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St. John’s wort – herbal medicine between tradition and modernity

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St. John's wort

The real St. John’s wort, (Hypericum perforatum), has been one of the most popular medicinal plants in Europe since the end of the 20th century. In 2015, the characteristic yellow flowering forest and meadow herb was named medicinal plant of the year in Germany.

The Swiss natural philosopher and doctor Paracelsus formulated the beneficial effects of the “perforata” as early as the 15th century. The effects are diverse and range from wound care to the treatment of inflammation and infections. With more than 5,000 scientific publications in 2020, researchers around the world are still paying widespread attention to this traditional remedy.

St. John's wort for mild to moderate depression

The mood-enhancing effect of St. John’s wort is particularly interesting. Special ingredients from real St. John’s wort are able to influence the neurotransmitter balance in specific brain regions. Neurotransmitters transmit information between nerve cells in the brain. According to current knowledge, the imbalance of neurotransmitters is the cause of depressive illnesses.

Above all, the inadequate effect of the neurotransmitters serotonin, noradrenaline and dopamine in the corresponding brain areas should play a major role in the development of symptoms. The neurotransmitter activity can be increased by treatment with St. John’s wort preparations and thus counteract a depressive mood.

St. John's wort as an alternative for the elderly

Treatment with St. John’s wort is particularly promising in older patients. Treating depression with common synthetic antidepressants is problematic in this age group. Older patients often have to struggle with the severe side effects of classic antidepressants. This often means that the dose of the medication is too low or that therapy has to be interrupted. St. John’s wort offers an alternative therapeutic option.

Side effects can also occur when taking St. John’s wort preparations. Compared to the chemical alternative, however, these are significantly milder.

The potential of St. John’s wort has also been researched in other areas. On this blog, we have already reported on the use of St. John’s wort extracts for Alzheimer’s.

St. John's wort for Alzheimer's

Plaques, (protein deposits), play a particularly important role in the course of Alzheimer’s dementia. So-called amyloid-β peptides are deposited on functional neurons if the concentration is too high. In the long run, this phenomenon leads to impairment of neural functions. A decrease in memory, restricted mobility and emotional disturbances are just a few of a wide range of symptoms.

A pathological deposit occurs above all when the peptide, which is toxic in high concentrations, is insufficiently removed from the brain. This happens, among other things, when the transport molecules in the brain no longer work properly. The improvement of these transport mechanisms is therefore aimed directly at the cause of the disease.

It could be shown that ingredients from St. John’s wort activate precisely this mechanism and are therefore a possible causal therapy for specific forms of Alzheimer’s disease. In combination with Greek mountain tea (lat. Sideritis scardica) this effect is particularly evident. Extracts from Greek mountain tea dissolve plaque deposits in the brain, by taking St. John’s wort extracts (80 percent ethanolic extract) these dissolved deposits are removed.

In addition, a depressive mood is a common symptom of Alzheimer’s disease. The use of St. John’s wort preparations therefore has a double benefit in Alzheimer’s patients.

Side effects and interactions of St. John's wort

Like all herbs, St. John’s wort has the potential for side effects and interactions. Above all, a possible sensitivity to light caused by long, regular intake of the herb is known. The reason for this is the active ingredient hypericin contained in St. John’s wort. This effect occurs primarily on light skin types. However, an increased risk can simply be avoided by taking the extract in the evening. The body breaks down most of the active ingredient overnight.

If this measure is observed, any side effects caused by light sensitization can easily be avoided. In addition, St. John’s wort preparations always showed significantly fewer side effects than synthetic antidepressants in various studies.

Again and again, the relevant portals warn against the interactions of St. John’s wort with other drugs. That is only partly true. The ingredient hyperforin can stimulate liver activity and thus increase the metabolism. If large amounts of hyperforin are taken spontaneously, the effectiveness of other drugs can be influenced.

However, this effect can be circumvented. Because the body adapts to the changed conditions over time. In this way, the body can usually be “dosed”. This means, for example, 250 mg per day are taken in the first week. In the second week, 500 mg per day are taken, etc. So the body can slowly get used to the intake. The liver activity is kept at the usual level.

If you are taking vital medication, especially blood thinners, always discuss the use of additional medication with your doctor in advance.


In any case, St. John’s wort is a powerful natural resource for depression and Alzheimer’s. Due to the current research effort, further interesting medical properties can be confirmed and therapies supplemented or completely new applications discovered in the future.

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