotecan) and Glivec (imatinib)

  • Blood thinners like Coumadin (warfarin)

  • Specific cholesterol-lowering drugs, including statins

Where To Find It

In the United States, St. John's wort is often purchased as an herb or supplement. You can find it in a variety of places, including:

  • Health food stores: Many local health and natural food stores carry St. John's wort, often in the supplements section. You can also find it in some larger chain stores.

  • Vitamin and supplement stores: Stores like GNC and The Vitamin Shoppe typically carry St. John's wort supplements.

  • Pharmacies: Some mainstream pharmacies stock St. John's wort in the dietary supplements area.

  • Online retailers: Online retailers usually have a range of St. John's wort products, including capsules, teas, and tinctures.

  • Herbalists or natural remedy shops: A local herbalist or natural remedy shop may carry St. John's wort in various forms, including dried herbs and tinctures.

Supplements are not regulated by the FDA, so make sure any products you choose are third-party tested.

Side Effects of St. John's Wort

Side effects other than medication interactions are generally uncommon and mild. They include:

  • Dry mouth

  • Headache

  • Upset stomach

  • Confusion

  • Photosensitivity (increased sensitivity to sunlight)

However, St. John's wort can cause more serious side effects, including:

  • Worsening symptoms of conditions like schizophrenia or bipolar disorder

  • Feeling overly agitated

  • Diarrhea

  • Seeing or hearing things that aren't there

There's not enough evidence to determine if using St. John's wort topically is safe. For example, it might cause harsh skin reactions if you're exposed to sunlight after applying it. Some people who use St. John's wort regularly report getting sunburned more easily.

A Quick Review

St. John's wort is a yellow-flowered plant. Supplements like teas, tinctures, and oils are made from ground flowers and dried leaves of the plant.

St John's wort might help reduce symptoms of conditions like depression, anxiety, and PMS. However, more research is needed to determine possible benefits.

Always consult a healthcare provider before using natural or alternative remedies. Side effects of St. John's wort are generally mild, but the herb can affect how drugs work and should not be used with certain medications. Complications can be serious and even life-threatening.

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