David Wilkenheiser, ND
Anyone concerned about recent reports on St Johnâ??s Wort may want to get a second opinion. On February 12, 2000 the prestigious medical journal The Lancet published results of a study by S.C.
Anyone concerned about recent reports on St John’s Wort may want to get a second opinion.
On February 12, 2000 the prestigious medical journal The Lancet published results of a study by S.C. Piscitelli, a researcher at the U.S. National Institute of Health, on the interaction of St John’s wort and the antiviral HIV/AIDS drug Crixivan.
St John’s wort is a medicinal plant that has been used for over 2,000 years in the treatment of psychological complaints, mild depression and external wounds. It’s still widely used today. In Germany, St John’s wort is the leading antidepressant preparation, with over 66 million daily doses prescribed in 1994. A 1998 consumer survey reports that St John’s wort was the second most popular herbal preparation sold in the United States, with over $150 million in sales.
In Piscitelli’s study, St John’s wort was administered three times per day to people who were also taking Crixivan. Results showed that blood levels of Crixivan dropped by an average of 57 per cent in the eight people in the preliminary study.
Even though the study was based on just eight people, the US Food and Drug Administration (FDA) released a Public Health Advisory. The advisory urged caution in combining protease inhibitors and non-nucleoside reverse transcriptase (HIV/AIDS medications) with St John’s wort preparations. The agency speculated that the standardized extract of St John’s wort reduced the blood levels of these HIV/AIDS medications by inducing the Cytochrome P450 detoxification pathway of the liver.
The advisory went on to advise caution in using St John’s wort with a wide range of prescription medicines that are processed through the P450 pathway. These included heart medicines, antidepressants, seizure medicines, certain cancer medications, organ transplant medicines and oral contraceptives.
The FDA’s time and energy would be better spent advising health care professionals and the public of known interactions between standardized St John’s wort extract preparations and certain drugs. With the release of the latest advisory it looks like the administration is over-reacting to speculation regarding the biochemical actions of a widely used, traditionally extracted herbal preparation.
Safe For Centuries
In Europe and North America heart medicines, antidepressants, seizure medicines, certain cancer medications, organ transplant medicines and oral contraceptives are in wide-spread use. It is remarkable that there have been no cases of negative reactions reported between these common medicines and St John’s wort. Are the safe experiences of millions of people over many years more valid than the recent conjectures of scientific researchers?
St John’s wort has been widely studied through laboratory testing. It has been shown to be a more effective antidepressant with fewer side effects than the standard prescriptions of Imiprimine and Amitriptyline. St John’s wort has also been found effective in the treatment of the herpes simplex virus (types I and II), influenza, HIV and the Epstein-Barr viruses. St John’s wort is effective in the treatment of seasonal affective disorder (SAD) and insomnia.
The active ingredients in St John’s wort are contained in the characteristic red oil of the plant. These ingredients include pseudohypericin, isohypericin, protohypericin and flavonoid compounds. Hypericin was previously considered the main active ingredient, but at the 1997 Drug Information Association meeting in Washington DC, European researchers stressed that hypericin was not an important active ingredient and that preparations which were standardized to 0.3 per cent hypericin content caused more reactions and side effects than did traditionally extracted preparations with lower levels of hypericin.
I recommend traditionally extracted St John’s wort in the treatment of depression, SAD, viral infections, topical wounds and insomnia. These are the best preparations and they contain a full spectrum of active ingredients. These ingredients are extracted from St John’s wort flowers, processed in virgin olive oil and exposed to natural sunlight for a minimum of 1,000 hours. Avoid preparations that are only standardized to 0.3 percent hypericin.