St. John's Wort

Hypericum perforatum

COMMON NAMES

• Amber Touch-and-heal
• Goatweed
• Hypericum
• Johnswort
• Klamath Weed
• Rosin Rose
• St. John's Grass
• St. John's Wort
• Tipton Weed

Because Hypericum perforatum L., an aromatic perennial herb belonging to the family Hypericaceae, produces golden yellow flowers that seem to be particularly abundant on June 24, the day traditionally celebrated as the birthday of John the Baptist, the plant is commonly known as St. John's wort. Its overground parts (leaves and flowering tops) that are medicinally applied also begin to be harvested at about that time. The plant is native to Europe but is found throughout the United States.

St. John's wort was known to such ancient authorities on medicinal  plants as Dioscorides and Hippocrates; indeed it is described and recommended as a useful remedy in all of the herbals down through the Middle Ages. But as with many plant drugs, it fell into disrepute in the late nineteenth century and was nearly forgotten. Quite recently, a tea prepared from the herb acquired a renewed reputation, particularly in Europe, as an effective nerve tonic, useful in cases of anxiety, depression, and unrest. Users also value it internally as a diuretic and in the treatment of various conditions, ranging from insomnia to gastritis.
An olive oil extract of the fresh flowers of St. John's wort acquires a reddish color after standing in sunlight for several weeks. This so-called red oil is taken internally for the same conditions as is the tea, but it is also applied externally to relieve inflammation and promote healing. It is highly valued in the treatment of hemorrhoids.

Chemical investigations have detected a number of constituents in St. John's wort, including about 1 percent of a volatile oil and approximately 10 percent of tannin. The latter compound probably exerts some wound-healing effects through its astringent and protein-precipitating actions. Much of the activity reported for the plant was initially thought to be due to the presence of hypericin, a reddish dianthrone pigment. Studies then tentatively linked the anti- depressant effects of St. John's wort to various contained xanthones and flavonoids. However, most recent investigations definitely suggest that other constituents in the whole extract, rather than hypericin and related compounds, are responsible for efficacy in mild to moderate forms of depression. Hyperforin is one currently being investigated.
The exact mechanism of action by which St. John's wort improves these depressive states is still unknown. It may involve the dopaminergic system. Other proposed mechanisms of action in- clude an increase of neurotransmitters; inhibition of catechol-O- methyltransferase; modulation of cytokine activity; hormonal effects; and photodynamic effects. It is quite possible that the herb functions by a variety of these, or similar, mechanisms, thereby explaining its minimal side effects.

It is a wonderful remedy for the nervous system, relaxing tension and anxiety, and lifting the spirits -it is considered specific for emotional problems during the menopause. Its tranquilizing effect has been attributed to hypericin, which reduces blood pressure, capillary fragility and benefits the uterus. St. John's wort can be used for painful, heavy and irregular periods as well as PMS. St.John's wart has a diuretic action, reducing fluid retention and hastening elimination of toxins in the urine. St.John's wort has been used to good effect for bed-wetting in children. St.John's wart is also useful for gout and arthritis.

St. John's wort also has an expectorant action, clearing phlegm from the chest and speeding recovery from coughs and chest infections. St.John's wort has an antibacterial and antiviral action, active against TB and influenza A, and is being researched for its beneficial effect in the treatment of AIDS and HIV as well as cancer. Its astringent and antimicrobial action is effective in the digestive tract where it can treat gastroenteritis, diarrhea and dysentery. St.John's wort is also said to heal peptic ulcers and gastritis. Used both internally and externally, St. John's wort is a wonderful remedy for nerve pain and any kind of trauma to the nervous system. St.John's wort can be used for neuralgia such as trigeminal neuralgia and sciatica, fibrositis, back pain, headaches, shingles and rheumatic pain. The herbal oil soothes and heals burns, cuts, wounds, sores, ulcers and calms inflammation.

PARTS USED

Flowering tops, aerial parts.

USES

Nervous complaints - St. John's wort is one of the most valuable European medicinal plants for nervous problems. Herbalists have long used it as a tonic for anxiety, tension, insomnia, and depression particularly that associated with menopause.
Menopause - The herb is especially helpful for menopausal problems, alleviating the symptoms of hormonal change and treating decreased vitality.
Tonic properties - St. John's wort is valuable tonic for the liver and gallbladder.
Infused oil - The red oil is an excellent antiseptic. Externally, it is used for wounds and burns and to relieve cramp and nerve pain. Internally, the oil maybe taken for peptic ulcers and gastric inflammation. Its antiviral, anti-inflammatory, and healing powers work just as well within the body as externally.
Other medical uses - Homeopathy, Abscess, Breast cancer, Manic depression.

HABITAT AND CULTIVATION

Native to Britain and Europe, St. John's wort now grows wild throughout much of the world. It is found in meadows, on banks, and by roadsides, and prefers sunny positions and chalky soils. St.John's wort can be grown from seed in spring or by dividing the rootstock in autumn. The flowering tops are harvested in midsummer.

RESEARCH

Depression - In a recent research study in Austria, 67% of patients with mild to moderate depression improved when given an extract of St. John's wort. This confirmed findings of earlier trials that showed the herb to be good for depression.
Hypericin - The red color of the oil is due to products of hypericin. This constituent is antidepressant and so strongly antiviral that it is being researched for use in treating HIV and AIDS.
Whole herb - Research shows that the whole herb is effective against many viral infections.

CONSTITUENTS

St.John's wort contains glycosides, flavonoids (inc. rutin), volatile oils, tannins, resins.

USUAL DOSAGE

Many people take 500 mg per day of herbal extract, tablets, or capsules of St. John's wort standardized to contain 0.2% hypericin. Higher intakes of St. John's wort extract, such as 900 mg per day, may be used in some instances. St. John's wort should be taken close to meals. If used to support depression treatment, its effectiveness should be assessed by a nutritionally oriented doctor after four to six weeks. Herbal tinctures are also available; they are often taken in doses of 1-2 ml three times per day.

SIDE EFFECTS AND CAUTIONS

St. John's wort makes the skin more light-sensitive. Persons with fair skin should avoid exposure to strong sunlight and other sources of ultraviolet light, such as tanning beds. It is also advisable to avoid foods like red wine, cheese, yeast, and pickled herring. St. John's wort should not be used during pregnancy or lactation.

When not to use St. John's Wort

• Do not use St.John's wort if you are taking any kind of prescription antidepressant, particularly one of the selective serotonin reuptake inhibitors, such as Prozac. A potentially serious medication interaction called serotonin syndrome may occur if you do. If you are taking a prescription antidepressant and also want to try St.John's wort for another medical condition-PMS or insomnia, for example-please talk with a practitioner first. Do not self-medicate with St.John's wort if you are already taking a prescription antidepressant.
• Do not take hypericum for bipolar disorder (manic-depression) or severe depression that involves suicidal thoughts. Although some recent research suggests that higher daily doses of hypericum (1,800 mg or more per day) may be effective in treating more severe depressions, significantly more research is needed to justify those claims. Right now, St.John's wort is only indicated for mild to moderate depression and for seasonal affective disorder (SAD).
• Do not take St.John's wort if you are pregnant or nursing. St.John's wort has never been tested for possible teratogenicity, that is, medication-caused genetic malformations in fetuses. Further, St.John's wort has a long traditional use as a uterine tonic and mild uterine stimulant; at least one contemporary study has verified its mild uterine-stimulating property in laboratory animals.
• Do not treat children under the age of 12 with topically (externally) applied St.John's wort. For example, there is a long-standing and apparently effective traditional use of St.John's wort as a treatment for colicky babies. The baby is submerged in warm bathwater to which fresh St.John's wort (flowers and leaves) or liquid extract has been added. St.John's wort has antispasmodic, analgesic, and sedating properties-all of which are useful in treating colic. A St.John's wort bath also is an excellent treatment for anxiety, restlessness, and stomach cramping.
• Do not use St.John's wort if you have a substance-abuse problem (with alcohol, cocaine, crack, heroin, or amphetamines). A serious medication interaction may occur, despite some anecdotal reports that St.John's wort is an effective "detox" medication. Instead, work with a qualified practitioner, or counselor. Then consider taking St.John's wort during the recovery phase, to treat related anxiety and insomnia.

When to use St. John's Wort with caution

• Use St.John's wort with caution and only under a qualified medical practitioner's care if you have chronic heart, liver, or kidney disease, or if you have been diagnosed with a connective tissue disease, such as lupus or rheumatoid arthritis. In chronic organ diseases, the body's defense mechanisms are severely compromised and often cannot effectively metabolize many medicines, botanical medicines included. People with heart, liver, and kidney disease are especially susceptible to serious medication-related side effects, even with a mild medicine such as St.John's wort. In connective tissue diseases, such as systemic lupus, photosensitivity and severe sun-related skin reactions are actual symptoms of the disease. Self-medicating with St.John's wort, a known photosensitizing plant herb, might seriously exacerbate these symptoms.
• Use St.John's wort with caution, and only under a practitioner's care, if you have chronic high blood pressure.
• Use hypericum with caution, and only under a practitioner's care, if you have AIDS, cancer, or hepatitis, or have been diagnosed with HIV or tuberculosis. There has been much exciting news about St.John's wort's anti-viral, anticancer, antibacterial, and immune-boosting properties. St.John's wort appears to hold substantial promise as a therapeutic agent for all of these illnesses. Nevertheless, considerably more research is called for, as clinical trials in humans have been limited and stringently controlled. People with any of these diseases should continue with conventional treatment protocols and only add St.John's wort as a supportive or adjunctive therapy under a doctor's advice.
• Use St.John's wort with caution, and only under the advice of a qualified practitioner, in children over the age of 12.

HOW IT WORKS IN THE BODY

St John's wort works primarily in  the nervous system, the hypericin in combination with the other constituents acting as an antidepressant. American studies have found that this herb may be used in combination with Ginkgo biloba to increase antidepressant effectiveness. However, if you wish to combine-these herbs, or are already taking prescription antidepressants, it is advisable to first consult your medical or herbal practitioner. St John's wort is also a tonic for the nervous system as a whole, and can be used, for example, in the reproductive system in menopause, where physical changes are aggravated by mental and emotional debility. In the digestive system, the herb is beneficial to the liver, and in the respiratory system, the antiviral properties make it especially useful in colds and flues. Its antiviral benefits are used to improve the immune system as a whole. Externally, the oil is used as an antiseptic to heal wounds and to ease nerve pain, for example, in shingles and repetitive strain injury.

APPLICATIONS

AERIAL PARTS:

INFUSION - Use for anxiety, nervous tension, irritability or emotional upsets, especially if associated with the menopause or premenstrual syndrome.

TINCTURE - Take for at least two months for long-standing nervous tension leading to exhaustion and depression. For childhood bedwetting, give 5 - 10 drops at night.

WASH - Use the infusion to bathe wounds, skin sores, and bruises.

FLOWERING TOPS:

CREAM - Use for localized nerve pains, such as sciatica, sprains, and cramps, or to help relieve breast engorgement during lactation. Can also be used as an antiseptic and styptic on scrapes, sores, and ulcers.

INFUSED OIL - Use on burns and muscle or joint inflammations including tennis elbow, neuralgia, and sciatica. Add a few drops of lavender oil for burns, or yarrow oil for joint inflammations.

ST. JOHN'S OIL

• 2 cups (500 ml) olive oil
• 1 1/2 oz (50 g) St. John's wort flowers
• 1 colored glass jar (blue, brown or green)

Harvest the St. John's wort flowers on a dry and sunny day. Put them in the jar and cover with the oil. Store away from light; stir regularly. Macerate for 2 months and strain by wringing in cheese-cloth.
This oil treats minor burns, contusions, neuralgia and rheumatism. It soothes all sorts of internal and external pain. To preserve longer, add 5% lavender essential oil.

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