Internal Uses

• Mood Support: Much like the tisane, St. John's Wort tincture was a popular remedy for mild to moderate cases of depression, anxiety, and general low spirits. It was believed to promote emotional balance.
• Nerve Calming: The tincture was used to ease nervous tension, restlessness, and sleep disturbances associated with anxiety.
• Digestive Support: Some traditional uses include St. John's Wort tincture to soothe digestive issues and support overall gut health.

External Uses (use macerated st john's wort for this purpose)

• Wound Healing: macerated st john's carrier oil has a long history of topical application to aid in the healing of cuts, burns, bruises, and skin inflammation. Its potential antiseptic and anti-inflammatory properties were valued.
• Muscle and Nerve Pain: macerated st john's carrier oil applied topically to help relieve muscle aches, joint pain, and nerve-related discomfort.

Traditional Preparation and Dosage

St. John's Wort tincture is created by extracting the medicinal components of the plant (often the flowering tops) into alcohol. Traditional dosages vary, and it's crucial to consult with a qualified healthcare professional for personalized guidance.

Important Considerations:

• Drug Interactions: St. John's Wort can significantly interact with several medications, including antidepressants, birth control, and blood thinners. Thoroughly discuss potential interactions with your doctor before use.
• Sun Sensitivity: The tincture, like the tisane, may make your skin more sensitive to sunlight. Practice sun protection measures.
• Pregnancy and Breastfeeding: St. John's Wort is generally not recommended during pregnancy or breastfeeding.
• Not a Cure-All: Always seek professional medical advice. Traditional remedies should not replace necessary medical treatment.

Source : http://www.wikiphyto.org/wiki/St John's Wort

Reference on http://www.wikiphyto.org

Translation in English by Google Translate  (go to the page of the source linked | on Chrome cellphones go on the 3 dots on the top right and select translate in your preferred language | on laptop right click your mouse and select option translate when hoovering on the page

plant name

St. John's wort, St. John 's wort, perforated St. John's wort , St John's wort (English)

International Latin denomination

Hypericum perforatum L.

botanical family

Clusiaceae (= Guttiferaceae = Hypericaceae)

Description and habitat

• Herbaceous plant of Eurasian origin, perennial, erect angular stem, branching
• Up to 80 cm high
• Oval leaves, opposite and punctuated with black on the edges ( hypericin secretory pockets ), presenting on their surface numerous small translucent essence pockets, visible by transparency as small perforations, justify its name (the adjective “perforated” is therefore a pleonasm)
• Bright yellow flowers grouped in panicles
• The plant is currently cultivated in many temperate regions of the world to meet very high demand.

History and tradition

• One of the flowers of Saint John
• Was used in the manufacture of "tranquil balm" and nowadays "Commander's balm" because of its vulnerary properties, in the Middle Ages, treated cases of dementia
• Associated with solar cults for two reasons: flowering at St Jean, and bright red coloring of the oily macerate of the flowers after exposure to light for several weeks
• We only find mention of its antidepressant properties from the 1960s in Germany, where it was extensively studied, with numerous pharmacological and clinical studies.
• Decision of January 22, 2001 published in the Official Journal of January 27, 2001: any magistral preparation of St. John's Wort, even homeopathic, must include the following statement on the packaging: “warning, risk of drug interaction. The combination of this preparation of St. John's wort with other drugs can lead to a reduction in their effectiveness. Conversely, a sudden interruption of the intake of St. John's wort can increase the toxicity of these drugs. Ask your doctor or pharmacist."

Parts used

• Flowering tops harvested in summer

Dosage forms available

• Whole plant tincture
• Hydro-alcoholic dry extract titrated in hypericin and/or hyperforin (the most active)
• whole plant EPS
• Fluid extract

Usual dosages

• 600 mg per day of dry extract titrated to 0.2% minimum hypericin or equivalent galenic forms
• Corresponds to 2-4 g of drug, 0.2-1 mg of hypericin
• A mother tincture contains on average 5 mg of hypericin per 100 ml, which corresponds, for a daily dose of 3 times 20 drops (= 3 ml), to a quantity of 0.15 mg of hypericin
• In general 2 to 3 doses per day (i.e. 1 mg to 3 mg maximum of total hypericins )
• Minimum dose of hypericin for activity: 0.6 to 1 mg/day

Composition

Main components of the plant

• Red pigments from the group of anthrones (0.06-0.15%): naphthodianthrones including hypericin (usual tracer of extracts), pseudohypericin , isopseudohypericin , protopseudohypericin , and cyclopseudohypericin
• Phloroglucinol -derived phenolic compounds (2-5%): hyperforin (prenylated derivative), adhyperforin , hydroperoxycadiforin (best candidate for antidepressant effect)
• Flavonoids  : hyperoside , isoquercitroside , rutoside , quercetol
• Biflavonoids (0.1-0.5%): biapigenin , amentoflavone (its isomer)
• Xanthones in small quantities: tetrahydroxyxanthone (and kielcorine in the roots)
• Tannins and proanthocyanidins
• Essential oil  : n - alkanes and monoterpenes
• Melatonine (4490 ng/g) [1]

Main components of buds or young shoots

Main components of essential oil

• Methyl-2-octane (main component, approximately 50%), n-nonane , n-undecane
• Alpha-pinene , beta-pinene , limonene , myrcene , caryophyllene , alpha-terpineol , geraniol , caprylic ( n-octanal ) and capric ( n-decanal ) aldehydes [2]

Properties

Plant properties

• Antidepressant, the activity is linked to an inhibition of the reuptake of neuromediators (especially serotonin, dopamine, norepinephrine) and a moderate interaction with GABA -A receptors ( hyperforin especially), [3] , [4] , [5 ] , [6] , [7] , [8] , [9] , [10] , hyperforin would be the most serious candidate, but the antidepressant effect is probably due to a synergy between different substances [11] , [12]
• Anxiolytic [13] , [14]
• Sedative [15] even with extracts lacking hyperforin
• Many molecules are synergistic with each other, by two complementary mechanisms:
  • Pharmacodynamic synergy, where components have effects on the same targets or multi-target effects: hypericin , flavonols and xanthones inhibit monoamine oxidase MAO and catechol-O-methyltransferase COMT, hyperforin inhibits serotonin reuptake
  • Pharmacokinetic synergy, which affects the absorption, distribution, biotransformation, or elimination of molecules: procyanidin increases the water solubility of naphthodianthrones, therefore their bioavailability [16]
• Hydro-alcoholic extracts are selective inhibitors of type A mono-amine oxidase (MAO) by flavonoids and xanthones (which would nevertheless be present in too small quantities), inhibition of catechol-O-methyl transferase [17]
• Hypericin has weak activity (preparations lacking it are active) but it binds to receptors for the Y1 and Y2 neuropeptides, thought to play a role in anxiety and depressive states. Naphthodianthrones are very reactive in the presence of light and they are the ones that provide the red color of the oil
• Flavonoids are also catechol-o-methyltransferase (COMT) inhibitors , but studies show too little activity in this regard and in the inhibition of MAO
• Amentoflavone binds to the benzodiazepine receptor
• Hypericin is sedative and melatonergic
• Hypericin may fight cytomegalovirus (CMV) and herpes simplex [ 18]
• Neuroprotecteur [19]
• Hyperoside acts on human brain tumors
• Hyperforin induces inhibition of tumor growth of leukemia cells, cerebral glioblastoma cells, synergistically with hypericin and procyanidin B2, activation of caspases, induction of apoptosis [20]
• Serotonergic and melatonergic (causes an increase in melatonin levels)
• Modest activity against behavioral stressors [21]
• St. John's wort powder-based products for oral consumption, sold without medical prescription, are currently marketed in France illegally
• In the fresh plant, naphthodianthrones exist in proto- or precursor form ( protohypericin ), protohypericin is much weaker phototoxic
• Anti-inflammatory and analgesic [22]
• Cholagogue, digestive
• Anti-asthmatic?
• Externally: antiseptic, astringent, healing, vulnerary, especially in the form of oily maceration [23]
• Usable in the treatment of inflammatory periodontal disease, inhibits plasma extravasation and decreases bone resorption [24]
• Hypericin can be an agent for photo-detection and dynamic phototherapy of ovarian cancer micrometastases [6]
  • Hypericum lanceolatum has antimalarial properties [25]

Bud properties

Properties of essential oil

• Anti-inflammatory
• Potential anti-angiogenic properties [26]

Indications

Indications of the whole plant (phytotherapy)

• Depressive states (mild to moderate depression), especially seasonal depression, and occurring during nervous fatigue and physiological states such as menopause
• A meta-analysis [27] in 1996 reported the results of 27 trials (out of 1757 patients in all) comparing St. John's wort either with a placebo or with active treatments. It suggests that St. John's wort is more effective than a placebo and as effective as low-dose tricyclic antidepressants (TCAs) in treating depression. Its mechanism of action seems similar to that of classic antidepressants: inhibition of the reuptake of monoamines
• A double-blind trial of 324 patients with mild to moderate depression treated with a 0.2% alcoholic extract of hypericin showed identical efficacy to 50 mg imipramine twice daily [28] , another study showed the same efficacy as imipramine, with better tolerance [29]
• Similar efficacy to IRS (serotonin reuptake inhibitors) in a meta-analysis [30]
• It was observed, in patients treated with an extract of St. John's wort, a significant reduction in the Hamilton score (initial evaluation scale of depression) compared to patients treated with paroxetine, with improvement in the severity score of depression and better medium-term remission [31]
• Efficacy and good tolerance [32]
• No positive effects should be expected before 10 - 14 days of treatment
• Stop if no effect has appeared after 4 to 6 weeks of treatment
• According to the experience of clinicians, the effectiveness is clearer in winter-like depression (action on melatonin?)
• Wounds and burns, sunburn (external route)

Indications of the bud (gemmotherapy)

Specific indications of essential oil (aromatherapy)

Known or suspected mode of action

• The pharmacological activity seems to be attributable to a synergy between naphthodianthrones ( hypericin ), phloroglucinol derivatives ( hyperforin ) and different flavonoids [33].
• Kielcorine ( xanthone ) would be one of the active principles
• St. John's wort is a source of melatonin (Pr Robert Anton)
• Mechanism of action: St. John's wort inhibits synaptosomal reuptake of serotonin, dopamine, and norepinephrine (norepinephrine) with equal affinity
• Also in vitro, it shows affinity for adenosine, GABA (A) and (B) and glutamate receptors
• In vivo it exerts a decrease in beta-adrenergic activity at the level of its receptors and an increase in the activity of serotonin

Usual formulations

• Dry extracts in capsules or tablets, dosed between 200 and 300 mg per capsule
  • Take 600 to 900 mg per day
• Preparation of St. John's wort oil  : macerate a good handful of St. John's wort flowers in ¾ liter of olive oil (in a wide-necked container). Leave the bottle closed, in direct sunlight, for three weeks: the oil gradually takes on a beautiful red color. Attention, it is photosensitizing, it should not be used before sun exposure, only in burns or sunburn

Regulations

• French Pharmacopoeia list A (flowering top)
• Activity recognized by the German Commission E

Possible side effects and precautions for use

• Photosensitizing (by induction of singlet O2 formation)
• Interactions [34] with "low therapeutic margin" drugs, including anti-retrovirals (anti-HIV such as indinavir [35] ), digoxin, theophylline, vitamin K antagonists, ciclosporin, contraceptives oral, SSRI antidepressants, amitriptyline, cyclosporine, fexofenadine, indinavir, methadone, midazolam, nevirapine, phenprocoumon, simvastatin, tacrolimus and warfarin. These interactions are linked to enzymatic induction of cytochrome P450 and induction of membrane glycoprotein P [36].
  • Possible reduction of drug effect secondary to decreased plasma concentration, as a result of possible induction of CYP2C9 isoenzyme, CYP3A4 and CYP1A2 [37] , [38] , induction of CYP3A activity , with reduced therapeutic efficacy of drugs metabolized by CYP3A, other sources do not find any alteration in the activity of CYP2C9, CYP1A2, CYP2D6 [39]
  • Interactions with protease and transcriptase inhibitors, immunosuppressants ciclosporin and tacrolimus, irinotecan, imatinib, low-dose hormonal contraceptives, serotonergic antidepressants by induction of cytochrome P450 CYP3A4 ( hyperforin ) and P-glycoprotein ( hypericin ) [40]
  • A sudden interruption of the intake of St. John's wort can therefore also lead to an increase in the plasma concentration of these drugs.
  • St. John's wort gradually and powerfully induces the activity of CYP3A4, the elimination of ethinylestradiol, a major substrate of CYP3A4, will be greatly accelerated in the presence of St. John's wort, therefore the contraceptive effect will no longer be assured and another method of contraception [41]
  • In 2014, the MHRA (Medicines and Healthcare Products Regulatory Agency) issued an alert on the risk of interaction between St. John's wort and hormonal contraceptives containing progesterone, microdose combination pills and etonogestrel implants: 19 suspicious interactions were reported between 2000 and 2014, including 15 unwanted pregnancies [42]
• Hyperforin is presumably the main culprit of the interactions:
  • It has been shown that the hyperforin content of a St. John's wort preparation is significantly correlated with the level of CYP3A4 induction [43].
  • A low- hyperforin Hypericum extract was studied in 20 healthy volunteers receiving a drug cocktail, and no pharmacokinetic interactions were observed for CYP1A2, CYP2B6, CYP2C9, CYP2C19, CYP3A4 and P-glycoprotein [44].
• A few cases of serotonin syndrome have been reported in the literature in elderly patients treated with a serotonin reuptake inhibitor antidepressant and having taken St. John's wort.
• Good job security otherwise [45]
• The essential oil can be allergenic

Bibliographic references

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Store in a cool, dry place, away from light. Keep tightly closed, away from the reach of Children and pets.

Do not exceed the daily dose.

This product is not intended to prevent or cure any form of illness or disease.
 

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