St. John's Wort

Not medical advice. St. John's Wort is discussed here for informational and harm-reduction purposes only. We do not endorse use, and any dosing context is informational, not a protocol.

Also known as	Hypericum perforatum, St Johns wort extract
Category	Supplement
native_region	Europe, western Asia; now naturalized worldwide
active_compounds	Hyperforin, hypericin, additional polyphenols
US legal status	St. John's Wort is a lawful dietary supplement under DSHEA. Not FDA-approved for medical use. Subject to multiple contraindications and drug interactions; consult a healthcare provider before use.

What is St. John's Wort?

A flowering plant containing hyperforin and other compounds. St. John's Wort is traditionally used for mood support. It functions as a CYP3A4 and CYP2C9 inducer, causing significant drug interactions.

How it works

Hyperforin and hypericin modulate serotonin, norepinephrine, and dopamine pathways. Acts as CYP3A4 and CYP2C9 inducer, increasing metabolism of many drugs and reducing their efficacy.

Background & history

Used in European traditional medicine for centuries. Modern clinical research accelerated in 1990s-2000s; popular in Germany for mood support before FDA scrutiny of interactions.

What the research says

Moderate evidence from clinical trials shows St. John's Wort may have modest mood-supporting effects comparable to some prescription antidepressants in mild cases. However, efficacy in moderate to severe conditions is limited. Drug interactions are well-established and serious.

Reported effects

Reported to support mood in mild cases
Studied for mood and emotional wellness
May have mild antioxidant properties
Traditional use for emotional resilience
Some users report improved sleep quality

Dosing & administration (informational)

Standard supplemental dose 300-900 mg daily in divided doses (typically 0.3 percent hypericin content). Discuss timing and duration with healthcare provider, especially with other medications.

This is general research/context information, not medical advice or a recommended protocol.

Safety & side effects

MAJOR: Causes severe serotonin syndrome risk with SSRIs, SNRIs, tramadol, and other serotonergic drugs
MAJOR: Reduces efficacy of oral contraceptives, warfarin, digoxin, and immunosuppressants via CYP induction
Avoid during pregnancy and breastfeeding
Photosensitivity possible, especially with high doses or extended sun exposure
Not recommended for bipolar disorder or severe depression

Drug & supplement interactions

MAJOR: Severe serotonin syndrome risk with SSRIs, SNRIs, tramadol, MAOIs
MAJOR: Reduces efficacy of oral contraceptives, warfarin, digoxin, many anticonvulsants
Reduces efficacy of immunosuppressants and HIV medications
Photosensitivity with extended sun exposure
Induces metabolism of many CYP3A4 and CYP2C9 substrates

Who should avoid it

All antidepressants (SSRIs, SNRIs, MAOIs, tricyclics)
Oral contraceptives and hormone therapies
Warfarin and other anticoagulants
Immunosuppressants and transplant medications
Severe or moderate depression; use only under medical supervision

How it is commonly combined

Do NOT combine with other mood-supporting or serotonergic herbs or supplements without medical supervision.

Legal & regulatory. St. John's Wort is a lawful dietary supplement under DSHEA. Not FDA-approved for medical use. Subject to multiple contraindications and drug interactions; consult a healthcare provider before use.

Quality & harm reduction

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Lab testing & harm-reduction tools

If you are going to research a compound, verifying identity and purity is the single most protective step. Independent analytical testing and sterile-handling supplies reduce risk.

Compare testing options

Frequently asked questions

Can I take St. John's Wort with my antidepressant?

No. St. John's Wort causes severe serotonin syndrome risk with most antidepressants. Do not combine without medical supervision.

Will it interfere with my birth control?

Yes. St. John's Wort significantly reduces oral contraceptive efficacy. Consider alternative birth control or avoid St. John's Wort.

Is it safe for severe depression?

No. Evidence supports only mild mood support. Severe depression requires medical treatment. Consult a psychiatrist.

How long does St. John's Wort take to work?

Effects typically appear after 2-6 weeks of consistent use; response is variable and modest.

Does sun exposure matter?

St. John's Wort can cause photosensitivity; use high SPF sunscreen and limit extended sun exposure during use.