St. John's Wort

St. John’s Wort: Hypericum Perforatum. Hypericaceae/Clusiaceae family St. John’s wort is one of the most well-known herbal remedies specific for depression. It has a long history of use from medieval times being used to “magically protect from demons” and in current times research has shown it as effective as many SSRI antidepressants. It is an herb associated with the sun astrologically, and that is the energy it exudes, a cheerful and happy glow. It is a specific for all injuries related to the nervous system, and depression especially associated with feelings of isolation. The following is a monograph (herbal encyclopedia entry) I wrote on this plant, one of my favorites and most used. It makes a beautiful crimson red tincture when extracted in alcohol, and according to the naturopathic tradition is strongly synergistic with valerian, an herb that’s mentioned in the insomnia section, but that also has anti-anxiety, anti-stress and muscle relaxant abilities. This beautiful plant can bring the sun back into your life and is quite potent, so be careful about mixing it with any pharmaceuticals and be sure to check with your holistically minded physician about any possible interactions. At the bottom of this monograph there are some potential interactions, with the biggest worry being that St. John’s wort is an MAOI, so can increase the concentration of certain pharmaceutical medications. Aside from its well-known uses for depression, St. John’s Wort can also be applied to the skin in its oil form (extracted into oil kind of like cannabutter) to help wound healing, ulcers, viral outbreaks and nerve damage. This herb is the go-to for long term nervous system deficiency that leads to depressive symptoms and has a restoring effect on the nervous system over time with little to no reported toxicity from use for several months. A 2019 study even suggested that St. John’s wort may improve short term memory in small doses (250mg). (4) Another study done in 2018 suggested that it may function through modulating neuroplasticity, or in less fancy speak regrowth of neuron connections or adaptation that allow new connections to form. Personal Experience:

I have dabbled with this plant mostly through taking potent tinctures made from the beautiful golden flowers. What I noticed was that it overall made my mood better, helped me react to stress better, made me a little more cheerful and seemed to improve the clarity of my mind. In my experience this is the perfect plant for any winter blues I may feel, especially given that I live in Portland, Oregon which has notorious gloomy and overcast winters. Qualities: Taste: Astringent, sweet, and bitter. Warming. Associated with the Solar Plexus, digestive organs and nervous system (esp. Enteric Nervous System) Etymology: Greek name: “Hypericon” (above the icon) & “Perforatum” (perforated). Common name in recognition of this herb’s flowering around St. John’s Day (June 24). Chinese name: Guan Ye Lian Qia Clears Toxic Heat and Dispels Wind-Damp Parts used: Flowering Tops: mixture of buds and open flowers. Most effective fresh. Oil made with St. John’s wort used orally or applied topically. Bulk herb used as tea or tinctured. Homeopathic mother tincture, salve, cream or oil used (1) (2). Major Constituents: Hypericin is an uptake inhibitor of serotonin, dopamine, noradrenaline, GABA, and L glutamate (1). (often standardized to 0.2-0.3%) Hyperforin shown to raises melatonin levels. Theorized to also influence serotonin production by increasing light utilization (1). (often standardized to 2-5%) Bioflavonoids Historical Usage: During the middle ages was used magically to protect against demons, witchcraft, hallucinations and the supernatural. American Indians used for this purpose as well, calling it the herb of the Little People (2).

Usage as a wound medicine since ancient times. Homeopaths held that it was specific for nerve injuries with sharp, shooting pains and puncture wounds (2).

Paracelsus writes that St. John’s wort is “almost a universal medicine, driving away phantasmata in the sphere of man that produce spectra (which) induce epilepsy, madness, insanity and suicidal ideation.” Father Sebastian Kneip called it the “perfume of God” and the “Flower of Fairies” (2). Biomedical usages: General: Sedative nervine & gastrointestinal tonic. (1) Specific: Nervous trophorestorative, vulnerary, anti-viral, anti-bacterial, anti-inflammatory, and hepato-protective effects.

Indicated for:

- Chronic illness with a associated chronic pain, nervous exhaustion, physical weakness and emotional depression.

- Nerve trauma with associated neuropathy (pain characterized as sharp, shooting or burning) and facial neuralgias (toothaches or neurasthenia from dental extraction) (1)

- Oil used internally for: gastric inflammation, gastric ulcers and as an enema for colitis or topically applied over abdomen to treat indigestion or generalized GI inflammation. (1)

- Widely studied for use as an anti-depressive medication: anxiety, insomnia, anorexia, seasonal affective disorders.

Safety: Contraindicated for pregnancy, not to be taken with MAOI. Known inducer of cytochrome P3A4, P1A2 and P2C9 enzyme systems and P-glycoprotein.

Caution in use along with HIV protease inhibitors, HIV non-nucleoside reverse transcriptase inhibitors, graft antirejection drugs, blood thinners, oral contraceptives, SSRI’s, triptans, narcotic sleep medications (esp. Xanax). (3) May cause photo-sensitivity, especially in light skinned patients (1). Saint John’s wort is often otherwise well tolerated showing less adverse effects than conventional antidepressants. Dosage: 1:1 Fresh strength liquid extract: 10-60 drops 1-4X/daily. (1) St. John’s wort extract (0.3% hypericin) 300mg 3x/daily for 6 weeks. (take note that benefits with this herb typically take >2 weeks of continued usage) (3) Extracts seem to be safe used for up to 12 weeks and some evidence suggests up to a year, with more tolerability than SSRI’s and TCA’s.

References:

Tilgner SM. Herbal Medicine from the Heart of the Earth 2nd edition. Wise Acres LLC. 2009Wood M. The Book of Herbal Wisdom: Using Plants as Medicines. North Atlantic Books. 1997St. John’s Wort. Professional Monograph. Natural Medicines Database.https://link.springer.com/article/10.1007%2Fs00213-018-5088-0 link to St. John’s wort study on memory