Top Ten Herbs: St. John’s Wort

Hypericum perforatum, or St. John’s Wort, is an herb that grows wild in many places. It has yellow flowers shaped like five-pointed stars. It is found all over the world, including Australia, New Zealand, Eastern Asia, Europe, and North and South America. For centuries, it has been used to improve mental health. 

Health Benefits and Side Effects

This herbal supplement is available over the counter. It has been known to aid in combating depression and improving mental health, which is the main use of the herb. Tests have shown it effective for some against severe depression, and slightly less so against mild to moderate depression. It increases serotonin production. 

It has also been used to treat menopause symptoms like hot flashes and mood swings. An ointment from the herb has also been used as a wound salve.

It is believed to have properties that make it astringent, antibacterial, and anti-inflammatory, due to the chemical hypericin. Some other maladies St. John’s Wort has been used to treat include psoriasis, eczema, minor burns and bruises, insect stings and bites, inflammation, earaches, rashes, cuts, abrasions, nerve pain, insomnia, and hemorrhoids.

However, it can have dangerous side effects, and it interacts negatively with a variety of prescription medications. The use of St. John’s Wort should be avoided during the use of:

  • Xanax (alprazolam)
    St. John’s Wort is likely to decrease the effectiveness due to causing the body to eliminate it more quickly.
  • Aminolevulinic acid (used to remove certain skin lesions)
    Because the above acid works by causing the area to be super sensitive to light (especially sunlight and UV light) and St. John’s Wort can also cause photosensitivity, the combination can result in blistered areas of the skin.
  • Elavil (amitriptyline)
    The effectiveness of this medication may be decreased by St. John’s Wort causing it to be eliminated sooner.
  • Contraceptives (birth control pills)
    The birth control pills that contain estrogen may have decreased effect due to St. John’s Wort moving it through the system more quickly.
  • Neoral, Sandimmune (cyclosporine)
    For those who are taking this due to an organ transplant or another reason, it is wise to avoid St. John’s Wort. It may decrease the effectiveness by encouraging the body to break it down more quickly.
  • Lanoxin (digoxin)
    This heart support medication may have decreased results due to St. John’s Wort decreasing the absorption of the medicine.
  • Pondimin (fenfluramine)
    Because this medication increases serotonin and St. John’s Wort also increases serotonin, taking these together can cause a dangerous overproduction of serotonin. This can cause anxiety, shivering, headache, nausea, and heart problems.
  • Gleevec (imatinib), Camptosar (irinotecan)
    These cancer treatments may have reduced effects due to St. John’s Wort causing it to be broken down and eliminated more quickly.
  • Liver-affected medications, such as Allegra (fexofenadine), Halcion (triazolam), Mevacor (lovastatin), Nizoral (ketoconazole), Sporanox (itraconazole), etc.
    These require the liver to change them to be effective; St. John’s Wort may make them break down faster, reducing their effectiveness. 
  • Antidepressants
    Because many of these work by increasing serotonin, and St. John’s Wort increases serotonin, combining these can cause dangerous side effects. Some of these medications include: Anafranil (clomipramine), Elavil (amitriptyline), Paxil (paroxetine), Prozac (fluoxetine), Tofranil (imipramine), and Zoloft (sertraline). 
  • HIV/AIDS treatments (NNRTI – Nonnucleoside Reverse Transcriptase Inhibitors)
    St. John’s Wort’s increase in breaking down medications can cause these medications to be less effective. These medications include Rescriptor (delavirdine), Sustiva (efavirenz), and Viramune (nevirapine). 
  • HIV/AIDS treatments (Protease Inhibitors)
    As with the NNRTI’s, the quick breaking down of the medications can reduce their effectiveness. These medications include Agenerase (amprenavir), Fortovase/Invirase (saquinavir), Norvir (ritonavir), and Viracept (nelfinavir). 
  • Narcotic pain relief
    Because of the increase in processing speed caused by St. John’s Wort, these medications may be less effective. 

This is not a comprehensive list. Any medications that increase serotonin or need time to work or be absorbed can be negatively affected by St. John’s Wort. Anyone who is taking prescription medications should discuss St. John’s Wort with the doctor before taking it. 

Food and Nutrition

This herb is not used in food. It is a medicinal herb. However, it can be made into a tea or tincture or infused into oil which can be easier to give to someone such as a Menopausal Godmother.

Growing St. John’s Wort

Just growing this pretty plant can boost anyone’s mood! It grows into a shrub and blooms pretty yellow flowers starting in the middle of the summer and continuing until fall. It also produces berries.

The plant likes partial shade and can handle pretty much any kind of soil. It can handle a wide range of moisture, from the occasional flood to dry spells (though adding a bit of water during drought will help it thrive). Too much sun can scorch the leaves and too much shade will limit the flowers. It likes a place where it gets sunshine in the morning and shade in the hottest part of the day. The shrubs will grow up to 3 feet tall and should be 2-3 feet apart. They can also be planted in pots. There are ornamental varieties that look great as filler and need little care. If allowed to go to seed, this plant may take over the yard. 

Its leaves release an unpleasant, turpentine-like smell when the leaves are bruised or broken, so they should be planted away from high traffic areas.

Plants can be easily started from seed. Soak overnight before planting to prepare it. Plant indoors 6-8 weeks before the final spring frost, then transplant outdoors.