The above-ground parts of the plant are harvested during the flowering season and used for medicinal preparations. Hypericin was one of the first compounds to be identified and established as an active constituent responsible for St John’s medicinal effects. Later hyperforin was discovered and it too is thought to be active. In addition to hypericin and hyperforin, St John’s wort contains many flavonoids such as rutin, quercetin and lutein. Even though many preparations are standardized to hypericin (or sometimes hyperforin)* , the actual active compounds are not yet fully understood and, as with many herbs, the beneficial activity is likely to come from a synergy of the many different compounds rather just one or two isolated ones.

Mood Support

St John’s wort is probably best recognized as a natural treatment for mild to moderate depression. There have been over 35 studies of the effects of St John’s wort on mood conducted in the last 45 years. In nearly all of the studies, people taking St John’s wort showed a greater improvement in mood than did those taking placebo.[fn value=2][/fn] [fn value=3][/fn] [fn value=4][/fn]St John’s wort has also been compared head-to-head with prescription medications for depression. In these studies, those taking St John’s wort experienced benefits similar to or better than the results achieved with prescription medications, without significant side effects.[fn value=5][/fn]Exactly how St John’s wort works to improve mood is not known. Most research has suggested that it slows the uptake of neurotransmitters in the brain, making them available longer to do their mood balancing work.[fn value=6][/fn] One study has suggested that it may also help to regulate the hypothalamic-pituitary-adrenal axis and modulate stress-induced brain impairment that may contribute to or aggravate mood imbalances.[fn value=7][/fn]

Nerves and Nerve Health

St John’s wort is traditionally thought of as a nervine, an herb that is beneficial for calming both the emotional nerves and the physical nerves. Unfortunately, to date there has been very little research on its effects on nervous conditions or nerve pain. However, as a homeopathic preparation, Hypericum perforatum is well recognized as a treatment for nerve pain.

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* Because the quality and potency of an herb is dependent on variables in season, soil, weather, growing location and post-harvest handling, some companies choose to standardize their herbal products in an attempt to deliver a consistent product every time. Standardization in botanical extracts refers to delivering a consistent, measurable amount of a recognized plant constituent, often one believed to be an active ingredient.

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Topical Uses

Herbalists in Europe and the United States often use St John’s wort as a “go to” for skin conditions such as bruises, burns, sunburns, wounds and minor skin irritations. Topically, St John’s wort is thought to help fight microbes, modulate inflammation and support healing.[fn value=8][/fn] The German Commission E has approved the use of St John’s Wort extracted in oil for the treatment of acute injuries, myalgia (muscle pain) and first-degree burns.[fn value=9][/fn] A few small studies have confirmed that topical preparations of St John’s wort improve the symptoms of atopic dermatitis.[fn value=10][/fn] [fn value=11][/fn]

Using St John’s Wort

St John’s wort is available for internal use as a tea, a liquid tincture or in pill form. In tincture and pill form it may come from the crude (whole) herb, or the herb may be standardized, usually to hypericin or hyperforin. No matter which form you choose follow the directions given on the bottle. St John’s wort can be slow to work in the body and it can take as long as six to eight weeks for its effect to be noticed. For external use, St John’s wort may be found in creams, lotions and ointments. It is also commonly used in eardrops intended for earaches.

St John’s wort does not generally produce side effects, although in some sensitive individuals it may increase photosensitivity. This appears to be a relatively rare side effect when the herb is taken as directed. St John’s wort should not be taken with pharmaceutical antidepressants, and anyone wishing to transition from their prescription medication to St John’s wort should work with their physician. As always, caution should be used when starting any new herb, nutrient, or medication, especially if you are already taking other supplements or medications or have a medical condition.