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St. John's Wort II
St. John's Wort
Latin binomial: Hypericum perforatum
Synonyms: Johnswort, St. John's Grass, Klamath Weed 1
Parts Used: Aerial parts including flowers
Constituents: Volatile oils containing mono and sesquiterpene compounds, dianthrone derivatives (hypericin, pseudohypericin), flavonols (quercitin, rutin, (+)-catechin), xanthones and coumarins.2
Medicinal Action: Anxiolytic, sedative, antiviral, astringent, antiphlogistic.
Pharmacology While many components of St. John's Wort seem to possess medicinal action, most attention has been shown towards hypericin. Hypericin, together with the xanthones and flavonol components, appear to inhibit both monoamineoxidase A and B, consequently interfering with catecholamine metabolism.3 Standardized preparations of hypericin have been shown in both animal and human studies to improve symptoms commonly associated with mild to moderate depression including insomnia, morning depression, anorexia and feelings of low self esteem.2,4,5 Though still at a basic level of investigation, extracts of St. John's Wort have been shown to inhibit several varieties of retrovirus, including HIV. Again, it appears hypericin is the constituent primarily responsible.2,5,7 Historically, St. John's Wort has been used to improve wound healing and aid myalgias and traumatic injuries to nerves. Clinically, extracts have been shown to decrease the healing time of bums, exhibit antibacterial activity against Staphylococcus aureus and suppress inflammation and leukocyte infiltration. St. John's Wort oil has been used as a sunscreen, but the efficacy of this indication is highly questionable.2
Indications St. John's Wort has been suggested useful in the treatment of:  | Mild to moderate depression and associated symptoms. |  | Myalgias, minor bums and skin abrasions (topically as the oil). |
Toxicology and Contraindications St. John's Wort appears to be free of major adverse effects. Due to the phototoxic nature of hypericin, patients, especially those with fair skin, should be asked to avoid bright sunlight.2 While this reaction has been noted more often in grazing animals, it has been observed occasionally in humans.8 There was concern that St. John's Wort may be potentially carcinogenic, but this has been shown not to be the case.9 Since this herb exhibits monoamine oxidase inhibiting activity, patients should be advised to avoid foods and drinks with a high tyramine content such as cheese, game, beer and wine.4
Drug Interactions While no reports of drug interactions could be found, it is still advisable to avoid concomitant use with drugs known to interact with monoamine oxidase inhibitors (MAOI), such as amphetamines, sympathomimetics, tyrosine or tryptophan.4
Administration St. John's Wort is available in many different forms, but solid extract standardized to hypericin content and the oil appear particularly popular.
Dosage: Three times daily: 1 to 2g of dried herb, raw or in infusions 10 3 to 6ml of tincture (1:5) 10 0.5 to 1ml of fluid extract (1:1) 10 De Koog luxury hotels125 to 250mg of solid extract standardized to hypericin content (1:5 or 0.125%) 10
Solutions of St. John's Wort are typically red in color, and will stain clothing and skin. St. John's Wort is a common ingredient in many creams and ointments used for basic first aid, often combined with Calendula officinalis and Echinacea species. It is often taken with other nervine herbs such as Passiflora incarnata (Passionflower) and Melissa officinalis (Lemon Balm) for insomnia and anxiety.
References 1. Hutchens, A. (1991). Indian Herbology of North America. Page 257. Shambhala Press, Boston, MA. 2. Hobbs, C. (1989). St. John's Wort. HerbalGram 18/19:25. 3. Suzuki, 0. et a]. (1984). inhibition of monoamine oxidase by hypericin. Planta Medica 50: 272-4. 4. Harrer, G. and Sommer, H. (1993). Therapy of mild or moderate depression with Hypericum. Munch med Wschr 135, 22:305-309 reviewed by Reichert, R. (1994). Quarterly Review of Natural Medicine. Spring: 17. Seattle, WA. 5. Harrer, G. Sommer, H. (1994). Treatment of mild/moderate depressions with Hypericum. Phytomedicine Vol. 1: 3-8. 6. Bergner, P. (1990). Hypericum and Aids. Medical Herbalism. 2 (1) January, Page 1. 7. Murray, M., Werbach, J. (1994). Botanical Influences on Illness. A Sourcebook of Clinical Research. Page 40-4 1. Third Line Press, Tarzana, CA. 8. Bergner, P. (1995). Photosensitivity and St. John's Wort. Medical Herbalism Vol. 6,4: 10. 9. Tyler, V. (1994). Herbs of Choice. The Therapeutic Use of Phytomedicinals. Page 122. Pharmaceutical Products Press, Binghamton, NY. 10. Murray, M. (1992). The Healing Power of Herbs. Page 198. Prima Publishing, Rocklin, CA.
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