Heather Boon, BScPhm, PhD and Michael Smith, BPharm, MRPharmS, ND
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 A Canadian study published after this review that compared the efficacy of st. john's wort (300 mg standardized to 0.3% hypericum three times daily) and sertraline (50 mg daily) over a 12-week period concluded that there were no important differences between the two treatments and that significantly more adverse effects were reported by individuals taking sertraline.64 This finding is further supported by another USA comparison trial.65
Severe Depression
Several systematic reviews and meta-analyses have concluded that St. |
Mark Blumenthal
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 John's wort provides an example: Between October 1991 and December 1999, over 8 million patients are estimated to have been treated with Germany's leading st. john's wort preparation (Jarsin® or Jarsin®300, manufactured by Lichtwer Pharma, Berlin); during this period only 95 reports of side effects were received by the German Adverse Drug Reaction Recording System. While it is possible that additional adverse reactions may have occurred and that there are additional reports relating to other St. |
J. E. Williams, O.M.D.
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 Pascotox
Though there is no scientific or clinical evidence to support this rationale, st. john's wort is a safe herb with few side effects. If you have a chronic viral condition and depression, try it for four to six weeks, which is how long it typically takes to show benefits.
German studies indicate that 2.4 percent of patients develop adverse effects within four weeks of using of st. john's wort, which include stomach upset, dizziness, headache, dry mouth, and restlessness. Sensitivity to sunlight is also a reported reaction to this herb. |
Brenda Davis and Tom Barnard
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 It is made from ephedra (ma huang) and a combination of other active ingredients such as st. john's wort, caffeine, and aspirin. Ephedra is on the FDA's list of dangerous diet supplements because of reports of adverse effects, including nervousness, headaches, tremors, insomnia, high blood pressure, irregular heart beat, chest pain, heart attack, stroke, seizures, and death. This is definitely one to steer clear of.
Several spices, including red pepper, ginger, mustard seed, cinnamon, and cardamom are also thought to boost metabolic rate. |
Phyllis A. Balch, CNC
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 Best: alfalfa, flaxseed oil, garlic, st. john's wort (herbal extracts). Also, S-adenosylmethionine (SAMe), spirulina.
Good: cat's claw, ginkgo biloba, gotu kola, parsley, Siberian ginseng, slippery elm (herbal extracts). Also, aloe vera juice, gamma-aminobutyric acid (GABA), lecithin, selenium, zinc.
Diabetes
Best: all leafy greens, Brussels sprouts. No fruit juices.
Good: asparagus, broccoli, celery, green bean, green pepper, kale, kohlrabi, spinach, turnip green.
Best: dandelion root, garlic, huckleberry, parsley (herbal extracts). |
Mark Blumenthal
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| Greek physician Hippocrates was one of the first to document therapeutic uses of st. john's wort (SJW). It rose from virtual obscurity in the U.S. to become the fifth best-selling dietary supplement in mainstream retail stores in the U.S. after major media coverage of clinical research documenting its relative safety and efficacy for treating mild to moderate depression. |
Earl L. Mindell, RPh, PhD with Virginia Hopkins, MA
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| Diuretics, especially those that don't spare potassium, and digoxin (lanoxin) can both lead to irregular heartbeats, cardiac arrest, and dangerously high blood pressure.
• st. john's wort (Hypericum) to help control anxiety, 300 mg three times daily.
• 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. |
| Kava or st. john's wort capsules, tablets, or tincture for stress and anxiety.
• Chromium picolinate tablets (200 meg) to balance blood sugar.
• Oscillococcinum, a homeopathic remedy, to prevent the flu. Open one tube, pour it into your mouth, and suck on the contents until gone (it's tiny sugar pellets). Since this is a homeopathic remedy, it is important not to consume caffeine, menthol, or peppermint within 30 minutes of taking it. Take every six hours. If it doesn't work after three tubes ifs probably not going to. Oscillococcinum's action is fast and dramatic when it works. |
| Soothing herbal teas such as chamomile, skullcap, and passionflower can be helpful, and when necessary, you can use the more powerful antianxiety and antidepressant herbs st. john's wort or kava.
Treating Arthritis Pain Naturally
Sometimes you can take care of arthritis naturally, covering all your bases with nutrition and exercise, and still get a painful flare-up that leaves permanent damage to joints. Mary is a good example. |
| For the same reasons, avoid using other serotonin-raising substances in combination with these drugs, including amphetamines, buspirone, amantadine, bromocriptine, st. john's wort, the amino acid tryptophan, and 5-HTP.
The drug selegiline (Eldepryl), when combined with Prozac or the other SSRIs, has caused mania and hypertension. |
| The encouraging results of these studies have inspired further research into the possible uses of st. john's wort. Some of the most interesting work has revealed its effectiveness against premenstrual syndrome (PMS) and as a gentle remedy for depression and other psychological problems in children.
Researchers at the University of Exeter's Department of Complementary Medicine in England gathered a group of 19 women who had PMS, but who were otherwise in good mental and physical health and had not undergone any treatment for their PMS symptoms. |
| If you are coming off 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. |
Ray Strand, M.D.
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 After all, they reason, st. john's wort is "natural," right? The thought of harm never crosses their minds. By itself, St. John s wort is relatively safe if the manufacturer has produced a quality product. But when a person combines herbal therapy with a pharmaceutical antidepressant, he or she may experience a serious adverse drug reaction. This occurs because two drugs are being combined—-just like any other drug interaction. The combined pharmaceutical effect may create difficulties that neither one would cause when used alone. |
Mark Blumenthal
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| Screen of receptor and uptake-site activity of hypericin component of st. john's wort reveals sigma receptor binding. Life Sci 1998;62(l6):PL265-70.
Reichling J, Weseler A, Sailer R. A current review of the antimicrobial activity of Hypericum perforatum L. Pharmacopsychiatry 2001 ;34 Suppl. 1 :S 116-8.
Rezvani A, Overstreet D, Yang Y, et al. Attenuation of alcohol intake by extract of Hypericum perforatum in two different strains of alcohol-preferring rats. Alcohol and Alcoholism 1999; 34(5):699-705.
Robinson DS, Rickels K. Concerns about clinical drug trials [editorial]. |
Walter Last
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 Avoid heavy-metal contamination; sanitize your teeth; apply violet color therapy systemically; treat for parasites and Candida; use st. john's wort as an herbal tincture during depression.
Scleroderma: Antimicrobial therapy including colloidal silver and oxygen therapy are recommended, as is the herbal parasite cure with use of the electronic zapper and magnetic pulser. Make external applications to affected skin areas as rubs, packs, or immersions using tea tree oil, aloe vera gel, magnesium chloride, a solution of copper salicylate with MSM, and blue light. |
Gary Null
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 Studies at New York University have shown that st. john's wort contains two potent chemicals that are highly effective in preventing the spread of retroviruses, like HIV, both in laboratory samples and in patients.
One of the researchers, Meruelo, found that one of these chemicals would stop the spread of AIDS, even crossing the barrier into the brain, which serves as a reservoir of HIV cells, to combat the disease there. Meruelo comments that St. John's wort's "antiviral activity is remarkable both in its mechanism... |
Gary Null, Ph.D.
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 Prime among these is st. john's wort, which is very popular in Europe. Clinical double-blind, placebo-controlled studies exist to support the efficacy of st. john's wort. Also consider valerian, skullcap, hops, kava kava root, passionflower, Chinese schizandra berry, wild oats, and calamus root.
Light Therapy
According to Dr. Michael Norden, author of Beyond Prozac, light therapy has shown positive results in overcoming mild depression associated with the winter season (called seasonal affective disorder, or SAD). |
| Things like acupuncture or herbal remedies such as echinacea or st. john's wort that have been used for thousands of years and which have some scientific backing are very likely to be safe. Less is known about the newer alternatives.
•Approaches that are proven to work for one condition may not work for others. Aspirin can get rid of a headache but it won't do a thing for constipation. Similarly, the herb st. john's wort appears to be effective for mild to moderate depression but there's no evidence it works for weight loss. |
Walter Last
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| Try hypericum or st. john's wort and the Bach Flower Remedies Aspen, Gentian, Gorse, and Mustard. Correct constipation; take cultures of acidophilus and bifidobacteria. Have any dead teeth removed and preferably mercury amalgam fillings replaced. Avoid lead pollution. Kyolic (aged garlic), cooked garlic, and raw garlic assist in detoxification. Candida can go into the bloodstream and cause depression and other psychiatric symptoms. For treatment, see Candidiasis above. |
David Hoffman, FNIMH, AHG
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 At the height of the media frenzy over the "discovery" that st. john's wort can help alleviate mild depression, I was asked to present a paper on the topic of "Herbal Alternatives to Prozac." This quest to identify an herbal alternative to Prozac is a perfect example of how the real gifts of herbalism can be deflected by underlying assumptions. By phrasing the topic in this way, we are forced to respond to the issue in terms of the efficacy and pharmacological mechanism of Prozac, rather than by highlighting the potential contribution of phytotherapy to the treatment of depression. |
Walter Last
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| For internal and external use: aloe vera, burdock (for psoriasis), calendula, chaparral, echinacea, goldenseal, horsetail, pau d'arco, sarsa-parilla, sassafras, st. john's wort, and vervain. additional therapies: If B-vitamin deficiencies are suspected, use a paste of food yeast or bran on affected skin parts: concentrated B vitamins, especially B2 and B6, can be added to this as well. Have frequent cleansing periods; regulate bowel movements; use colonics. |
David Hoffman, FNIMH, AHG
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| Hyperforin
Hyperforin
This is a derivative of phloroglucinol found in the flowers and fruits of st. john's wort (Hypericum perforatum). Currently, hyperforin is thought to be pivotal to the mild antidepressant properties of this herb.
XANTHONES
Xanthones are related to flavonoids, as they share precursors, but xanthones have a single carbon bridge (C6-Cx-C6) instead of the 3-carbon bridge of the flavonoids. A biologically active yet taxonomically restricted group, xanthones demonstrate a range of effects in living organisms. |
Patrick Holford
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 So too have the herbs agnus castus, dong quai, black cohosh, and st. john's wort. Vitamin E is also helpful for menopausal symptoms. One possible explanation is that vitamin E protects essential fats and prostaglandins from oxidation.
Balancing your hormones
The following guidelines will help you keep your hormones in balance. However, if you are suffering from a major hormone imbalance such as estrogen dominance, it may be necessary also to take small amounts of natural progesterone. |
| If you have PMS or menopausal symptoms, consider taking a hormone-friendly supplement containing extra vitamins B3, B6, and C, and biotin, magnesium, and zinc, and/or the herbs agnus castus, dong quai, black cohosh, and st. john's wort (see Resources).
Read more about balancing hormones in my book Balancing Hormones Naturally, coauthored with Kate Neil.
Bone Health—A Skeleton in the Cupboard
Not many people think about nourishing their skeleton. There is almost a belief that once your bones are formed they are there for good—until they start to break down, as in arthritis or osteoporosis. |
Heather Boon, BScPhm, PhD and Michael Smith, BPharm, MRPharmS, ND
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| Theoretically, st. john's wort may also have an additive effect with other drugs causing photosensitization (e.g., piroxicam, tetracycline and others).98123
DOSAGE REGIMENS
ž standardized extract (equivalent to 0.4-2.7 mg hypericin daily): 350-1800 mg daily in divided doses.2
ž standardized extract (0.3% hypericin): 300 mg three times daily.64
ž standardized extract (5% hyperforin): 300 mg three times daily.56
ž dried herb: 2-4 g three times per day.2
ž infused oil or cream: applied externally as needed. |
Patrick Holford
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| A medical trial in Germany found that 80 percent of women felt that their symptoms had gone or substantially improved after taking st. john's wort for twelve weeks.
Dong quai
The other "hot" herb for hot flashes is dong quai, botanically called Angelica sinensis. One placebo-controlled experiment giving dong quai plus chamomile to fifty-five postmenopausal women who complained of hot flashes and refused hormonal therapy found that they experienced a big reduction, of almost 80 percent, in hot flashes. These results became apparent after one month. Try 600 mg a day. |
Heather Boon, BScPhm, PhD and Michael Smith, BPharm, MRPharmS, ND
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| Extracts of st. john's wort have reported affinities for a variety of neurotransmitter receptors, including: adenosine, GABAA, GABAB, 5HT1( central benzodiazepine, forskolin, inositol triphosphate, and the monoamine oxidase A and B enzymes. However, based on the concentrations normally attained after oral administration, only GABA binding appears possible in vivo. |
David Hoffman, FNIMH, AHG
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| Carefully pour off the oil and store in an airtight, opaque container. st. john's wort oil may be rubbed on areas of rheumatic pain, used for neuralgic or sciatic pains, or applied to minor burns.
Broader Context of Treatment
Exercise is an essential component of any treatment plan for osteoarthritis. Appropriate activity improves mood and outlook, decreases pain, increases flexibility, improves heart health and blood flow, helps reduce or maintain weight, and promotes general physical fitness. |
Walter Last
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| John's wort can be added while the herbs steep. st. john's wort is effective against depression.
The immune system can be strengthened with echinacea, propolis, European mistletoe (Viscum album), Easter lily, and reishi and other Asian mushrooms. Echinacea can be added to all other herb combinations. However, there are some research findings that echinacea can cause problems if taken uninterruptedly for several months, so it may be advisable to interrupt its use after a month and then to take it again a few weeks later. |
| With lung cancer use also horehound, lobelia, mullein, and st. john's wort. Pimpernel is used partly to gargle and partly to drink in spoonful amounts for cancer of the mouth, throat, and neck glands.
Mistletoe is especially good for leukemia and is often used as the Anthroposophic medicine Iscador or Plenosol for injection near tumors and swollen lymph glands. With prostate cancer, use also saw palmetto and/or willow herb (Epilobium, mainly parviflorum). With leukemia, especially use herbs to strengthen the immune system. |
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