St. John's Wort

St. John’s Wort is an effective alternative to many antidepressants based on the literature that I have reviewed.

But, you'll find in North America at least, the powers that be are trying to shape the view of this herb to be less efficacious than it really is. It's in the best interest of drug companies after all to promote their products and discredit other viable alternatives.

More than 30 million Americans are currently on antidepressants and doctors in the U.S. wrote more than 250 million prescriptions for painkillers last year.  Sadly, most people got hooked on these drugs very innocently.  They trusted that their doctors would never prescribe something for them that would be harmful, and they trusted that the federal government would never approve any drugs that were not safe.  And once the drug companies get you hooked, they often have you for life.  You see, the reality of the matter is that some of these “legal drugs” are actually some of the most addictive substances on the entire planet.  And when they start raising the prices on those drugs, there isn’t much that the addicts can do about it.  It is a brutally efficient business model, and the pharmaceutical industry guards their territory fiercely.  Very powerful people will often do some really crazy things when there are hundreds of billions of dollars at stake. We are talking about piles of money larger than most people would ever dare to imagine. And with so much money floating around, it is quite easy for the pharmaceutical industry to buy the cooperation of politicians and of the media.

St. John’s Wort is a very powerful herb it comprises of 25% of all antidepressant prescriptions by doctors in Germany. Not surprising when it has shown in clinical trials to be as equally effective as the antidepressant drug “Prozac”, without the undesirable side effects (muscular weakness, insomnia, sexual dysfunction and drowsiness). It is prescribed just over 50% of the time as opposed to Prozac which sits around 2%.

Some history: St John’s Wort has the botanical name Hypericum perforatum. Today it has become known as the king of herbal antidepressants. St John’s wort has been used medicinally since ancient Greek times when, it is believed, the father of medicine Hippocrates used it to rid the body of evil spirits.

Since the time of Swiss physician Paracelsus (1493 – 1541), it has been used to treat neuralgia, anxiety, neurosis and depression. Externally, it has also been used to treat wounds, bruises and shingles. The name ‘St John’s Wort’ is related to its yellow flowers, traditionally gathered for the feast of St John the Baptist and the term ‘wort’ is the old English word for plant.

Why bodybuilders, powerlifters, fitness-enthusiasts and other iron warriors would need St John’s wort?

First of all they are only human and as so many others can easily get anxious and/or depressed, especially post cycle. Not mentioning the appetite suppressant

And it also influences Growth Hormone, androgens, prolactine etc, more on that later in this blogpost.

A careful recent analysis of 23 different studies of St. John's wort concluded that the herb can be used to treat a myriad of medical conditions. It is indicated and effective for treating the following: Sleep disturbances, mild to moderate depression, Seasonal affective disorder, low self-esteem or lack of confidence, pessimism, hopelessness or despair, lack of interest in ordinary pleasures and activities, withdrawal from social activities, fatigue or lethargy, guilt or ruminating about the past, irritability or excessive anger, lessened productivity, difficulty concentrating or making decisions and menopausal symptoms. More recently it has been shown in clinical trials to be effective for treating alcoholism and nicotine addiction.

Franklin et all 2001: ”Results in normal volunteer studies show that St John's wort caused significant increases of salivary cortisol and plasma growth hormone (GH) whereas it decreased plasma prolactin versus placebo. Plasma hormone levels were associated with a rise in plasma hyperforin but not with hypericin, however no significant correlation was found.” “Plasma prolactin was significantly reduced by acute treatment with hyperforin treatment but not by hypericin.”

St. John's Wort contains two main active ingredients: hyperforin and hypericin. Hypericin inhibits the action of the enzyme dopamine ß-hydroxylase, as a result, this may lead to increased dopamine levels. Plasma hormone levels were associated with a rise in plasma hyperforin. Hyperforin also has a strong reuptake inhibitor effects on all four of the mood neurochemicals (serotonin, norepinephrine, dopamine and GABA). Most probably the quality is important meaning the ratio of the standardized product, plus St. John's Wort also contains dozens of other biological active ingredients.

Comparing Germanic and non-Germanic studies.

Out of the 11 Germanic trials, 8 found that St John’s Wort was significantly better than placebo and the other 3 were all very close. None of the 8 non-Germanic trials found it to be effective and only one was close.

The German studies use St John’s Wort that is standardized for hyperforin content as opposed to hypericin. Only St John’s Wort standardized for hyperforin is effective. The German brands Perika and Kira and the U.S. brand New Chapter are, as far as I know, the only SJW products on the market standardized for hyperforin. New Chapter has at least one product that is standardized for both, but I prefer the German products, the ones with a lot of hypericin tend to keep me up at night. The German studies probably used Perika or Kira. Hyperforin also degrades quickly. The German products are supposedly formulated to have a longer shelf life. I expect the difference in results is due to the specific formulation used.

In Europe several standardized pharmaceutical-grade preparations of SJW are commercially available, as opposed to the USA were St John’s Wort, like all herbal remedies, is listed as a dietary supplement by the Food and Drug Administration (FDA).

Or as I read on a discussion-board: “..could it be that the German studies are more immune to the pressures of the pharmaceutical industries??!!! In the US and England the Medical community are fearful to be black listed by the industry, at the danger of being refused jobs, contracts and grants....”

Growth Hormone

in the July edition of Pharmacopsychiatry 2001, two British neuro-psychiatrists examined the effects of different preparations in humans and rats. They concluded that the herb, increases the amount of serotonin in the brains, and produces more growth hormone and cortisol.

The animal studies showed that cortisol decreases as the animals used the herb for longer period of time. Also prolactin ran through the spice back.

In the same edition of the magazine German researchers also wrote about their experiments with St. John's Wort on people. They worked with a standardized preparation, WS 5570. Of these, 300 milligrams was already sufficient to increase the production of growth hormone "small but noticeable". Cortisol production thereby did not change. A dose of 600 milligrams made the GH-increase in the serum al 'clear'. In addition, however, increased in this case, also the release of cortisol. The effects were more than 30 to 90 minutes after ingestion.

Graphic: Schüle et al concluded in 12 healthy males: “In most cases, the GH stimulation was observed more than 150 min after administration of WS 5570. However, GH-stimulatory effects occurred inconsistently after WS 5570 was given.”

A blog concluded at the outcome of the study from Franklin and Cowen: “After a work-out with weights the production of growth hormone increases. That peak is greater than the one during sleep. Bodybuilders and strength athletes would perhaps benefit the most of their supplementation with as they work-out just before swallowing their St. John's wort, so that St John-peak and the exercise-peak in their blood coincide.” Well 30 – 90 minutes differs from 150 minutes, as Schüle remarked ..inconsistently.. as always I guess it depends on many factors, maybe even what you have been eating before taking SJW.

Regarding the increase in cortisol production: it is questionable how bad it is. British researchers who, in 1999, gave healthy people a hefty dose of St. John's Wort (9 tabs) reported a marked reduction in the production of prolactin, no effect on cortisol and a significant increase in growth hormone. In the long term, the production of cortisol by St. John's wort decreases.

Effects of St John's wort (Hypericum perforatum L.) extract on plasma androgen concentrations in healthy men and women: a pilot study

St John's wort extract (SJW; Hypericum perforatum L.) is taken extensively as a putative herbal antidepressant. It has been shown to induce the activity of cytochrome P-450 3A4 (CYP3A4) and to increase the clearance of numerous drugs and steroids such as cortisol and ethinyl estradiol. This study was conducted to determine if SJW exposure also alters the concentrations of circulating androgenic steroid hormones. The study was conducted using healthy volunteers (6 Males, 6 Females) studied before and after a 14-day treatment period with a SJW preparation previously demonstrated to induce the activity of CYP3A4. Plasma concentrations of testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG) and the combined concentrations of androsterone sulfate (AoS) and epiandrosterone sulfate (epiAoS) were measured by immunoassay methods. The results of analysis demonstrated that SJW did not significantly alter the majority of the androgens studied although the combined concentrations of the 5alpha-reduced steroids, AoS and epiAoS, significantly declined following treatment in all subjects, and in males. Furthermore, the testosterone to DHT ratio was increased in both men and women. Although the latter increase did not reach statistical significance, it is also consistent with the possible inhibition of 5alpha-reductase by SJW. It is concluded that despite significant induction of CYP3A4, short term administration of SJW does not significantly alter the concentrations of most circulating androgens in men and women but may produce a dimunition in some of the circulating 5alpha-reduced androgens.

St John's Wort makes fat cells resistant to insulin

It's perhaps not a good idea for people with diabetes type-2 to use Saint John's Wort, but for healthy athletes looking to reduce fat Saint John's Wort may be an interesting supplement. We reached this conclusion after reading about a test tube study that biochemists at Louisiana State University did, the results of which will soon be published in Biochemical and Biophysical Research Communications.

Because Saint John's Wort is a popular supplement and because increasing numbers of people are fighting obesity, the researchers thought it would be a good idea to study the effect of the plant on fat cells. They exposed fat cells of mice to extracts of the roots, leaves and flowers of the plant and measured how much glucose the fat cells were then capable of absorbing. The tests resulted in the figure shown below.

The graph shows the effect of extracts of the flowers of Saint John's Wort. These are also found in supplements. Root extracts of the plant had little effect. Extracts from the leaves, which are also found in supplements, were as effective as the flower extracts. The researchers exposed cells to a 25-microgram/millilitre concentration of the extract. The cells, which were also exposed to insulin, absorbed less glucose as a result.

When the researchers determined the protein production of the fat cells, they got the figure shown below. The extract had deactivated PPAR-gamma, the molecular sensor with which fat cells observe fatty acids. CTL & V = control groups.

"A current hypothesis is that Type 2 diabetes can be viewed as a failure to appropriately expand fat mass in the context of a positive energy balance", the researchers write. "In light of this notion, the ability of Saint John's Wort to inhibit adipogenesis may not be metabolically favorable." Maybe not for people with diabetes-2. But for fighting fit athletes, it may be a different matter.

I used some text from my Dutch colleague Willem Koert.