![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 58 to 82 of 89. Go back in thread:
Posted by TenMan on November 5, 2009, at 9:56:31
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 5, 2009, at 9:41:32
> > > > > >
> > > > > > > > Grazing: St. Johnswort presents difficult problems for grazing, given its chemical constituents. It depresses the central nervous system and increases the animals' sensitivity to temperature change and handling. St. Johnswort also affects the liver, causing temporary sensitivity to sunlight. Livestock usually avoid it unless food is scarce. Excess consumption leads to blistering and itching on light-haired or unpigmented skin areas including the mouth, nose and ears. Dark skin is not affected. The animals may lose weight, become difficult to manage, and they may die of dehydration or starvation if there is swelling or soreness in the mouth. Cattle need to ingest only 1% of their body weight to be affected, whereas sheep can consume up to 4% of their weight. The wool and meat of affected animals is often of poor quality. Horses, rabbits and pigs are also affected by the herb, but I have not found any information reporting whether or not goats are affected. The dried plant as found in hay is much less potent than fresh, but may still cause problems.
> > > > > >
> > > > > > Sorry, I wasn't aware there were any cattle on this board taking SJW for mood disorders? What exactly is the point of this? If it makes you feel better I promise not let my cow or goat graze on SJW. Can we now drop this sillyness?
> > > > > >
> > > > > > > Also read the link in Scott's post. I posted for what I thought a genuine health risk. If you feel free to google this topic on cattle and sjw this apparently is quite common. I for one will not use the product but feel free to ingest large quantities of sjw since herbal means safe. I guess you're entitled to do what you wish with your eyes. I won't waste my time any more as this is becoming quite childish.
> > > > > >
> > > > > > Again with the cattle.
> > > > > > Childish? What is childish, taking 1 or two potential side effects and blowing them way out of proportion to what the literature indicates and then using it as justification for hysteria.
> > > > > >
> > > > > > Furthermore, not one person in this thread has made any statement to the extant that SJW is completely safe and requires no caution or education before ingestion. Anything that you put into your body is potentially going to cause an adverse reaction. Heck, people even die from too much water! True story. Acetaminophen causes many deaths every year. If you eat too many calories you can develop metabolic syndrome and die. Etc. Etc. Etc.......
> > > > > >
> > > > > >
> > > > >
> > > > > There seem to be two sets of rules around here. The alt med people frequently use rat and other animal studies to further their views. I guess that doesn't apply to negative sides.
> > > >
> > > > And yet, you haven't even managed to post a single rat study, much less a cow study. Your arguments are built on sand.
> > > >
> > >
> > > There are probably other natural options that don't put your eyes at risk. My p-doc is actually in favor of anything natural or pharm that will help his patients. But in light of some of the new evidence coming out on sjw he is telling his patients to not take it.
> > >
> > > I published a post which I saw in a forum. Just something for people to be aware of. There was no intent to make this an alt med versus the conventional med debate. I believe you were the one that turned the thread in that direction.
> >
> > Yes, a post with the header: DO NOT TAKE ST. JOHNS WORT IT IS DANGEROUS
> >
> > You then proceeded to provided zero evidence to the claim beyond anecdote and observations that when cows ingest multiple pounds of the stuff while grazing they get sick.
> >
> > And you wonder why there is a debate?
> >
> > You are well intentioned but ignorant. That is a very dangerous combination.
> >
> >
>
> At this point you are being uncivil.
>
> This is the title of my post
>
> You Must Use Caution With St. Johns Wort
>
> That is far from what you said my post was titled.
>
> The part underneath that said do not ever take sjw was part of the post of the person who had the bad reaction.
>
> You are becoming shrill and hysterical. I published a legitimate post from a well known sjw forum and you seem to be having some type of psychotic breakdown. I published what appeared to be a genuine post and you can't deal with it. I'm sorry that a serious sjw reaction somehow is upsetting to your world. Maybe it is time to close this thread. This thread has gone far of course.If you had even bothered to read the original post you put up you would see that I am correct about the header. So now you are putting up posts that you don't even read?
Posted by SLS on November 5, 2009, at 10:05:45
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 8:00:36
> I have been taking SJW for years. I am well aware of the published studies, good and bad,
Perhaps other people were not. Now, they are.
> However, to this point, I have seen nothing that warrants major concern to the effect that taking the standard doses used for mood disorders orally...
I guess the evaluation of the import of the studies I referenced is a personal matter, rather than a scientific one.
> will hasten the formation of cataracts, as for now it is all theoretical.
Why do you say this?
It is not theoretical that processes associated with cataract formation are seen in the most recent studies. They are an empirical observation.
> Personally, I'm far more concerned with the potential unknown consequences of a lifetime of SSRI or Atypcial AP use than SJW.
Talk about theoretical...
- Scott
Posted by SLS on November 5, 2009, at 10:08:52
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 8:03:08
Here is something you can stick in the sand:
- Scott"Therefore, in the presence of light, hypericin can induce changes in lens protein that could lead to the formation of cataracts. Appropriate precautions should be taken to protect the eye from intense sunlight while on this antidepressant medication."
Photochem Photobiol. 2000 Aug;72(2):200-3.
Photooxidation of lens alpha-crystallin by hypericin (active ingredient in St. John's Wort).Schey KL, Patat S, Chignell CF, Datillo M, Wang RH, Roberts JE.
Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, USA.
Hypericin is the active ingredient in the over the counter antidepressant medication St. John's Wort. Hypericin produces singlet oxygen and other excited state intermediates that indicate it should be a very efficient phototoxic agent in the eye. Furthermore it absorbs in the UV and visible range, which means it can potentially damage both the lens and the retina. Lens alpha-crystallin, isolated from calf lenses, was irradiated in the presence of hypericin (5 x 10(-5) M, 10 mM ammonium bicarbonate, pH 7.0) and in the presence and absence of light (> 300 nm, 24 mW/cm2). Hypericin-induced photosensitized photopolymerization as assessed by sodium dodecylsulfate-polyacrylamide gel electrophoresis. Further analysis of the oxidative changes occurring in alpha-crystallin using mass spectrometry showed specific oxidation of methionine, tryptophan and histidine residues, which increased with irradiation time. Hypericin did not damage the lens protein in the dark. Damage to alpha-crystallin could undermine the integrity of the lens directly by protein denaturation and indirectly by disturbing chaperone function. Therefore, in the presence of light, hypericin can induce changes in lens protein that could lead to the formation of cataracts. Appropriate precautions should be taken to protect the eye from intense sunlight while on this antidepressant medication.
PMID: 10946573 [PubMed - indexed for MEDLINE]
Posted by SLS on November 5, 2009, at 10:10:15
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 9:00:24
> You are well intentioned but ignorant. That is a very dangerous combination.
Yup.
- Scott
Posted by TenMan on November 5, 2009, at 10:13:06
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by SLS on November 5, 2009, at 10:05:45
> > I have been taking SJW for years. I am well aware of the published studies, good and bad,
>
> Perhaps other people were not. Now, they are.
>
> > However, to this point, I have seen nothing that warrants major concern to the effect that taking the standard doses used for mood disorders orally...
>
> I guess the evaluation of the import of the studies I referenced is a personal matter, rather than a scientific one.
>
> > will hasten the formation of cataracts, as for now it is all theoretical.
>
> Why do you say this?
>
> It is not theoretical that processes associated with cataract formation are seen in the most recent studies. They are an empirical observation.
>
> > Personally, I'm far more concerned with the potential unknown consequences of a lifetime of SSRI or Atypcial AP use than SJW.
>
> Talk about theoretical...
>
>
> - ScottScott, until there is evidence that oral consumption leads to cataract formation it is theoretical. Plain and simple.
As to my statement about SSRI's and AP's; it is purely my opinion but one I made in response to the safety of SJW being unfairly attacked. I am making no statements to the extent that they should not be taken at all or that they are extremely dangerous, unlike others in this thread.....
Is the difference not obvious?
Posted by SLS on November 5, 2009, at 10:29:34
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 5, 2009, at 9:41:32
Bulldog:
For what it may be worth, I do not think that you are ignorant... at least no more so than me.
:-)
I find nothing wrong with ignorance. We don't exit the womb being omniscient. It is just the perpetuation of ignorance that I have a problem with (not that I am not guilty of this from time to time). If you hadn't brought up the issue of SJW and cataracts, I would never have investigated it.
- Scott
Posted by SLS on November 5, 2009, at 10:51:33
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 10:13:06
I have not come to any conclusions as to how high might be the risk of people developing cataracts as a result of SJW use. I performed a simple, cursory, literature search on Google and Medline to find out more about this issue once I saw it brought up in the thread. That you dismissed the study citations that I provided so quickly only provided me with more motivation to corroborate the results of the first study I found.
The information is there. What people do with it is a matter of personal choice.
Funny thing. Many of the studies involving the genesis of cataracts use bovine eyes. Cows.
- Scott
Posted by TenMan on November 5, 2009, at 11:01:53
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by SLS on November 5, 2009, at 10:51:33
> I have not come to any conclusions as to how high might be the risk of people developing cataracts as a result of SJW use. I performed a simple, cursory, literature search on Google and Medline to find out more about this issue once I saw it brought up in the thread. That you dismissed the study citations that I provided so quickly only provided me with more motivation to corroborate the results of the first study I found.
>
> The information is there. What people do with it is a matter of personal choice.
>
> Funny thing. Many of the studies involving the genesis of cataracts use bovine eyes. Cows.
>
>
> - ScottSott, where did I dismiss any of the studies?
There is nothing wrong with putting them into context. None of us here are putting hypericin directly onto our eyes, or eating 1-4% of our bodyweight of the herb. It is important to understand that in relation to how we use the herb, surely you don't disagree?
There is a wealth of long term literature on the use of St. Johns Wort. Cataract formation in humans from orally ingested standard doses for mood disorders has not been shown. Nothing about that statement is false or disingenuous.
If my debating with you is motivating you to further educate yourself on the subject then good! That is how good debate works!
Posted by bulldog2 on November 5, 2009, at 11:04:38
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 10:13:06
> > > I have been taking SJW for years. I am well aware of the published studies, good and bad,
> >
> > Perhaps other people were not. Now, they are.
> >
> > > However, to this point, I have seen nothing that warrants major concern to the effect that taking the standard doses used for mood disorders orally...
> >
> > I guess the evaluation of the import of the studies I referenced is a personal matter, rather than a scientific one.
> >
> > > will hasten the formation of cataracts, as for now it is all theoretical.
> >
> > Why do you say this?
> >
> > It is not theoretical that processes associated with cataract formation are seen in the most recent studies. They are an empirical observation.
> >
> > > Personally, I'm far more concerned with the potential unknown consequences of a lifetime of SSRI or Atypcial AP use than SJW.
> >
> > Talk about theoretical...
> >
> >
> > - Scott
>
> Scott, until there is evidence that oral consumption leads to cataract formation it is theoretical. Plain and simple.
>
> As to my statement about SSRI's and AP's; it is purely my opinion but one I made in response to the safety of SJW being unfairly attacked. I am making no statements to the extent that they should not be taken at all or that they are extremely dangerous, unlike others in this thread.....
>
> Is the difference not obvious?
>
>
>
>
>
>Yes I remember when there was a theory that a wonderful herb called tobacco caused lung cancer. By time the theory was proved millions had already died of lung cancer. So I guess by time you get the evidence you need you will be walking with a seeing eye dog.Obviously that is none of my concern.
It is intuitively obvious to the most casual of observers that this herb must be approached with the greatest concern. I understand that this herb has helped you. Well you say it has helped you and I can understand that you are upset that this formerly believed benign herb is far from benign. I would also be upset. The theoretical studies that show a strong connection between hypericin and cataracts is very powerful. Why else would there be companies trying to produce lowered hypericin products or eliminate it all together. Obviously there is a strong concern. I talked to new chapter on the phone and they wouldn't even committ to saying that their lowered hypericin product sc27 was not a hazzard to the eyes. Also I asked about prescription meds and the told me that it's the hyperforin that's implicated in altering blood levels of meds. For millions of us on blood pressure meds,cholesterol meds etc. that is also an unacceptable risk. So a potent sjw product with standardized levels of hypericin and hyperforin is basically a pharmacuetical med.
If you get pharmacuetical quality results from an herb than that powerful product is going to be accompanied with significant sides. Basically one goes with the other.
I have said that i believe this drug does have promise but with what is emerging it needs to be produced in a quality controlled way by a pharmaceutical company (s) so that a standardized product is produced. Than prescribed by a doctor who knows what meds you take and wether this can safely be taken with them. Possibly eliminate hypericin and eliminate cataracts.
Right now there might be dozens of products out there that vary widely in potency. If it acts like a med, smells like a med,etc than it is a med. Again intuitively obvious to the most casual of observers.
Posted by TenMan on November 5, 2009, at 11:15:56
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by bulldog2 on November 5, 2009, at 11:04:38
> > > > I have been taking SJW for years. I am well aware of the published studies, good and bad,
> > >
> > > Perhaps other people were not. Now, they are.
> > >
> > > > However, to this point, I have seen nothing that warrants major concern to the effect that taking the standard doses used for mood disorders orally...
> > >
> > > I guess the evaluation of the import of the studies I referenced is a personal matter, rather than a scientific one.
> > >
> > > > will hasten the formation of cataracts, as for now it is all theoretical.
> > >
> > > Why do you say this?
> > >
> > > It is not theoretical that processes associated with cataract formation are seen in the most recent studies. They are an empirical observation.
> > >
> > > > Personally, I'm far more concerned with the potential unknown consequences of a lifetime of SSRI or Atypcial AP use than SJW.
> > >
> > > Talk about theoretical...
> > >
> > >
> > > - Scott
> >
> > Scott, until there is evidence that oral consumption leads to cataract formation it is theoretical. Plain and simple.
> >
> > As to my statement about SSRI's and AP's; it is purely my opinion but one I made in response to the safety of SJW being unfairly attacked. I am making no statements to the extent that they should not be taken at all or that they are extremely dangerous, unlike others in this thread.....
> >
> > Is the difference not obvious?
> >
> >
> >
> >
> >
> >
>
> Yes I remember when there was a theory that a wonderful herb called tobacco caused lung cancer. By time the theory was proved millions had already died of lung cancer. So I guess by time you get the evidence you need you will be walking with a seeing eye dog.Obviously that is none of my concern.
>
> It is intuitively obvious to the most casual of observers that this herb must be approached with the greatest concern. I understand that this herb has helped you. Well you say it has helped you and I can understand that you are upset that this formerly believed benign herb is far from benign. I would also be upset. The theoretical studies that show a strong connection between hypericin and cataracts is very powerful. Why else would there be companies trying to produce lowered hypericin products or eliminate it all together. Obviously there is a strong concern. I talked to new chapter on the phone and they wouldn't even committ to saying that their lowered hypericin product sc27 was not a hazzard to the eyes. Also I asked about prescription meds and the told me that it's the hyperforin that's implicated in altering blood levels of meds. For millions of us on blood pressure meds,cholesterol meds etc. that is also an unacceptable risk. So a potent sjw product with standardized levels of hypericin and hyperforin is basically a pharmacuetical med.
> If you get pharmacuetical quality results from an herb than that powerful product is going to be accompanied with significant sides. Basically one goes with the other.
> I have said that i believe this drug does have promise but with what is emerging it needs to be produced in a quality controlled way by a pharmaceutical company (s) so that a standardized product is produced. Than prescribed by a doctor who knows what meds you take and wether this can safely be taken with them. Possibly eliminate hypericin and eliminate cataracts.
> Right now there might be dozens of products out there that vary widely in potency. If it acts like a med, smells like a med,etc than it is a med. Again intuitively obvious to the most casual of observers.
>
>
>
>
bulldog, why do you continually insist on putting words into my mouth? I have never said that SJW is benign. Not once. I have stated multiple times that it does involve risk and that there are legitimate concerns. I mean, what is so hard to understand about that? Until you actually bother to read my posts I'm going to have to put you on ignore.As for the rest of your statement-I agree with you. And I hope that I am not using a seeing eye dog one day. However for me the benefits of a life worth living far outweigh the theoretical risk of cataracts.
Posted by bulldog2 on November 5, 2009, at 11:41:01
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 11:15:56
Thank God for that present
Posted by SLS on November 5, 2009, at 15:07:11
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 11:15:56
At the very least, one might consider not exposing their eyes to bright sunlight without wearing amber sunglasses.
- Scott
Posted by TenMan on November 5, 2009, at 15:32:08
In reply to Re: You Must Use Caution With St. Johns Wort, posted by SLS on November 5, 2009, at 15:07:11
bulldog, I just want to apologize for calling you ignorant. I was out of line and hope you will forgive me.
I've said all I wanted to in this thread and will now bow out.
Take care all.
Posted by bulldog2 on November 5, 2009, at 15:52:33
In reply to Re: You Must Use Caution With St. Johns Wort, posted by TenMan on November 5, 2009, at 15:32:08
> bulldog, I just want to apologize for calling you ignorant. I was out of line and hope you will forgive me.
>
> I've said all I wanted to in this thread and will now bow out.
>
> Take care all.
>
>I'm fine...I think we just got to worked up...Good luck with the sjw...we're all just looking for something that works and doesn't harm us...you take care also
Posted by bleauberry on November 5, 2009, at 18:19:54
In reply to Re: You Must Use Caution With St. Johns Wort » TenMan, posted by SLS on November 5, 2009, at 10:08:52
This study is full of words like "could", "should", "potentiall", and theory.
No actual case reports of documented SJW-induced eye damage have been presented.
In general, isolated concentrated singular molecules, such as prescription meds, that have only a few years or a few decades of experience, probably in my opinion present much greater risks than plants that have been tested in realtime for centuries or thousands of years.
Whatever the case, the risks and actual events are extremely low.
This study, if anything, tells me that if I were to take a high dose of SJW for a prolonged period of time, it would be wise for me to have good sunglasses when outdoors. In essence, that was the stated conclusion at the end of the study in the last sentence.
Rather than guessing, maybe we can recruit the assistance of hundreds or thousands of longterm SJW users to see what their experiences have been. That can be found in the archives of sjwinfo.org. Plan on spending a few days there because it is huge. I spent an entire weekend there once trying to make a list of all reported side effects, an estimate of improvement vs remission vs failure, results with diffferent brands (trying to choose my own brand), bizarre outcomes, and such. Finding out what happened with real people like you and me trounces anything a theorist can dream up.
Not prescribed 6 times more often than SSRIs, but rather, 6 times more often than Prozac. I don't think even Lexapro or Effexor or Zoloft are prescribed 6 times more often than Prozac. So no matter, the point remains the same. It is prescribed a lot, and that would not be happening if it was not providing safe repeatable results statistically equivalent to or better than other medical options.
> Here is something you can stick in the sand:
>
>
> - Scott
>
> "Therefore, in the presence of light, hypericin can induce changes in lens protein that could lead to the formation of cataracts. Appropriate precautions should be taken to protect the eye from intense sunlight while on this antidepressant medication."
>
>
>
>
>
>
>
>
> Photochem Photobiol. 2000 Aug;72(2):200-3.
> Photooxidation of lens alpha-crystallin by hypericin (active ingredient in St. John's Wort).
>
> Schey KL, Patat S, Chignell CF, Datillo M, Wang RH, Roberts JE.
>
> Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, USA.
>
> Hypericin is the active ingredient in the over the counter antidepressant medication St. John's Wort. Hypericin produces singlet oxygen and other excited state intermediates that indicate it should be a very efficient phototoxic agent in the eye. Furthermore it absorbs in the UV and visible range, which means it can potentially damage both the lens and the retina. Lens alpha-crystallin, isolated from calf lenses, was irradiated in the presence of hypericin (5 x 10(-5) M, 10 mM ammonium bicarbonate, pH 7.0) and in the presence and absence of light (> 300 nm, 24 mW/cm2). Hypericin-induced photosensitized photopolymerization as assessed by sodium dodecylsulfate-polyacrylamide gel electrophoresis. Further analysis of the oxidative changes occurring in alpha-crystallin using mass spectrometry showed specific oxidation of methionine, tryptophan and histidine residues, which increased with irradiation time. Hypericin did not damage the lens protein in the dark. Damage to alpha-crystallin could undermine the integrity of the lens directly by protein denaturation and indirectly by disturbing chaperone function. Therefore, in the presence of light, hypericin can induce changes in lens protein that could lead to the formation of cataracts. Appropriate precautions should be taken to protect the eye from intense sunlight while on this antidepressant medication.
>
> PMID: 10946573 [PubMed - indexed for MEDLINE]
Posted by bleauberry on November 5, 2009, at 18:44:45
In reply to You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 2, 2009, at 18:55:47
I favor prescription meds.
I favor natural plant medicines.
Both have their place.
The prescriptions I view as single molecule strongarm nuclear bombs to accomplish a narrow defined desired mechanism. Appropriate for acute and dire needs. But often problematic or toxic with longterm use.
The plants offer an array of dozens or hundreds of molecules that provide a wide spectrum synergistic mechanism, generally more suitable for longer term use with slower onset of action. These mechanisms have been discovered and passed on through generations over hundreds and thousands of years from all around the planet. Even tribes who had not the slightest sense of science could depend on XYZ herb to cure diarhea or XYZ herb to cure leprosy or syphillis, or XYZ herb to lift the spirits, or induce sleep, or dispel worms, or heal burns without scarring, or whatever. The plants still do it today. Many of them have documented scientifically studied extremely low toxicity levels and are suitable for longterm use.
So I favor both sides. Even better is when the benefits of both can be combined in logarithmic synergy. Someone adding a bit of tyrosine to an SSRI, someone adding a few immmune herbs or antispirochetal herbs to their antibiotic, anti-inflammatory herbs with just about anything, etc.
However, when I see anyone attacking one or the other (prescription or plant), I feel compelled to offer some counterbalance in defense of the attacked.
Here it is.
The following are side effects that did and do occur with one of the most common meds mentioned on pbabble, with a high enough significance to be reported by the manufacturer and the FDA.
Shakiness (tremor)
Anemia
Nose bleed
Weight loss
Hemorrhoids
Muscle pain or bone pain
Liver problems
Mania or hypomania
Decreases in blood sodium levels (hyponatremia)
Asthma
Acne
High blood sugar (hyperglycemia)
Hair loss
Confusion or other mental changes
A rapid heart rate
Nausea, vomiting, or diarrhea
Hallucinations
Blood pressure changes
An irregular heart rhythm
Overactive reflexes
Fever, sweating, or shivering
Shakiness
Agitation
Seizures
Coma
Chest palpitationsThis thread just needs a little balance. We are all worked up over possible eye problems with SJW that no one yet has verified, but the above documented side effects are ok?
ps..the drug is Lexapro.
Posted by Phillipa on November 5, 2009, at 18:48:49
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bleauberry on November 5, 2009, at 18:19:54
I believe I posted wear good sunglasses earlier on and cataracts arent deadly and can be surgically fixed when disturb vision. As when mine found was told when the matured medicaire would pay for the surgery. Laser does this as at the time was having PRK lasix for distance sight. And the lady who had just had one eye done and now the other said she no longer needed glasses for distance or reading and she drove herself to the appointment. Lens Implantation is now being use. Phillipa
Posted by Phillipa on November 5, 2009, at 19:07:22
In reply to Re: You Must Use Caution With St. Johns Wort, posted by Phillipa on November 5, 2009, at 18:48:49
Just a simple google search on pro's and cons. Phillipa
Pros & Cons of Using St. John's Wort for Depression
Contributor
By Melody HugheseHow Contributing Writer
Rate: (1 Ratings) St. John's wort is also known was hypericum perforatum. It is a perennial shrub with orange and yellow flowers. Extracts of this plant are often used to treat depression. St. John's wort is sold as a dietary supplement and is available at health-food stores and supermarkets. According to the National Institutes of Health, St. John's wort has been used to treat mental-health problems for centuries. Whether St. John's wort is truly an effective treatment for depression has yet to be irrevocably proven. However, many individuals take this supplement in the hopes that it will alleviated depression.
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.Conflicting Scientific Evidence
According to the Mayo Clinic, multiple studies have indicated that St. John's wort is just as effective as prescription tricyclic anti-depressant drugs such Tofranil and Elavil in treating either mild or moderate depression. In addition, some studies have suggested that St. John's wort may also be as effective as serotonin aids Prozac and Zoloft. Studies have not gathered evidence indicating whether St. John's wort is effective in the treatment of anxiety disorders, obsessive compulsive disorder or seasonal affective disorder. The NIH asserts that, while some studies have shown St. John's wort to be as effective as prescription medications, two studies have concluded that St. John's wort was not any better at treating depression than a placebo.
Cost
St. John's wort is significantly cheaper than prescription anti-depressants. However, medical insurances will not cover the expense at all. At Walgreens.com, a 2 ½-month supply of St. John's wort is $19.99. Prescription anti-depressants medications may cost $100 or more for a month's supply, and, even with medical insurance, they will still be more than the cost of St. John's wort.
Dosages
The recommended adult dose of hyperacin is 0.17-2.7 milligrams, and the recommended dose of St. John's wort extract is 900-1800 milligrams. However, doses may vary depending on what brand of St John's wort is purchased. The strength of herbal supplements may vary by manufacturer, which make proper dosing difficult. Dosages of prescription medications are always exact.
Side Effects
According to the Mayo Clinic, recent studies have indicated that only 1 to 3 percent of those individuals taking St. John's wort experience any side effects, and those that do have side effects generally have fewer than would be present with a prescription medication. The most common side effects noted for St. John's wort are upset stomach, fatigue, headache, dizziness, sunlight sensitivity and restlessness. Some individuals may experience an allergic reaction to St. John's wort in the form of a skin rash, and some may have sexual side effects. The occurrence of side effects with prescription medications is greater than with St. John's wort. Prescription anti-depressants may cause side effects like sleep problems, dry mouth, memory loss, concentration problems, weight gain, disorientation and sexual problems.
Drug Interactions
St. John's wort may interact negatively with other supplements, herbs or prescription drugs. Thus, anyone using St. John's wort should check with a physician or pharmacist before beginning treatment with St. John's wort. St. John's wort causes problems with how fast or slow other drugs are processed by the body. Possible negative interactions may include a combination of St. John's wort with medications such as anti-depressants, birth-control medications, Warafin, Irinotecan, Indinavir, Digoxin and Clyclosporine.
Posted by SLS on November 5, 2009, at 19:07:59
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bleauberry on November 5, 2009, at 18:19:54
> Not prescribed 6 times more often than SSRIs, but rather, 6 times more often than Prozac. I don't think even Lexapro or Effexor or Zoloft are prescribed 6 times more often than Prozac. So no matter, the point remains the same.
No, it does not. The possibility remains that the usage of SJW remains substantially less than antidepressants in general. A doctor may choose SJW six times more often than Prozac, but he might also choose Zoloft six times more often than SJW. See?
If you can accomplish your proposed study of SJW users and the occurrence of cataracts, please do. But in the absence of such clinical data, I figured it might be important to look at the research data. Better minds than mine have cautioned SJW users to avoid exposing their eyes to sunlight or UV rays. It is just a precaution based upon the observations made in the laboratory.
Personally, I hope that SJW is not cataractogenic. I have no emotional or monetary investment in the belief that it is.
On a positive note, I did come upon one study that reported that the chaperone-like functioning of the lens alpha-crystallins was not significantly altered by hypericin combined with light exposure, despite the observed alteration in protein structure.
- Scott
Posted by ricker on November 5, 2009, at 19:38:05
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bleauberry on November 5, 2009, at 18:44:45
>
> ps..the drug is Lexapro.
>Hey hey!!!! I rather liking my Lexapro! And I have zero side-effects to boot :-)
I did have a go with SJW about 5 years ago and I felt extremely wired/irritable??
Like you say BB, each to their own.
Regards, Rick
Posted by 49er on November 6, 2009, at 5:22:12
In reply to You Must Use Caution With St. Johns Wort, posted by bulldog2 on November 2, 2009, at 18:55:47
Bulldog,
I am so sorry you had a bad experience with St. Johns Wort.
But using your logic, because I suffered hearing loss due to Remeron, I should be able to say it should be banned. If I posted that on this board, people would be all over me, including you.Even though I use supplements, they are definitely not completely safe. I took Inisotol, which on a psychiatry page, was deemed that way. It caused weakness and an ear blockage.
Regarding St. Johns Wort, it stopped severe depression I developed as the result of stupidly cold turkeying an SSRI. According to my therapist, it was one of the most effective antidepressants I was on. As soon as I started it, I lost all the weight I had gained on the SSRI without any effort whatsover.
What people don't realize about SJW is the brand does matter and the percentage of Hypercium. I don't know if I have that exactly right but I think I am in the ballpark
I do not recall Natures Aid as being one of those brands but I could be wrong.
I realize SJW is not side effect free and I have seen the link to cataracts. But if someone held a gun to my head and forced me to pick between SJW and any antidepressant, I would pick SJW every time.
49er
PS - I know I put myself at risk for serotonin syndrome when I started SJW but the risk was small according to my psychiatrist
Posted by Phillipa on November 6, 2009, at 18:26:54
In reply to Re: You Must Use Caution With St. Johns Wort, posted by 49er on November 6, 2009, at 5:22:12
49er it really works? Love Phillipa
Posted by bleauberry on November 6, 2009, at 18:46:28
In reply to Re: You Must Use Caution With St. Johns Wort » bleauberry, posted by SLS on November 5, 2009, at 19:07:59
Scott, you might be missing my point. By focusing on a single tree you are missing the landscape.
I don't recall proposing me to do a study on SJW and cataracts. I got way better things to do with my time thank you though.
I do not in general put a whole lot of credence on most clinical studies, as there are just too many flaws, variables, unknowns, biases, economics, narrow scopes, editing, or politics involved, not to mention the cherrypicked wording of abstracts versus whole documents. I do however put a great deal of credence on experience and results in the real world with real patients.
The words "could" or "should" or "may be" are sure signs that the result of a study are of curious note but not bible.
With that in mind, SJW has done pretty well for a very long time and probably will continue to do so. With the risk of cataracts being extremely low, especially with sunglasses, and the similar potential of SJW working as well as any other AD, I defend it as being a reasonable option for the depressed patient.
> > Not prescribed 6 times more often than SSRIs, but rather, 6 times more often than Prozac. I don't think even Lexapro or Effexor or Zoloft are prescribed 6 times more often than Prozac. So no matter, the point remains the same.
>
> No, it does not. The possibility remains that the usage of SJW remains substantially less than antidepressants in general. A doctor may choose SJW six times more often than Prozac, but he might also choose Zoloft six times more often than SJW. See?
>
> If you can accomplish your proposed study of SJW users and the occurrence of cataracts, please do. But in the absence of such clinical data, I figured it might be important to look at the research data. Better minds than mine have cautioned SJW users to avoid exposing their eyes to sunlight or UV rays. It is just a precaution based upon the observations made in the laboratory.
>
> Personally, I hope that SJW is not cataractogenic. I have no emotional or monetary investment in the belief that it is.
>
> On a positive note, I did come upon one study that reported that the chaperone-like functioning of the lens alpha-crystallins was not significantly altered by hypericin combined with light exposure, despite the observed alteration in protein structure.
>
>
> - Scott
Posted by 49er on November 7, 2009, at 5:42:43
In reply to Re: You Must Use Caution With St. Johns Wort » 49er, posted by Phillipa on November 6, 2009, at 18:26:54
> 49er it really works? Love Phillipa
At the time it did. Approximately 3 years.
But the poopout could have been the other meds I was on not working either. Hard to say.
As we always say on any board, your mileage will vary and start slowly.
49er
Posted by SLS on November 7, 2009, at 6:34:04
In reply to Re: You Must Use Caution With St. Johns Wort, posted by bleauberry on November 6, 2009, at 18:46:28
I agree that St. John's Wort has antidepressant properties. In fact, I recommended it to a family member over Nardil. Her depression was mild at the time, and I preferred that she not go back to another antidepressant right away. It seemed to work. Were she to have been severely depressed, I would have recommended the Nardil first. I don't think she would have tolerated so much time invested in experimenting with a substance that does not have enough scientific evidence of utility in treating severe depression.
Once someone becomes severely depressed, non-functional, or suicidal, time is of the essence. Until I am persuaded otherwise by evidence that I trust, I would not choose SJW as a first-line treatment.
I am glad that you question the validity of clinical studies. In kind, I question the validity of much of the literature extolling the virtues of herbal remedies, as I find them extremely biased towards these treatments and wholly dismissive of standard drug treatments.
As I have said before, herbs are drugs too. Prior to the last century, medicines were exclusively herbal. These substances should be subject to the same scrutiny as are other pharmaceuticals to establish safety and efficacy if they are to be recognized by mainstream evidence-based medicine as being effective. This would be important since it is mainstream medicine that treats the mainstream patient.
- Scott
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