| St. John's Wort
Posted: 9/25/2009 12:09:16 PM | Yesterday I was in a large, nationally known health food store and the tables all had cards promoting St. John's Wort for "healthy mood." I was a bit alarmed about this since St. John's Wort has been shown to affect liver function and should not be taken by anyone taking birth control pills or drugs for HIV/AIDS. It can render those drugs ineffective due to increased output of certain liver enzymes. I first saw this reported in Science magazine several years ago. It was discovered when a couple of doctors had patients who were on birth control pills became pregnant and HIV/AIDS patients started showing dramatically decreased T-cell counts. Further investigation led to the discovery of its affect on liver function.
I went back and checked the shelves and found four brands of St. John's Wort. Only one of them warned about this. The others had warnings that it should not be taken by pregnant or nursing women or people taking antidepressants but nothing about people taking other medications.
I asked one of the employees in that department if they knew that people taking these medications should not take St. John's Wort and he didn't know this.
I find this a bit alarming and I'm wondering why this important information is not being included? | |
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| St. John's Wort
Posted: 9/25/2009 12:54:45 PM | | Maybe it's not required to be revealed on the label under the current laws. They might not know which is their fault for not thoroughly researching their product...meaning research beyond reading some hippy dippy stuff but real scientific research. Or they may know but just aren't the most ethical and do anything to cut corners to get a few more bucks. | |
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| St. John's Wort
Posted: 9/25/2009 1:48:52 PM | | Herbs are regulated so there are no requirements for warning labels etc. I would never take herbs without advice from a naturopathic doctor. Otherwise you are just asking for trouble. I remember taking bee pollen but I should have because I had liver problems. I ended up having more problems than I started. No amount of research from the internet is going to replace professional training. | |
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| St. John's Wort
Posted: 9/25/2009 5:27:42 PM | many times the trials involve a synthetic version of a single property in an herb. researchers isolate one compound, synthesize it and make it much stronger than in the natural form. when one does that, of course it will cause problems. look at ephedra. i've used whole ephedra for years with no problem. because i used it in its complete form, as opposed to simply ingesting ephedrine, which does cause problems.
so, when i see phrases like 'trial studies show...' i take it with a grain of salt. having worked with healing herbs for 14 years, i feel far more secure using something like st. john's wort than i would using something like prozac. in fact, the only problem we saw with st. john's wort was a slight photosensitivity. so, if you take tons of it, you stay out of direct sunlight. real simple.
but i've known plenty of hiv/aids sufferers who have used it for years with no detrimental effect. i don't take alarmist 'studies' too seriously. | |
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| St. John's Wort
Posted: 9/25/2009 11:33:40 PM | Good Grief! I have had horrible side effects with anti depressants so I was advised to take this. I looked online before I started on it, and didn't see anything about it effecting the liver. I have to be really careful with my liver because I DO have problems with my liver.
Can you direct me to something I can read regarding St. John's and the liver? Thank you! | |
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| St. John's Wort
Posted: 9/26/2009 7:20:17 AM | | Just to be clear, St John's Wort doesn't appear to harm the liver per se, but can affect or interfere with the way the body processes certain drugs that rely on the liver's enzyme system for delivery. In other words, St John's Wort taken in combination with other drugs can render those drugs less or more potent than the intended effectiveness as the prescribed dosage. | |
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| St. John's Wort
Posted: 9/26/2009 12:46:04 PM | Sassy why don't you get some mild exercise out doors during day light hours. It has been proven mild exercise with sunlight exposure can be keep depression at bay.
http://www.vitamindcouncil.org/depression.shtml | |
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| St. John's Wort
Posted: 9/26/2009 7:49:03 PM |
Can you direct me to something I can read regarding St. John's and the liver? Thank you!
If you know someone who can do a search in Science magazine for you, that's where I initially read about it. Since that time, I see there's a plethora of research articles on St. John's Wort from 2006 on, probably spurned by the earlier discovery. If you look it up in Wikipedia, it has a brief description of what's going on on a physiological level. If you want further information, you're going to have to wade through some scientific papers, not an easy task. Try googling "St. John's Wort, liver function" and you'll find some articles.
Curiously, Consumer Reports did an article on St. John's Wort. They bought several bottles, several different brands, several sources, and had them tested for potency. Only one had as much of the active ingredient stated on the label, one had significantly more than stated on the labels, and all the rest had less. One sample had hardly any at all. This is one of the drawbacks to herbs, a lack of consistency.
many times the trials involve a synthetic version of a single property in an herb. researchers isolate one compound, synthesize it and make it much stronger than in the natural form. when one does that, of course it will cause problems. look at ephedra. i've used whole ephedra for years with no problem. because i used it in its complete form, as opposed to simply ingesting ephedrine, which does cause problems.
This had nothing to do with clinical trials, synthetic compounds, or concentrated extracts. A couple of doctors had patients turn up with unexpected results. One was a woman on birth control pills, had been taking them regularly without fail, and got pregnant. Another was an AIDS/HIV patient whose body unexplicably began to behave as if he wasn't taking his meds. Upon investigation, it was found they were both taking St. John's Wort and, when further investigated, it was found that St. John's Wort increased the production of a liver hormone that breaks down certain compounds, thus rendering the prescribed drugs ineffective. It does *not* harm the liver, as far as I know (though some of the papers seem to suggest it might), just makes the liver produce more of an enzyme that eliminates certain classes of drugs from the body more quickly.
In other words, St John's Wort taken in combination with other drugs can render those drugs less or more potent than the intended effectiveness as the prescribed dosage.
Exactly. This is important to know if you're taking any medications. | |
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| St. John's Wort
Posted: 9/26/2009 8:06:06 PM | By the way, this is how some of these things are found out. A doctor has a patient turn up with puzzling reactions and starts wondering why, starts investigating it. Back in the early 70s a young, otherwise healthy woman turned up in a Canadian emergency room with what turned out to be severe liver damage of a sort usually only seen in long-term, serious alcoholics. The doctors couldn't figure this out and, upon questioning her, could find the only thing unusual about the woman, who had a very healthy diet and lifestyle, was that she drank large quantities of comfrey tea every day and had been for quite some time, believing it had healthful properties. When they started investigating, they found that comfrey contained a compound that caused liver damage. There was a move to ban the sale of comfrey both in the U.S. and Canada particularly the sale of Russian comfrey, which had very high concentrations of the problematic compound. I was the herb & spice buyer for both a vegetarian restaurant and an organic food coop at the time. Comfrey was a very popular herb and so this story was of significant interest to myself and members of the coop.
Someone mentioned earlier they would never take any herbs without the advice of a naturopath but my experience, since 1971 when I first became familiar with the use of herbs, is that it's rare when people consult and sort of doctor before taking herbs. Unfortunately, most MDs know little or nothing about herbs and there's very little research available to inform them. Herbalists, naturopaths, etc., are suspicious of scientific channels, don't stay informed and don't trust them. As a result, there's very little information available. However, herbs can have unwanted side effects just as pharmaceuticals can and I'm surprised that the people who sell something that can have very significant side effects wouldn't put a warning on the label. | |
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| St. John's Wort
Posted: 9/28/2009 1:16:21 PM | | arwen-where is the link/citation for your info? (and no, I am not referring to info about contraindications w/ SSRI's-that topic is all over the place), but the other info re liver enzymes I would be interested to read about. Thanx-Wiyan | |
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| St. John's Wort
Posted: 9/29/2009 10:01:43 AM | | Don't take it and go out in the sun. You will look like a cooked lobster. And that might not be to good for your mood, hahahaha | |
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| St. John's Wort
Posted: 10/2/2009 3:35:32 PM |
arwen-where is the link/citation for your info? (and no, I am not referring to info about contraindications w/ SSRI's-that topic is all over the place), but the other info re liver enzymes I would be interested to read about. Thanx-Wiyan
This, from Widipedia, is easy to read and concise. Just look up "St. John't Wort."
"St John's wort has been shown to cause multiple drug interactions through induction of the cytochrome P450 enzyme CYP3A4, but also CYP2C9. This results in the increased metabolism of those drugs, resulting in decreased concentration and clinical effect. The principal constituent thought to be responsible is hyperforin.
St. John's wort also has been shown to cause drug interactions through the induction of the P-glycoprotein (P-gp) efflux transporter. Increased P-gp expression results in decreased absorption and increased clearance of those drugs which leads to lower clinical concentrations and efficacy.[20]
Examples of drugs causing clinically-significant interactions with St John's wort Class Drugs
antiretrovirals non-nucleoside reverse transcriptase inhibitors, protease inhibitors
benzodiazepines alprazolam, midazolam
hormonal contraception combined oral contraceptives
immunosuppressants calcineurin inhibitors, cyclosporin, tacrolimus
others digoxin, methadone, omeprazole, phenobarbitol, theophylline, warfarin, levodopa, suboxone, Irinotecan
Reference: Rossi, 2005
For a complete list, see CYP3A4 ligands and CYP2C9 ligands. For further updating on interactions and appropriate management, see Herbological.com - St John's Wort Interactions table."
Here's one from Medscape:
http://www.medscape.com/viewarticle/429776_17
If you google St. John's Wort and cytochrome or hyperforin you'll get a bunch of articles. I don't know what issue of Science magazine it was first reported in. You'd have to get someone else to do that search for you. Hope that helps. | |
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| St. John's Wort
Posted: 10/2/2009 7:11:47 PM | | Herbs are not required to be evaluated by the FDA. Many DO have serious side-effects and can impact the effects of other drugs. Let your physician know EVERYTHING you are on and stop taking all herbs at least 2 weeks before any proceedures or as your PCP advises. | |
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| St. John's Wort
Posted: 10/3/2009 11:33:38 PM | Drugs
antiretrovirals non-nucleoside reverse transcriptase inhibitors, protease inhibitors
benzodiazepines alprazolam, midazolam
hormonal contraception combined oral contraceptives
immunosuppressants calcineurin inhibitors, cyclosporin, tacrolimus
others digoxin, methadone, omeprazole, phenobarbitol, theophylline, warfarin, levodopa, suboxone, Irinotecan
Reference: Rossi, 2005
I'm sorry- I don't fine this easy to read and concise. It may be easy to read but it's very confusing. What does this mean for someone who takes any of these things? | |
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| St. John's Wort
Posted: 10/4/2009 2:03:31 PM | | ^It means don't take St. John's Wort as it is contraindicated for these people. | |
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| St. John's Wort
Posted: 10/4/2009 7:38:41 PM | ^^^^^what he said.
If you take any of those drugs, don't take St. John's wort. Specifically, if you take drugs for HIV/AIDS, are on birth control pills, or immonosuppressants (people who have had organ transplants, for instance) you should not take St. John's wort. If you are on antidepressants, don't take St. John's wort. Really, if you are on *any* prescription drugs, find a pharmacist who knows about this and ask if there's a problem. | |
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| St. John's Wort
Posted: 10/4/2009 8:35:26 PM | I am on hormones. They are not used for birth control. What is St. John's Wort going to do to my hormones?
then there are the benzos. I take ativan occasionally for panic attacks. What does St. John's Wort to these medications. I am not on anything for HIV, or anti depressants. That's the reason I started the St. John's Wort. I had horrible side effect with every single anti depressant my doctor tried or wanted me to try. | |
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| St. John's Wort
Posted: 10/4/2009 9:39:44 PM | I worked with supplements for many years... They are not regulated by the FDA or anyone for that matter, I could mix a bucket of candybars with creatine and tell you it will make you ripped in thirty seconds... Just like i could tell you that St. Johns wort sometimes helps with depression... and sometimes it worsens your condition... do your own research and don't expect the supplement guy to be 100% accurate all the time.
And as previously stated... if you are on meds currently it's wise to tell your doc everything you are putting into your body. | |
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| St. John's Wort
Posted: 10/4/2009 10:12:08 PM | Synthetic pharmaceuticals all have origins in botanical herbology.
Treat your herbs the same way you'd treat pharmaceuticals. | |
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| St. John's Wort
Posted: 10/4/2009 10:26:44 PM |
Sassy, ask your Dr.
I told my doctor I was taking it and he told me that he had heard of it but knew
nothing about it. | |
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| St. John's Wort
Posted: 10/5/2009 12:19:44 AM | | St. John's Wort interacts adversely with enough commonly prescribed meds that if he is ignorant of it I would be concerned. | |
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| St. John's Wort
Posted: 10/6/2009 12:19:59 PM | I stopped taking it. I can't take any chances. Exercise is the best anti depressant anyway.
I was going through a rough patch because I had several bad situations hitting me all at once, but I am past that now. Thanks for bringing this to my attention. | |
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| St. John's Wort
Posted: 10/6/2009 2:48:48 PM | There is a difference between being stressed/feeling down, and being depressed. SSRI's and other anti-depressants will fix 40% of the symptoms, 100% of the time, but the other 60% is up to you through thought and lifestyle modification. Excercise can become an addiction too. I am not one to talk, but I still tell this to people. There are more forms of addictions than just pills. If you are excercising to cope instead of facing a situation, it will result eventually in you feeling less and less confident in yourself to face that situation. Just as an aside, I have listed 5 of the major clinical signs of depression for you:
Sleep disturbance
Inability to concentrate
Loss of interest in things that formerly interested one
fatigue, decreased energy
Persistant pain/discomfort/GI upset that does not respond effectively to conventional treatment
If you are experiencing these, I suggest talking with your physician about prescribing an anti-depressant AND! setting up an appointment with a recommended therapist. | |
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| St. John's Wort
Posted: 10/6/2009 5:06:19 PM | Yes, I had all those symptoms. I had been on an anti depressant previously which was taken off the market because it causes liver failure. At that time, ( this was a few years ago) my doctor tried me on Zoloft, Cymbalta, Prozac, Lexapro, Effexor and Paxil. They all made me feel like I was on speed. I couldn't handle that.
I started seeing a therapist in July when I had 3 major issues cause me to be very depressed again. I am still going, but I am not going back on any of those medications.
I can't handle that feeling like I stuck my finger in a light socket. Plus they made my insomnia 100 times worse. | |
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