St. John’s Wort supplement side effects, 300 mg – People sometimes misspell the name of this herb as wart
November 22 2016

St. John’s wort has been used for several centuries as a natural herbal treatment for mental disorders. In recent times, it is often used by the public to improve mood and to treat depression.

Where to buy St. John’s wort
More doctors are gradually beginning to recognize that natural supplements such as SAM-e, (this article on SAM-e reviews the latest research on depression and natural ways to treat it and where to buy St. John’s wort) and the nutrient 5HTP are as potent or effective as pharmaceutical medicines in terms of mood enhancement, with far fewer side effects. This plant has also been touted as a weight loss herb.

St. John’s Wort Extract, 300 mg for mood support, hyperforin rich
Scientific research shows hat it may lighten mood and support a positive emotional balance.  Remember that a sensible program of diet and exercise can enhance the benefits of this standardized herbal product.
St. John’s Wort (Hypericum perforatum) is standardized to contain 0.3% hypericin and 3% hyperiforin.

Active ingredients
This plant has hypericin and other dianthrones, flavonoids, xanthones, and hyperforin. New research suggests that extracts may exert their antidepressant actions by inhibiting the reuptake of the neurotransmitters serotonin, norepinephrine, and dopamine. Long-term administration of St. John’s wort modifies levels of neurotransmitters in brain regions involved in the pathophysiology of depression.

Long term use, chronic intake
There is always a concern when taking a particular herb for prolonged periods. Thus far, it does not seem that it has any significant side effects (particularly compared to standard pharmaceutical antidepressants). However, we often recommend taking breaks from a supplement every few weeks. It also depends on dosage. If a person is only taking one pill a day, they can continue taking this much longer that someone taking three pills a day.
One study indicates St. John’s wort does not influence heart rate variability.

Anxiety treatment
I have been taking St. John’s wart extract for about a year and it has helped me a lot with my anxiety attacks.
Avoid high doses of St. John’s wort since too much can lead to anxiety and insomnia.

Q.  I was taking Paxil for about 2 years but stopped because I wanted to go with a natural way of healing my anxiety. I’m currently taking 2 pills of St Johns wart a day. One St; John’s wart in the morning and one in the evening. I’m thinking of quitting the St John wart because I don’t want to take medications anymore. I started exercising and feel alot better and feel like I dont need them anymore. Is there any benefits from getting off St Johns wort? Also is it true that it can lower your sex drive? Should I get off them slowly or just stop at once? Is it ok to stop St. John’s wort for a few weeks, and get back on?
A. Not much has been said about the sexual effects of St. John’s wort so, at this time, it does not appear that St. John’s wort has a major influence on sexuality or libido. Each person is different regarding the benefit or side effects they may get from St. John’s wort or other natural supplements for depression and that is a decision you would have to make for yourself. There is no harm in stopping St. John’s wort and restarting as long as the depression is not severe that would put someone in a suicidal state if they were not on any antidepressants.

Cholesterol management
The main components of St John’s Wort inhibit low-density lipoprotein atherogenic modification: a beneficial “side effect” of an OTC antidepressant drug?
Free Radic Res. 2007.
Hypericin and pseudohypericin are polycyclic-phenolic structurally related compounds found in Hypericum perforatum. As hypericin has been found to bind to LDL one may assume that it can act as antioxidant of LDL lipid oxidation, a property which is of prophylactic/therapeutic interest regarding atherogenesis as LDL oxidation may play a pivotal role in the onset of atherosclerosis. Therefore, in the present paper hypericin, pseudohypericin and hyperforin, an other structurally unrelated constituent in St John’s wort were tested in their ability to inhibit LDL oxidation. They were found to be potent antioxidants in the LDL oxidation systems used.

Depression, influence on mood
I recently fell into a moderate depression spell that was verging on four weeks. As I did when it similarly occurred when I started college almost seven years ago; I went and bought St. John’s Wort. I started taking it three times a day, 300 mg with .3% hypericin, once at 8:30am, 2:00pm and 8:30pm. I’m on it about a week already and am already noticing a significant improvement. The only thing I noticed is the past three nights that I am waking up at 5:00am and not being able to fall back to sleep. I read that insomnia is sometimes a side effect at high dosages. I really don’t want to lower my dosage because I’m feeling much better than I was. I have Biotics De-Stress (alpha-S1 casein trypsichydrolysate) and was wondering if I can take this at night time or when I wakeup during the night or if you have any suggestions.
Reducing the dosage is the best option or trying another mood lifter such as 5 HTP.

Use with SAM-e natural antidepressant
Can St. John’s wort be taken together with SAM-e? What kind of interactions could be expected? What about with 5HTP?
All are potent natural anti-depressants. The former two can cause insomnia in high doses, so we don’t recommend combining them unless a doctor who has experience using both supplements supervises you. Other side effects on high doses of the combination could be restlessness, irritability, anxiety, and increased heart rate. 5-HTP may be taken in the evening in low dosage whereas the herb can be used in the morning in a low dosage.

St. John’s Wort caution, adverse effects, toxicity
The most common side effect of St. John’s wort is insomnia, which is likely to be worse on higher doses. Headaches and irritability or anxiety have also been reported. Reduce exposure to sunlight when you take it. One study has indicated that in the presence of light, hypericin can induce changes in lens protein that could lead to the formation of cataracts. Appropriate precautions should be taken to protect the eye from intense sunlight while taking it.

In an analysis of product labels for St. John’s wort supplements, hardly any mentioned all of the serious safety issues associated with using this herb. Dr. Kevin A. Clauson of Nova Southeastern University in West Palm Beach, Florida, caution that taking St. John’s wort with AIDS medications or with drugs that suppress the immune system, or with oral contraceptives, or the blood-thinning drug warfarin can reduce the effectiveness of these drugs. St. John’s wort may not be appropriate for people with bipolar illness or those taking prescription antidepressants. Taking St. John’s wort with antidepressant drugs can cause anxiety, restlessness, and increased body temperature.  Dr. Kevin A. Clauson of Nova Southeastern University evaluated labels of 74 St. John’s wort products to find out whether these cautions were mentioned. None of the products listed all of the potential drug interactions and contraindications. Three mentioned seven of the eight criteria, while four listed no safety information at all. The most common warnings included not to take the drug with antidepressants; phototoxicity, and advice to consult a health care professional before taking the drug. BMC Complementary and Alternative Medicine, 2008.

Birth control pills, BCP
St. John’s wort may interfere with oral contraceptives. it is an inducer of cytochrome P450 (CYP) 3A enzymes and may reduce the efficacy of oral contraceptives.

Antidepressant drug use
This herb interacts with many medicines, including antidepressants, so caution is advised when combining this herb with other medicines. Combining St. John’s wort with SSRIs or other pharmaceutical antidepressants should only be done under medical supervision since their effects are additive and it is possible that the combination could cause serotonin syndrome.

HIV drugs
St. John’s wort may increase metabolism of certain drugs such as indinavir used in treating HIV. The mechanism is likely due to st. john’s wort inducing the production of cytochrome P450 3A, an enzyme that breaks down certain drugs, but the specifics of this interaction are not yet clear. St. John’s wort may also interefere with the metabolism of Camptosar, a medicine used to treat some kinds of cancer.   

Digoxin heart medication
Certain formulations of St. John’s wort seem to reduce levels of digoxin, a drug that helps the heart to pump in people who have heart failure. If the digoxin level falls too low, the drug may not provide a beneficial effect. St. John’s formulations rich in chemicals called hypericin and hyperforin seemed to reduce blood-stream levels of digoxin. There were no interactions, however, when volunteers took “traditionally used” St. John’s wort preparations. The hypericin- and hyperforin-rich formulations produce their effect by turning on enzymes that break down digoxin.

Withdrawal effect
You mentioned about taking breaks every few weeks . Is this possible since it works like a SSRI? Shouldn’t it be tapered off to avoid withdrawal side effects? Will it cause the MAO enzymes to go crazy if you go off it, causing you to feel worse? Can you take it occasionally to get some sort of benefit?
Withdrawal effects are not likely to be as dramatic as going off a SSRI medication, especially if it has not been taking for long periods and especially if, even taken for many months, during this period breaks from use have been done.

Anti-inflammatory benefit
Compounds within this herb, one being hypericum, have very strong biological activity, including the ability to reduce inflammation and fight against bacterial infections. In a study conducted at Ege University, in Izmir, Turkey, scientists investigated the in vitro effects of three Hypericum species, on human white blood cell myeloperoxidase (MPO) activity. MPO is a major component of the antimicrobial system of white blood cells. MPO helps the conversion of hydrogen peroxide and chloride to hypochlorous acid. Hypochlorous acid is a strong oxidant produced by white blood cells that contributes to inflammatory tissue damage. The researchers found that hypericum reduces the oxidative activity of white blood cells, thus potentially reducing damage from oxidation.
Comments: It appears that St. John’s wort has many roles to play in the human body. For now, the most common use for St. John’s wort is as an antidepressant. Even though studies have used 300 mg three times a day, I find that most people notice some uplifting in mood even with 300 mg once a day in the morning. High doses could cause insomnia.

Alzheimer’s disease
An in vitro study found that treatment especially with St. John’s wort extract restores or improves microglial viability and thereby attenuate amyloid-beta mediated toxicity in Alzheimer’s disease.

Mind Power Rx combined with St. John’s wort for students in college as brain booster
Q. I’ve been taking St. John’s wart most recently to help with my studies and social abilities. Do you know of any negative side effects of taking St. John’s wart and Mind Power Rx at different times during the day?
A. Sometimes taking many supplements together can cause overstimulation and restlessness along with insomnia. It is often a good idea to take a day or two off from a particular herb a week, and perhaps Mind Power Rx could be substituted during the days St. John’s wort is not being used.

Q. Have had trouble with mild depression, anxiety and, hence, sleep. Started taking Kira brand sainy johns wort about 2 weeks ago (300mg, 3x daily) and the difference vs the generic stuff seems to be significant (perhaps the hyperforin content). Appears to have really helped. Have augmented with L-Tryptophan (500mg, 3 times per day, empty stomach, with juice). Is 5-HTP generally better? One pharmacy told me they recommend 5-HTP in the day and L-Tryptophan at night. Another well respected author in her book indicated that 5-HTP was not nearly as safe as L-Tryptophan (the book is about 7 years old). Does either have an “easier” time crossing the blood-brain barrier? Main purpose is depression / anxiety relief with better sleep being a secondary goal. One comment – am wary of Serotonin Syndrome and so realize I need to go light on combining these. Finally, does there appear to be the same massive difference in L-Tryptophan and 5-HTP quality and effect (between brands) as there is with saitn johns wort?
A. There are differences in quality between different brands but there are so many different ones out there that it is difficult to compare. Some people prefer tryptophan, other 5-HTP, so it is difficult to say which is better. Using lower dosages is a safer way to begin.

Q. I have been taking St Johns wort for many years after giving up on Prozac and some other pharms. My dosage may seem quite high, about 1200 mg daily. A couple years ago I got turned onto 5 htp and now I am taking about 300 mg of that daily. When I decide I am going to take a break fro 5 htp, I immediately go right back on it b/c I am disappointed with my lack of concentration. Likewise when I decide to try cutting back St Johns Wort, I don’t get very far and reverse course b/c I am disppointed that I have turned very moody and agitated for no reason. I am worried that maybe I am taking too much, but from my experience, I am very happy with the results . I am just not sure how to cut back on my “meds” w/o losing the benefits of them, or if I should even worry about it. I certainly dont want “seretonin syndrome”.
A. Thank you for your email, but this is a personal type of question that is more appropriate for a health care professional who knows your medical history quite well, rather than us.

I occasionally use Klonopin to treat anxiety episodes. This would mean taking 0.25 mg at bedtime. I do not take Klonopin on a daily orregular basis. Can you tell me if St. John’s wart is compatible with occasional Klonopin use? Are there some extracts of St. John’s wart that would be better for me than others?
We can’t say in any particular individual whether the combination of a supplement and medication is safe to use. But, as a general rule, if dosages of medications and supplements are low, and a person does not have any major health issues, the drug and the herbal extract can be taken on separate days with little chance of an adverse effect.

In brief, I am 35 years old, I have a problem started at the age of 18, it is the excessive doubt for something which I fear may not be perfect or as I expected and need for reassurance, sudden impulses started in the mind and take me to a series of internal dialog both for and against on which the doubt has triggered. It may be on relationships or anything else, sometimes fear of any fault or danger caused by my activities which I doubt may hurt some one. anyway I have seen a combination of supplements in different internet sites would cure OCD, so I am going to order the following items and what I would kindly expect from one of your health care specialist is to advise me whether these supplements can be taken together if not what can be dropped and the recommended best package. I am from Sri Lanka, and since these items are not available here its difficult for me to get a correct consultation, so pls help me out in this regard. Items are Inositol Calcium Citrate Plus Magnesium Vitamin B-6 TMG Trymethylglycine Spirulina Ashwaganda 5-HTP St. John’s Wort SAMe Highly appreciate your earliest reply.

I wonder if you know whether it is ok to take Lithium orotate with it? I have just started the Lithium orotate and looking forward to results, but not sure about taking them together.

Would the use of this herb for depression reduce the risk for suicide?
Perhaps, see this page on suicide the act of intentionally taking one’s own life.

I have heard of this herb for years and have researched the many different products available. I was thrilled to see that you offer a product that not only has the 0.3% hypericin, but also 3.0% hyperforin. This was very exciting because accumulated data indicates that hyperforin is the possible antidepressant constituent of Hypericum perforatum. I placed an order with Physician Formulas last week and received my shipment yesterday. I noticed, however, that the label on my bottle does not indicate hyperforin at all. Although the packing slip notes 3% hyperforin content, but I was concerned that the wrong supplements may have been shipped. To further investigate, I pulled up your website today. Again, your text mentions hyperforin in its description of the herbs, but the photo of the medicine itself does not. Please offer any clarification you can on this matter. Thank you in advance for your time and response.
Yes, this product contains Standardized St. John’s Wort (flower, leaf, stem) extract (3.0 % hyperforin and 0.3 % hypericin)