Earl L. Mindell, R.Ph., Ph.D.
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 Don't take these drugs if you are already using tryptophan or 5 hydroxy tryptophan (5-HTP), which are natural precursors to serotonin, or st. john's wort, an herb with similar effects.
What Are the Interactions with Other Drugs? |
| And, you guessed it, those taking the prescription antidepressants suffered from drowsiness, constipation and dry mouth, while those taking st. john's wort reported no side effects.
ALTERNATIVE MEDICINE TREATMENTS THAT WORK FOR CHRONIC PAIN
There are literally dozens of safe, effective alternative medicine techniques for healing pain that don't involve surgery or medication. |
| Don't use for more than three weeks if you have high blood pressure.
• st. john's wort (Hypericum) to help control anxiety.
• Ginkgo biloba in a standardized extract, 60 mg one to three times daily.
• MSM (methylsulfonylmethane) is a form of organic sulfur. It binds to allergens, thus preventing allergic reactions, and it coats the intestinal lining to prevent dust mites and their droppings from playing havoc with allergies and worsening asthma. Take 1,000 mg, two to three times daily. You can take up to 6,000 mg daily. |
| Before you resort to prescription drug sedatives, try some of the natural anti-anxiety remedies such as kava and st. john's wort.
Your first attempts at reassuring and calming a stroke victim should be the best sedatives of all: loving, supportive family and friends, gentle massage, humor, beautiful music, a good view out the window, good nutrition and competent medical care and physical therapy.
Drugs to Lower High Blood Pressure
The dangers of high blood pressure (hypertension) have been extremely well-publicized over the past decade. |
| If you are experiencing a lot of anxiety in the week or so prior to surgery, you can use the anti-anxiety herb st. john's wort to help you through. Follow the directions on the container and don't overdo it, please.
Preparing for Surgery
The two biggest challenges of surgery for your body, besides that of healing the actual wound, are the threat of infection and the stress on your liver. There's no way around it: When you have surgery you will be given lots of drugs, and most of them are very hard on your liver. This especially applies to anesthesia drugs. |
Textbook of Natural Medicine 2nd Edition Volume 1Michael T. Murray, ND
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| Linde K et al. st. john's wort for depression - an overview and meta-analysis of randomized clinical trials. BMJ 1996; 313: 253-258
8. Thiede HM, Walper A. Inhibition of MAO and COMT by hypericum extracts and hypericin. J Geriatr Psychiatry Neurol 1994; 7(1): S54-56
9. Thiele B, Brink I, Ploch M. Modulation of cytokine expression by hypericum extract. J Geriatr Psychiatry Neurol 1994; 7(1): S60-62
10. Perovic S, Muller WEG. Pharmacological profile of hypericum extract. Effect of serotonin uptake by postsynaptic receptors. Arzneim Forsch 1995; 45: 1145-1148
11. Griggs B. Green Pharmacy. |
Sheldon Saul Hendler and David Rorvik
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 Especially rich sources of quercetin include onions, red wine, green tea and st. john's wort.
Quercetin is typically found in plants as glycone or carbohydrate conjugates. Quercetin itself is an aglycone or aglucon. That is, quercetin does not possess a carbohydrate moiety in its structure. Quercetin glycone conjugates include rutin and thujin. Rutin is also known as quercetin-3-rutinoside. Thujin is also known as quercitrin, quercetin-3-L-rhamnoside, and 3-rhamnosylquercetin. |
Textbook of Natural Medicine 2nd Edition Volume 2Michael T. Murray, ND
See book keywords and concepts |
| Linde K, Ramirez G, Mulrow, CD et al. st. john's wort for depression: an overview and meta-analysis of randomized clinical trials. Br Med J 1996; 313: 253-258
268. Priestley J, personal communication
Diagnostic summary 1303 General considerations 1303
Therapeutic considerations 1303
Conventional antihypertensive drugs 1303 Dietary and lifestyle factors 1304 Botanical medicines 1307
Therapeutic approach 1308
Hypertension
Michael T. Murray, ND Joseph E. |
Sheldon Saul Hendler and David Rorvik
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| HERBS
Theoretically, high-dose myo-inositol may have additive effects with st. john's wort.
OVERDOSAGE
Not reported.
DOSAGE AND ADMINISTRATION
For the management of depression and panic attacks, 12 grams of myo-inositol daily, in divided doses, were used in clinical studies. In the clinical studies performed with myoinositol, effects, if any, were seen in about one month. Compliance with such doses may be a problem.
HOW SUPPLIED
Capsules — 500 mg Powder
Tablets — 324 mg, 500 mg, 650 mg
LITERATURE
Barak Y, Levine J, Glassman A, et al. |
National Women's Health Network
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 It should be noted that the doses of antidepressants in these trials were lower than those normally prescribed in the United States, and there are no trials comparing st. john's wort with the popular selective serotonin reuptake inhibitors Prozac, Zoloft, etc.)
Side effects in these trials were reported less often with SJW than with antidepressants: 19.8 percent of those on SJW reported symptoms, compared with 52.8 percent of those on tricyclic antidepressants. |
| A recent meta-analysis evaluated twenty-three randomized trials (twenty were double-blind) of st. john's wort in a total of 1,757 outpatients with mild to moderate depression.45 Improvement in depressive symptoms occurred in all groups.
In fifteen placebo-controlled trials, SJW was found to be almost three times better than placebo. In eight treatment-controlled trials, clinical improvement in those receiving SJW did not differ significantly from those receiving tricyclic antidepressants. |
Sheldon Saul Hendler
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 The presence of hypericin and pseudohypericin distinguish st. john's wort from other herbs.
Hypericin and pseudohypericin are promising candidates for the treatment of HIV disease, including ARC and AIDS, as noted above. The mechanism of viral inhibition by these substances is not known, but their chemical structures suggest that they could interact with the membranes of these viruses, leading to their increased fluidization. Fluidi-zation of the HIV membrane would essentially inactivate the virus. More studies related to the effects of these substances in AIDS urgently need to be done. |
| St. John's wort had never been, prior to 1988, a major star in the world of medicinal herbs. In fact, because it grows as an aggressive weed, many have considered it to be quite a nuisance. Hypericum infestation of the pasture and range lands of California led to serious financial losses in 1930. Economic loss from the effects of this weed is now slight because of a certain beetle which took a liking to it and now keeps its growth under control.
St. |
| St. John's wort is a primary photo-sensitizer for cattle, sheep, horses and goats. It makes these animals highly susceptible to damage from the sun's rays. The exact location and, to some degree, the nature of sun-caused skin damage in these animals depends largely upon the species or breed of animal. Black-skinned animals are rarely affected. Animals suffering from an acute case of photosensitization develop intense itching of the skin and may rub the affected areas until they are raw. |
| For example, a 1984 report in a leading German medical journal demonstrated significant improvement in depression, anxiety and insomnia in nine people who received oral extracts of st. john's wort. Side effects did not occur. Further research of this issue is definitely warranted.
It is reasonable to ask at this point, why hasn't this herb, which appears to have an enormous therapeutic potential, been given more serious consideration by medical researchers? The answer to the question must take into account its known toxicity. |
| Robert Na-gourney, Alan Kapuler and I have shown (manuscript in preparation) that extracts of st. john's wort inhibit the growth of some strains of Staphylococcus aureus, enterococcus and Pseudomonas aeruginosa that are highly resistant to antibiotics. Extracts of the herb have also been reported to have anti-viral activity against herpes simplex virus, influenza virus and hepatitis B virus. It just may be that this nasty weed has some remarkable broad-spectrum activity against many different types of infectious agents. More research is needed. |
Textbook of Natural Medicine 2nd Edition Volume 2Michael T. Murray, ND
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| De Smet PAG, Nolen W. st. john's wort as an antidepressant. Br Med J 1996; 313: 241-242
100. Harrer G, Hubner WD, Podzuweit H. Effectiveness and tolerance of the hypericum extract LI 160 compared with maprotiline. A multicenter double-blind study. J Geriatr Psychiatry Neurol 1994; 7(suppl 1): S24-28
101. Singh Y. Kava: an overview. J Ethnopharmacol 1992; 37: 13-45
102. Lindenberg D, Pitule-Schodel H. D,L-kavain in comparison with oxazepam in anxiety disorders. A double-blind study of clinical effectiveness. Forschr Med 1990; 108: 49-50, 53-54
103. Kinzler E, Kromer J, Lehmann E. |
Earl Mindell
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 At this writing there have been no controlled trials with botanicals, but many patients have found that st. john's wort helps enormously in alleviating depression and in improving decreased appetite. Shiitake mushrooms and lemon balm also may help fight CFS by stimulating the body's production of interferon and inhibiting viral replication. And for long-term support of the adrenal glands, Siberian ginseng and Asian ginseng have been recommended as effective adaptogens—that is, herbs that enhance the body's reaction to stress and improve resistance against infection. |
Dr. Mary Dan Eades
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| Avoid intense sun exposure while using St. John's wort; it can make the skin more sensitive to sunlight.
• This herb contains monoamine oxidase (MAO) inhibitors. If you take an MAO inhibitor on a regular basis, avoid alcoholic beverages and smoked or pickled foods. Also stay away from cold and hay fever remedies, amphetamines, narcotics, tryptophan, and tyrosine.
- Sarsaparilla -
Smilax officinalis
Forms—The roots are used to make dried herb and tincture. |
Dr. Julian Whitaker
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| Black cohosh is effective in easing some of the discomforts of menopause. st. john's wort elevates mood. And some herbs, such as Ginkgo biloba, ginseng, Huper-zine A, and vinpocetine, have been clinically proven to preserve and restore memory. Let's take a closer look at these herbal brain boosters.
Ginkgo biloba
If I could recommend only one herbal supplement for optimizing brain function, it would be Ginkgo biloba. The ginkgo tree, dating back over 200 million years, is one of the oldest living plant species on the planet. |
Dr. Mary Dan Eades
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| Oregano and self-heal contain antioxidants that can help maintain immune function in those who are HIV-positive.
• st. john's wort contains two antiviral compounds: hypericin and pseudohypericin. Much research still needs to be done to determine the full therapeutic value of these two compounds in treating HIV The results of test-tube and animal studies have been positive. A mixture of hypericin and several derivatives has been patented as a treatment for cytomegalovirus infection, one of the many infections that strike people with AIDS. |
Lesley Tierra
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 John's wort, peony, burdock
Rheumatism ginger, calendula, cinnamon, prickly ash, angelica, garlic Siberian ginseng, cayenne sarsaparilla, reishi, ginkgo leaf bayberry, burdock, st. john's wort, black cohosh
Scabies chapparal
Sciatica aconite
St. |
Richard Lucas
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 Here is another formula Chinese herbalists often prescribe for tonsillitis: Place 1 ounce of sage and 1 ounce of Chin-ssu-ts'ao (Hypericum chinensis a species of st. john's wort) in a container and add one quart of boiling water. Cover, and allow the tea to stand for one-half hour. Strain, and add one teaspoon La-chiao (ground capsicum). Reheat, and gargle with it frequently.
• Dr. |
Earl Mindell
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| And for a soothing, mood-elevating and muscle-relaxing aid, try a st. john's wort polyphenol combination in the morning.
236. Menstruation
Between the cramps and the bloating, menstruation is for most women a monthly annoyance. But this annoyance can dwindle down to a mere distraction once the discomfort is alleviated.
MVP (see section 172)
Vitamin B6, 50 mg. 3 times daily (most effective as a natural diuretic) B complex, 50 mg. a.m. and p.m. Evening primrose oil, 500 mg., 3 times daily
237. Motion Sickness
This is one condition where remedies are most effective if taken beforehand. |
| St. John's wort tablet with polyphenol complex daily
2 tbsp. acidophilus 3 times daily or 3-6 caps 3-4 times daily (Acidophilus or mild vinegar douche can also help.)
100 mg. B6 3 times daily Potassium 99 mg. 3-6 tabs daily
SYMPTOM: Vaginal Itching
Milk, liver, kidney, yeast, cheese, fish, eggs
SYMPTOM: Water Retention
Dried nutritional yeast, liver, organ meats, legumes, whole-grain cereals, fish
SYMPTOM: White Spots on Nails
Zinc Vegetables, whole grains, wheat bran, wheat germ, pumpkin and sunflower seeds
164. |
Earl L. Mindell, R.Ph., Ph.D.
See book keywords and concepts |
| If you are coming off of an SSRI such as Prozac and want to try st. john's wort, allow a three-week period in between so that you don't end up with serotonin syndrome (a dangerous condition where too much serotonin remains in the synapses).
The B Vitamins
The B vitamins together and separately play important roles in nerve and brain function and in relaxing muscles. If you are older and not absorbing nutrients as well as you might be, your body may not be able to utilize the B vitamins in your food. It's important to include the B vitamins in a multivitamin. |
Earl Mindell
See book keywords and concepts |
| CAUTION: st. john's wort may cause sensitivity to light and could seriously exacerbate sunburn. (This usually only occurs with high doses.) Do not combine with prescribed antidepressants. (NOTE: Contrary to earlier reports, this herb's antidepressant action is not due to monoamine oxidase [MAO] inhibition, which means it is safe for users to enjoy tyramine-rich foods such as wine, cheese, and chocolate—in moderation, of course. That should perk up spirits right there.)
152. |
Earl Mindell, R.Ph., Ph.D.
See book keywords and concepts |
 If you are taking st. john's wort, avoid exposure to the sun.
Acne
Acne is not just for kids! It can strike anyone, at any age.
Countless teenagers have been made miserable by acne, but so have countless adults. Although acne typically strikes between the ages of eighteen and twenty-four, it can occur at any age, and often does.
Acne is a disorder of the sebaceous glands in the skin. The sebaceous glands secrete a substance called sebum, a fatty lubricant that is secreted through pores and hair follicles, which are most abundant on the face and scalp. |
Earl Mindell
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| For the irritability that occurs, take 1 st. john's wort polyphenol complex, a chelated calcium (250 mg.) and magnesium (125 mg.) tablet, and a B complex, 50 mg. in the morning with food. Between meals take 1,000 mg. cysteine. With the evening meal, take another calcium and magnesium tablet and a 50 mg. B complex. And don't forget your MVP (see section 172).
CAUTION: If you are using a nicotine gum to help you quit smoking, be aware that consuming coffee, cola, or acidic drinks before chewing nicotine gum significantly inhibits its absorption.
247. |
Mark Stengler, N.D.
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 One] study reported that some people experienced digestive upset, fatigue, restlessness, and allergic reactions using st. john's wort extract." Woelk H, Burkard G, Grunwald J, Benefits and risks of the hypericum extract LI 160: Drug monitoring study with 3,250 patients. Journal of Geriatric Psychiatry and Neurology 1994; 7(suppl):S34-S38.
• "... The constituents hypericin and pseudohypericin have shown in test-tube studies to have strong antiviral activity against herpes simplex virus—both Type 1 (mouth) and Type 2 (genital)—as well as influenza virus A and B, and Epstein-Barr virus. |
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