St. John's Wort Hypericum perforatum super function.

  seminal trace...St. John's Wort Extract.Hypericins 0.3%1%UV.Hyperforin 0.3%HPLC.Hypericin.M.F.C30H16O8.M.W.504.45.CAS.No.548-04-9.EINECS.No.208-941-0.Acute toxicity of hyperin.Hyperforin.0.3%HPLC.M.F.C35H52O4.M.W.536.80.CAS No.11079-53-1.Hypericum perforatum Extract...

 


 Basic Botanical Info of St. John's Wort.
 St. John's Wort:Origin and Phytochemicals.
 St. John's Wort and the Treatment of Depression:
 Why might the U.S. trial have contradicted the European research?
 Why is St. John's wort used as an alternative therapy for depression?
 Does St. John's wort work as a treatment for depression?
 Folklore:St. John's wort
 St. John's wort As a Ward
 St. John's wort Administrations:
 Research update of St. John's Wort Hypericum perforatum and hypericin.


   Basic Botanical Info of St. John's Wort.

 Scientific Name:Hypericum perforatum (L)
 Order: Hypericaceae
 German=Tupfelharthen, French=mille pertuis, Spanish=Hierba de San Juan, Italian=Perforata
 Botanical Source:Hypericum perforatum (L)
 Botanical Synonyms and Common names:Common St. John's Wort, perforate St. John's wort, amber, goatweed, Johnswort, Klamath weed, Tipton weed, Hyperici herba
 Name Archeology and Origin:6th Century Christians named St. John's Wort ("wort" means plant) after St. John the Baptist,as they believed the flowers bled at his beheading. In fact, small glands in the flower petals exude a red oil which contains the marker chemical of interest, hypericin.


   Botanical Description:

 Hypericum perforatum is a native British upright perennial, reaching a height of up to 90 cm. It grows throughout Britain and Europe and well into Asia and prefers open, sunny situations and dry calcareous soils. The smooth stem branches in its upper part, bearing opposite, sessile, oblong leaves which exhibit numerous translucent oil glands, as well as a few dark ones on the underside. The bright yellow five-petaled flowers, which are borne in a terminal corymb, have over fifty stamens, fused in the lower part into three bundles. The long lanceolate petals and shorter sepals are marked with dark dots. The fruit is a capsule which opens by three valves.
 A herbaceous perennial growing freely wild to a height of 1 to 3 feet in uncultivated ground, woods, hedges, roadsides, and meadows; short, decumbent, barren shoots and erect stems branching in upper part, glabrous; leaves pale green, sessile, oblong, with pellucid dots or oil glands which may be seen on holding leaf to light. Flowers bright cheery yellow in terminal corymb. Calyx and corolla marked with black dots and lines; sepals and petals five in number; ovary pear-shaped with three long styles. Stamens in three bundles joined by their bases only. Blooms June to August, followed by numerous small round blackish seeds which have a resinous smell and are contained in a three-celled capsule; odour peculiar, terebenthic; taste bitter, astringent and balsamic.
 There are many ancient superstitions regarding this herb. Its name Hyperieum is derived from the Greek and means 'over an apparition,' a reference to the belief that the herb was so obnoxious to evil spirits that a whiff of it would cause them to fly.


   St. John's Wort:Origin and Phytochemicals.

   Phenolic compounds from Hypericum perforatum:

 Constituents: naphthodianthrones (including the red pigment hypericin, pseudohypericin and their biosynthetic precursors), flavones and flavonols (quercetin glycosides including quercitrin, rutin, quercetin, kaempferol, luteolin), carotenes, essential oil, resin, tannins, pectin
 Dr.Jurgenliemk G, Nahrstedt A. find some result from researches:During a re-investigation of phenolic compounds from the dried crude drug material of St. John's wort (Hypericum perforatum L.) 22 phenolic compounds were detected by HPLC; 14 of them were quantified using the same system. Twelve phenolic compounds were isolated from the plant material and their structures identified mainly by spectroscopic methods, among them quercetin-3-O-(2"-O-acetyl)-beta-D-galactoside as a new natural product. Cryptochlorogenic acid, protocatechuic acid, 3-O-[Z]-p-coumaroylquinic acid, isoorientin, cyanidin-3-O-alpha-L-rhamnoside, and astilbin were obtained for the first time from this source; the earlier suspected neochlorogenic acid, 3-O-[E]-p-coumaroylquinic acid, mangiferin, miquelianin and guaijaverin were confirmed.


   Medicinal Action and Uses: Aromatic, astringent, resolvent, expectorant and nervine. Used in all pulmonary complaints, bladder troubles, in suppression of urine, dysentery, worms, diarrhoea, hysteria and nervous depression, haemoptysis and other haemorrhages and jaundice. For children troubled with incontinence of urine at night an infusion or tea given before retiring will be found effectual; it is also useful in pulmonary consumption, chronic catarrh of the lungs, bowels or urinary passages. Externally for fomentations to dispel hard tumours, caked breasts, ecchymosis, etc.

   Collection: During the flowering period, from June to August. To make the macerated oil, pour half a litre of sunflower or almond oil onto 120g of flowers in a glass jar, then place in direct sunlight for about six weeks or longer until the liquid has turned bright red. Strain through muslin and decant off from any watery layer.

   Actions:  Anxiolytic, sedative, astringent, anti-inflammatory, topically analgesic and antiseptic.

   Indications: Excitability, neuralgia, fibrositis, sciatica. Topically for wounds. Specifically indicated in menopausal neurosis.

   Therapeutics and Pharmacology:  Hypericum has a thymoleptic action which results in an improved sense of well-being. It has long been used as a nerve healer in melancholic conditions, depression, exhaustion and convalescence. It is also used to treat conditions where there is a degree of overtension, such as insomnia, cramps and colic of the viscera and uterus, epilepsy, diarrhoea, and enuresis in children. Of the many conditions where nervous tension and depression occur together, one of the most common is the problems that can arise during menopause, and Hypericum helps to counter these symptoms. ESCOP recommends its use in mild to moderate depressive states (ICD-10, F32.0, F32.1). The flavonoid aglycones and quercitrin have an anxiolytic effect by inhibiting Type A monoamineoxidase (hypericin has a rather low activity). Both the restorative and relaxing actions of the herb are relatively long-term ones, so treatment should be continued for some time. Clinical trials have reported improved sleep quality, an increase in deep sleep phases, and an improvement in cognitive functions as well as significant improvement in mood and levels of interest and activity. In a preliminary study of a Hypericum preparation combined with light therapy in patients with seasonal affective disorders, the antidepressant effect of Hypericum was shown to be enhanced by light therapy.
 

 Hypericum has a reputation as an analgesic, and is used either internally or externally to treat neuralgic pain. The macerated oil can be applied externally for neuralgia and will ease the pain of sciatica. It also soothes burns by lowering the temperature of the skin. Hypericum can also be used to treat local and peptic ulcers and inflammation of the lining of the upper digestive tract. Its astringent action is due primarily to the high levels of tannins in the flowers, and the volatile oil has an anti-inflammatory action. Hypericum has been shown to stimulate the formation of granulation tissue, and an antibacterial action, attributed to hyperforin, has been observed experimentally, particularly against Staphylococcus aureus. Some anti-viral activity has been reported for hypericin against the HIV and hepatitis C viruses.

 Caution: There is no evidence of toxicity at therapeutic doses. However, cattle and sheep can develop photosensitivity if they consume the plant in large quantities, and several HIV+ve patients on large doses of Hypericum have reported rash, pruritis and erythema after exposure to UV light. This is thought to be due to the presence of hypericin. Therefore, excessive exposure to bright sunlight should be avoided whilst taking the herb. If a significant response in depressive disorders is not apparent after 6 weeks, the use of Hypericum should be discontinued; however, the antidepressive effect should not be expected until at least two weeks of treatment.

 Though the net effect of taking St. John's wort and 5-HTP may be the same, if taken together SJW and 5-HTP are even more effective. St. John's wort is a SSRI, a Serotonin reuptake inhibitor, (Actually SJW inhibits the reuptake of all three feel-good neurotransmitters: serotonin, nor-epinephrine, and dopamine) but 5-HTP is a precursor to serotonin. What this means is that your body breaks 5-HTP down (in the neurons) into serotonin, the very chemical that St. John's wort manipulates to help you feel happier, calmer . . . The metaphor being; if you were an automobile you would be filling up your gas tank with 5-HTP, at which time the St. John's wort takes over, acting like a carburetor; instructing the serotonin where to (or in this case where not to) go. So, in essence, taking SJW and 5-HTP creates a synergy (1+1=3). Most studies were conducted using a dose of 50-100 mg. three times per day. Obesity patients 20 minutes before meals. The onset of action is fairly rapid, (3 to 5 days).


   St. John's Wort and the Treatment of Depression:

  Introduction: The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet on the use of St. John's wort for depression. It is one of a series of fact sheets intended to help consumers make informed decisions about whether to use complementary and alternative medical (CAM) therapies for a disease or medical condition. NCCAM defines CAM practices as those health care and medical practices that are not currently part of conventional medicine. There are many CAM practices. A few examples include traditional Chinese medicine, meditation, chiropractic, therapeutic touch, and herbs.

  Key Facts: St. John's wort is an herb that has been used for centuries for medicinal purposes, including to treat depression. The composition of St. John's wort and how it might work are not well understood. There is some scientific evidence that St. John's wort is useful for treating mild to moderate depression. However, recent studies suggest that St. John's wort is of no benefit in treating major depression of moderate severity. More research is required to help us know whether St. John's wort has value in treating other forms of depression. St. John's wort interacts with certain drugs, and these interactions can be dangerous. Herbal products vary greatly as to their chemical composition and quality.

  Mode of Action:

 St. John's Wort has a wide reputation as an antidepressant.The alkaloid is said to have a tonic effect on the ventricles of the heart, the aorta and arterioles. It is also useful for pulmonary complaints, bladder trouble, suppression of urine, dysentery, worms and nervous depression.
 The tranquilizing quality was once attributed to hypericin, but now it is believed to be another constituent or a combination of several. Even small amounts have been found effective, by increasing blood flow to stressed tissue. This blood flow has also been shown to be hypotensive, reduce capillary fragility and to enhance uterine tone. St. John`s wort may cause photosensitivity in a very small group of sensitive individuals.
 St John's Wort has antibacterial and antiviral activity against a range of organisms including tuberculosis, Gram positive organisms, Micrococcus, Bacillus, and influenza A/PR8. Tests at the U.S. National Cancer Institute have shown an extract of St. John`s Wort has promise against cancer.

  More than a dozen studies, all conducted in Europe, have found that St. John's wort relieves some of the symptoms of mild to moderate depression in about half the people who take it for at least three or four weeks.That's the same success rate as prescription anti-depressants like Prozac, Zoloft, Elavil, and Tofranil. Placebos, on the other hand, appear to help about a quarter of those with depression.

 What really sets St. John's wort apart is that the side effects commonly experienced with prescription antidepressants, such as a dry mouth or diminished sex drive, are milder and less frequent with the herb.

 After reviewing all the evidence, the American College of Physicians-American Society of Internal Medicine told its 115,000 members last May that St. John's wort "may be effective in treating mild depression in the short term." But that conclusion was reached before the first large U.S. study found that people taking St. John's wort fared no better than those taking a placebo.


  The studies of St. John's wort done in Europe, while impressive, left many questions unanswered, says Jacques Bradwejn, Chief of Psychiatry at the Royal Ottawa Hospital in Canada. Among them:

  Who benefits?  St. John's wort has been studied almost entirely in people with mild to moderate depression. That's a persistent state of sadness, decreased energy, irritability, or other symptoms that interfere with work, sleep, eating, and activities that were once considered pleasurable. (Since depression can lead to suicide, it should be treated by a qualified health professional and not left to self-medication.)

 Still unsettled is St. John's wort's effect on moderate to severe depression or on anxiety symptoms. What's more, "there is no evidence that it can elevate mood in people who are not depressed," says psychiatrist Richard Shelton of Vanderbilt University, who conducted the latest U.S. study.

  For how long does it work?  The European studies lasted an average of only about 5 weeks. Just one exceeded two months. No one knows how long the benefits of St. John's wort last.
  How much of which extracts work?  The European studies used 300 to 1,800 mg a day of any of 11 different formulations prepared from the St. John's wort flower, so there's no way to tell which brands work consistently in which amounts.
  How does it compare with prescription antidepressants?  St. John's wort has only been tested against low doses of the older tricyclic antidepressants like Elavil and Tofranil. Researchers don't know how well St. John's wort would do in a head-to-head competition with higher doses or with the newer generation of antidepressants like Prozac or Zoloft.
 

 Given the promising results from the European research, the National Institutes of Health (NIH) has made St. John's wort the subject of the first federally funded, large-scale trial of an herbal supplement in the U.S.
 At 12 medical centers across the country, researchers are giving 336 patients with at least moderate depression one of three identical-looking preparations: 900 mg a day of the LI-160 extract of St. John's wort (available as the Kira brand), the prescription antidepressant Zoloft, or a placebo (sugar pill). Those who respond to St. John's wort during the two-month trial will take it for four more months. Results are not expected until next year.
 Meanwhile, the first large-scale study of St. John's wort in the U.S. has turned up disappointing results. At Vanderbilt University and ten other medical centers, Richard Shelton and his colleagues gave 200 patients with moderate depression either 900 mg of the LI-160 extract of St. John's wort or a placebo every day for eight weeks. Those who didn't respond to the herb after four weeks were given up to 1,200 mg a day.
 After eight weeks, St. John's wort was no better than a sugar pill."Our data suggest that St. John¡¯s wort is no more effective than a placebo in patients with at least moderate depression," says Shelton. The study, funded by Pfizer (which makes Zoloft), has not been published yet.


   Why might the U.S. trial have contradicted the European research?

 "Some of the earlier studies in Europe were conducted in primary-care practice settings with physicians who may not have had any experience with research in depression," says Shelton."We selected highly respected researchers here in the U.S. who were more experienced with doing a study on depression."

  What is St. John's wort?

 St. John's wort (Hypericum perforatum in Latin) is a long-living plant with yellow flowers. It contains many chemical compounds. Some are believed to be the active ingredients that produce the herb's effects, including the compounds hypericin and hyperforin.

 How these compounds actually work in the body is not yet known, but several theories have been suggested. Preliminary studies suggest that St. John's wort might work by preventing nerve cells in the brain from reabsorbing the chemical messenger serotonin, or by reducing levels of a protein involved in the body's immune system functioning.

 For what medicinal purposes has St. John's wort been used?
 St. John's wort has been used for centuries to treat mental disorders as well as nerve pain. In ancient times, doctors and herbalists (specialists in herbs) wrote about its use as a sedative and treatment for malaria as well as a balm for wounds, burns, and insect bites. Today, St. John's wort is used by some people to treat mild to moderate depression, anxiety, or sleep disorders.

  What is depression?

 Information on depression is available from the National Institute of Mental Health. Here is a brief overview.
 Depression is a medical condition that affects nearly 19 million Americans each year. A person's mood, thoughts, physical health, and behavior all may be affected. Symptoms commonly include:

 Ongoing sad mood
 Loss of interest or pleasure in activities that the person once enjoyed
 Significant change in appetite or weight
 Oversleeping or difficulty sleeping
 Agitation or unusual slowness
 Loss of energy
 Feelings of worthlessness or guilt
 Difficulty "thinking," such as concentrating or making decisions
 Recurrent thoughts of death or suicide.
 Depressive illness comes in different forms. The three major forms are described below. Each can vary from person to person in terms of symptoms experienced and the severity of depression.

 In major depression, people experience a sad mood or loss of interest or pleasure in activities for at least 2 weeks. In addition, they have at least four other symptoms of depression. Major depression can be mild, moderate, or severe. If it is not treated, it can last for 6 months or more.

 In dysthymia, a milder, but more chronic form of depression, people experience a depressed mood for at least 2 years (1 year for children) accompanied by at least two other symptoms of depression.

 In bipolar disorder, also called manic depression, a person has periods of depressive symptoms that alternate with periods of mania. Symptoms of mania include an abnormally high level of excitement and energy, racing thoughts, and behavior that is impulsive and inappropriate.

 Some people still hold outdated beliefs about depression--for example, that the emotional symptoms caused by depression are "not real." However, depression is a real medical condition. It can be treated effectively with conventional medicine, including by antidepressant drugs and certain types of psychotherapy (talk therapy).
 


   Why is St. John's wort used as an alternative therapy for depression?

 Some patients who take antidepressant drugs do not experience relief from their depression. Other patients have reported unpleasant side effects from their prescription medication, such as a dry mouth, nausea, headache, or effects on sexual function or sleep.
 Sometimes people turn to herbal preparations like St. John's wort because they believe "natural" products are better for them than prescription medications, or that natural products are always safe. Neither of these statements is true (this is discussed further below).
 Finally, cost can be a reason. St. John's wort costs less than many antidepressant medications, and it is sold without a prescription (over the counter).

 How widely is St. John's wort used for treating depression?
 In Europe, St. John's wort is widely prescribed for depression. In the United States, St. John's wort is not a prescription medication, but there is considerable public interest in it. St. John's wort remains among the top-selling herbal products in the United States.

 How is St. John's wort sold?
 St. John's wort products are sold in the following forms:

 Capsules

 Teas:the dried herb is added to boiling water and steeped for a period of time.

 Extracts:specific types of chemicals are removed from the herb, leaving the desired chemicals in a concentrated form.


   Does St. John's wort work as a treatment for depression?

 There has been scientific research to try to answer this question.
 In Europe, results from a number of scientific studies have supported the effectiveness of certain St. John's wort extracts for depression. An overview of 23 clinical studies, published in the British Medical Journal in 1996, found that the herb might be useful in cases of mild to moderate depression. The studies, which included 1,757 outpatients, reported that St. John's wort was more effective than a placebo (a "dummy" pill designed to have no effect) and appeared to produce fewer side effects than some standard antidepressants.
 Other studies conducted recently have found no benefit from the use of St. John's wort for certain types of depression. For example, the results of a study funded by Pfizer Inc., a pharmaceutical company, found that St. John's wort, when compared with placebo, was not effective for treating major depression (Shelton, et al. JAMA, 2001).

 Are there any risks to taking St. John's wort for depression?
 Yes, there are risks in taking St. John's wort for depression.
 Many so-called "natural" substances can have harmful effects--especially if they are taken in too large a quantity or if they interact with something else the person is taking.
 

 Research from the NIH has shown that St. John's wort interacts with some drugs~including certain drugs used to control HIV infection (such as indinavir). Other research shows that St. John's wort can interact with anticancer, or chemotherapeutic, drugs (such as irinotecan). The herb may also interact with drugs that help prevent the body from rejecting transplanted organs (such as cyclosporine). Using St. John's wort limits these drugs' effectiveness.
 Also, St. John's wort is not a proven therapy for depression. If depression is not adequately treated, it can become severe and, in some cases, may be associated with suicide. Consult a health care practitioner if you or someone you care about may be experiencing depression.

 People can experience side effects from taking St. John's wort. The most common side effects include dry mouth, dizziness, gastrointestinal symptoms, increased sensitivity to sunlight, and fatigue.

 What are some other possible problems with using St. John's wort?
 Herbal products such as St. John's wort are classified as dietary supplements by the U.S. Food and Drug Administration (FDA), a regulatory agency of the Federal Government. The FDA's requirements for testing and obtaining approval to sell dietary supplements are less strict than its requirements for drugs. Unlike drugs, herbal products can be sold without requiring studies on dosage, safety, or effectiveness.
 The strength and quality of herbal products are often unpredictable. Products can differ in content not only from brand to brand, but from batch to batch. Information on labels may be misleading or inaccurate.


   Folklore:St. John's wort

 This herb was named "hypericum" from the Greek meaning 'over an apparition' referring to the herb's ability to be so obnoxious that a mere whiff would cause evil spirits to flee. St. John's Wort is used in all pulmonary complaints, bladder trouble, dysentery, worms, diarrhea, depression, jaundice and cancer. It can be found in the herbals of Gerard (1597), Hill (1751), Withering (1796) and the Eclectics.
 A number of Hypericum species were used by Amerindian tribes. Records of the use of H. perforatum are known for the Cherokee, Iroquois and the Montagnais. All these tribes seemed to have used the plant as a febrifuge/cough medicine however, the Cherokee made very broad use of the plant.

   St. John's wort As a Ward:

 The red sap of this plant resembles blood. "If anyone trod on the plant after sunset a fairy-house would appear and carry them about. Used on Midsummer, when picked under certain conditions and while uttering certain words, for divination" (Miller - St. John's Wort).
 As a Ward:Also known by the Italian name of "devil-chaser," St. John's Wort was considered potent against faeries (Britannica Online - Fairy), and was thought to be able to strip a witch of her will.
 St. John's wort "was in great request, and hence it was extensively worn as an amulet, especially in Germany of St. John's Eve, a time when not only witches by common report peopled the air, but evil spirits wandered about on no friendly errand" (Thiselton-Dyer 62).
 Sir Walter Scott gave a rhyme spoken by a demon lover who could not approach a girl because she was carrying St. John's Wort and vervain:

   If you would be true love mine,
   Throw away John's Wort and Verbein (K. Briggs 346).
 


   St. John's wort Administrations:

  Toxicity and Contraindications:
 It is considered safe for human consumption but hypericin has been shown to produce photosensitization in cattle and a very small number of sensitive humans.

 Acute toxicity(LD50):Hypericin

 St. John's wort paste: LD-Lethal dose,Oral.Rodent-mouse.>23600 mg/kg.
 St. John's wort paste: LD50-Lethal dose,50% percent death.Oral.Chicken.[32.42+-0.0312]g/kg.
 Details of toxic effects not reported other than lethal dose value.
 Reference:Acute toxicity tests of extractum hypericin.Chinese Journal of Veterinary Drug.2005 Vol.39 No.8 P.19-20.by CUI Ying.LIANG Jian-ping.LUO Yong-jiang.WANG Xuan-hui.ZHU Yan-hua.SHANG Ruo-feng.WANG Xue-hong.HUA Lan-ying

 Acute toxicity(LD50):Hyperforin

 Hyperforin LD50:Lethal dose,50% percent death.Oral.Rat.5628mg/kg.
 Hyperforin LD50:Lethal dose,50% percent death.Skin.Rabbit.15800mg/kg.
 Details of toxic effects not reported other than lethal dose value.

  Official Recognition and Medical References:

 USA - Dietary supplement
 Escop - requires 0.04 % napthodianthrones
 France - Approved for topical applications
 Germany - Commission E
 UK - Legal Category (Licensed Products) for external use, in BHP

  Dosage:
 Infusion - 1 - 2 tablespoons
 Fluid extract (1:1) - 20 - 30 drops - three times daily


  Scientific References:

  1.St. John's Wort Hypericum perforatum super function.