St. John's Wort
Important Disclaimer
This is not medical advice. Consult a qualified healthcare provider before using any remedy, especially if pregnant, breastfeeding, on medication, or managing a health condition.
Overview
St. John's Wort is a perennial herb with bright yellow star-shaped flowers that bloom around the feast of St. John the Baptist (June 24th). It is one of the most extensively studied herbal medicines in the world, with over 30 clinical trials confirming its effectiveness for mild to moderate depression. The flowers contain hypericin and hyperforin — compounds that modulate serotonin, dopamine, and norepinephrine reuptake, producing antidepressant effects comparable to standard antidepressants with fewer side effects.
Traditional Use
St. John's Wort has been used medicinally for over 2,000 years. Ancient Greeks used it for wounds, burns, and as a nerve tonic. In medieval Europe, it was hung over doors on St. John's Eve to ward off evil spirits and used medicinally for wounds, burns, and melancholy. Traditional herbalists used it for nerve pain, depression, anxiety, and wound healing. In the 20th century, German physicians began prescribing it for depression, and it became the most prescribed antidepressant in Germany by the 1990s.
Key Active Compounds
Hyperforin
The primary antidepressant compound, inhibiting reuptake of serotonin, dopamine, norepinephrine, GABA, and glutamate. Also responsible for most drug interactions through CYP450 enzyme induction.
Hypericin & Pseudohypericin
Naphthodianthrone compounds that contribute to antidepressant effects and have antiviral properties. Responsible for photosensitivity side effects.
Flavonoids (Quercetin, Rutin, Amentoflavone)
Anti-inflammatory and antioxidant compounds that contribute to the overall therapeutic effect and support nervous system health.
Xanthones
Compounds with MAO-inhibiting properties that may contribute to antidepressant effects.
Evidence-Based Benefits
Mild to moderate depression
Strong evidenceOver 30 RCTs and multiple meta-analyses confirm St. John's Wort is significantly more effective than placebo and equally effective as standard antidepressants for mild to moderate depression, with fewer side effects.
Anxiety and mood support
Moderate evidenceClinical studies show St. John's Wort reduces anxiety symptoms, particularly when combined with depression. Effective for seasonal affective disorder (SAD) and menopausal mood changes.
Nerve pain relief
Some studiesTopical St. John's Wort oil has been used for nerve pain, sciatica, and neuralgia. Some clinical evidence supports its use for neuropathic pain.
Wound healing
Some studiesTopical preparations reduce inflammation, promote wound healing, and have antimicrobial properties. Traditional use for burns, bruises, and skin injuries.
Common Preparation Methods
Standardized Extract Capsules
Take standardized St. John's Wort extract (standardized to 0.3% hypericin and 3–5% hyperforin) with meals.
Dosage: 300mg, 3 times daily (900mg total)Allow 4–6 weeks for full antidepressant effect. CRITICAL: Check drug interactions before use.
Herbal Tea
Steep 1–2 teaspoons of dried St. John's Wort herb in 8 oz of hot water for 10 minutes. Strain and drink.
Dosage: 2–3 cups dailyLess standardized than capsules; variable hyperforin content.
Tincture
Use a 1:5 tincture in 60% alcohol. Take 2–4 ml three times daily.
Dosage: 2–4 ml, 3 times dailyEffective for mood support. Check drug interactions.
Topical Oil (Red Oil)
Apply St. John's Wort infused oil to bruises, nerve pain, or minor wounds. Massage gently into affected area.
Dosage: Apply 2–3 times dailyAvoid sun exposure on treated areas — photosensitivity risk.
Safety & Cautions
Please read carefully before use
Contraindications
- Severe depression, bipolar disorder, or psychosis: use only under medical supervision
- Pregnancy and breastfeeding: avoid
- Photosensitive skin conditions: may worsen
- Organ transplant recipients: AVOID (reduces cyclosporine levels)
Drug Interactions
- CRITICAL: Induces CYP3A4 — reduces levels of MANY medications
- Antidepressants (SSRIs, MAOIs): risk of serotonin syndrome
- Oral contraceptives: may reduce effectiveness
- HIV medications: significantly reduces drug levels
- Warfarin: reduces anticoagulant effect
- Cyclosporine: may cause organ rejection
Possible Side Effects
- Photosensitivity (increased sunburn risk)
- Digestive upset
- Dizziness, dry mouth
- Anxiety or restlessness in some individuals
- Serotonin syndrome if combined with serotonergic drugs
Special Populations
- Pregnancy: AVOID
- Organ transplant patients: STRICTLY AVOID
- Anyone on prescription medications: ALWAYS check interactions first
- Bipolar disorder: may trigger manic episodes
Sources & References
Cochrane Database of Systematic Reviews
Quick Reference
Hypericaceae
Aerial parts (flowers, leaves, buds), Essential oil
Bitter, astringent, slightly aromatic
Safety First
Always consult with a qualified healthcare provider before starting any new remedy, especially if you have existing health conditions or take medications.