4 Benefits of St. John’s Wort: Dosage & Safety

St. John’s wort is a medicinal plant with a long history of use as a natural antidepressant. Clinical research shows that St. John’s wort benefits the body in a variety …

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Medical Review by: Daniel Powers, MS
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St. John’s wort is a medicinal plant with a long history of use as a natural antidepressant.

Clinical research shows that St. John’s wort benefits the body in a variety of ways.

In this article, we will look at the health benefits of St. John’s wort, its safety, and its history.

benefits of st. john's wort

What is St. John’s Wort?

St. John’s wort is a perennial plant native to Europe, North Africa, and Asia. It is often found growing in fields, pastures, and along country roads. 

The Latin name for this herb is Hypericum perforatum L. It’s also called hypericum and klamath weed.

St. John’s wort has a long history of use dating back to ancient Greek times. 

This plant is widely used for treating depression. However, there are additional benefits of St. John’s wort such as the ability to reduce menopausal and PMS symptoms, skin healing properties, and the ability to manage OCD and SAD.

Health Benefits of St. John’s Wort:

There are many purported health benefits of St. John’s wort. This popular herb has a great amount of human clinical research – which is included below.

health benefits of St. John's wort

1. May Relieve Depression

Numerous studies show that St. John’s wort is an effective and safe natural treatment for moderate depression.

Depression is a mood disorder that’s defined as a persistent feeling of sadness and loss of interest. It’s estimated that 17 million people in the US have experienced depression (however this number is thought to be low).

In a 2017 review article, 27 clinical studies with a total of 3,808 participants were examined to compare St. John’s wort and SSRIs. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that are commonly prescribed for those with depression and anxiety disorders. These studies indicate that St. John’s wort is effective in alleviating depressive symptoms for those with mild-to-moderate depression; thus making it comparable to SSRIs.

In a randomized, double-blind study, researchers compared St. John’s wort extract and fluoxetine (an SSRI) in elderly patients with mild-to-moderate depression. St. John’s wort was found to be as effective as fluoxetine in managing depression and had no adverse effects on cognitive performance.

In another randomized, double-blind study, researchers compared St. John’s wort extract and imipramine (an antidepressant) in 263 patients with moderate depression. Both treatments were shown to be effective in improving the quality of life in those with depression, while St. John’s wort was shown to be better tolerated.

The effectiveness of two different extracts of St. John’s wort was examined in a randomized, double-blind study. 147 participants with mild-to-moderate depression were studied. The findings showed that the plant’s effectiveness in depression is based on its primary chemical component, hyperforin. The higher the content of hyperforin in the St. John’s wort extract, the more effective it may be for those suffering from severe depression.

A study investigating the efficacy of St. John’s wort for depression concluded that the extract is not effective in treating major depression. This finding may indicate that St. John’s wort is more effective in treating mild-to-moderate depression.

The Commission E, a governmental health agency in Germany,  indicates that St. John’s wort is appropriate for use in depressive moods, anxiety, psychovegetative disturbances, and nervous unrest.

Additionally, the European Scientific Cooperative on Phytotherapy (ESCOP) reports the use of St. John’s wort for mild-to-moderate depressive states, restlessness, anxiety, and irritability.

Summary:

Clinical research indicates that St. John’s wort may be helpful for individuals with mild-to-moderate depression. Individuals with major depressive symptom should reach out to their personal healthcare provider for more in-depth treatment.

2. May Help With Menopausal Symptoms

St. John’s wort benefits the body by helping to protect against menopausal symptoms.

As women age and estrogen production drops, menopausal symptoms may arise. Common menopausal symptoms include:

  • hot flashes
  • vaginal dryness
  • sleep disturbances
  • anxiety
  • depression

The transitional period before menopause is referred to as perimenopause, while the period after menopause is considered post-menopause.

The effects of St. John’s wort on perimenopausal women who experienced menopausal symptoms were examined in a double-blind, randomized study. After three months of treatment with 900mg of St. John’s wort extract daily, results showed that St. John’s wort decreased hot flashes and fatigue and improved sleep.

A clinical trial investigated the effects of a herbal combination of St. John’s wort and Black cohosh (Cimicifuga racemosa) in 301 menopausal women. This combination was found to be highly effective in alleviating various menopausal complaints.

Another double-blind, randomized placebo-control study of 100 women examined St. John’s wort as an effective treatment for perimenopause and post-menopause. The results revealed a significant decrease in the number of hot flash episodes and their severity when given St. John’s wort extract.

Summary:

Research indicates that St. John’s wort may be an effective aid for reducing menopausal symptoms. More research needs to be conducted on this herb as a stand-alone treatment.

3. Skin Healing Properties

In traditional medicine, St. John’s wort was said to help to benefit skin health.

In a double-blind, placebo-controlled study, researchers tested the effects of a St. John’s wort ointment as a topical treatment for psoriasis. The results showed a significant decrease in skin redness, thickness, and scaling.

Germany’s Commission E approves the use of St. John’s wort for external use for acute and contused injuries, myalgia (muscle pain), and first-degree burns.

Summary:

Initial research, and traditional usage, indicates that St. John’s wort may be helpful for skin health. More in-depth research needs to be conducted.

4. Other Benefits:

Other purported St. John’s wort health benefits include:

  • Premenstrual syndrome: A small study of 19 women with premenstrual syndrome (PMS) took St. John’s wort extract daily for two menstrual cycles. Findings revealed a significant reduction in PMS symptoms with at least a 50% decrease in symptom severity.
  • Obsessive-Compulsive Disorder: A 12-week open-label trial demonstrated significant improvements in Obsessive-Compulsive Disorder (OCD) symptoms with the administration of St. John’s wort. Improvements began as early as week one of the trial and increased throughout.
  • Seasonal Affective Disorder: A controlled, single-blinded study evaluated the effects of St. John’s wort extract on those with seasonal affective disorder (SAD). The participants were given 900mg of St. John’s wort extract daily, along with light therapy, either bright light or dim light. In both groups, there was a significant reduction in depressive symptoms.
  • Fatigue: An uncontrolled, open study examined St. John’s wort extract on fatigue. Findings showed a significant decrease in fatigue, as well as symptoms of depression and anxiety over six weeks of treatment.

While these various other health benefits of St. John’s wort are interesting, large human clinical trials are needed to verify these findings.

Summary:

St. John’s wort has been tied to a wide variety of health benefits. Human clinical trials are needed to verify these findings.
St. John's wort benefits

St. John’s Wort Safety:

Safety Class: 2d

Interaction Class: C

St. John’s wort should not be used during laser, ultraviolet, or other phototherapy treatments. Excessive sunlight exposure in fair-skinned individuals taking St. John’s wort is not recommended.

St. John’s wort should not be taken in combination with antidepressant medications.

When used appropriately, St. John’s wort has been shown to be well tolerated in clinical trials without any serious adverse effects.

Pregnancy & Lactation:

There are limited studies that demonstrate an increased risk when using St. John’s wort during pregnancy and lactation. It may be safe to use when using an appropriate dose and under the supervision of a qualified health practitioner.

St. John’s wort may be an effective treatment for postpartum depression.

Dosing:

Standard dosing for St. John’s wort is as follows:

Infusion (tea): Add 1 cup of hot water to 1-2 tsp. of dried herb. Cover and steep for 15 minutes. Drink 1 cup three times per day.

Tincture (1:5): Take 2 to 4 mL three times per day.

External Application: Apply oil ointment (flowering tops of St. John’s wort with olive oil) onto affected areas 2 to 3 times per day.

Sustainability:

St. John’s Wort is not on the United Plant Saver’s “at-risk” list of plants that are sensitive to the impact of human activities. Thus, it’s a low-risk plant. 

In fact, St. John’s wort is actually considered to be an invasive species, meaning that the plant rapidly spreads. In some countries, it is considered to be a weed.

Naming & Taxonomy:

St Johns wort’s scientific name is Hypericum perforatum. It’s a perennial plant that belongs to the Hypericaceae family of plants.

The name “Hypericum” originated from the Greek name for the plant “hyperikon”. Literally translated, the name is an amalgamation of the root words “hyper” (meaning over) and “eikon” (meaning image or apparition), referring to the plant’s supposed ability to ward off evil spirits.

The word “perforatum” refers to the leaves, which have a perforated appearance.

This herb’s common name was given due to the fact that it blooms around St. John’s day (June 24th).

This herb is native to Europe but has spread to temperate locations in Asia, Africa, Australia, and North and South America

The plant grows about 6 inches tall. It has star-shaped yellow flowers with showy stamen in the center.

History & Traditional Use:

In traditional Greek medicine, St. John’s wort was used as a vulnerary, diuretic, and for neuralgic conditions.

Swiss physician Paracelsus used the herb to treat psychiatric disorders and referred to it as “arnica for the nerves”.

The flowers of St. John’s wort were used to treat neuralgia, anxiety, neurosis, and depression in traditional European medicine.

During the nineteenth and twentieth centuries, American Electric physicians prescribed St. John’s wort for hysteria, nervous conditions, depression, and externally for wounds, bruises, and sprains.

Constituents:

St. John’s wort contains a variety of phytochemicals, including:

  • Volatile oil
  • Naphthodianthones
  • Phloroglucinols
  • Catechins
  • Proanthocyanidins
  • Flavonoids

Actions:

  • Nervine, anti-inflammatory, anti-microbial, astringent, vulnerary

St. John’s Wort vs. Other Herbs:

St. John’s Wort is often compared with many other types of herbs. We have put together helpful articles going over the most common comparisons.

St. John’s Wort vs. Ashwagandha

Conclusion:

St. John’s wort appears to be a safe and well-tolerated herb when taken at appropriate dosages.

Clinical research shows that hypericum may be an effective and safe treatment for mild-to-moderate depression, however, it may not be as suited for those with major depression.

As always, make sure to consult your doctor before making any changes to your diet or adding a new supplement.

American Botanical Council (2022). St. John’s wort. Herbal Medicine: Expanded Commission E Monographshttps://www.herbalgram.org/resources/expanded-commission-e/st-johns-wort/

Gardner, Z. & McGuffin, M. (2013). Botanical safety handbook (2nd ed.). American Herbal Products Association.

Hoffman, D. (2003). Medical herbalism: The science and practice of herbal medicine. Healing Arts Press: Rochester, VT.

Romm, A. (2018). Botanical medicine for women’s health (2nd edition). Elsevier: St. Louis, MO.

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About Tara Bassi, MS, CNS, LDN

Tara is a Licensed Nutritionist and Clinical Herbalist, specializing in women’s health. She has a Master’s of Science in Clinical Nutrition and Herbal Medicine from Maryland University of Integrative Health and is a Board Certified Nutrition Specialist (CNS®).

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