St. John’s Wort – An Interview

I wanted to enlighten the readership to the long history of St. John’s Wort and go into the numerous aspects of its use. Currently it is being used for mild to moderate depression with many good results. It is important that we keep in mind that herbs work differently than pharmaceuticals. Herbs work synergistically with the compounds within them and their interaction with the body chemistry. The format of today’s article will be in an interview format. Let’s begin this interview by looking into the past.

Hawkins: Tell us about yourself and how you got your name St. John’s Wort?

St. John’s Wort: I have been used as a medicinal herb since ancient times (approximately 2000 years). My botanical name is hypericum perforatum which is derived from the Greek words hyper and eikon which translates to “above” and “icon”. Many people used to believe that it would protect them from evil spirits. My name came about because the plant blooms around St. John’s Day which is June 24. Of course, I bloom anywhere from June to September depending on climate. I was known by Hippocrates and the Greek herbalist Dioscorides. Christian mystics named me after John the Baptist.

Hawkins: Since you mention climate, where can you be found and when is the best time to harvest you?

St. John’s Wort: I am native to Europe, North Africa, and West Asia. I was brought to the United   States early on by European settlers. I also grew quite well in Northern California and Oregon as well as the Appalachians. The aerial part of me is used medicinally. Only the top 6-9 inches are harvested when I am in bloom. The leaves, stems, flowers and unopened buds are used medicinally. They have the highest levels of hypericum, which I will discuss later.

Hawkins: When did healers begin to document your value, and what type of ailments were you treating?

St. John’s Wort: About 400 years ago herbalists started to really recognize me. I am used in four different applications. They are prepared as infusions (teas), tinctures (extracts), oil macerations, and standardized extracts. I have been used for numerous conditions. I will mention a few here. The oil has been used topically for burns by helping to calm the skin and aid wound healing. Nervous disorders, depression, neuralgia, insomnia, seasonal affective disorder and kidney problems have been some of the main ailments that I work with, and currently I am being studied for anti-viral properties working with HIV and AIDS patients.

Hawkins: Tell us about your biochemistry and what makes you work within the body?

St. John’s Wort: This will probably be too complex for most, but I will give you some of the major constituents. Scientists have been able to identify hypericin and its derivatives, flavonols, flavonoids, essential oils, carotenoids, and phytosterols as some of these main compounds. This explains why I am used in so many different aspects. Let me explain further some of the research that is going on currently.

The West Germans have done most of this research with over 20 studies involving thousands of patients. Their results confirm my ability to help those with mild to moderate depression.

Hawkins: Tell us more about depression and the mechanisms of your actions?

St. John’s Wort: Compared with both placebos, inert comparison substances and various anti-depressant drugs I have come out on top every time. The success rate is between 60-80% which is equal, I might add, to the drug Prozac; however, with me there are fewer side effects. In a study in 1994 which included 3,250 patients, it was found that only 2.4% had any side effects worth noting. Compare that to conventional drug therapies currently being used today and this is very low. Scientists still are having a hard time discerning which part of me works to create these positive effects in the body. Some say I work with GABA receptors in the brain. (GABA is the neurotransmitter that calms down the nervous system.) Some say I work like a MAO inhibitor drug; however, that is not accurate either. It has been noted that I might work with the neurotransmitter serotonin, which helps you to feel good and elevate your mood. I keep telling the scientists that it is all of me that does the work and not just one single isolated compound. I think that is the conclusion they are coming too, also!

Hawkins: In the research you just mentioned people in the studies were using a standardized extract. Tell us about dosage and how it is taken and how long before a person would feel the benefits?

St. John’s Wort: In the standardized extract used in the studies, the hypericin content was measured at 0.3% concentration. Even though hypericin does not have antidepressant properties, it is used as a reference point. This means that 300 mg by weight contains 0.9% hypericin. The current dosage recommendation is 300 mg three times a day for a total of 900 mg daily. It is important to spread it out throughout the day. Remember that more is not always better. A person needs to take the extract for at least two weeks before benefits are to be expected and this, too, will vary individually.

Capsules and tinctures are also valuable, but they will be dependent on the quality of the material. Remember, a medicine is only as good as its starting material. When taking powdered herbs in capsules, you need to take more of it; and in regards to tinctures, 20 drops taken 3 times a day is recommended.

Hawkins: Before we finish our interview, tell us about any side affects or any toxicity factors that might interfere with your ability to work well. Please mention any cautions with regard to contraindications with pharmaceuticals!

St. John’s Wort: As I mentioned earlier, side affects are relatively low. However, the following are possible: Gastrointestinal symptoms (nausea, loss of appetite, and abdominal pains) which can occur with any substance. Taken with meals seems to help. Allergic reactions – skin rashes and itching. Phototoxicity – this has happened more with grazing animals than with humans, but fair-skinned people who have taken large doses might have sensitivity.

Contraindications are that this herb is not to be taken during pregnancy or nursing. The only drug interaction possibility is with MAO inhibiting drugs or L-dopa, and it is due to an increase in blood pressure. Hundreds of people in Europe with high blood pressure have been using me without problems. Remember, it is wise to be cautious when taking any substance. Please consult with your health care practitioner.