St. John’s Wort

Disclaimer: While I believe in the scientific basis for some herbal remedies, this information is meant to complement, not replace, conventional medicine. I'm sharing this herbal approach as an alternative option to consider. Always consult with a healthcare provider before trying any new treatment to ensure it is appropriate and safe for your specific health needs.

Latin Name: Hypericum perforatum

Common Name: St. John’s Wort

Description: St. John’s Wort is a low-lying shrub type plant. It can grow from between 30-75 centimeters in height. The flowers sit at the top of the stem, are bright yellow with characteristic black dots, and have many stamens. The blooms are about 2 cm in width and have five petals each which are rounded. The leaves are about 2 centimeters in length and are light green. They are oblong shaped and have transparent spots. Leaves occur in opposing positions along the stem.

Habitat: St. John’s Wort is native to Europe, Northern Africa, and Western Asia and grows throughout temperate regions of the world. Its introduction to North America is unknown, but was known to be established in several western states early in the 1900s. It is often viewed as an invasive weed and can invade areas with hospitable conditions. It is found in fields, roadsides, and forest clearings.

Harvesting: Harvesting is recommended either right before or right after the flowers open and before pollination. The buds, flowers, and leaves are useful. St. John’s Wort is easy to harvest, and you only need your fingers. Harvesting is done by grasping the stem below the flowers and then gently pulling upward to separate the buds. If this is done gently, the pollinated buds should remain on the stem. The buds have a higher concentration of valuable constituents, and it is optimal to harvest when the plant is budding. Rosemary Gladstar recommends harvesting on a dry, sunny day. She suggests testing a bud to see if it is ready for harvest by squeezing a bud between your fingers. If deep red or purple squirts out of the bud, it is ready to harvest. If not, it is either too early or too late in the season.

Preparations and Medicine Making: St. John’s Wort can be taken internally or applied to the skin depending on the reason for usage. For a skin application it is best to use the buds, but you can also utilize the flowers and leaves. A ratio of 70 percent buds to 30 percent leaves and flowers is ideal. This is made by adding the herb to a jar and covering it with an inch of olive oil. The mixture is then placed in direct sunlight for 2-3 weeks for infusion. The oil will turn a deep red color. When the preparation is finished, drain the herb and the oil is ready for use. This oil can then be used as is or made into a salve.

If you wish to use the herb internally, it can be made into a tea or a tincture. For the tincture, chop the flowers and then place in a jar and cover with 80-proof alcohol. Let the jar sit in the sun for 4-6 weeks, shaking daily and keeping the herbs below the alcohol line. Add more alcohol as needed. When ready, strain the herbs and store the tincture in a dark, cool area.

Constituents: The main constituents in St. John’s Wort are hypericin, pseudo hypericin, tannins, flavonoids, hyperforin, and procyanidins. It contains important flavonoids such as quercetin, kaempferol, luteolin, and glycosides. Hypericin is extremely photoreactive and may be the reason the herb preparations are placed in sunlight. It also makes the consumer more susceptible to sun exposure when using.

Medicinal Applications: This herb has been used throughout history in a variety of medicinal systems. It has a broad range of medicinal uses and is particularly known for its anti-depressant and wound healing potential.

The anti-depressant effects are likely due to the effects of hypericin on the inhibition of dopamine and serotonin reuptake. The flavonoids quercetin, kaempferol, and luteolin have also been shown to improve depressive states. St. John’s Wort has been seen to be neuroprotective and approved for treatment of mild mood disorders. It can take 4-6 weeks for the effects to manifest, however this is a similar window to that of common SSRIs. In one meta-analysis which looked at 27 clinical trials, St. John’s Wort response and remission rates were comparable to the rates of SSRIs, but had significantly fewer dropouts from the trial than the pharmaceuticals.

St. John’s Wort has been shown to have antimicrobial, antibacterial, and anti-fungal effects. It has been used for the treatment of wounds, burns, bruises, and muscle pain. It is believed that the synergistic effects of the various constituents are what contribute to this effect and it is therefore not recommended to isolate a specific component for pharmaceutical use.  In vitro studies suggest that the wound healing properties occur because hypericin, rutin, isoquercitrin, epicatechin, and hyperoside activate and increase production of collagen cells.

There are indications for using St. John’s Wort medicinally for several other conditions. When used along with valerian root and passionflower, it was shown to be useful in improving emotional and behavioral complications in children and young adults. This would include attention issues and sleep disturbances. Researchers are looking into using it as a treatment for obsessive-compulsive disorder and it has been shown to be comparable to SSRIs. It may be useful in lessening premenstrual syndrome symptoms such as bloating, pain, irritability, and depression. And finally, patients using St. John’s Wort for treatment of psoriasis had less scaling and thickness in their lesions than those using a topical placebo.

Contraindications: The most common concern with St. John’s Wort is serotonin syndrome. It is not indicated for use along with other psychiatric medications. It has the potential to increase psychotic symptoms in someone with schizophrenia or bipolar disorder and should not be used in those conditions. Side effects include sensitivity to sunlight, anxiety, dizziness, dry mouth, insomnia, fatigue, headache, gastrointestinal symptoms, and sexual dysfunction. Careful sun exposure is important while using St. John’s Wort. It may cause severe skin reactions if used topically along with sun exposure. It is also contraindicated for use in pregnancy and while breastfeeding.

Herb and Drug Interactions: Any drug that uses the cytochrome P450 system can have diminished effectiveness when used along with St. John’s Wort. These would include antidepressants, birth control pills, some heart medications, some HIV drugs, cyclosporine, some cancer medications, warfarin, and some statins. Any herbs or supplements which have the potential to increase serotonin can also be problematic when taking St. John’s Wort due to serotonin syndrome. This would include supplements such has 5-HTP, SAMe, and L-tryptophan.

Sources:

1. St. John’s Wort. Brandeis University. Available at: http://www.bio.brandeis.edu/fieldbio/Wildflowers_Kimonis_Kramer/PAGES/STJOHNSWORT_PAGE_FINAL.html. Accessed: August 30, 2023.

2.  Reeves, Kelly. Exotic Species: St. Johnswort. Southern Colorado Plateau Network Inventory and Monitoring Program. National Park Service. Available at: https://www.nps.gov/articles/st-johnswort.htm#:~:text=of%20the%20insects.-,St.,slightly%20acid%20to%20neutral%20soils. Published 2010. Updated May 26, 2016. Accessed August 30, 2023.

3.  Kloos, Scott. Pacific Northwest Medicinal Plants. Seventh Edition (2021). Portland, Oregon: Timber Press, Inc; 2017.

4. Gladstar, Rosemary. Medicinal Herbs: A Beginner’s Guide. North Adams, Massachusetts: Storey Publishing; 2012.

5. Klemow KM, Bartlow A, Crawford J, et al. Medical Attributes of St. John’s Wort (Hypericum perforatum) In: Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. Chapter 11. Available from: https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/books/NBK92750. Accessed August 30, 2023.

6. Nobakht SZ, Akaberi M, Mohammadpour AH, Tafazoli Moghadam A, Emami SA. Hypericum perforatum: Traditional uses, clinical trials, and drug interactions. Iran J Basic Med Sci. 2022 Sep;25(9):1045-1058. doi: 10.22038/IJBMS.2022.65112.14338. PMID: 36246064; PMCID: PMC9526892. Accessed August 30, 2023.

7. Kenda M, Kočevar Glavač N, Nagy M, Sollner Dolenc M. Medicinal Plants Used for Anxiety, Depression, or Stress Treatment: An Update. Molecules. 2022 Sep 15;27(18):6021. doi: 10.3390/molecules27186021. PMID: 36144755; PMCID: PMC9500625. Accessed August 30, 2023.

8. Peterson B, Nguyen H. St John's Wort. [Updated 2023 May 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/books/NBK557465. Accessed August 30, 2023.

9.  St. John’s Wort. National Center for Complementary and Integrative Medicine. U.S. Department of Health and Human Services. Updated October 2020. Available at: https://www.nccih.nih.gov/health/st-johns-wort#:~:text=be%20potentially%20serious.-,St.,%2C%20headache%2C%20or%20sexual%20dysfunction. Accessed August 30, 2023.

10.  SAMe. Mayo Clinic. Available at https://www.mayoclinic.org/drugs-supplements-same/art-20364924. Updated August 10, 2023. Accessed August 30, 2023.

11. Photo by Sow True Seed