In an era centuries before scientific reasoning and modern chemical analysis, people observed herbs to understand their healing powers. They took clues from a plant’s appearance and the places where it grew. The Chinese, for instance, thought of ginseng as a tonic for the whole body, in part because the root resembles a stick-figure human being. When ancient peoples in Europe and the Mediterranean studied St. John’s wort, or hypericum, they saw a plant with yellow blossoms that grew not in dark forests but in places with bright sunshine. So, based on the instant visual pharmacology of the time, they concluded that it must also shine favorably on the human spirit.
"It was yellow. It possessed the powers of sun and light. The flowers resembled shooting stars," explains Eran Ben-Arye, M.D., a researcher at the natural medicine research unit at Hadassah University Hospital in Jerusalem. For these reasons and more, it came to be revered as well as used.
For thousands of years, people considered St. John’s wort a magic herb with supernatural powers, as implied by its Latin name, Hypericum perforatum, which means "over an apparition." Loaded with do-good potency, it was considered powerful medicine against evil spirits and protection against demonic possession. Herbalists called it the Devil’s Scourge and prescribed it as a nerve tonic and to relieve depression.
Today, although the study of this herb is much more scientific, the conclusions reinforce those of yesteryear: For the despondent, discouraged, and depressed, hypericum holds promise of letting in the light.
A Rush to Hypericum
Chemical analyses, clinical trials, and a major study undertaken by the National Institutes of Health all support the benefits of St. John’s wort. It appears to be an exciting new treatment for mild to moderate depression, says Andrew Weil, M.D., clinical professor of internal medicine and director of the program in integrative medicine at the University of Arizona College of Medicine in Tucson, and author of Eight Weeks to Optimum Health.
"Until recently, it was largely dismissed by our own medical community, but that’s changing," says Dr. Weil. "It’s been widely used in Europe for 15 years."
In any year, German physicians are likely to prescribe as many as 66 million doses of St. John’s wort to treat depressive states, anxiety, nervous excitement, and other emotional or psychological disturbances. In Germany, for each single prescription written for the drug fluoxetine (Prozac), which is widely used as a pharmaceutical antidepressant, there are 25 prescriptions written for hypericum.
Interest in St. John’s wort grew dramatically in 1996 after the British Medical Journal published a review of 23 scientific studies done on the herb in Europe. Looking at the results of the studies, the reviewers concluded that St. John’s wort is significantly superior to a placebo (an inactive substance with no medicinal value) in treating patients with mild to moderate depression. Evidence is less conclusive that it works as well as standard pharmaceutical antidepressants.
Although the authors were cautiously optimistic about the herb’s benefit, the news made big waves in the American medical community and the nutritional supplement industry. Currently, St. John’s wort can be found in many drugstores, most health food stores, and some discount stores and supermarkets across the country.
SUPPLEMENT SNAPSHOT
| St. John’s wort Botanical name: Hypericum perforatum; also known as hypericum. May help: Mild to moderate depression, binge-eating disorder, anxiety, nervous disorders, and HIV. Origin: Native to Europe and Asia; now grows well in parts of California and Oregon. Cautions and possible side effects: If your doctor has prescribed MAO inhibitor antidepressants, or you are pregnant consult your doctor before taking. St. John’s wort may cause photosensitivity. |
With news spreading by word of mouth, through the Internet, and in media reports, the public has taken to St. John’s wort, says Bernard Beitman, M.D., chairman of the department of psychiatry and neurology at the University of Missouri School of Medicine in Columbia.
"It’s gotten very popular, partly because it’s an herbal medicine. You don’t need a doctor’s prescription to get it," he says. "Plus, it fits with the whole new notion of ‘Patient.......heal thyself.’ People are hearing about it and trying it on their own. I’ve had some women tell me that they are giving it to their husbands who are feeling depressed but won’t go to the doctor," he says. "They tell me that their husbands are more fun, but the husbands don’t notice anything different."
A Mild-Mannered Herb
Another reason that people are trying St. John’s wort may be its apparent lack of side effects as compared to antidepressant drugs, says Dr. Ben-Arye. Dry mouth, headaches, nausea, digestive problems, insomnia, and loss of sexual desire are common problems with prescription medications. Users of St. John’s wort only occasionally report some agitation and sleep loss. The most frequently mentioned problem is increased sensitivity to sunlight that causes a tendency toward sunburn, he says.
Although St. John’s wort seems to be very safe compared to other antidepressants, that doesn’t mean that people should self-medicate, especially if their depression is severe, warns Dr. Ben-Arye. It shouldn’t be considered some sort of cure-all for depression, as it may not be strong enough to do the job. It’s not recommended for treatment of severe depression or disorders that may include hallucinations and suicidal thoughts, he says.
"There are a lot of aspects to depression, and many treatments. You should be talking to a health professional about your problem, not just taking an herb or a drug," he suggests.
Magic and Myth
The folk use of St. John’s wort goes back at least 2,000 years. Physicians and herbalists in Europe have used the plant to treat wounds and kidney and lung ailments as well as depression.
Native to Europe and Asia, the plant was first brought to the United States by European colonists. Although its main use has always been for psychological ailments and nervousness, St. John’s wort has antiviral, anti-inflammatory, and diuretic properties.
An oil made from hypericum was used to heal bruises and sunburn. The herb’s sedative effect helped reduce pain associated with nerve-related disorders like neuralgia and sciatica and rheumatic pain in the joints. It was sometimes given during menopause or menstrual periods to soothe irritability and mood swings.
Wort, another term for "plant," comes from Old English. The name St. John’s wort may have come about because red or bloodlike spots appear on hypericum leaves in June, around the anniversary of the beheading of St. John the Baptist. During the Middle Ages, on the saint’s anniversary, peasants slept with cuttings of the plant under their pillows. They hoped that St. John would appear in their dreams, bless them, and give them life for another year.
The primary medicinal part of the herb is the flower. In the United States, most medicinal supplies are grown in the eastern states and the Pacific Northwest. Western ranchers consider hypericum a noxious weed.
A Sum of Its Parts
The major known compounds in St. John’s wort are hypericin and pseudohypericin, which are found in low concentrations in the leaves and in much higher amounts in the flowers. The plant also contains a broad spectrum of flavonoids. While these chemicals contribute to the herb’s healing properties, there may be as many as 10 groups of chemicals that also have some effect.
It’s likely that some of these chemical compounds work together, or synergistically, says Dr. Beitman. "You can compare it to a symphony orchestra giving a concert. We like what we hear, but we don’t know who all the individual players are."
When the plant extract is used in studies, it usually includes a standard percentage of hypericin, the mostly widely known and studied active ingredient. Having standardized, measurable amounts of this ingredient in the plant extract ensures its quality, researchers believe.
Keeping the Good Stuff Flowing
Exactly how St. John’s wort elevates mood isn’t clear, but the mechanism is probably much like that of prescription antidepressant drugs, says Woodson Merrell, M.D., a specialist in alternative and complementary medicine and assistant clinical professor of medicine at the Columbia University College of Physicians and Surgeons in New York City.
Chemicals in the brain called neurotransmitters are used by nerve cells to communicate with one another. When the levels of some neurotransmitters fall, depression can set in. St. John’s wort—like pharmaceutical antidepressants—helps to remedy the situation by normalizing the amounts of neurotransmitters. When that happens, you begin to feel better, says Dr. Merrell. "You get a better sense of well-being," he explains.
St. John’s wort apparently binds more weakly to sites in the brain than its prescription counterparts. In other words, it seems to do its work more gently, says Dr. Merrell. That may be why the herb is more suited to mild or moderate depression for which the strength of prescription drugs isn’t required. "Herbs, in general, tend to be gentler than prescription drugs, and that may make them safer, with fewer side effects," he says.
If you’re already taking an antidepressant or other types of medications, however, there’s reason to be cautious, says Dr. Beitman. Be sure to consult your doctor before taking this or any herb for a medical condition.
"Studies haven’t been done on its interaction with other drugs," he says. "Just because it’s been around for centuries and is thought to be safe doesn’t mean that we know anything about its interaction with modern pharmaceutical drugs."
Turning On the Light
St. John’s wort is widely available as a tincture and capsules. Look for a standardized extract that contains 0.3 percent hypericin, which approximates the standard used in Germany and in many of the medical studies. A typical dose of the extract is 300 milligrams three times a day.
Because of its mild action, St. John’s wort takes more time to build up in your system than prescription antidepressants do, says Dr. Merrell. "It will take somewhere between four and six weeks before you’ll start noticing any effect." <% var productcode1 = new String("8750007382"); var productcode2 = new String("4746900538"); var productcode3 = new String("1906710087"); var productcode4 = new String("2743400377"); %>
