St. John’s Wort (Hypericum Perforatum)
St. John's Wort (Hypericum Perforatum) Benefits, Uses, Dosage, Interactions, Side Effects & Contraindications
St. John’s Wort (Hypericum Perforatum) has effects on the nervous system. It calms the mind and restores the natural functioning of the brain. Generally, it is indicated for mild to moderate type of depression, anxiety, stress, and mood disorders. It is also found to be helpful in cases of premenstrual syndrome (PMS). It reduces cramps, irritability and breast tenderness in women with PMS. It is also helpful to reduce menopausal symptoms especially anxiety and mood changes. The external application exerts anti-inflammatory and antibacterial actions on the skin. It helps to treat eczema and skin irritation. It enhances healing of wound and burns.
- 1 Botanical Description
- 2 Medicinal Parts
- 3 Phytochemistry (Chemical Composition)
- 4 Pharmacological Actions
- 5 Therapeutic Indications
- 6 St John’s Wort Benefits and Uses
- 7 St John’s Wort Dosage
- 8 Safety Profile
Scientific Name of St. John’s Wort is Hypericum Perforatum.
Synonyms & Vernacular Names
|Botanical Name||Hypericum Perforatum|
|English Name||St. John’s Wort, Common St. John’s Wort, Saint John’s Wort, Klamath weed, Common Saint John’s Wort, Perforate St. John’s Wort|
|Indian Name (Hindi)||Choli Phulya|
|Chinese Name||Guan Ye Lian Qiao|
|Tamil Name||Vettai Pakku|
|Infra Kingdom||Streptophyta (Land Plants)|
|Division||Tracheophyta (Tracheophytes Or Vascular Plants)|
|Sub Division||Spermatophytina (Spermatophytes Or Seed Plants)|
|Species||Hypericum Perforatum L.|
St. John’s Wort is a perennial plant that grows up to 2 feet.
|Type of Plant||Herbaceous Perennial|
|Native Range (Geographic Distribution)||North and South America, New Zealand, India, Australia and South Africa|
|Height (grows up to)||2 Feet, sometimes up to 3 feet|
|Habitat (type of environment)||Chalky|
|Leaf||Leaf is around 3 cm long and oblong or elliptic, and clasp to stem. Leaf has a smooth edge, light green and translucent dots that appears due to transparent oil glands.|
|Flowers||Flowers are yellow in color and star-shaped with 5 petals with several black dots.|
|Fruits||Capsule form contains small seeds|
|Seeds||Dark brown seeds|
|Spread||Up to 2 Feet|
|Bloom Time||June to August|
|Sun||Found in Sunny areas|
|Tolerate||It can tolerate Drought|
- Aerial Parts
- Flowers or flowering tops
Phytochemistry (Chemical Composition)
St. John’s Wort yellow flowers contain Hypericin, an active substance. It is an anthraquinone derivative and exerts antidepressant action. The standardized extract of St. John’s Wort contains 250 µg Hypericin per 300 mg. In HPLC analysis, there are two main compounds are found in St. John’s Wort extract in the following percentage. (1, 2, 3)
|Hypericin||0.3% (250 µg Hypericin per 300 mg extract)|
|Pseudohypericin||0.6% (500 µg Hypericin per 300 mg extract)|
|Hypericin and Hyperforin are likely to be psychoactive components.|
The psychoactive components of St. John’s Wort act as a dopamine-related anti-depressant. It increases dopamine level in the brain by inhibiting dopamine reuptake. It has similar effects on serotonin and acts as serotonergic. It inhibits serotonin reuptake, so it also increases the level of serotonin. (4)
St. John’s Wort has following medicinal properties.
- Dopaminergic – modifies the effects of dopamine by inhibiting dopamine reuptake, so it increases the level of dopamine in the brain.
- Serotonergic – modifies the effects of serotonin by inhibiting serotonin reuptake, so it increases the level of serotonin in the brain.
St John’s Wort (Hypericum Perforatum) is helpful in following health conditions.
- Mood disorders
- Premenstrual syndrome (PMS)
- Menopausal symptoms – Anxiety and mood changes in menopause
- Chronic mental fatigue
- Insomnia or sleeplessness
- Attention Deficit-Hyperactivity Disorder (ADHD)
- Obsessive-Compulsive Disorder (OCD)
- Seasonal Affective Disorder (SAD)
- Skin irritation
St John’s Wort Benefits and Uses
St. John’s Wort is most commonly used for depression treatment. The main area of its actions is neurological and mood disorders. It promotes normal energy level in the body. It also promotes normal sleep. It reduces restlessness, stress and the feeling of being nervous.
St John’s Wort for Depression
St John’s Wort is a natural antidepressant. It is effective for mild to moderate depression. It is a safer option than prescription antidepressants because it has fewer side effects as compared to them.
How Does St John’s Wort Work in Depression?
In depression, serotonin level decreases. However, whether low serotonin level causes depression or depression causes a decrease in serotonin level is yet not confirmed, but St John’s Wort inhibits the reuptake of serotonin, which helps to increase serotonin level in the brain. It also has similar effects on dopamine and increases its level due dopaminergic action. It also acts as dopamine reuptake inhibitor. It also improves the level of norepinephrine in the brain. All these mechanisms of action improve the mood and reduce the symptoms of depression.
Research studies for the use of St John’s Wort in depression
St John’s Wort is also effective for teenage depression. It shows good results to treat mild depression in some adolescents. (5)
Another study suggests St. John’s Wort is effective than Placebo. The improvement was observed in participants with mild to moderately severe depressive disorders or neurotic depression (emotionally unstable) when treated with St. John’s Wort. (6)
An analysis of 29 trials on 5489 patients with major depression concludes St. John’s Wort is more effective than placebo. It shows similar results as standard antidepressants but has fewer side effects. However, some of the current evidence suggests St. John’s Wort has minimal benefits in major depression than placebo and others suggest it has similar beneficial effects as standard antidepressants. (7, 8)
St John’s Wort for Anxiety
Anxiety occurs due to reaction to stress. St John’s Wort improves mood and reduces stress, which ultimately helps to reduce anxiety. It reduces symptoms such as feeling weak, tiredness, loss of interest, and trouble concentrating. In anxiety, it does not work directly on anxiety. Actually, it works on stress. It makes a person feel good, easy and elevated.
How Does St John’s Wort Work in Anxiety?
In anxiety disorders, serotonin, dopamine, norepinephrine and corticotropin-releasing factor (CRF) are likely to be involved. Hypericin and Pseudohypericin in St John’s Wort have antagonist effects at corticotropin-releasing factor receptors. (9, 10)
Secondly, St John’s Wort improves dopamine and serotonin level in the brain and acts to reduce stress similarly as described under depression heading above.
Who should not take St. John’s Wort in the case of Anxiety?
There are very common questions. Does St John’s Wort work for anxiety? Does St John’s cause anxiety? Can St John’s Wort make anxiety worse? You might have read opposite views about its effects on anxiety. Some state it causes anxiety and other suggests it treats anxiety. You also might read anxiety as a side effect of St. John’s Wort.
You need to understand where it works and where it does not. There are two types of anxiety – active anxiety and passive anxiety. However, both conditions occur due to underlying stress.
In the case of active anxiety, people are anxious, but also have increased heart rate, hyperventilation, trembling, sweating, and dry mouth. In these symptoms, St John’s Wort will not work and it will likely to worsen the condition. People tends to have this type of symptoms are likely to suffer from anxiety as a side effect of St. John’s Wort.
In the case of passive anxiety, people feel nervous, but have stress, feel tired, weak, low energy, loss of interest, and avoid to work, procrastination and laziness. In such case, St John’s Wort will work to reduce anxiety. People tends to have this type of symptoms are likely to get benefits from St. John’s Wort.
Also Read: Home Remedies for Anxiety
Premenstrual Syndrome (PMS)
St John’s Wort relieves behavioral and physical symptoms of premenstrual syndrome. (11)
Seasonal Affective Disorder (SAD)
Seasonal Affective Disorder (SAD) or winter blues occurs due to lack of sunlight and characterized by feeling of sadness, moodiness, irritability, anxiety, loss of interest in usual activities, craving for carbohydrates, weight gain, tiredness even when sleeping more and trouble in concentrating.
St John’s Wort improves mood and reduces other symptoms of SAD. Some evidence suggests taking St. John’s Wort with light therapy gives better results in the treatment of SAD than phototherapy alone.
St John’s Wort Dosage
St John’s Wort is available for therapeutic use in a different form including crude herb powder, extract, and tincture. Extract capsules or tablets are also available for which dosage should be as per the extract dosage.
Dosage of St. John’s Wort Powder
St. John’s Wort Powder is a natural, unprocessed, crude form of the herb. It is prepared by drying the herb under shade or in the sun and pulverized to make powder. It is the safest option and has fewer or negligible side effects. It is safer than St. John’s Wort extract and alcoholic tincture. It contains all-natural components of the herb, which also helps to pacify the adverse effects of each other and exerts a synergetic action to provide benefits.
|The general dosage of St. John’s Wort (Hypericum Perforatum) Powder is as follows.|
|Children (under 18 years old)||Safe Dosage: 30 mg per Kg body weight, but should not exceed 2 grams|
|Adults (over 18 years old)||2 to 6 grams (Safe dosage: 2 grams)|
|Maximum Possible Dosage||12 grams Per Day (in divided doses) **|
|Doses: 2 to 3 Doses per Day|
|Best Time to Take: Best when taken with Meal|
|** The maximum dosage of St. John’s Wort Powder is a general estimate.|
Dosage of St. John’s Wort Extract
St. John’s Wort standardized Extract contains 0.3% Hypericin. So, 300 mg extract will contain 250 µg Hypericin. Generally, St. John’s Wort tablets or capsules contain extract.
|The general dosage of St. John’s Wort (Hypericum Perforatum) Extract is as follows.|
|Children (under 18 years old)||Safe Dosage: 5 mg per Kg body weight, but should not exceed 300 mg.|
|Adults (over 18 years old)||300 to 900 mg (Safe dosage: 300 mg)|
|Maximum Possible Dosage||2.7 grams Per Day (in divided doses) **|
|Doses: 2 to 3 Doses per Day|
|Best Time to Take: Best when taken with Meal|
|** The maximum dosage of St. John’s Wort Extract is a general estimate. Sometimes, St. John’s Wort Extract is also given in a dosage of 1800 mg thrice daily i.e. 5.4 grams per day. This dosage seems to be very unsafe, so we wrote maximum possible dosage up to 2.7 grams per day.|
St. John’s Wort (Hypericum Perforatum) is likely safe for the most people in the dosage less than 6 grams/day for its powder and 900 mg/day for its extract.
St. John’s Wort Side Effects
St. John’s Wort (Hypericum Perforatum) has some side effects:
- Anxiety: it is not suitable for people with active anxiety having palpitation, hyperventilation, trembling, sweating, and dry mouth
- Dry mouth
- Skin rash
- Stomach upset
- Trouble sleeping
- Vivid dreams
- Hypersensitivity for sunlight: In large dosage, it can increase sensitivity to sunlight, which might cause sunburns.
St John’s Wort Interactions
St. John’s Wort interacts with antidepressants, anxiolytics, anaesthetics, antiepileptics and analgesics. It affects plasma concertation of these drugs, which can decrease or increase the effects of these medicines.
Photo Attribution Forest & Kim Starr