Side-Effects of St. John's Wort

This is an important section. Please try to read it all.

First, an introduction: side-effects, what side-effects? Okay, yes I'm mostly joking that there aren't any side-effects at all -- but there are far fewer, and possibly less severe, side-effects than what many people experience with other antidepressants. St. John's Wort is a herbal remedy, and in most parts of the world it is readily available in heath food stores and drug stores alike without a prescription. Obviously then, it does not pose a serious health threat to the public. But St. John's Wort is not perfect, it is not a cure-all, it is not a miracle drug. For me and many millions of other people it just works, will little to no side effects at all.

In fact, side-effects are the single biggest reason why I started taking St. John's Wort -- to avoid the perils typical of other antidepressants (SSRIs like Paxil, Prozac, Serzone, Zoloft, and many others), such as the sexual side-effects I experienced with Paxil. Overall, with SJW I have experienced nearly no side-effects at all. Of the tens of thousands of people who have written me, seldom are side-effects even mentioned as they must either not be present or not intrusive enough to cause any concern. The exception to this is the very occassional email I get that goes along the lines of, "I took just one pill and ten minutes later I could hardly breathe, I was gasping for air and though I was going to die!" yet fortunately these emails come seldom enough that I do not always take them seriously.

I am not an expert in this area, I am not a medial doctor. I just know my own experiences, and what many thousands of people who have written to me have said. There is valid information in the emails to me from thousands of people. Please, above all use common sense! If you keep everything else in your life and your diet constant, and you feel that your heart or blood pressure has started racing, then discontinue use! I would hope that this is obvious. I've never heard of anyone dying from SJW.

Known Side-Effects

These are the side-effects that have been published, or that I have compiled based on thousands of people's experiences that have been emailed to me:

Sensitivity To Sunlight.

This is bad if you like to tan, as you will very likely burn. 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. A number of people have written to say that they are well-tanned and even visit tanning salons, yet they started to burn after taking SJW. Personally, I visit a tanning studio from time-to-time in the winter because I live in Canada and we don't get much sunlight then. In Canada many people suffer from Seasonal Affective Disorder (S.A.D.) in the winter; I suspect this is true for many northern countries.

Possible long-term Eye concerns

There is some new, preliminary research that suggests that drugs which increase your sensitivity to sunlight (of which St. John's Wort is one, there are many others) may help in the formation of cataracts in your eyes, long term. My recommendation to combat this is that *everyone* wear good quality sunglasses when outside, and avoid staring into bright lights for an extended period.

"It is most important that the patients avoid intense light from skiing, sunbathing or light boxes for seasonal depression therapy." This is according to Dr. Joan E. Roberts, Ph.D. and Professor of Chemistry, Fordham University. Please be aware and cautious of this.

Skin Rash

Unlikely, but you can have an allergic reaction to just about anything. If you break out in a rash, consider the possibility that you're allergic to St. John's Wort. I've had only a few people email me about this but enough to warrant putting up a note here. You could reduce your dosage, and build up to the proper dosage slowly, or perhaps even try a different brand (as different brands often use different non-medicinal "fillers" that people may react to).

Interaction with Birth Control Pills

It is suspected that SJW may reduce the effectiveness of some birth control pills. Unfortunately, at this point it's only suspected and nothing is scientifically proven. I wanted to put up a warning here so you are cautious anyway. You may want to read the press release by the Health Department in the UK.

Fatigue

The studies suggest only a very limited number of people on SJW experience this. The weird thing is, the degree of fatigue that you experience 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. Your serotonin levels are at their highest in the morning, so I choose to take it in the evening and "sleep on it." Personally, I've tried taking it spread throughout the day, or all of it either in the morning or before bed but have had the best luck taking it about an hour before bed, and after three years that is what I continue to do. Honestly I was surprised how much of a difference this made. That's probably the first thing to consider.

The second thing to combat this is regular exercise, fresh air, eating well, etc. Hopefully you're already doing some of this. If you're taking St. John's Wort and it working for you, but fatigue is the only problem you're experiencing, then I'd recommend experimenting with the above until you find a routine that works for you. Some people take other herbs or supplements to give them energy, and that's fine and certainly your choice, but you can read about those things (such as Ginkgo Biloba) other places.

Stomach Upset

Some people experience some stomach upset, but I haven't heard of many people who have. And I'm one of those people with a weak stomach. If you experience this, considering whether or not you're taking it with food, and if not trying doing so, or vice versa.

Interaction with protease inhibitors (for HIV and AIDS drug treatments)

There is some suggestion that St. John's Wort has some interaction with protease inhibitors (currently the drug of choice for HIV and AIDS patients) and should not be taking if you are on these medications. You should definitely have your doctor research other antidepressants for you, to see if they have any similar interactions.

Weight Loss or Weight Gain ???

Thanks to thousands of people who've written to me, I think this is a myth. St. John's Wort itself has no impact on your weight! Yet for many people it is psychological, and not being depressed or just being in a better frame of mind causes them to eat less, and for some others it causes them to eat more. All evidence that I have read points to any change in one's eating habits as being a psychological result of a change in one's mood, at least as far as St. John's Wort is concerned. You may have seen brands of "herbal weight loss" pills that actually contain St. John's Wort as the active ingredient, and so companies seem to prey on this knowledge. It's a minor misrepresenatation in my opinion, but then herbal remedies obviously aren't regulated. Some drugs that do actually have proven weight loss effects, like the dangerous Phen-Fen that was taken of the market recently (interestingly, it's an SSRI - a cousin to the prescription antidepressants), have been found to have severe interactions with your heart .

Note that some people do claim that there is a small impact on their weight while taking SJW. You can read their own posts in my discussion forum.

Hyper-tension, heart starts racing ???

There are always wild reports. Please, use common sense! While these things are highly unlikely, if you experience problems just stop taking St. John's Wort. I don't know of anyone who had died from it, but that's not to say that someone won't be the first.

Go to next section (general cautions)