Potential Dangers of St. John's Wort

Although it is, at best, marginally effective as a depression treatment compared to other natural alternatives like fish oil and Sam-e, Saint John's Wort remains one of the most popular options utilized by those seeking natural supplements to ease the symptoms of depression and anxiety.

Because it is a natural supplement, Saint John's Wort is usually assumed by patients to be safe. While, compared to conventional psychiatric medications, it does carry few risks of severe side effects, it is still something that should not be taken without first researching the potential hazards of this popular herbal remedy.

Herbs, like their refined, synthetic counterparts, are, in fact, medications. Like conventional medications, they carry both benefits and risks. For the most part, the dangers of natural cures are minimal compared to the dangers of man-made drugs, but patients must still make themselves fully aware of the potential dangers so as to avoid inflicting harm on themselves unknowingly.

It may be disappointing to many who are suffering from moderate to severe depression that Saint John's Wort has been shown to be ineffective at treating moderate to severe depression, according to a series of 2002 double-blind studies carried out by the National Center for Complementary and Alternative Medicine. While studies by NCCA and other organizations have shown it to be effective for mild depression, its effects are considered to be limited, at best, for those with severe depression.

One of the most critical dangers of taking Saint John's Wort is that it has a tendency to induce manic episodes in patients who are bipolar. According to a 1999 statement released by Biol Psychiatry based on placebo-controlled studies, it should not be used to treat depression in those with manic-depressive disorders, because, rather than stabilize the patient, it tends to swing them in the opposite--but equally dangerous---psychological direction.

If you are fair-skinned, sunburn easily, or spend a lot of time outdoors under direct sunlight, Saint John's Wort may not be a good option for you. It is believed by many herbalists, based statements released by the companies that grow and sell the herb, to increase photosensitivity in some people, and may have led to severe sunburn or even melanoma in people who would not have otherwise been quite as sensitive. It is also believed to react with light to produce free radicals, which damage the body's healing capabilities and may, rarely, exacerbate symptoms of depression.

Saint John's Wort also has a noticeable effect on both male and female reproductive systems, according to the National Center for Complementary and Alternative Medicine . It has been linked to erectile and ejaculatory dysfunction in men, as well as lowered sperm count. Equally unwanted by many is its opposite effect on women. It may drastically reduce the effectiveness of progesterone-containing contraceptives, including the traditional birth control, the progesterone-only "minipill", and Mirena IUDs. This may lead to unwanted pregnancies. More frightening is the potential for causing ectopic pregnancies (always fatal for the embryo and sometimes fatal for the woman) among those who are using progesterone-containing intrauterine devices.

In addition to its interaction with hormonal contraceptive medicines, Saint John's Wort is known to interact negatively with many other medicines, leading to a warning by the American FDA and the British government that it should not be taken with any prescription medication. Saint John's Wort slightly speeds the body's metabolism of drugs that it ingests. While this increase in metabolism is relatively small, it can still be a significant issue to those who rely on prescription medications that need to be released slowly. Immunosuppresants, benzodiazepines, and antiretrovirals, as well as many other prescription drugs, are known to interact negatively with Saint John's Wort. The effect has been especially documented in patients who are HIV positive or whose immune systems are otherwise compromised.

The interaction caused by Saint John's Wort that needs the most warning--since many who are using it to treat depression are also likely taking other medications--occurs when it is combined with antidepressants. Taking Saint John's Wort with MAOI's, SSRI's, or other antidepressants can lead to a drastic overproduction of the neurotransmitter serotonin, which may be a life-threatening reaction. Serotonin syndrome, as it is known, can also be caused when Saint John's Wort is taken in conjunction with other natural serotonin-increasing supplements, such as tryptophan, kanna and 5-HTP.

Many natural treatments for depression carry far fewer side effects and drug interactions than Saint John's Wort. Kanna, an herb that acts similarly to Prozac, is one example of an depression-treating herb not known to cause any adverse reactions. Fish oil is an effective treatment of depression that requires very massive doses before the threshold of benefit is reached. Vitamin B complexes have long been used to treat psychiatric disorders, and are water-soluble, with no potential for overdose. Sam-e is also known to be very effective, and is often prescribed along with conventional medications in Germany and Italy. While Saint John's Wort may carry more benefits than risks for some people, it has a higher profile of potentially problematic reactions than some other supplements,

If you are considering taking Saint John's Wort, make sure you thoroughly research its potential dangers. Be certain that you are not taking any medications that might interact negatively with it, and consider another natural alternative if you are. Always discuss it with your doctor before you make any change in your medications, especially if you have a medical condition, are taking prescription drugs, or are under treatment for bipolar disorder.