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Side Effects of St John’s Wort


St. John’swort is safe for most people when taken by mouth short-term. AlthoughSt John’sWort has been safely used for hundreds of years, any herb that has medicinal properties may also have side effects. There are some potential St John’sWort side effects, warnings and contraindications which you may want to take note of if you are using it.

Side Effects of St. John’s Wort

Side effects: Photosensitivity

A condition where there is an increased sensitivity to sunlight. It is not extreme sensitivity, but is significant enough that you want to ensure that you wear proper clothing and a good sunscreen, such as SPF 15 or better. Thus, anyone usingSt. John’swort should take extra caution in terms of getting exposure to sunshine. Having some exposure during the morning and evening periods of the day – would be a good idea.

 Side effects: Nausea,Vomiting, Headaches, Dizziness, Confusion and Fatigue

The studies suggest only a very limited number of people onSt. John’swort experience fatigue. The weird thing is, the degree of fatigue can vary even based on the time of day that you take St. John’s Wort (morning or evening), or whether you take it all at once or spread it out through the day. You can do some regular exercise, take fresh air and eat well, etc to overcome this problem.  Some people take other herbs or supplements to give them energy, and that’s fine and certainly your choice, such as Ginkgo Biloba.

 Side effects: Anxiety, Agitation or Panic Attacks, Hostility or Aggressiveness, Trouble Sleeping, Vivid Dreams and Restlessness

Side effects: Dry mouth, Gastrointestinal Discomfort and Stomach Upset (taking it with food to overcome this problem), Diarrhea and Interferes with the absorption of iron and other minerals

Side effects: Lack of Libido (decreased sex drive)

Side effects: Skin Irritation and Skin Rashes

If you break out in a rash, consider the possibility that you’re allergic toSt. John’sWort.

Side effects: Possible long-term Eye concerns

There is some new, preliminary research that suggests that drugs which increase your sensitivity to sunlight (of whichSt. John’sWort is one, there are many others) may help in the formation of cataracts in your eyes, long term.

Side effects: A fast heart rate (tachycardia), High blood pressure (hypertension) and Difficulty breathing

Special Precautions & Warnings:

Pregnancy and breast-feeding:  There is some evidence that it can cause birth defects in unborn rats. No one yet knows whether it has the same effect in unborn humans. Nursing infants of mothers who take St. John’swort can experience colic, drowsiness, and listlessness. Until more is known, don’t use St. John’swort if you are pregnant or breast-feeding.

Infertility: If you are trying to conceive, don’t use St. John’swort, especially if you have known fertility problems.

Attention Deficit-Hyperactivity Disorder (ADHD): There is some concern that St. John’s wort might worsen symptoms of ADHD, especially in people taking the medication methylphenidate for ADHD. Until more is known, don’t use St. John’s wort if you are taking methylphenidate.

Bipolar disorder: People with bipolar disorder cycle between depression and mania, a state marked by excessive physical activity and impulsive behavior. St. John’s wort can bring on mania in these individuals and can also speed up the cycling between depression and mania.

Alzheimer’s disease: There is concern that St. John’s wort might contribute to dementia in people with Alzheimer’s disease.

Anesthesia and surgery: Use of anesthesia in people who have usedSt. John’s wort for six months may lead to serious heart complications during surgery. Stop usingSt. John’s wort at least two weeks before a scheduled surgery.

Interaction with Other Medications

Research has shown thatSt. John’swort interacts with many medications in ways that can interfere with their intended effects. Examples of medications that can be affected include:

Antidepressants:Taking St.John’s wort with certain antidepressants may lead to increased serotonin-related side effects, which may be potentially serious.

Birth control pills: It is suspected that SJW may reduce the effectiveness of some birth control pills

Cyclosporine, which prevents the body from rejecting transplanted organs

Digoxin, a heart medication

Indinavir and possibly other drugs used to control HIV infection

Irinotecan and possibly other drugs used to treat cancer

Seizure-control drugs, such as phenytoin and phenobarbital

Warfarin and related anticoagulants.

Avoid the following substances when using St. John’s Wort: Amino acids tryptophan and tyrosine; amphetamines; asthma inhalants; beer, coffee, wine; chocolate, fava beans, salami, smoked or pickled foods, and yogurt; cold or hay fever medicines; diet pills; narcotics; nasal decongestants. They all contain chemicals that react adversely to hypericin, causing high blood pressure and nausea.
-Murray, M. — The Pill Book Guide to Natural Medicines: Vitamins, Minerals, Nutritional Supplements, Herbs, and Other Natural Products. — Bantam, 2002. 786.

If you have high blood pressure, and your doctor agrees to your use ofSt. John’sWort, the following precautions should be taken:Have your blood pressure checked at least weekly for the first six weeks, and at least monthly thereafter. Do not eat foods containing tyramine.

 Tell all your health care providers about any complementary and alternative approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care

 More information about St. John’s Wort

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