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How St John’s wort benefits were found?

Ancient Greeks had used St. John’s wort to treat many internal and external diseases. Hypericum perforatum is the botanical name of this herb found throughout temperate regions, including European, American and Asian countries. Since ancient time, this herb is effective to treat different mental conditions like anxiety, depression, burns, and cuts. Later researchers discovered this herb has potent neuroprotective, antioxidant, anti-inflammatory and antimicrobial properties. 

After discovering these therapeutic benefits, many European pharmaceutical companies started to prepare St. John’s wort containing herbal formulation and earn several billion dollars. The efficacy of this herb is tested through both animal and human trials and also identify the possible mechanism of action of this herbal medicine. [1]

What are the phytochemicals present in St John’s wort?

There are a wide variety of phytochemicals present in St. John’s wort. Hypericin and hyperforin have great medicinal properties. St. John’s wort also contains flavonoids, quercetin, rutin, and kaempferol, which also add medicinal benefits. 

The detail chemical analysis of St. John’s wort reported that seven groups of medicinally active compounds present in St. John’s wort. Flavonoids like biflavones, flavonol glycosides, and phenylpropanes, certain essential oils, naphthodianthrones, and phloroglucinols are some recently identified phytochemicals present in St. John’s wort herb. Among the wide variety of phytochemicals present in St. John’s wort herb, 20% are biologically active. [1]  

Phytochemical present in St. John's wort | HealthSoul

What is the mode of action of St John’s wort benefits?

St. John’s wort containing hypericin has the main antidepressant property which stimulates capillary blood flow. An animal study reported that this active phytochemical has MAO A and MAO B inhibitory effect. This active constituent facilitates neurotransmission activity by preventing the degradation of amine neurotransmitters. St. John’s wort treatment also enhances dopamine activity by binding with sigma receptors. 

Hyperforin is another phytochemical present in St. John’s wort, which acts as a serotonin uptake inhibitor. Treatment with this antidepressant increases the concentration of both Na+ and Ca2+ ions. [1]

St. John’s wort has a growth inhibitory effect against a wide variety of disease-causing germs. Hyperforin is active against MRSA (Methicillin-resistant Staphylococcus aureus ) and PRSA (penicillin-resistant Staphylococcus aureus). These gram-negative bacteria have often developed resistance against conventional antibiotics.

Flavonoid and catechin-containing active ingredients of St. John’s wort effective against viral infections. Hypericin interferes with viral cell cycle and provides an antiviral effect. [1]

Hyperforin and hypericin, both of these active ingredients have anticancer properties. They induce apoptosis and inhibit tumor growth. Hypericin acts as a powerful natural photosensitizer and has potent antioxidant property. The mechanism involves in anticancer activity includes prolonging cell growth inhibitory effect, induces apoptosis and reduces phototoxicity. [1]

The anti-inflammatory and gastroprotective activity exerted by St. John’s wort obtained due to inhibition of pro-inflammatory genes expressions like cyclooxygenase-2, interleukin 6, and inducible nitric oxide synthase (iNOS). This herb also reduces prostaglandin E2 production. [1]

St. John’s wort extract enhances the collagen production and activates fibroblast cells to accelerate the wound healing process.[1] 

St. John’s wort herb can activate the opioid receptors without causing withdrawal symptom. [1]

How St. John's wort Prevent & Cure Diseases | HealthSoul

What are the different forms of St John’s wort?

Different dosage forms of St. John’s wort herb is available in the market. The herbal preparations of St. John’s wort herb may contain flowering tops to prepare tablets, capsule, teas, tincture, liquid extract and skin lotions for external application to accelerate wound healing. Most of these herbal preparations contain 0.3% hypericin.  

St. John’s wort herbal preparations usually recommended for adults, however, a pediatric study also reported this relatively safe to use for children having mild to moderate depression problem. 

Tablet and capsules containing dry herb are recommended for mood disorder or mild depression. The recommended adult dosage is 300mg thrice daily with meals. Sustainable release St. John’s wort herbal capsules also available in the market. 

St. John’s wort herbal tea and liquid extract are also available. It is advised to take experts opinion for dose determination. Usually 3 to 6 weeks treatment period require to check the efficacy of St. John’s wort herbal preparation. Experts also recommended not to stop the drug suddenly, as it may cause a side effect. Gradually lower the dose before complete stopping of the medicine. [2]

 Different forms of St. john's wort & Their Uses | HealthSoul

ST JOHN’S WORT BENEFITS

The primary use of St. John’s wort containing medications is an anti-depressant. Apart from depression, this herbal medication has other uses also which include treatment for obsessive-compulsive disorder, attention-deficit hyperactivity disorder, and menopausal symptoms. It is also widely used as natural chemotherapy agents. [3]

Antidepressant activity

Incidence of depression is increasing day by day due to the increased rate of neurochemical disorder. Many synthetic antidepressant medications are already available in the market, but they often cause an adverse reaction for long term use. The anti-depressant property of St. John’s wort herbal remedy is well established through different research studies. It is a relatively safe natural alternative treatment for mild to moderate depression symptoms. A placebo-controlled clinical trial reported that John’s wort herbal remedy gives significantly better result than the placebo-controlled group and the effect is comparable with synthetic antidepressant medications. [1]

Control of infectious disease

This herbal remedy effective against MRSA and PRSA bacterial infection, which cannot be treated by using conventional antibiotic treatment due to resistance development. 

Not only bacterial infections but viral diseases like influenza can be controlled by treating with St. John’s wort herbal remedy. Some of the active constituents have identified with have efficacy against HIV infection. Herbal researchers are quite confident that this could be a non-expensive alternative AIDS treatment shortly. [1]

Anticancer Property

The potent anticancer effect of hypericin inhibits the growth of multiple cancerous cell growth, including leukemia, melanoma, sarcoma, glioma, adenoma, neuroblastoma, mesothelioma, and carcinoma. 

The photodynamic therapy is previously applied for skin lesions, but nowadays this property active against tumor development. [1]

This herb is to restrict cancerous cell proliferation against urinary bladder carcinoma, pancreatic cancer cell, prostate cancer. Hypericin acts as an immunomodulator effect and induces cancerous cell death by modulating antioxidants activity, which is effective against melanoma cells. [1]

Neurological protection

St. John’s wort has a neuroprotective effect due to its potent antioxidant property. This helps to treat oxidative stress-related neurodegenerative disorders such as Parkinson's and Alzheimer's diseases. [1]

Gastroprotective activity

The anti-inflammatory property of this herb is effective to control colonic inflammation and provide protection against gastric ulcers. [1]

Wound healing property

Topical application of St. John’s wort lotion surprisingly accelerate wound healing. This is a great benefit to treat external lesions. [1]

ST. JOHN’S WORT SIDE EFFECTS

St. John’s wort is a safe herbal medication within the therapeutic dosage. But increase dosing causes side effects like allergic reactions, gastrointestinal symptoms, lethargy, dizziness, restlessness, confusion, and dryness of the mouth. But these adverse effect list is quite short than the conventional synthetic antidepressant medications. Acute neuropathy may occur in a toxic dose. AIDS patients may show cutaneous phototoxicity with a large dose of hypericin due to interaction with conventional anti-AIDS treatment. Individuals who are undertaking St. John’s wort medications should take precautionary measure during sunlight exposure. 

Drug-drug interaction is a common incidence with St. John’s wort herb. This herbal preparation usually enhances the activity of other drug's action by interacting with liver enzyme activity. 

Experts recommended following drugs should not be used concomitantly with St. John’s wort herbal treatments, like antihistamine (Fexofenadine), cardioactive drugs (Digitalis), anticancer medications (imatinib mesylate), immunosuppressants (Cyclosporin and tacrolimus), antihypertensive agents (verapamil), benzodiazepine sedatives and tricyclic antidepressant (amitriptyline),etc. [1]

Side effects & Precautionary Measures of St. john's wort | HealthSoul

References

  1. Kenneth M. Klemow er al. Chapter 11 Medical Attributes of St. John’s Wort (Hypericum perforatum).Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition.
  2. St. John's wort. TriHealth.
  3. St. John’s Wort. Jun J. Mao, Jyothirmai Gubili. The ASCO Post.

Ayurveda


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