By: Candice Carlson 10/17/11

Popular herbal remedy. Used world-wide. Learn new information. Nutrition. Family, friends.

Describe St. John’s wort History Botanical composition Health claims The science behind the claims Recommendations Safety Efficacy Conclusion

St. John’s wort is an herb. Herbaceous perennial. An herb is a small plant that bears seeds. Fleshy parts instead of woody parts. Hypericum perforatum Saint John’s Word, Hardhay, Goatweed, Amber, Klamath weed, and Tipton weed. Yellow flowers and leaves are used to make medicine. Large amount of chemical compounds. Ingredients believed to produce effectiveness-hypericin and hyperforin.

Native to Europe. Common in United States, Canada, and Australia. Found in meadows and woods. Australia considered it a weed. Now grown as a crop, produces 20% of the world’s supply. United States Nutritional supplement Europe Prescription medication

Dates back to ancient Greece. Hippocrates documented the medical use of St. John’s wort. Encircled with folklore. Greeks used it to fight evil spirits and fevers. England provided the house with protection. Eliminate witches. Scientific name is Greek Hyper (over) Eikon (ghost) St. John the Baptist Blooms around his birthday. June 24th

Thought that placing the plant under the pillow would prevent death from occurring throughout the year. St. John’s Eve Folk remedy Used for centuries. Treat wounds, nervous disorders, and gout. Native Americans used the plant to treat help with treatment of snakebites. United States Not known until 1900’s Popular Concerns about the risks and harms.

Has been used as an antidepressants and diuretics. Used for burns and fevers. Europe Used for depression, bedwetting, skin problems, liver problems, and mental exhaustion.

Perennial herb. Stoloniferous, extensive rhizomes. Leaves contain dots on the surface. Five petals, bright yellow Contains Melatonin Tannins Flavonoids Flavonal Glycosides Phenolic acids Naphtodianthrones Hypericin Phloroglucinols Hyperforin Essential oils Comprised of sesquiterpenes.

Reduces anxiety symptoms. May be ineffective for ADHD symptoms. Improves menopausal symptoms. Possibly improve wound healing. Improves dermatitis symptoms. May reduce premenstrual symptoms. May be effective treatment for somatoform disorders. Reduces fatigue. Effective in treating mild to moderate depression. Ineffective for treating major depression.

Not enough current evidence that St. John’s wort improves anxiety symptoms. May be beneficial to some. Study declared 3 cases relieving anxiety symptoms. Study had participants take 900 mg of St. John’s wort twice a day. In 4 weeks a woman who had previously suffered from chronic anxiety for 8 years found symptoms were relieved. Before the treatment she experienced: insomnia, worry, tension, and irritability. After the study she experienced: reduced worry, ability to cope with stress, sense of relaxation, and improved sleep.

Unclear whether St. John’s wort is effective for treatment. May be beneficial for treatment. Hyperforin (active ingredient) Inhibit reuptake of serotonin and nor epinephrine (brain chemicals). Study of 54 children from 6 to 17 years old showed symptom improvement from the placebo and the treatment. 300 mg of Hypericum perforatum, 3 times a day for 8 weeks. Although it showed improvement there were no additional benefits found. Concerns it may worsen ADHD symptoms when taken with methylphenidate (used for treatment of ADHD). Further studies need to be performed.

Some research showing St. John’s wort can improve menopausal symptoms. Combined with black cohosh. Study of 301 women St. John’s Wort combined with black cohosh was superior to placebo. Improvements in physical and subjective symptoms. Not enough scientific evidence.

May be effective for wound healing. St. John’s wort can be used externally as an oil. Can treat first degree burns Post therapy A few research studies conducted regarding application of St. John’s wort ointment. Taken 3 times a day for a couple weeks may show improvement in wound healing. May reduce the formation of scars following a C-section.

Positive results regarding sub acute atopic dermatitis. Further studies need to be conducted. Ointment applied approximately 3 times a day for a couple weeks may improve wound healing. Result in reduction of scar formation. Study of 21 participants 4 weeks Participants used a treatment with hypericum. Applied 2 times a day. Tolerance of cream was excellent. Eczematous lesions significantly more effective than placebo.

A few studies show that St. John’s wort may be able to reduce premenstrual symptoms. May improve symptoms by 50% in some women. One study found that taking 300 mg of St. John’s wort reduced daily symptom ratings. Modified Social Adjustment Scale scored improved. Hospital Anxiety and Depression Scale improved. Preliminary evidence. Further studies are needed.

St. John’s wort can possibly be effective for symptom reduction. After 6 weeks approximately. Study 600 mg of St. John’s wort were given daily to outpatient adults. Proven safe and effective for treatment of mild or moderate somatoform disorders. Proven equally safe as placebo. Well tolerated. St. John’s wort may help with Somatoform Disorders but to clearly confirm this further research is needed.

St. John’s wort may reduce fatigue. Study Open, uncontrolled Patients were given hypericum 3 times a day for approximately 6 weeks Results showed a reduction in fatigue. Also showed reduction in anxiety and depression. Further control studies should be completed. This study did no include a control group. Results were difficult to determine. St. John’s wort can possibly reduce fatigue.

St. John’s wort taken for treatment of mild to moderate depression is likely to be effective. Scientific evidence is inconsistent on effectiveness of St. John’s wort. Likely to improve mood, insomnia, and reduce anxiety As effective as prescription drugs. St. John’s wort is considered an antidepressant that can be used as a short-term treatment for mild to moderate depression. 37 clinical trial were conducted. Results show St. John’s wort may benefit people with mild depression. Benefits were similar to other antidepressants May contribute to less side effects

Major depression is a common disorder that is likely to spread modern society. St. John’s wort provides minimal benefits for major depression. Studies show St. John’s wort is ineffective for major depression. Study of 340 participants Measured Hamilton Depression Scores. St. John’s wort dropped their scores. Results do not support St. John’s wort for treatment of major depression.

Preparation of an infusion 2 tsp of drug 150 mL boiling water Steep for 10 minutes. Dried herb Tablets Tinctures Capsules Storage Room temperature Keep away from sunlight and heat. Away from moisture. Limited shelf life.

Dose and Frequency: Recommended to take 200 to 1,000 mg/day for depression treatment. Capsules and tablets: take 300 mg three times a day (0.3% Hypericin). 0.2% Hypericin-take 250 mg twice a day. 5% Hyperforin-take 300 mg three times a day. Under age 12, 300 mg daily is recommended (0.3% Hypericin). If taken for premenstrual syndome: 300 mg once a day (0.3% Hypericin). If taken for somatization disorders: 600 mg a day is advised Special extract

Dried herb: 2 to 4 grams three times a day. A traditional method is Tea. For one dose 2 to 3 grams of the dried herb is recommended. Place in boiling water. Tincture: 2 to 4 mL three times a day. Cost: For 90 capsules approximately $13.00

Food and Drug Administration (FDA) Classifies St. John’s wort as a dietary supplement. Herbal products are allowed to be sold without dosage studies. Not required for safety and effectiveness as well. Misleading Information Inaccurate Information “Natural” is not necessarily considered “safe.” Especially when taken in large doses Interaction with drugs

St. John’s wort for general use is believed to be safe for short-term use. Safety concerns. Some of the chemical compounds, when combined with prescription drugs, is not advised.

Short term use Likely safe May cause side effects Trouble sleeping Diarrhea Dizziness Irritability Upset stomach May be unsafe taken in large doses by mouth. Special Precautions Possibly unsafe for: Pregnancy Breast feeding Infertility Major depression Alzheimer’s Disease Anesthesia & surgery ADHD Schizophrenia Bipolar Disorder

Do not combine St. John’s wort with certain medications. Can decrease effectiveness when taking: Amitriptyline Contraceptive drugs Digoxin Eplerenone Imatinib Irinotecan Tacrolimus Several anti-human immunodeficiency drugs Ivabradine Warfarin Cyclosporin Voriconazole

Additional interactions Alprazolam (Xanax) Aminolevulinic acid Cyclosporine Fenfluramine Antidepressants (Medications for depression) Medications for pain (narcotic drugs) Meperidine Mephenytoin Nefazodone Phenobarbital Phenprocoumon Phenytoin Reserpine Sertraline Tramadol Nortriptyline Paroxetine Pentazocine

Wort-and-Surgery Wort-and-Surgery

Quality of Research Human research suggests that further research is needed for evidence to support many of the health claims. St. John’s wort has been used for centuries. Documented it’s use. Many studies show that St. John’s wort is likely to be effective for mild depression.

Efficacy Improves anxiety symptoms is weak. Evidence is unclear on the effect on ADHD symptoms. Not enough scientific evidence to show it improves menopausal symptoms. Some evidence it may be effective for wound healing. Further research needs to be done on improvement in dermatitis symptoms. Reducing premenstrual symptoms is weak.

Efficacy To clearly confirm the use of St. John’s wort for somatoforam disorders further research is needed. Further control studies are needed to prove the reduction in fatigue. Research on depression is inconsistent. Most likely to help with mild to moderate depression. Not likely to help with major depression.

Safety Safe for general, short-term use. Only used 4 to 6 weeks. May cause side effects. Unsafe when taken in large doses. Possibly unsafe when: pregnant, breastfeeding, infertility, major depression, alzheimer’s disease, anesthesia and surgery, ADHD, schizophrenia, bipolar disorder. Unsafe when combined many medications Birth control pills, antidepressants, anticancer medicines, and medicines to control HIV

Ethics in marketing Marketed capsule and tablet form. Ointments are marketed for wound healing, helping with skin irritations, and bruises. Marketing is directed towards those suffering from mild to moderate depression and anxiety. Marketed as being as effective as Prozac for treatment of depression. Many articles showing that it is effective for short-term use for mild to moderate depression.

What you should know: Botanical and chemical composition of St. John’s wort Health claims The science behind the claims Herbal preparation Recommendations Concerns and risks associated with St. John’s wort Interactions with medicines Safety, efficacy, ethics in marketing

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