St John's Wort: Natural But Not Without Side Effects

What Is St John’s Wort?

Like other natural remedies, St John’s wort is a herb of which the leaves and flowers are used in medicinal preparations. The majority of those who have heard of it know that it is a common remedy used in the natural treatment of depression, and there has been some scientific evidence showing it can be effective for milder or moderate cases of depression.

St John’s wort has also been used in other medical disorders, such as ADHD, menopause symptoms, seasonal affective disorder, heart palpitations, fibromyalgia and many others. Generally it is taken by mouth, but it can also be made into an oil for application to the skin to treat bruises, muscle pain, bug bites and other minor irritations of the skin.

St Johhn's Wort Side Effects

Provided you are not taking any other medications, research has shown that it is safe to take St John’s wort for a short period, no more than 3 months. Also, the correct dosages must be taken as too large a dose can be harmful. Possible side effects can include:

• Anxiety
• Headache
• Muscle cramps and sweating
• Dry mouth
• Skin irritation
• Photosensitivity
• Increased risk of Serotonin Syndrome
• Menstruation problems
• Mania or psychosis
• High levels of thyroid stimulating hormone
• Altered sugar processing
• Heartburn
• Nausea, vomiting, diarrhea and constipation
• Loss of appetite
• Liver damage
• Altered blood pressure
• Abnormal heart rate
• Swelling
• Insomnia
• Nervous system disorders
• Increase cholesterol
• Difficulty with anesthetic induction
• Allergic reactions

As you can see by the list above, there are numerous potential side effects from taking St John’s wort. Some of these side effects may not seem too bad or harmful, but others are very serious indeed.

Who Should Not Take St John’s Wort?

Certain medical conditions can be greatly affected by St John’s wort, so it is imperative you know who should or should not take this medicine. As with any herbal remedy, you should always seek professional advice from a health care worker first.

Pregnancy

To date there has not been any definitive research into the effect on pregnant humans, but during lab tests on rats, those given St John’s wort were more prone to deliver babies with birth defects. For this reason, it is highly recommended that you do not take this medicine if you are pregnant or if you are breastfeeding.

READ Depression: It's Not Just In Your Mind, It's Also in Your Genes

Fertility Problems

Researchers are concerned that St John’s wort may cause infertility. There is no definitive proof yet, but the concerns are strong enough that if you do have fertility problems or are trying to conceive you should avoid taking St John’s wort.

Who Should Not Take St John's Wort: Mental Health And Surgery

Bipolar Disorder

Those with bipolar disorder experience a cycling between mania and depression. When manic, these people exhibit excessive activity and impulsive behaviors. St John’s wort is known to induce mania, so in a person with bipolar disorder, this can make the cycle between mania and depression more rapid.

ADHD

Some people think that St John’s wort is beneficial for those with ADHD, to aid with controlling the symptoms. However, because there has been evidence of the development in mania in people with ADHD, particularly if they are taking Methylphenidate at the same time, you should not take St John’s wort.

Major Depression

Like other mood disorders, taking St John’s wort for major depressive episodes could induce a state of mania, so it should not be taken.

Schizophrenia

St John’s wort can cause those with schizophrenia to develop psychosis, so it should definitely be avoided.

Alzheimer’s Disease

There are concerns that it may increase the level of dementia suffered by those with Alzheimer’s.

Surgery and Anesthesia

St John’s wort can cause serious heart complications during surgical procedures, so it should be avoided for at least two weeks before any scheduled operations. It can also affect the serotonin levels in the brain during surgery.

Drug Interactions

St John’s wort interacts with multiple different types of drugs, and many of these interactions can be severe, posing a serious health risk. As well as interacting with all forms of medication that is prescribed for mental health issues, other notable drug classes that interact with St John’s wort are those that are used to treat pain, seizures, cancer, heart disease and many others.  Following are the main drugs that St John’s wort interacts with and the effects that can be caused.

• Aminolevulinic Acid: Causes increased photosensitivity, leading to higher risk of sunburn, blistering and rashes on skin that is exposed to the sunlight.
• Contraceptive Pills: This interaction may result in an increase in the breaking down of estrogen, leading to failure of the birth control pill.
• Cyclosporine: Causes an increase of the speed at which Cyclosporine is broken down by the body, reducing the effectiveness of the Cyclosporine.
• Digoxin: The effectiveness of digoxin on the heart may be decreased when taken in association with St John’s wort.
• Imatinib (Gleevec): Also may increase the speed at which the Imatinib is broken down, reducing the effectiveness.
• Irinotecan (Camptosar): This cancer treating drug is compromised because of the increase in the speed at which the body breaks down the Irinotecan, leading to less effectiveness.
• Demerol: Because both Demerol and St John’s wort both cause an increase in serotonin, serious side effects can occur including anxiety and heart problems.
• Dilantin: Again St John’s wort effects how Dilantin works because it speeds up the breaking down of the Dilantin by the body, removing it too quickly.
• Warfarin: St John’s wort can increase how fast the Warfarin is broken down, potentially resulting in a higher risk of blood clotting.

To Take Or Not To Take?

Just like any other medicine, natural or pharmaceutical, whether or not you take a particular medicine should be discussed with your doctor. Generally, provided you don’t have any serious health issues and are not on other medications, short term usage may be quite safe for you, but this is something only your doctor can determine. Remember – just because it is natural, doesn’t mean it isn’t harmful.