A Hack from the Past: St. John’s Wort
St. John’s wort may not be as popular today, but consult your nana! It has been used since centuries (first used in 1st century AD in Roman military[1]) for balancing mood, relieving sleep disturbances, restlessness and nervousness. As it happens, the current pandemic could be a comeback time for this traditional medicine herb. Stress can harm your body in multiple ways (read more here). As pointed out in a recent news article ‘Mental health therapists' caseloads and waiting lists for appointments are growing. Anxiety and depression are rising amid the coronavirus crisis’. [2]
Ensuring a good mental health helps to better cope with the uncertainties of COVID-19. Many herbs act to reduce stress and anxiety, see here. Let’s see why St. John’s wort is so well known for its anti-depressant properties.
How to recognize St. John’s wort?
| Also known as Hypericum, this perennial herb has been growing as an invasive species across North America. Wondering the reason behind its name? It blossoms around St John's Feast Day on 24 June. The herb was traditionally hung on doors on St John's Feast day to ward off evil spirits (today, there are better ways to deal with them!). |
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How is it used as a medicine?
| You can’t just bite into it. The stem, leaves and flowers of St. John’s wort are used in herbal medicine. After drying the cut parts, it is powdered and the actives are isolated into an extract by a special distillation process. Thereafter, it can be used in the form of tincture, tea or capsules. Visit our product containing St. John’s wort here. |
How does it work?
Yes, there is a deep science to it! Hypericum extract contains at least 10 substances that have been shown to have biological activity, including hypericin, pseudohypericin, hyperforin, xanthones, monoterpenes, β-sitosterol, quercetin and catechin. Many of these substances have been shown to bind neuroreceptors in the brain and to inhibit the uptake of various neurotransmitters thought to be involved in depression.[3] This is pretty much the way SSRIs (Selective serotonin reuptake inhibitors) and tricyclic antidepressants act. Supplement of St. John’s wort is usually recommended to be taken for maximum of 18 weeks before consulting a doctor.[4]
Is the action of St. John’s wort backed by evidence?
The use of St. John’s wort in depression has attracted a lot of research. A meta-analysis published in the ‘JAMA Internal Medicine’ studied the use of St John's wort in mild to moderate depression. It reported increased response rate ranging from 23% to 55% higher than with placebo[3] (another study put this number at 50%).[5] In another meta-analysis of 27 clinical trials with a total of 3808 patients, St John’s wort was found to have comparable efficacy as SSRIs for mild-moderate depression.[6]
What are the side-effects?
St. John’s wort is better tolerated than most anti-depressants which are plagued with plenty of side-effects. Common side effects include photosensitivity, nausea, constipation, dizziness, confusion, hair loss and dry mouth.[7] Since St. John’s wort is a potent inducer of liver enzymes, it can interact with some medications.[8] Please read the label information before using supplements.
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References:
- Pöldinger W. [History of St. Johns wort]. Praxis 2000;89(50):2102–9.
- Tanner L. Depression, anxiety spike amid COVID-19 pandemic and turbulent times [Internet]. CP242020 [cited 2020 Oct 29];Available from: https://www.cp24.com/world/depression-anxiety-spike-amid-covid-19-pandemic-and-turbulent-times-1.5089895
- Gaster B, Holroyd J. St John’s wort for depression: a systematic review. Arch Intern Med 2000;160(2):152–6.
- Natural Health Products Ingredients Database. ST. JOHN’S WORT - HYPERICUM PERFORATUM - Oral [Internet]. 2004 [cited 2020 Oct 29];Available from: http://webprod.hc-sc.gc.ca/nhpid-bdipsn/atReq.do?atid=stjohnswort.millepertuis.oral&lang=eng
- Johnson G, Shadiack A. Does St. John Wort relieve symptoms of major depressive disorder in adults? Evid-Based Pract 2018;21(8):50.
- Ng QX, Venkatanarayanan N, Ho CYX. Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. J Affect Disord 2017;210:211–21.
- St. John’s Wort and Depression: In Depth [Internet]. NCCIH [cited 2020 Oct 29];Available from: https://www.nccih.nih.gov/health/st-johns-wort-and-depression-in-depth
- St John’s Wort: Interactions [Internet]. [cited 2020 Oct 29];Available from: https://reference.medscape.com/drug/amber-amber-touch-teal-st-johns-wort-344549#3
