St John’s Wort Guide

supplementing with st johns wortSt John’s wort (Hypericum) has been used since ancient Greek times as a remedy for all maladies, from bruises to anxiety – it was even thought to rid the body of evil spirits…

These days, St John’s wort has gained popularity for its anti-depressant actions and wound-healing powers.

This yellow-flowering plant is rich in active constituents including hyperforin and hypericin, which have been shown to affect the nervous system, hormone levels, and neurotransmitter function.

It is also packed full of antioxidants, tannins, and even phytoestrogens that can work throughout the body to improve immune function, regulate inflammation, improve skin integrity, and balance internal temperature control.

St John’s Wort for Depression & Anxiety

Note: Seek professional advice before taking any herbal medicines for symptoms of depression.

St John’s wort has been investigated extensively as an anti-depressant and has been shown to work through multiple channels in a similar fashion to many pharmaceutical antidepressant drugs.

Extracts of St John’s wort can affect the levels of neurotransmitters – the chemical messengers of the brain – including serotonin. It can block the “re-uptake” of serotonin in a similar way to SSRI (selective serotonin re-uptake inhibitor) medications.

St John’s wort has also been seen to block the re-uptake of other feel-good neurotransmitters such as dopamine, noradrenaline and GABA – all of which are involved in conditions of depression and anxiety.

This powerful herb also helps GABA (a soothing, calming neurotransmitter that is often low in anxiety) to bind to receptors, boosts the number of receptors for serotonin, and inhibits the breakdown of dopamine.

All of this translates to higher levels and greater activity of neurotransmitters that promote happiness, motivation, and calmness…

Or at least it might for some people, some of the time.

While many studies have found that St John’s wort can be as effective as conventional medication for depression, other results are somewhat mixed.

In 2008, a Cochrane review of 29 studies concluded that St John’s wort probably works better than a placebo and is just as effective as antidepressant medications to treat mild to moderate depression, and with fewer side effects [1].

But more recently, trials have found that St John’s wort may not be nearly this effective in all types of populations, and that it should be used cautiously [2].

That said, German physicians have been prescribing the herb for hundreds of years, and continue to do so – in fact, a leading brand of hypericum extract, Jarsin 300, is the most widely prescribed antidepressant in all of Germany.

It may be “worth a shot” but be sure to speak to a healthcare practitioner before you experiment with St John’s wort.

CAUTION: Combining St John’s Wort with certain antidepressant medications can lead to potentially life-threatening increases of serotonin. Depression may also be caused by other factors that St John’s wort may fail to address. Do NOT try to treat depression with St John’s wort on your own. Seek effective, professional help before taking St John’s wort.

St Johns Wort for Skin Health

St John’s wort has been historically been used topically on the skin in messy poultices and washes. There are now creams, gels and even powders on the market that contain St John’s wort to treat a huge range of skin conditions, from dermatitis to burns.

Not only does St John’s wort contain a high level of antioxidants to boost the skin’s natural healing processes, it also acts as a powerful antiviral and antibacterial agent and can help the immune system remove pathogens from the skin including Staphyloccocus aureus and Candida albicans. This antimicrobial activity is particularly effective when used topically – these anti-pathogen powers are activated when in the presence of light!

St John’s wort is also a gentle analgesic and can help to relieve pain from mild first degree burns, while preventing opportunistic infections.

It may also improve chronic, stubborn skin conditions. In 2003, a study found that a cream containing St John’s wort with a standardized 1.5% hyperforin content significantly improved the symptoms of atopic dermatitis – and the effects were seen within one week! [3]

St John’s Wort in Menopause

St John’s wort may assist in managing the symptoms of menopause including hot flushes, mood swings, and low libido that are often caused by low levels of estrogen.

St John’s wort is naturally packed full of phytoestrogens, which may act as an alternative to estrogen in the body.

It also contains tanins, flavanoids and plant acids that may help to modulate temperature control throughout the body.

A 12 week study found that participants who took 300mg of St John’s wort three times a day experienced an improvement in both psychological and physical symptoms, with particular improvement in sexual well-being and relief of hot flushes [4].

Another study found that hot flushes were improved after 8 weeks in patients who took a liquid St John’s wort extract every day. [5]

Cautions When Considering St John’s Wort

St John’s wort is a powerful herb and comes with a host of potential side effects, cautions, and contraindications. Because of its effects on neurotransmitters, St John’s wort can cause an imbalance, leading to a worsening of symptoms and even potentially fatal side effects.

Do NOT take St John’s wort without supervision if you:

  • Are taking antidepressant medication
  • Have a history of serotonin imbalance
  • Experience manic episodes
  • Have OCD, bipolar disorder, or ADHD

Always take St John’s wort with a meal and NEVER on an empty stomach.

Side effects from St John’s wort include: 

  • Mild stomach upsets
  • Diarrhoea
  • Allergic skin reactions
  • Restlessness
  • Anxiety
  • Sensitivity to the sun (skin, eyes, and hair)
  • Vivid dreams and nightmares
  • Issues with arousal and erections
  • Dizziness
  • Dry mouth
  • Fatigue and tiredness

With such a long list of potential side effects, it makes sense that St John’s wort is not for everyone. Speak to a qualified herbalist for personalized advice before taking St John’s wort.


5 Best St John’s Wort Supplements

#5 Amalth St John’s Wort Extract (300mg, 60 capsules)

St. John's Wort SupplementAmalth have created a simple St John’s wort supplement using a high potency extract with 0.3% hypericin, and packed into vegetarian-friendly capsules. This product is gluten free, dairy free, and wheat free. This is a good choice if you’re looking for an easy way to get a standard dose of St John’s wort extract each day.

#4 Tea Tonix Be Happy (40g)

Tea TonixTea Tonix have combined dried St Johns wort with other mood boosting herbal teas such as skullcap, chamomile and passionflower that work in synergy with one another. This combination works on the nervous system and is particularly good for people who suffer from stress, anxiety, and tension. The blend is created with fresh organic ingredients and each herb has been thoughtfully sourced. To brew, combine 1 tablespoon of the tea with boiling water, steep for 5 – 10 minutes and drink. Even though herbal teas naturally contain lower amounts of active constituents found in extracts, tablets and oils, the cautions remain the same. Seek advice from a healthcare practitioner before drinking St John’s wort tea regularly, particularly if you are taking any medications.

#3 Estercare St John’s Wort Oil (30mL)

Liquid St. John's WortIf you’re looking for a St John’s wort extract for topical use, this is a great choice. Estercare have combined a cold-pressed carrier oil and a blend of other essential oils with a pure St John’s wort extract for optimal skin care, nerve nourishment, and pain relief. Massage daily into sore joints, areas affected by nerve pain, and damaged or dry skin.

#2 Natures Aid U Calm (300mg, 60 tablets)

UcalmNatures Aid have created a high dose St John’s wort tablet. Each tablet contains 300mg of Hypericum extract (equivalent to 2100mg of dried St John’s wort herb) and are film coated to make them easy to swallow with no bitter taste. This is a good choice if you’re looking for a simple St John’s wort tablet with no other added nutrients or herbs.

#1 Innovative Natural Products Liquid 5HTP with St John’s Wort (4oz)

Innova 5HTP and St. John's WortInnovating Natural Products have combined a standardized St John’s wort extract (containing 0.3% Hypericin) with liquid 5-HTP, the precursor to serotonin. 5-HTP can boost the level of serotonin while St John’s wort can act directly on the receptors – the combination could result in a higher level of serotonin and greater mood. If the anecdotal evidence is anything to go on, it seems to work – reviews for this product are outstanding, with some people saying it has completely changed their life!

However, we advise being particularly cautious and seeking professional guidance before using this product. The combination of St John’s wort and 5-HTP creates a risk of serotonin excess and should not be taken if you are on antidepressant medication.


About James Lyons

James Lyons (BHSc Nutritional Medicine) is a clinical nutritionist, medical writer, and educator. He specialises in plant-based nutrition and is passionate about improving public access to reliable and accurate health information.

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