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What Are the Risks and Side Effects of St. John’s Wort Supplements?

St John, St Johns Wort, Wort

Depression is a difficult condition to deal with and, unfortunately, many of the prescription medications used to treat it have a variety of undesirable side effects. Because of the serious risks associated with using prescription anti-depressants, more people are turning to natural remedies such as St. John’s wort to help relieve their symptoms. Unfortunately, natural and herbal doesn’t always mean safe. If you’re taking St. John’s wort supplement, here are some of the risks you need to be aware of.

Risk of St. John’s wort supplements: Drug interactions

This is one of the most common problems seen with St. John’s wort supplements. St. John’s wort can interact with a variety of medications and cause their blood levels to be altered sometimes to dangerous levels. This is particularly true of blood thinners and other mood altering medications. St. John’s wort should never be taken with prescription anti-depressants as it can compound the side effects of these medications. Keep in mind that St. John’s wort can also interact with alcohol causing increased sedation. Use of this herb alters the P-450 system the liver uses to metabolize medications which can cause problems with the breakdown of certain drugs. It appears to alter levels of anti-seizure medications increasing the risk of seizure if you have epilepsy and may alter the action of drugs used to treat AIDS as well as decrease the effectiveness of birth control pills. Always let your doctor know if you’re taking St. John’s wort so you can avoid dangerous drug interactions.

Risk of St. John’s wort supplements: Cataracts

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A study suggests that using a St. John’s wort supplement could increase the risk of cataracts. Although the mechanism isn’t clear, it’s thought that the active ingredient in St. John’s wort can break down and produce free radicals when exposed to sunlight. If you plan on sunbathing or spending any significant amount of time in the sun, don’t take St. John’s wort. There’s also evidence that St. John’s wort increases photosensitivity, so avoid the sun and when you can’t wear protective eyewear and a sunscreen.

Risk of St. John’s wort supplements: Pregnancy

The long term safety of using St. John’s wort in pregnancy is uncertain. One animal study suggested that using it during pregnancy can increase the risk of a low birth weight baby. It’s probably best avoided if you’re pregnant or breast feeding.

Although a St. John’s wort supplement may be a natural option to prescription anti-depressants, it should be used with caution if you’re taking other medications since drug interactions are so common with this herb. Discuss these concerns with your doctor before making the decision to use this herbal treatment.

Reference:

  • Prescriber’s Letter. September 1999. page 91