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St. John’s Wort

About

St. John’s wort is a little yellow-flowered wonder – it’s a natural remedy deeply rooted in traditional medicine across continents. Found in Europe, West Asia, North America, and North Africa, St. John’s wort has been historically used for various ailments, from headaches to wound care and mood elevation.

Benefits

Mood Management:
St. John’s wort is renowned for its ability to support emotional well-being and promote mood balance. Its active compounds, hypericin and hyperforin, work like conventional antidepressants by boosting the production of neurotransmitters like serotonin, dopamine, and norepinephrine, crucial for optimal brain function.
Evidence
Clinical studies have shown that St. John’s wort appears to be more beneficial than a placebo at minimizing mild to moderate mood-related issues [NCCIH]. Several other clinical studies have compared the effectiveness of St. John’s wort with other SSRI antidepressants.

A 2016 meta-analysis of 27 studies compared the safety and health benefits of SSRIs and St. John’s wort. The researchers were able to confirm the findings of previous studies, which showed that St. John’s wort is comparable to SSRIs for mood enhancement. Additionally, using St. John’s wort led to fewer side effects compared to conventional SSRI antidepressants. [PMC4946846]

A review of 43 studies concluded that St. John's wort "monotherapy for mild and moderate depression is superior to placebo in improving depression symptoms and not significantly different from antidepressant medication." [PMC5010734]

St. John’s wort has been tested for use in other issues, such as intense feelings of worry, seasonal mood imbalances, smoking cessation, inattentiveness, and hyperactivity. To date, there isn’t enough evidence to say whether St. John’s wort may be beneficial for these types of issues.

Potential risks*:

Possible Side Effects:

Despite its natural origin, St. John’s wort may induce side effects such as:

  • Headaches
  • Nausea
  • Drowsiness
  • Insomnia
Contraindications:

Pregnant or breastfeeding women should avoid St. John’s wort due to potential miscarriage risk and adverse effects on breastfed infants. 

While St. John’s Wort can be beneficial for mood enhancement, its potential interactions with a variety of medications require careful consideration and professional guidance. Always inform your healthcare provider about all supplements and medications you are taking to avoid harmful interactions. Here are important details regarding its interactions:

  • Antidepressants: St. John’s Wort can interact with other antidepressants, potentially leading to a condition called serotonin syndrome, which can be life-threatening. This includes SSRIs, MAOIs, and other medications used to treat depression.
  • Birth Control Pills: It can reduce the effectiveness of hormonal contraceptives, leading to an increased risk of unintended pregnancy.
  • Blood Thinners: St. John’s Wort may interfere with the effectiveness of blood thinners like warfarin, increasing the risk of bleeding or clotting issues.
  • Immunosuppressants: It can reduce the levels and effectiveness of immunosuppressant drugs like cyclosporine, which are critical for patients who have had organ transplants.
  • HIV Medications:The herb can reduce the effectiveness of antiretroviral medications used to treat HIV, potentially leading to treatment failure.
  • Chemotherapy Drugs: St. John’s Wort may decrease the effectiveness of certain chemotherapy agents, which could affect cancer treatment outcomes.
  • Antiepileptic Drugs: It can lower the levels of antiepileptic drugs, potentially leading to breakthrough seizures.
  • Cardiovascular Medications: The herb can interfere with the effectiveness of some cardiovascular medications, including digoxin and statins.
  • Sedatives: When taken with sedatives or medications that affect the central nervous system, St. John’s Wort can enhance the sedative effects, leading to excessive drowsiness or other issues.
  • Surgery: its use should be ceased before planned surgeries to mitigate potential complications.

* Talk to your healthcare provider to find out if these vitamins and herbal extracts are safe for you to use. Also, note that there might be additional drug interactions. Talk to your healthcare provider to find out if you take a medication that may interact with any of the vitamins or herbal extracts.

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