The herb St Johns Wort ( Hypericum perforatum ) is used in many clinical herbalists practice. It is used for depression. I use the homeopathic Hypericum for neuropathy in patients with diabetes or in a patient having post neuralgia symptoms from herpes or shingles. It also has a long history of traditional use to treat bacterial and viral infections, respiratory distress, skin wounds, peptic ulcers, and inflammation.
Of note there are many warnings in using St. Johns Wort when a patienmt is on some conventional medication. As an integrative physician/herbalist I know many herb-interactions but I rarely see them. An article appeared int he American Botanical Council HerbalGram which peaked my interest The active ingredients of St Johns Wort are hypericin, hyperforin, and flavonoids. I was interested in the study to determine which active ingredient interacts with pharmaceutical drugs. Hyperforin was identified as the major compound in SJW interacting with pharmaceuticals. The interaction had to do with the enzyme CYP3A4. I determine which medication a patient can take based on doing a genetic test called Kashi. This test is a cheek swab to determine a patient’s Apo E gene, MTHFR genes and 7 CYP genes. The CYP genes can be fast, normal, intermediate or rapid metabolizers.
The authors conclude that SJW extracts with low hyperforin content (≤ 1 mg of hyperforin daily) are safe and recommended It was stated more studies need to be conducted. I would like to see more studies. I would also like to see herbs that interact with coumadin ( warfarin )
Original article published in : Nicolussi S, Drewe J, Butterweck V, Meyer zu Schwabedissen HE. Clinical relevance of St. John's wort drug interactions revisited. Br J Pharmacol. March 2020;177(6):1212-1226. doi: 10.111/bph.14936