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St. John’s Wort: From Traditional to Modern Uses

St. John’s wort (SJW) is a poster child for strong and effective herbal remedies. If you’re looking for a natural remedy that’s been extensively studied, look no further than St. John’s wort. By far the most common uses for St. John’s wort today is for enhancing mood, relieving stress, and improving sleep quality. 1

But even herbal supplements can come with some risky interactions and side effects. While there is a little risk when this herb is taken on its own, it is known to interfere with many drugs. 2 However, many people have chosen to take SJW in spite of these risks, and some holistic practitioners recommend it to their clients.

If you’re considering taking St. John’s wort with the hopes of achieving a more positive mood, education is key. Understanding its history and the scientific literature behind its common uses and risks can help you incorporate this powerful nootropic safely and effectively into your daily life.

st john's wort What Is St. John’s Wort?

St. John’s wort ( Hypericum perforatum ) is a perennial flowering herb native to Europe, Africa, and Asia. 3 Its use as a traditional plant medicine dates back over 2,000 years to ancient Greece. 4

Its early traditional uses spanned from warding off evil spirits to wound-healing and treatment for menstrual disorders. During the Middle Ages, it was used to relieve pain and treat cuts, burns, and other external injuries.

Fast forward to eighteenth and nineteenth-century Europe and you’ll find it was used much like it is today. Tinctures and teas of St. John’s wort were commonly touted for their ability to help promote a positive mood and decrease stress.

Today SJW tinctures, teas, and pills of all varieties are a multibillion-dollar industry. Pharmaceutical-grade products are widely available in Europe—sometimes over-the-counter, and sometimes only as a prescription medication.

In the United States, SJW and other herbal remedies are all considered dietary supplements, and supplements are regulated differently than drugs. Supplements are not subject to the same level of regulation as are drugs which can lead to inconsistencies in quality and efficacy between different SJW products.

Fortunately, you can still find quality SJW supplements and tinctures in the U.S., it just requires some extra due-diligence on the part of the consumer. Many companies will use in-house and third-party lab testing to confirm the identity and quality of the products they sell.

Science-Backed Benefits of St. John’s Wort

All across the globe, you’ll find doctors and herbal medicine practitioners that suggest St. John’s wort to ease the symptoms of anxiety, low energy, brain fog, and more. Whether you’re looking to use this natural remedy on your own or following the advice of a trusted health professional, it’s helpful to know exactly what research shows as valid uses of SJW.

Helps Promote Positive Mood st john's wort

If you’re one of the millions of Americans and others around the world that struggle from depression or other mood disorders, research suggests that St. John’s wort may provide some symptomatic relief. Multiple studies have found that St. John’s wort may help those who are suffering from mild-to-moderate depression. 5

Last year, researchers published a meta-analysis of human clinical trials examining the effect of SJW or its constituents on those with depression. Twenty-seven studies were included that compared St. John’s wort with a common class of pharmaceuticals used to treat mild-to-moderate depression: selective serotonin reuptake inhibitors (SSRIs).

Researchers concluded that for patients with mild-to-moderate depression, SJW had comparable efficacy and safety to SSRIs. There were limitations, however. The studies available ranged from only 4 to 12 weeks, leaving questions about the impact of SJW long-term. Additionally, it wasn’t clear whether or not this herb would help those with severe depression.

These studies suggest that Saint John’s wort may provide some relief for those struggling with mild-to-moderate depression. However, they also warrant caution to its use due to to a lack of long-term clinical trials and questionable efficacy for those with more severe depression.

Alleviates Stress

Another prevailing use of St. John’s wort is to alleviate stress . In spite of a lack of controlled clinical trials, there is a reason to be optimistic that SJW may help lessen the experience of stress and anxiety.

The first piece of support revolves around how SJW works in the body: it exhibits GABAergic, serotonergic, and dopaminergic activity. Dysfunction of these neurotransmitters—GABA, serotonin, and dopamine—is believed to play a role in anxiety disorders and stress.

To add to this, stress is known to play a role in the development of some depression and anxiety disorders. 6 As certain anxiety disorders and depression may share similar causes, it follows that drugs and supplements that help for one condition may help for the other. 7

Some anxiety disorders have been effectively treated with SSRIs, which are traditionally used to treat depression. 8 As human clinical trials have found St. John’s wort to exhibit similar improvements in depression, it’s plausible that these benefits could extend to the stress-reducing benefits of SSRIs as well.

Furthermore, some preliminary studies have found SJW to help reduce stress or improve anxiety symptoms. These include both human case studies and animal studies.

st john's wort Other Evidence-Backed Uses

Outside of the realm of mental health, treating wounds and relieving menopause symptoms are the most thoroughly researched uses of St. John’s wort. 9

SJW has been used for treating wounds for thousands of years, and recent scientific studies support the validity of this use. Research has found benefits of topical application of this herb for burns, cuts, ulcers, bruises, and more. In one animal study, SJW was found to improve tissue regeneration in a model of rat diabetes. As tissue injury in diabetes can result in amputation, compounds that expedite wound healing are critical. 10

As for menopause, multiple human studies have found a greater improvement in symptoms with SJW than a placebo. These benefits include not just a decrease in hot flashes, but an improvement in mood, sleep quality, and overall quality of life, which are often impacted by menopause. 11

There are many other uses of SJW that have been postulated but not thoroughly tested. Some conditions that it may help with include:

More research is needed to determine what effect if any, SJW has on these conditions, however, preliminary studies have found positive results. 12

st john's wort How Does St. John’s Wort Work?

The mechanisms by which this herb exhibits its mood-lifting effects are largely credited to two components found in the plant: hypericin and hyperforin.

Hypericin stimulates blood flow and enhances the effects of neurotransmitters credited for improving mood. Some of these neurotransmitters include serotonin, GABA, dopamine, and norepinephrine. Hypericin exerts this effect by inhibiting enzymes involved in breaking down these neurotransmitters.

Hyperforin also works through increasing the effect of neurotransmitters but does so in a different manner. It works as a reuptake inhibitor, slowing the body’s reabsorption of these neurotransmitters, allowing each to have more impact. While both SSRIs and hyperforin are reuptake inhibitors, the ways that they accomplish this are different.

SSRIs block 5-HT receptors, but hyperforin increases the number of these receptors while also boosting the concentrations of calcium and sodium. These changes in concentration decrease the gradient between the synaptic cleft and the neuron, decreasing the reuptake of certain neurotransmitters.

This all means that the compounds in St. John’s wort enhance the effectiveness of the chemicals in the brain that promotes positive mood.

The Safety and Efficacy of St. John’s Wort

Where you live determines the likelihood of your being recommended St. John’s wort for trouble with mood and stress. While its use is fairly common in the U.K., it is not quite so common in the United States.

If you suffer from depression and have spoken with your doctor, chances are they didn’t mention this powerful herbal remedy. This begs the question of why SJW isn’t recommended for individuals with depression in the U.S. Answering this question boils down to two main reasons: safety and efficacy.

As far as safety is concerned, St. John’s wort is known to interfere with many drugs. These interactions lead to risks associated with its use, encouraging some physicians not to recommend it.

Of the numerous interactions, many fall under the category of interference with the efficacy of drugs, such as birth control pills and Xanax (a drug used for anxiety relief). SJW can make some drugs less effective. 13

Other, more dangerous, interactions can occur. Some examples include mixing SJW with certain antidepressants, which can lead to a condition known as serotonin syndrome. When too much serotonin builds up in the brain, fever, confusion, tremors, hypertension, and even death can occur. 14

Additionally, the efficacy of St. John’s wort is dependent upon the severity of depression. If your depression is severe or you’re experiencing suicidal thoughts, this supplement may not be the best option for you.

How To Use St. John’s Wort: Dosage and Forms st john's wort

St. John’s wort can be found in a variety of forms, including liquid tinctures, capsules, tablets, and even tea. If you are looking for relief from a specific medical condition, tinctures or pill forms are the best options because they provide the ability to precisely measure your dosage.

Research suggests that the optimal dosage is around 450 mg twice daily or 300 mg three times daily. You may not notice the effects right away, so it is important to take it continuously for multiple weeks in a row to see if it helps.

Always consult a medical professional before adding St. John’s wort to your daily regimen. There are many dangerous drug combinations that can occur. These are not just with prescription medications but also with over-the-counter and recreational drugs.


If you’re struggling with low energy, stress, and a lack of excitement for life that has lasted weeks or months in a row, speak with your doctor or licensed naturopath about this powerful herb. Remember, even though it is an herb, it can pose risks to your health if taken in combination with other drugs.

Nevertheless, there is no other herbal remedy that has such extensive academic support. If you’re looking for a natural supplement that may promote a positive mood, SJW could be the herb for you.

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