Table of ContentsView AllTable of ContentsUses of St. John’s WortSide EffectsPrecautionsDosageToxicityInteractionsHow to StoreSimilar SupplementsSources & What To Look ForFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Uses of St. John’s Wort
Side Effects
Precautions
Dosage
Toxicity
Interactions
How to Store
Similar Supplements
Sources & What To Look For
Frequently Asked Questions
St. John’s wort is an herb used in dietary supplements to relieve symptoms of depression. Research shows that St. John’s wort works as well as some antidepressants for the short-term treatment of depression. Be aware that taking supplements with antidepressants can cause a severe interaction.
St. John’s wort is also touted for treating skin conditions and reducing menopause symptoms. However, more scientific research is needed to back these benefits. It’s essential to consult your healthcare provider before taking St. John’s wort because it makes many medications less effective, including birth control pills and medicines for treating heart conditions.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
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Extracts of St. John’s wort are most commonly used for depression. Clinical trials have also studied it for skin conditions and menopause symptoms. The following is information on its effectiveness.
Depression
St. John’s wort is prescribed for depression in some European countries and is commonly used as an OTC supplement in the United States.
Studies show that around 56% of people who use St. John’s wort respond positively to treatment vs. 35% of people treated with a placebo (sugar pill without active medicine).
St. John’s wort is as effective as a common class of prescription antidepressants calledselective serotonin reuptake inhibitors (SSRIs)for mild to moderate depression.
It’s mainly been studied short-term for up to twelve weeks. This means that long-term effects are uncertain. And it’s unclear if St. John’s wort benefits severe depression or suicidality.
Supplement Facts
Skin Disorders
St. John’s wort has a long history of use for variousskin conditions, such as the following:
The component hyperforin in the herb is believed to be responsible for St. John’s wort’s antibacterial effects and wound care benefits.
Clinical trials are rare, however. It has been researched in small human trials for the following:
Though it may benefit these conditions, larger trials are needed before it can be recommended for routine use.
Menopausal Symptoms
A study of 80 postmenopausal females showed that those who took St. John’s wort for two months had fewermenopausal symptoms, includinghot flashesand depression, than those who didn’t.
Despite this, a review concluded that there isn’t enough evidence that St. John’s wort is safe and effective for menopause.
Additional Uses
St. John’s wort has also been studied for the following conditions, but more data is needed before it can be recommended:
What Are the Side Effects of St. John’s Wort?
Your provider may recommend you take St. John’s wort for depression or another condition.
However, supplements like St. John’s wort may have potential side effects.
These side effects may be common and mild or rare and severe.
Common Side Effects
Research suggests that most side effects of St. John’s wort are mild and relatively rare, particularly compared to those of prescription antidepressants.
Side effects typically occur in less than 3% of people who use St. John’s wort and can include the following:
Severe Side Effects
St. John’s wort has been reported to cause the following severe side effects:
If taken with other medicines that increaseserotoninlevels, such as antidepressants and some migraine medicines, St. John’s wort can contribute toserotonin syndrome. This can be life-threatening.
Symptoms of serotonin syndrome include the following:
Should you experience any of these, seek medical help immediately.
Do keep the following precautions in mind when using St. John’s wort:
Dosage: How Much St. John’s Wort Should I Take?
Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.
For depression, the typical dose of St. John’s wort is 300 milligrams (mg) three times a day.
What Happens If I Take Too Much St. John’s Wort?
There is little available data on St. John’s wort toxicity. One older (2009) trial concluded that daily doses of 500 mg were safe for up to one year,but more, long-term studies are needed.
The typical daily dose for depression (900 mg) is almost twice that used in the trial.
High doses of St. John’s wort, between 2 and 4 grams daily, are more likely to cause side effects like sun sensitivity.
St. John’s wort induces (increases the activity of) an enzyme called cytochrome P450 3A4. This enzyme metabolizes (breaks down) lots of medicines in the body.If these medicines are taken with St. John’s wort, they are broken down faster and will be less effective.
St. John’s wort lowers the effectiveness of the following medicines:
Hyperforin is believed to cause the herb’s numerous drug interactions. In theory, taking less than 1 mg of hyperforin daily is unlikely to cause interactions. However, supplements aren’t regulated in the same way drugs are in the United States, and researchers have found hyperforin levels can vary greatly between products.
It is essential to carefully read a supplement’s ingredients list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review the supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.
How to Store St. John’s Wort
Store St. John’s wort in a cool place, away from children and pets. It should be kept away from direct light.
Discard after one year or according to the manufacturer’s directions.
Some other herbs that have been studied in human trials for depression include the following:
Other supplements that may be helpful for depression include the following:
Other herbal products that may be useful for wound healing include the following:
Sources of St. John’s Wort & What to Look For
St. John’s wort is not found in commercial food products in the United States. However, teas made from it are readily available.
It can be found as an OTC herbal supplement in many different formulations.
St. John’s Wort Supplements
St. John’s wort is widely available as a supplement in health food stores, groceries, pharmacies, and online. It can be purchased in many forms, such as:
Quality testing from these companies does not assure safety or effectiveness.
Instead, the testing verifies that the ingredients listed on the package label match what is actually in the product and that the product is free of contaminants.
Summary
St. John’s wort is a flowering herb that may be an alternative to conventional antidepressants for mild to moderate depression, particularly for people not taking other medications.
It’s essential to keep in mind, though, that just because some substances are natural doesn’t mean it’s safe. Do involve a healthcare provider in any treatment plan for depression.
St. John’s wort can decrease the effects of many prescription medications, from birth control pills to heart medicines. Your provider can help you monitor for side effects and interactions.
Frequently Asked QuestionsSt. John’s wort decreases the effect of many other medicines. Some examples include antidepressants, birth control pills, blood thinners, and medications for cancer, HIV, blood pressure, and cholesterol.If you are taking any prescription or OTC medications or other supplements, discuss the use of St. John’s wort with your healthcare provider or pharmacist. This can help ensure that your medicines are being dosed appropriately and that there aren’t any significant drug interactions.Although St. John’s wort has been used in clinical trials of pregnant and nursing women, it is typically not recommended for these groups due to the possibility of congenital disabilities or side effects in nursing infants.In addition, effectiveness has not been proven for people who are pregnant or breastfeeding, so consult with your healthcare provider for further recommendations.Psychotherapy and behavioral therapy are common treatment modes for depression.Exercise, light therapy, yoga, and acupuncture may also be beneficial.Theoretically, St. John’s wort may interact with foods or drinks that contain tyramine, such as aged cheese or wine, to cause high blood pressure. Although one case report exists of an interaction happening,there’s no evidence to prohibit eating certain foods while taking St. John’s wort.
St. John’s wort decreases the effect of many other medicines. Some examples include antidepressants, birth control pills, blood thinners, and medications for cancer, HIV, blood pressure, and cholesterol.If you are taking any prescription or OTC medications or other supplements, discuss the use of St. John’s wort with your healthcare provider or pharmacist. This can help ensure that your medicines are being dosed appropriately and that there aren’t any significant drug interactions.
St. John’s wort decreases the effect of many other medicines. Some examples include antidepressants, birth control pills, blood thinners, and medications for cancer, HIV, blood pressure, and cholesterol.
If you are taking any prescription or OTC medications or other supplements, discuss the use of St. John’s wort with your healthcare provider or pharmacist. This can help ensure that your medicines are being dosed appropriately and that there aren’t any significant drug interactions.
Although St. John’s wort has been used in clinical trials of pregnant and nursing women, it is typically not recommended for these groups due to the possibility of congenital disabilities or side effects in nursing infants.In addition, effectiveness has not been proven for people who are pregnant or breastfeeding, so consult with your healthcare provider for further recommendations.
Although St. John’s wort has been used in clinical trials of pregnant and nursing women, it is typically not recommended for these groups due to the possibility of congenital disabilities or side effects in nursing infants.
In addition, effectiveness has not been proven for people who are pregnant or breastfeeding, so consult with your healthcare provider for further recommendations.
Psychotherapy and behavioral therapy are common treatment modes for depression.Exercise, light therapy, yoga, and acupuncture may also be beneficial.
Theoretically, St. John’s wort may interact with foods or drinks that contain tyramine, such as aged cheese or wine, to cause high blood pressure. Although one case report exists of an interaction happening,there’s no evidence to prohibit eating certain foods while taking St. John’s wort.
31 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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