St. John's Wort

St. John's wort once was thought to rid the body of evil spirits, but more recently it has been used to treat problems such as depression, anxiety, and sleeplessness. When steeped in oil and applied to the skin, it helps heal wounds and burns. Research suggests it may also be useful in treating infections caused by viruses.

Here are some illnesses and conditions that St. John's wort has been used to treat:

• Depression. St. John's wort reduces symptoms of depression in people with mild to moderate forms of the condition.
• Seasonal affective disorder. Used alone, St. John's wort improves mood. Effects are even greater when the herb is used in combination with light therapy.
• Other mood problems. St. John's wort helps reduce anxiety, listlessness, and feelings of worthlessness.
• Sleep problems. The herb relieves sleeplessness (insomnia) and the tendency to sleep too long (hypersomnia).
• HIV infection and AIDS. Research and patients' experiences suggest St. John's wort may improve the health of people infected with human immunodeficiency virus (HIV), the virus that causes AIDS.
• Wounds and burns. In forms that can be applied to the skin, St. John's wort reduces pain and inflammation and promotes healing.
• Hemorrhoids. "Red oil," a preparation made by steeping St. John's wort flowers in oil, eases discomfort when applied to hemorrhoids.

Plant Description

St. John's wort is a shrubby plant with clusters of yellow flowers. The plant is often in full bloom around June 24, the day traditionally celebrated as the birthday of John the Baptist. Both the flowers and leaves are used as medicine.

What's It Made Of?

The best-studied active components are hypericin and pseudohypericin, found in both the leaves and flowers. There has been recent research to suggest that these best-studied components may not be the most active in the plant, with significant debate ensuing within the industry. It also includes other components such as essential oils and flavonoids.

Available Forms

You can buy St. John's wort in many forms: capsules, liquids, oil-based skin lotions, and teas. You can also buy chopped or powdered forms of the dried herb. Look for products that are standardized to contain 0.3% hypericin.

How to Take It

When taken by mouth for depression and other mood problems, the usual dose is 300 to 500 mg at 0.3 percent, three times a day, with meals, for a minimum of four to six weeks. You can also make a tea by steeping 1 to 2 tsp. of dried St. John's wort in a cup of boiling water for 10 minutes. Drink 1 to 2 cups a day for four to six weeks. But keep in mind that the dose you get when you make St. John's wort tea may not be as consistent as what you get in capsules or other products.

For treating wounds, burns or hemorrhoids, use an oil-based preparation of St. John's wort that you can rub onto your skin.

Precautions

• Depression is a serious condition. If your depression is severe or if you feel like hurting yourself or someone else, see a health care professional before using St. John's wort. There are some conditions that you should not try to treat yourself with herbs or other over-the-counter medicines. A health care professional can help you decide whether St. John's wort is right for you.
• Do not take St. John's wort if you are pregnant or breast-feeding.
• St. John's wort may make your skin unusually sensitive to sunlight. Although this reaction is rare, you should be careful about sun exposure if you have fair skin or if you are taking St. John's wort in large doses or over a long time. Use a sunscreen with a skin protection factor (SPF) of at least 15, and do not use sunlamps, tanning booths or tanning beds.

Side effects of St. John's wort are usually mild and may include:

• Abdominal pain, bloating, constipation
• Nausea, vomiting
• Dizziness
• Dry mouth
• Itching, hives, skin rash
• Sleep problems
• Elevated blood pressure
• Unusual tiredness

Possible Interactions

Using St. John's wort with antiviral agents like indinavir and other protease inhibitors is not recommended. There is the possibility of an interaction between this herb and these medications that could undermine the effectiveness of the antiviral medications.

St. John's wort may interact with antidepressant medication that are used to treat depression or other mood disorders. Therefore, do not take this herb with any such medications.

You should not take St. John's wort if you are taking the heart medication digoxin because of the potentially dangerous interaction between this herb and this medication.

You should not take this herb with immunosuppressive medications like cyclosporin because it may reduce the effectiveness of these medications.

There have also been reports of bleeding in women taking St. John's wort with birth control medications. The interaction between St. John's wort and birth control medications may result in decreased effectiveness of these medications.

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