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St. John's Wort

Millions of people in Germany are taking this herb for depression

By Don Ollsin

In 1994 alone, St. John's Wort was prescribed for 20 million people in Germany. It accounted for over 50% of the prescriptions given to treat mild to moderate depression. It makes me wonder if there is a connection to the pharmaceutical industry's (via the Health Protection Branch) current interest in controlling herbs. Could it be greed or maybe fear? St. John's Wort has no major side effects and costs much less than comparable antidepressant drugs.

Hypericum enjoys a long colorful history. Dioscorides, Pliny and Hippocrates all used it during ancient Greek times. It was believed to possess magical properties to dispel evil spirits. There was a common medieval belief that sleeping with a piece under your pillow on St. John's Eve would protect one during the following year. In light of the current research on its use for depression, these herbalists of the past may have been on to something.

The results based on 25 scientific studies done since 1994 involving over 2000 people (Hypericum & Depression by Dr. Bloomfield, Dr. Nordsfors & Peter McWilliams) are in summary:

• The response rate ran between 50 to 80% comparable with synthetic antidepressants.
• St. John's Wort leads to an increase in deep sleep and does not impair cognitive functions or the ability to work or drive a car. One study showed an increase on the secretion of nocturnal melatonin, which aids deep sleep.
• It showed a positive long-term affect on anxiety.
• A Russian study showed good results combining it with psychotherapy on treating alcoholics with peptic ulcers.
• It demonstrated an effect comparable to light therapy on the treatment of seasonal effective disorder.
• It has anti-inflammatory and antibiotic effects when applied externally.

Every year I harvest this potent, yellow-flowered herb and turn it into a beautiful blood-red oil. Little did I dream that it would become so popular. St. John's Wort is free for the picking and grows locally. I introduced a group of students to it last Sunday on an herb walk. I harvest just enough each spring for my family's needs. Anyone suffering from Seasonal Effective Disorder (SAD) can gather their supply of the flowering tops of St. John's Wort in the spring and prepare their medicine for the winter blues. Note: this is not the large decorative St. John's Wort that most people are familiar with, but the small wild type.

If you are not on any antidepressant drug, then St. John's Wort is perfectly safe to take any time. You should, however, consult with a herbalist for exact instructions. St. John's Wort takes two to six weeks to take full effect. If you are already using a pharmaceutical antidepressant for mild to moderate depression and you want to try St. John's Wort then consult with your doctor and professional herbalist. St. John's Wort is not sufficient for people with severe depression. More studies need to be done on this as one study showed promising results.

St. John's Wort is also useful for other conditions. Many times with great success I have recommended St. John's Wort oil or tincture for bed wetting, stiff arthritic joints, Bell's palsy, and shingles and as a restorative for exhausted nervous systems. One man with painful muscles and joints applies the oil topically along his spine. Shortly thereafter, the pain is relieved and he is able to sleep. Another person has difficulty sleeping through the night. She takes St. John's Wort tincture internally in conjunction with some other herbs. She now sleeps more soundly. Another elderly woman came to see me with such stiff hands that she could no longer play the piano. She massaged St. John's Wort oil into her hands three times a day as well as taking another herb internally and within a short time she was playing the piano again.

Now that 20 million people in Germany are taking St. John's Wort for depression, you can imagine how many people worldwide will be benefiting from using St. John's Wort as the good news continues to spread.

Don Ollsin is a Master Herbalist, Iridologist, Bach Flower Counselor and Ayurvedic Practitioner. For private consultations call Gaia Gardens Herbal Apothecary in Vancouver 734-4372 or Self Heal Herbs in Victoria 383-1913.

Alive Magazine June/July 1997

FOCUS ON YOUR HEALTH

A NATURAL MOOD BOOSTER

More and more therapists are recommending a herb called Saint John's Wort to treat mild depression. Does it work?

By Sue Miller Newsweek May 5,1997

Karin Taylor's black moods were often accompanied by inexplicable bouts of insomnia, crying and lethargy. By last summer she had sunk so low she didn't care if she lived or died. But Taylor balked when her physician suggested a common antidepressant: she didn't feel comfortable taking drugs. Fortunately, she says, a friend visiting from California suggested a natural herb called Saint John's Wort. Within three weeks, Taylor's depression had lifted. "I feel restored," says the 58-year-old Toronto accountant, who continues to take two herb capsules daily. "I'm my normal self again".

People have been ingesting Saint John's Wort, a yellow-flowered plant with the Latin name of Hypericum perforatum, for some 2,000 years. Some believe it was initially used in ancient Greece to drive away evil spirits. It has been popular for about 15 years in Europe as a natural remedy for depression. In Germany, where it's currently the leading treatment, physicians write some 3 million prescriptions a year - 25 times the number they write for Prozac. Now, thanks to a spate of books and articles touting the herb's properties, its popularity is quickly spreading on this side of the Atlantic. American health-food stores now peddle a panoply of mood-boosting supplements, including kava root, the hormone pregnenolone and the amino acids 5-hydroxy-tryptophan and L-tyrosine. But Rob McCaleb of the Herb Research Foundation calls Saint John's Wort "the premier herb for treating moderate depression."

What's the evidence for this claim? The respected Journal of Geriatric psychiatry and Neurology aroused a good deal of interest in 1994, when it devoted an entire issue-17 research papers in all-to "Hypericum: A Novel Antidepressant." One compelling study tracked the herb's effects on 3,250 patients battling mostly mild and moderate depression and found that about 80 percent either felt better or became completely free of symptoms after four weeks. Then last August, the British Medical Journal published a review of 23 controlled studies involving 1,757 depressed patients. In that analysis, researchers from the United States and Germany found that Saint John's Wort worked nearly three times better than a placebo. The herb shows "definite promise", says Dr. Cynthia Mulrow, a University of Texas internist who co-authored the study. "It's a reasonable alternative to consider."

Despite the promising studies, researchers still know very little about the herb's active ingredients or how it works. They also aren't sure whether Saint John's Wort can help the severely depressed or if it is safe and effective for long-term use. Experts note that many of the products in the health-food stores contain overly diluted concentrations that render the herb impotent. The optimum dosage, based on the majority of medical studies, is 300 milligrams of Hypercum extract containing .3 percent of the active ingredient hypercin three times a day. Give the herb at least a few weeks to start working.

Though most psychiatrists favor drugs over herbs, some are incorporating Saint John's Wort into their practice. Dr. Harold Bloomfield, a Yale-trained psychiatrist and coauthor of a new book called "Hypericum & Depression," heard about the herb while researching his 1994 book. "How to Heal Depression." After reading the literature, nearly all of it from Germany, he started giving it to patients, and he claims the results have been excellent. Ever since Bloomfield's book was published last fall, he has been inundated with calls from curious psychiatrists and psychologists and clinical social workers, who can recommend it as a remedy for depression because it's simply a dietary supplement. Bloomfield estimates the number of therapists treating patients with the herb has grown from a few dozen six months ago to several hundred today.

Janet Lawson is one of the patients. An improvisational jazz singer once nominated for a Grammy, Lawson lives in East Stroudsburg, Pa., when she's not touring the world. For years, she suffered from severe mood swings but refused to take prescription antidepressants. Now she spends about $40 for four fluid ounces of Phyto Proz Supreme at her local health food store and takes a dropperful each day. The herbal concoction contains not only Saint John's Wort but a variety of other plant extracts, including the mildly calming extract of kava root. In Laguna Hills, Calif., 48-year-old Elizabeth Dante tried to overcome her depression with the drug Paxil but didn't like the slightly medicated way it made her feel. So she switched to 500 milligrams of Saint John's Wort three times a day. "I don't feel at all medicated now," she says. "It's like taking a vitamin."

Is Saint John's Wort as benign as a vitamin? Enthusiasts note that millions of Germans have used the herb extensively without any reported deaths. In the study of 3,250 depressed patients, only 2.4 percent experienced side effects. Those included restlessness, gastrointestinal irritations and mild allergic reactions. Purdue University herb expert Varro Tylor notes that prescription antidepressants, such as Prozac, cause more common and more serious side effects, such as insomnia, weight loss and sexual dysfunction. "The absence of serious side effects is one of Hypericum's biggest selling points," he says.

The biggest concern is that the herb might make some people dangerously sensitive to the sun. Certain animals, such as sheep, have grown sick and even died from exposure to the sun after ingesting large quantities of Saint John's Wort. No one has ever reported phototoxicity in people using the herb for depression, but Bloomfield says the potential "should be kept in mind…if one has a prior hypersensitivity to sunlight or if one is taking photosensitizing drugs" such as tetracycline. In light of the potential risks, most experts suggest consulting a physician before taking Saint John's Wort. They also recommend that patients avoid combining it with prescribed antidepressants or altering the dosages of those antidepressants by themselves.

Further research is clearly needed. "The studies in Germany were not done with the same kind of rigor as those generally done in this country," says Jerry Cott, a pharmacology expert at the National Institute of Mental Health. "I think mainstream psychiatry would say, 'I'm still unconvinced'." The doubts should soon be put to rest. U.S. researchers from the NIMH and NIH's Office of Alternative Medicine are now planning a large multi center trial of the herb. Meanwhile, America's penchant for self-care ensures that remedies like Saint John's Wort will continue to flourish.