St. John's Wort: Benefits, Risks, and Drug Interactions to Avoid

St. John's Wort: Benefits, Risks, and Drug Interactions to Avoid

Jan 19, 2024 · Angi Genes

St. John's Wort: Benefits, Risks, and Drug Interactions to Avoid

In the process of trying to understand and maintain mental wellness, many turn to nature's garden in search of remedies that can soothe the mind without overwhelming the body. St. John's Wort, a plant with delicate yellow flowers, has caught attention as a beacon of hope for those wrestling with the shadows of mild-to-moderate depression.

You're not alone if you’ve felt unsure about navigating traditional pharmaceutical options; perhaps you're seeking a more gentle ally in your journey towards balance and calm.

Interestingly enough, scientific studies suggest St. John's Wort may rival standard prescription antidepressants when it comes to lifting spirits without heavy side effects. St. John's Wort has been shown to relieve anxiety, provide focus against ADHD, and serve as a sleep aid. Now, you can demystify this herbal helper and get insights on potential benefits, necessary precautions, and critical drug interactions – all essential knowledge for informed decisions about your health. 

Dive into understanding St. John’s Wort with us and discover how this age-old herb could light up parts of your life dimmed by the challenge to hold on to a good mood. 

a field of yellow flower - st johns wort

Key Takeaways

  • St. John's Wort can help with mild to moderate depression and might be as effective as prescription medicines for this condition.
  • This herb may boost your mood by changing brain chemicals like serotonin and dopamine, but it does not work for more severe health problems such as serious heart conditions or major infections.
  • If you take St. John's Wort, you could become more sensitive to sunlight and need to protect your skin when outdoors.
  • Be careful mixing St. John’s Wort with drugs—it can interact badly with many medications like birth control pills, antidepressants, and those preventing organ rejection after a transplant.
  • Always consult a healthcare professional before starting St. John’s Wort because it may worsen certain medical issues or interfere with treatments you're already receiving.

Understanding St. John's Wort

 

St. John's Wort, also known as Hypericum perforatum, is a plant with yellow flowers. People have used it for centuries to treat wounds and various health conditions. Today, many know St.

John's Wort as a herbal remedy for depression. The plant contains active ingredients like hypericin that might help with mental health.

Scientists think St. John's Wort works by changing brain chemicals like serotonin and dopamine. These changes may improve mood and relieve stress or anxiety. However, the full effects of St.

John's Wort are not completely understood yet. It comes in forms such as tablets, capsules, teas, and liquid extracts.

Potential Benefits of St. John's Wort

a field of yellow flower - st johns wort

The exploration of St. John's Wort reveals a range of therapeutic possibilities, with scientific studies highlighting its efficacy in certain health conditions. Research indicates that this herb may offer benefits beyond its traditional use, contributing to mental wellness and addressing other specific health concerns.

Likely Effective for

St. John's Wort shows real promise in treating mild to moderate depression. Research indicates that it can be more effective than a sugar pill, and often just as helpful as prescription medications for this level of depression.

Many people choose St. John's Wort because it tends to cause fewer side effects than other antidepressants.

Studies also suggest St. John's Wort could help with somatic symptom disorder, where severe anxiety is linked to body symptoms. For those struggling with these issues, this herbal supplement might offer significant relief without the heavy impact of traditional drugs on their system.

Possibly Effective for

St. John's Wort might help with menopausal symptoms like hot flashes and mood swings. Women often seek natural treatments, and this herb appears promising for easing their discomfort.

Scientific studies show that taking it can lead to improvements similar to those from hormone therapy or antidepressants.

People suffering from social anxiety disorder could also benefit from St. John's Wort. Research indicates that it may reduce fear, shyness, and the stress of being around others. It has shown potential as an alternative option for managing social phobia symptoms without relying on traditional prescription drugs.

Mostly Ineffective for

St. John's Wort might not help with some health issues. Research shows it may not work well for cancer, heart problems, or serious infections. Despite its popularity as an herbal product, it doesn't seem to reduce inflammation or heal wounds quickly.

People also use St. John's Wort for conditions like irritable bowel syndrome (IBS) and Alzheimer's disease; however, scientific studies have not proven it effective in these cases.

This herb does not always work against bacterial and viral infections either. Although some people try using St. John’s Wort for skin issues and bruises, there is little evidence to support its effectiveness in promoting healing in these areas.

It’s important to know that taking this supplement might not improve certain medical conditions despite its wide use in integrative health practices.

Side Effects of St. John's Wort

a patch of yellow flowers - st johns wort - with a dark storm cloud in the background

St. John's Wort can make your skin more sensitive to the sun, so you might burn easier. If you take it, wear sunscreen and hats when you go outside. This herb might also cause problems like diarrhea, dizziness, and a dry mouth.

It is not safe for everyone. St. John's Wort can interfere with lots of drugs such as birth control pills, blood thinners, and some cancer medications. You could feel extra anxious or tired if you use it.

Be careful about mixing it with other herbs or supplements that affect mood.

Talk to your doctor before trying this plant as a supplement - especially if taking other meds or dealing with conditions like depression or bipolar disorder. It has real effects on the body and mind that need professional monitoring for safety.

Special Precautions and Warnings

st johns wort flower and supplement ingredients

St. John's Wort may cause serious interactions with many drugs. This includes prescription medications and over-the-counter products. People taking selective serotonin reuptake inhibitors or other antidepressants should not use it.

Doing so can lead to too much serotonin in the brain, a condition called serotonin syndrome. This is dangerous and requires medical attention.

Pregnant or breastfeeding women must avoid St. John's Wort since it could harm the baby. Those scheduled for surgery should stop using it at least two weeks before their procedure.

The herb might affect how your body reacts to anesthesia and bleeding risk during surgery.

Patients with certain conditions like bipolar disorder, major depression, or schizophrenia need to be very careful as well. St. John's Wort can make these problems worse.

Always talk with a health care provider before starting any new supplement including St John's Wort, especially if you take other medicines or have health issues.

Important Interactions of St. John's Wort


St. John's Wort is known for its potential to interact with a multitude of medications, sometimes with serious consequences. It's crucial for individuals taking any medication to be aware of these interactions and consult healthcare professionals before incorporating St. John's Wort into their regimen.

Major Interaction

  1. John's Wort has major interactions with certain medications. This herb can change how these drugs work in your body.
  • Alprazolam (Xanax): The effectiveness of Xanax may decrease if taken with St. John’s Wort, potentially reducing its sedative effects.
  • Birth control pills: This herbal supplement might make birth control pills work less well, which could increase the risk of pregnancy.
  • Cyclosporine: Used to prevent organ transplant rejection, cyclosporine's effectiveness can drop when used with St. John’s Wort, risking transplant failure.
  • Digoxin: The heart medication digoxin may lose some of its potency due to St. John’s Wort, jeopardizing heart stability.
  • Imatinib: When combined with this herb, imatinib—a cancer treatment drug—could become less effective, affecting cancer therapy outcomes.
  • Medications changed by cytochrome P450 3A4: St. John's Wort speeds up the breakdown of many drugs (like statins and protease inhibitors), making them less effective.
  • Warfarin (Coumadin): Taking St. John's Wort can reduce warfarin levels in your blood and decrease its efficiency, raising the risk of blood clots.

Alprazolam (Xanax)

Alprazolam, also known as Xanax, treats anxiety and panic disorders. If you take St. John's Wort and Alprazolam together, it may cause problems. Scientific studies show that St. John's Wort can decrease the effectiveness of Xanax by making your body break it down faster.

This means Xanax may not work as well when used with this herb.

People who need help with their anxiety should avoid combining these two. It is essential to talk to a doctor before mixing herbal supplements like St. John's Wort with medications such as Alprazolam to ensure safety and proper treatment.

Birth control pills

St. John's Wort can interfere with the effectiveness of birth control pills. This herb affects how the body processes certain drugs, including contraceptive drugs. Women taking St. John's Wort may experience breakthrough bleeding or irregular periods. The risk of an unplanned pregnancy goes up if you take this herbal product with birth control pills.

Talk to a doctor before using St. John's Wort if you're on oral contraceptives. You might need a different form of contraception to avoid unwanted side effects and pregnancy. Research shows that St. John's Wort can make your pill less effective, but we still need more large studies to fully understand this risk.

Cyclosporine

Cyclosporine is a medication that helps prevent organ rejection in transplant patients. Taking St. John's Wort with cyclosporine can be risky. This herbal supplement lowers how much cyclosporine is in the body by 40-60%.

Less cyclosporine means a higher chance of the body rejecting the new organ.

Doctors often warn against using St. John's Wort with certain prescriptions, especially like those for transplants. The CYP3A4 enzyme and P-glycoprotein are important for many drugs, including cyclosporine (Neoral, Sandimmune).

If you're taking these meds, adding St. John's Wort might cause unwanted interactions. Always talk to your doctor before mixing St. John's Wort with other medications to stay safe.

a variety of pills

Digoxin

Digoxin, also known by the brand name Lanoxin, is a heart medication used to treat various conditions. If you take St. John's Wort with digoxin, it might not work as well. Studies show that this herb can lower how much digoxin your body absorbs.

This drop in digoxin levels could be anywhere from 18% to 25%. Doctors say that if you're on digoxin, don't use St. John's Wort at the same time. It triggers P-glycoprotein and that makes less of the medicine stay in your system.

Always talk to your doctor before mixing herbal products like St. John's Wort with medications for your heart.

Imatinib

Imatinib is a cancer treatment drug. It needs to be taken carefully. St. John's Wort speeds up how fast your body gets rid of imatinib. This can make imatinib less effective. People on imatinib should not use St. John's Wort.

Many natural products interact with cancer treatments, like St. John's Wort does with imatinib. These interactions can change how the drugs work in your body. Patients must know about these risks before using St. John's Wort with other medicines.

Moderate Interaction

John's Wort can affect how some medications work in your body. It's essential to be aware of these moderate interactions to stay safe.

  • Clopidogrel (Plavix): Taking St. John's Wort with this blood thinner might lower its effectiveness, increasing the risk of blood clots.
  • Fexofenadine: This allergy medication may not work as well if you use it with St. John's Wort because the herb speeds up how quickly your body gets rid of it.
  • Procainamide: If you pair St. John's Wort with this heart medication, it could change the level of procainamide in your blood, which can be harmful.
  • Tramadol: This pain reliever might become less effective due to increased breakdown caused by St. John's Wort.
  • Medications that increase sensitivity to sunlight: Taking these drugs with St. John's Wort can make your skin more sensitive to light and lead to severe sunburns or sun allergies.

Clopidogrel

Clopidogrel needs certain enzymes to work properly in the body. One of these enzymes is cytochrome P450 2C19 (CYP2C19). If something blocks CYP2C19, clopidogrel can't do its job well.

This could make it less effective for people who need it.

St. John's Wort speeds up the activity of CYP2C19 and another enzyme called CYP3A4. Because of this, St. John’s Wort could change how clopidogrel works in the body. It may cause more bleeding because it makes clopidogrel work too well.

People should be careful using both together without talking to their doctor first.

st john wort pills

Fexofenadine

Fexofenadine is an antihistamine people often take to relieve allergy symptoms. But, you should know it might not work as well if you are using St. John's Wort. This herbal supplement can lower how much fexofenadine your body absorbs, making the medicine less effective.

If you're on this medication, talk with a doctor before starting St. John's Wort.

Taking both St. John's Wort and fexofenadine could lead to more side effects than usual. The combination may cause too much antihistamine to stay in your body. Always check with healthcare professionals about any interactions between supplements and your prescriptions.

Procainamide

St. John's Wort affects how the body processes procainamide. It can raise levels of this medication in your blood. Be careful if you take them together, as this might cause problems with your heart rhythm.

Doctors need to check these drugs closely when they are used at the same time.

Mixing Brexpiprazole with procainamide could slow down how fast your body gets rid of procainamide. This might increase side effects or make some heart issues worse. If you use St.

John's Wort and need procainamide treatment, tell your healthcare provider about any other medications you’re taking to stay safe.

Tramadol

Tramadol is a painkiller that doctors prescribe for severe pain. It works in the brain to change how your body feels and responds to discomfort. But this medication isn't simple; it has risks.

If you take tramadol, you might face serious side effects like seizures or serotonin syndrome, a rare but dangerous condition caused by too much serotonin in your brain.

Mixing St. John's Wort with tramadol can make these risks even higher. Serotonin levels can shoot up, increasing chances of serotonin syndrome. People need to be careful with dosages and watch out for signs of trouble when combining these two treatments.

Tramadol also has addiction potential, which means users must manage their use carefully to avoid dependency or abuse problems.

pills in a garden in the sunlight

Medications that increase sensitivity to sunlight

Some medications can make your skin more sensitive to sunlight. This is called "photosensitivity." When you take these drugs and go into the sun, you might sunburn more easily. St. John's Wort also makes your skin extra sensitive to light, especially if you use it with other photosensitizing drugs.

If you're taking a drug that sensitizes your skin to the sun, be careful when using St. John's Wort. Your risk of a bad reaction from the sun goes up if they are used together. These reactions can be dangerous and cause severe skin problems.

Always check with your doctor before mixing St. John's Wort with other medication interactions like these.

Minor Interaction

  1. John's Wort can sometimes lightly interact with certain medications. These interactions are less serious but still important to know.
  • Methylphenidate: This drug helps with attention deficit hyperactivity disorder (ADHD). St. John's Wort might decrease how well it works.
  • Theophylline: People take this for asthma and other lung problems. St. John's Wort could lower theophylline levels in the body, reducing its effectiveness.
  • Ambrisentan: This medication treats high blood pressure in the lungs. Using it with St. John's Wort might make it less powerful.

a glass of water next to pills

Methylphenidate

Methylphenidate works as a brain stimulant. Doctors often prescribe it for ADHD and narcolepsy. This drug boosts attention, focus, and self-control by increasing certain chemicals in the brain.

People taking methylphenidate need to follow their doctor's instructions carefully. The doses must be right to avoid side effects.

St John's Wort may have a minor interaction with this medication. If you use both, your body could process methylphenidate differently. Always talk to your healthcare provider before mixing St John's Wort with any drugs.

It can keep you safe and make sure all your treatments work well together.

Theophylline

Theophylline is a medication that some people take for lung problems like asthma. If you use St. John's Wort and theophylline together, you need to be careful. Studies have shown that St. John's Wort can make your body get rid of theophylline faster than usual by speeding up liver enzymes. This might mean that the medicine won't work as well because it leaves your system too quickly.

If you're on theophylline and want to start taking St. John's Wort, talk to a doctor first. They will check if it's safe and may change how much medicine you take to keep everything balanced in your body.

Ambrisentan

Ambrisentan is a medication that sometimes doesn't mix well with St. John's Wort. It can change how effective the drug is and lead to unwanted side effects. Foods, herbs, and alcohol might also affect ambrisentan when taken together.

If you're using this medicine, it’s smart to talk to your doctor about any supplements or changes in your diet. They can help ensure everything works as it should and keep you feeling your best without complications.

Conclusion

close-up of a woman smiling in a field of yellow flower - st johns wort

St. John's Wort has many uses, especially for mild to moderate depression. This herb also helps with menopause symptoms like hot flashes and night sweats and might improve your sleep quality. But be careful—St. John's Wort can affect the way your body metabolizes many other medications you're taking by impacting liver enzymes.

It's important to discuss using St. John's Wort with your doctor first, as it can potentially cause dangerous interactions with antidepressants, birth control pills, heart medications, and blood thinners among others. Your doctor needs a full list of any prescriptions, over-the-counter medicines, supplements, and herbs you currently take to advise you on potential risks. Never start taking St. John's Wort alongside other medications before getting your doctor's approval, as life-threatening complications can occur. Your doctor can help you carefully balance the benefits and risks of St. John's Wort for your individual health situation.

Remember that supplements are not regulated by the FDA, so the quality and purity of St. John's Wort preparations may vary widely. Work with a reputable manufacturer and trusted health provider to get the most benefits from this herbal supplement. Always talk to a doctor before trying new supplements, including St. John's Wort, to improve your wellbeing safely and informed. Take charge of your health, but do it wisely under your doctor's supervision.

 

St. John's Wort Benefits FAQs

Q: What is St. John's Wort and how does it help people?

A: St. John's Wort, also known as Klamath weed or Saint John’s Wort, is a plant used in dietary supplements that may boost mood and improve symptoms of mild to moderate depression.

Q: Is St. John's Wort effective for treating depression?

A: Studies have shown that St. John's Wort may be effective in treating mild to moderate depression. However, it's important to consult with a healthcare professional before using it as a treatment.

Q: Are there any potential interactions of St. John's Wort with other medications?

A: Yes, St. John's Wort can interact with many other medications, including certain antidepressants, birth control pills, and blood thinners. It's crucial to inform your healthcare provider about all the medications you are taking before using St. John's Wort.

Q: What forms is St. John's Wort available in?

A: St. John's Wort is available in various forms, including capsules, tablets, liquid extracts, and tea.

Q: How does St. John's Wort work for symptom-specific climacteric complaints?

A: St. John's Wort has been studied for its efficacy in addressing symptom-specific climacteric complaints in women, such as mood swings and irritability.

Q: Can St. John's Wort increase certain health risks?

A: St. John's Wort has the potential to increase the risk of certain health issues, including sun sensitivity and interactions with other medications. It's crucial to discuss the potential risks with a healthcare provider before using it.

Q: Is it safe to take St. John's Wort without consulting a healthcare provider?

A: It's not recommended to take St. John's Wort without consulting a healthcare provider, especially if you are already taking medications or have underlying health conditions. Consulting a healthcare professional is essential to ensure safe usage.

Q: What are the available St. John's Wort extract formulations?

A: St. John's Wort extract WS 5570 is one of the available formulations that have been studied for its efficacy in addressing depression and related symptoms.

Q: How should I approach taking St. John's Wort if I'm already on certain medications?

A: If you are taking certain medications, especially antidepressants or other prescription drugs, it's crucial to discuss the use of St. John's Wort with your healthcare provider to avoid potential interactions and adverse effects.

Q: Can St. John's Wort be used to treat major depression?

A: St. John's Wort is generally used for mild to moderate depression and may not be recommended as the primary treatment for major depression. It's essential to seek professional medical advice for the treatment of major depression.

Q: Can St. John's Wort be as effective as other depression medications?

A: Some clinical trials suggest that St. John’s Wort might work well for treating mild to severe depression and may be comparably effective to selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac).

Q: Are there side effects when taking St. John's Wort?

A: Yes, taking St. John’s Wort can lead to side effects such as restlessness, fatigue, and in rare cases increase the risk of suicidality especially if you have conditions like psychosis or schizophrenia.

Q: Does St. John’s Wort interact with other medicines?

A: St.John’s Wort can interact with many medications including antidepressants like paroxetine and MAOIs, anti-inflammatory drugs, and others which are metabolized by the liver enzyme cytochrome P450 2C9.

Q: Can I use St. John's Wort for menopause symptoms?

A: Research indicates that some women use black cohosh alongside Saint Johns' Wort to find relief from menopause symptoms.

Q: Is light therapy safe with using this herb ?

A: You should exercise caution combining light therapy with Saint Johns’ Wort since it could increase sensitivity to sunlight leading to quicker sunburns.

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Angi Genes

Angi Genes is a dedicated nutritionist and fitness enthusiast with a remarkable track record in bikini competitions. Her journey into health and wellness began as a personal quest to balance her busy life as a mother with her passion for fitness. Her success in bikini competitions is a testament to her dedication and knowledge in the field of nutrition and fitness.

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