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Positive Interactions: St. John’s Wort

January 7, 2011 Written by JP    [Font too small?]

Interactions between medications and nutritional supplements is a frequently cited concern by many health authorities and rightfully so. Part of the earnest trepidation has to do with the unknown effects that may occur when combining various foods, herbs, over-the-counter drugs and the like. The bottom line is that there are so many variables that it’s nearly impossible to predict exactly what will happen in such circumstances. Furthermore, the same holds true for patients who are taking multiple medications at the same time. There simply isn’t a viable way to conduct clinical trials to study every conceivable combination given to patients. But something that’s often lost in the mix is that interactions can also produce positive effects as well.

St. John’s wort (Hypericum perforatum) tops the list when it comes to potential drug-supplement interactions. This natural antidepressant is a documented inducer of an enzyme known as cytochrome P450 (CYP) 3A4 which can affect the metabolism of a large number of medications. This is why it’s very important to let your pharmacist and physicians know if you’re taking this herbal remedy prior to mixing with other medications or surgical procedures. (1)

Three recent studies point to a completely different sort of interaction that can also occur when utilizing H. perforatum extracts – a health promoting synergistic effect. The latest issue of the journal Fitoterapia reports that emerging in vitro and in vivo evidence indicates that combining St. John’s wort with passion flower (Passiflora incarnata) “significantly enhances the pharmacological potency of Hypericum”. The researchers involved concluded that this “suggests that the antidepressant therapeutic effects of Hypericum are possible with lower doses, when it is combined with Passiflora”. (2)

Another traditional use of H. perforatum is as a topical, anti-inflammatory preparation. A just published trial from Gazi University, Turkey describes that a blend of oils from olives, oregano, sage and St. John’s wort effectively promotes wound healing in an animal model. Other benefits, including bactericidal and fungicidal capacity, were exhibited by the medicinal ointment. Also noteworthy is that the combination of these therapeutic ingredients produced better results than a comparison cream containing only St. John’s wort and olive oil. The current results tend to support the historical use of select essential oils in protecting against skin infections while, at the same time, promoting the healing process. (3)

St. John’s Wort Extract (Hypericin) Is Being Investigated for It’s Anti-Cancer Potential

Source: Int J Mol Sci. 2010; 11(2): 562–594. (a)

Combining St. John’s wort with other floral and plant extracts isn’t a foreign concept to herbalists and natural healers the world over. However combining it with an extract of prawns and celery and using it to manage multiple sclerosis (MS) is certainly thinking “outside the box”. As unusual as it may sound, that’s exactly what a group of Iranian scientists is doing. Preliminary studies in both humans and test animals have found that this “herbal-marine compound” may ” slow down or halt the progression of multiple sclerosis” in an animal model and improve the quality of life of human patients with MS. Additional research and independent corroboration of this experimental medicine needs to be conducted. But it certainly seems to be an item worth following. (4,5,6,7)

This research presented today clearly illustrates what I firmly believe: most foods and herbs aren’t “one trick ponies”. They differ significantly from conventional medications in that these flowers, fruits, leaves, roots, seeds and stems often contain hundreds of (phyto)chemicals. In comparison, most prescriptive drugs are an isolated, synthesized chemical. This is but one reason why natural substances can impact animal and human health in very diverse ways. It’s not magic or just wishful thinking. It’s chemistry. And not all chemistry takes place within the sterile confines of a research laboratory.

Be well!


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Posted in Alternative Therapies, Mental Health, Nutritional Supplements

8 Comments & Updates to “Positive Interactions: St. John’s Wort”

  1. Theo Says:

    So I’ve been taking St. John’s Wort for five weeks. My hands have been insanely sensitive to slight temperature changes and hurt a lot if I brush them against anything hard. I just discovered that SJW causes something called… demyelination. This is damage to nerves’ “myelin sheath.” This is also what happens in MS patients. So how can SJW fix nerve damage when it – I hope to God – temporarily causes similar nerve damage to MS? Please see this blog:

    I’m scared. I hope that this is reversible and that I’m not screwing up nervous system from taking SJW. I also don’t want to be constantly thinking about death and dying. Life is hard. Big sigh.

  2. JP Says:


    I couldn’t find any scientific evidence associating St. John’s Wort with demyelination. I’ve seen this mentioned as a theory but never proven or even supported by direct research. The closest thing reported, in the medical literature, is a case of acute neuropathy that appeared to be connected to SJW and phototoxicity. Please keep in mind that there have been literally hundreds of studies on SJW. Many side effects have been identified – including phototoxicity. Why not this one?

    Are you taking SJW with any other medications? Which SJW product are you using? Dosage?

    If, for whatever reason, SJW doesn’t agree with you … there are many other natural options available. Please don’t despair.

    Be well!


  3. Theo Says:

    Hello, JP –

    Thank you for your reply. Well, I have very sensitive hands and feet. Especially when there is any slight temperature change. Could be cause by the sun because I first discovered it when I was in the ocean stand-up paddling. And I had this huge fear of getting wet. I did not want to be cold. I did not make the connection until I got home.

    The brand of SJW is Perika by Nature’s Way. I did a lot of reading on which would be the most effective and I read on consumerlab.com that the Hyperforin ingredient is being found to be most effective for depression. This brand seems to have the most and guarantees it. Maybe I’m taking too much. 3 tabs at 300mg each.

    I would love to know other options that would help me because I am concerned about any long term nerve damage now that that’s in my head it’s hard to get it out. I know there have been a lot of studies, but hey, I’m a worrier.

    I am going to email the company and see what they have to say about it.

    Thank you again for any suggestions or other options that might not have side effects like this.

  4. theo Says:

    Sorry I should clarify… I did not make the connection to St. John’s Wort and my sensitivity to cold and needling sensation in my hands until I got home. Sorry if that was unclear.

  5. JP Says:


    Thank you for the additional information. I concur that Perika is a fine product. The dosage you’re using is also appropriate.

    In terms of natural, safe alternatives for depression, here are several options that would top my list:

    1) Exercise – walking several times a week … preferably on a treadmill so that you can really get a consistent workout.

    2) Vitamin D – I’d have a blood test to verify my Vit. D status and supplement if warranted.

    3) Fish Oil or Krill Oil – Omega-3 fatty acids are among the most promising nutritional agents for poor mood states and much, much more.

    4) Meditation – I’m reading (and applying) the principles described in a wonderful new book entitled, Real Happiness: The Power of Meditation. This book will likely be transformative for many people who suffer from all sorts of psychological challenges.

    5) A Multivitamin/mineral – Many nutrients play pivotal roles in regulating our neurochemistry. Sometimes a high-potency multi is enough to make a profound difference.

    A few links that may be of interest:




    I’d be remiss if I didn’t mention diet. Maintaining balanced blood sugar levels can also be a game changer. This primarily involves avoiding refined and starchy carbohydrates and consuming plenty of healthy fats, fiber and protein from (mostly) whole food sources.

    Be well!


  6. theo Says:

    Hello JP –

    Thank you for your time. I’m quite grateful.

    I just had a treadmill delivered last week. Doing the fish oil – krill and regular stuff. I will get a copy of Real Happiness. A friend of mine told me about Mental Resilience – another meditation book, comes with a CD. I’ve started that one. And I’m taking a handful of supplements including an organic multi. So… I’m trying!

    I could do better with my diet for sure. I’m not a fast food person at all, but not a balanced diet thinker. And I do believe when my blood sugar drops so does my mood. I should probably have my D checked, or just take more.

    Other supplements I’m on – B complex, Cal-Mag Citrate, Inositol, Vit D3 800mg.

    Going to add Chromium to see if that helps. There’s 100mcg in my multi. But looks like I’ll have give that a few months to kick in.

    Thank you again for all your time!

  7. JP Says:


    You’re most welcome.

    I’m happy to see that you’re doing so many good things for your body and mind. Bravo! I’m confident that you’ll find positive results and I wish you all the best.

    If you’re willing, I’d love it if you’d report back and let me and my readers/visitors know how you’re doing. There’s always something interesting and new to be learned and inspiration to be found.

    Be well!


  8. Theo Says:

    Hi JP –

    I ordered the book you told me about last night and bought Chromium and more vitamin D this afternoon.

    You may have guessed, I am trying to get out of a horrible depression. I will keep in touch, cause if I can get on the other side of – without pharmaceuticals – the bottomless mug of despair that has been served to me, then anybody can.

    I’ll post back in a week or two or three.

    Thank you again.

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