The authors suggest that this may provide a rationale for the traditional treatment of inflammatory skin disorders with hypericum extracts. All reactions resolved after discontinuation of therapy. An in vitro study utilizing fetal calf serum indicates that pseudohypericin is more photoactive than hypericin. Schedule your appointment now for safe in-person care. Kasper S, Schulz V. [High dose St. John’s wort extract as a phytogenic antidepressant]. However, it can cause: There isn't enough information about the safety of using St. John's wort topically. Therefore, the authors speculate that pseudohypericin, which is present in higher concentrations than hypericin in hypericum, may be of greater concern regarding phototoxicity.5 However, at steady state, plasma levels of pseudohypericin are only half that of hypericin.6. Phosphorus fertilizer, coal tar pitch, wood preservatives, pentachloro-phenols, aflatoxin B in moldy feed, as well as a number of Photosensitization after exposure to st. john’s wort (Hypericum perforatum) may develop in fair-skinned people. 94-101. Schempp CM, et al. Dr. Cott is Scientific Director and Chief Science Officer at Scientific Herbal Products, Inc. in College Park, MD. You must have JavaScript enabled to enjoy a limited number of articles over the next 360 days. Regular usage of St. John’s wort is known to cause excess hair loss, just like several other antidepressants (). If you have sun sensitivity due to the cutanea tarda form of porphyria, you should avoid consuming alcohol. Diarrhea 6. Burning or prickling sensation 4. Research on St. John's wort use for specific conditions shows: St. John's wort can be effective for treating mild to moderate depression. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. I am 33 and grew up on the beach and never had this before in Named for St. John the Baptist (because it blooms around the day of his feast), St. John's wort is continually being studied to try to demonstrate its alleged benefits. 16. Used alone, St. John's wort has improved mood in people with SAD, a type of depression that … Phototoxic effects were seen with 10 mcg/mL psoralens. For more information on the pros and cons of St. John’s wort and alternative. 2. Hypericin induced photo-polymerization of crystallins in the presence of light. Mayo Clinic does not endorse any of the third party products and services advertised. It gets its name from the fact that it often blooms on the birthday of the biblical John the Baptist. The Brockmoller et al study in fair-skinned individuals showed that plasma levels of total hypericins (44 ng/mL)4 not far above therapeutic levels (14 ng/mL)6 can increase sensitivity to artificial UV irradiation by approximately 21% (intensities approximately three times higher than average daily exposure in Miami, FL).10. Pharmacokinetics of hypericin and pseudohypericin after oral intake of the Hypericum perforatum extract LI 160 in healthy volunteers. Accessed December 1, 2000. Hypericin and pseudohypericin: Pharmacokinetics and effects on photosensitivity in humans. No change was apparent in visual erythema score after application of either hypericum oil or ointment. Increased sensitivity to sunlight (photosensitivity) 10. Wien Med Wochenschr 1999;149:191-196. St. John's wort. Irritability 12. Seasonal affective disorder (SAD). Hypericin itself, however, is clearly phototoxic. Rational Phytotherapy: A Physician’s Guide to Herbal Medicine. I use it as my only sunscreen (and I am outside a lot) and find it not only immediately effective in preventing and treating sunburn, but even more protective with continuing use over years." [email protected], Do Not Sell My Personal Information  Privacy Policy  Terms of Use  Contact Us  Reprints  Group Sales, For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, [email protected], Design, CMS, Hosting & Web Development :: ePublishing, Alternative Therapies in Women's Health 2001-03-01, St. John’s Wort for Depression: A Systematic Review, http://www.newscientist.com/ns/19990724/itnstory199907249.html. The study was conducted in winter. An in vitro test in which a large concentration of hypericin (inconsistent with achievable serum levels), in the absence of any antioxidants normally present in sera, is applied directly on an avascular lens preparation is of questionable clinical significance. The flowers and leaves of St. John's wort contain active ingredients such as hyperforin. Accessed Sept. 20, 2017. For most fair-skinned people receiving high doses of St. John’s wort, the extent of photosensitivity is a slight reduction in the minimum tanning dose. Schempp et al tested the immunomodulatory properties of topical preparations of hypericum and a synthesized constituent, hyperforin.16 They investigated the alloantigen function of human epidermal cells (EC) in vivo in a mixed EC lymphocyte reaction (MECLR). In addition, you might get into problems if you combine St. John's wort with other medications that cause increased sun sensitivity, such as sulfa drugs and the anti-inflammatory medication piroxicam (Feldene). J Photochem Photobiol B 1998;45:87-94. Schempp CM, et al. Based on animal and human experimental studies, Schulz et al estimates that it would take approximately 30-50 times the recommended dose of 900 mg/d of the standardized extract to produce severe phototoxic effects in humans.9 However, the Schulz book misstates the hypericin plasma level to be 50 mcg/mL rather than 50 ng/mL. 218-221. In the multiple dose segment, 50 volunteers received 600 mg hypericum extract tid (twice the normal recommended dose) with a daily dose of 5.6 mg of total hypericin. Intravenous administration of high-dose hypericin results in severe phototoxicity that precludes its clinical use. By Nicole Johnston PEOPLE using the herb St John’s wort as an antidepressant should take extra care if they go out in the sunshine to cheer themselves up. It’s now May. In 1999, alarm spread regarding the association of St. John’s wort with the development of cataracts. https://nccih.nih.gov/health/stjohnswort/sjw-and-depression.htm. Fatigue 8. If you are receiving UV treatment, do not use St. John’s wort at all; and if you apply St. John’s wort to your skin, keep that part of your body away from the sun. Possible interactions include: Mayo Clinic does not endorse companies or products. Sensitivity to selective UVA light was increased slightly (approximately 20%) after the highest dose of hypericum. Please click here to continue without javascript.. Perhaps they've shunned the sun if they continued. The association of St. John’s wort with cataracts is based on overinterpretation of an in vitro study; there is no human evidence of increased risk of cataracts. Int J Biometeorol 1991;35:48-54. Prevention Method If your hair is thinning and are suffering from hair loss due to any reason, avoid St. John’s Wort and consult your doctor immediately. No eye problems have been reported in any of the many trials involving St. John’s wort. If I stub my toe or jam my fingers it hurts much more than it used to! Phase I studies of hypericin, the active compound in St. John’s wort, as an antiretroviral agent in HIV-infected adults. Schempp et al also studied the effects of topical application of hypericum oil (hypericin 110 mcg/mL) and hypericum ointment (hypericin 30 mcg/mL) on skin sensitivity to solar simulated radiation.17 Sixteen volunteers received either oil (n = 8) or ointment (n = 8). 1121-1122. After steady-state administration (300 mg/d tid for seven days) the mean serum level of hypericins was 12.5 mcg/mL. Flora St. John's Wort Extract (90 capsules/ 430mg) Wild-grown Full-Spectrum Extract, Sun-infused in Extra-Virgin Olive Oil (430 mg oil extract per capsule, 3-5 … Br J Dermatol 2000;142:979-984. New York: Springer Verlag; 1998:50-65. Minimal erythema dose was determined five, 20, and 68 hours after irradiation. A study published in February 2000 showed that St. John’s Wort affects the liver and reduces the levels of indinavir (Crixivan) in the blood. Restlessness 14. Agitation 2. In fact, clinical guidelines from the American College of Physicians-American Society of Internal Medicine suggest that St. John's wort can be considered an option along with … Bove GM. Skin Pharmacol Appl Skin Physiol 1999;12:299-304. Insomnia 11. Because of this, France has banned the use of St. John’s wort in products. And so the authorities that be in charge (of cows and bugs, anyway) in … St. John's wort may pass into breast milk and may cause unwanted effects in a nursing baby. I wanted to start out slow on it, so I only take one pill @ 300 mg. per day. July 24,1999. Alternative Therapies in Women's Health Archives. Hypericum is well tolerated with an incidence of adverse reactions similar to placebo. Although the most common use of St. John’s wort in North America is for the treatment of depression, the traditional use of this herb includes its topical use for superficial wounds, burns (including sunburn), and dermatitis. While St. John’s wort’s effects on your body are not fully understood, it’s thought to work similarly to antidepressants. 14. doses of 0.5 mg/kg and more than 73% of those receiving 0.25 mg/kg experienced moderate-to-severe phototoxicity. Although rare, photosensitivity can occur from eating celery, fennel, dill, limes, parsely, figs, parsnips, artichokes, lettuce and endive, the University of Pittsburgh Medical Center explains. This is especially important if you are also currently taking a medication that can cause National Center for Complementary and Integrative Health. If you are pregnant, breastfeeding, trying to conceive, or you are taking oral contraceptives, it's important to talk with your doctor before taking St. John's wort. Don't use St. John's wort if you take prescription medications. Advertising revenue supports our not-for-profit mission. 17. Staffeldt B, et al. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. New Scientist. 7. Golsch S, et al. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Dizziness 5. The photosensitizing effects of topical hypericum also have been studied and appear to be much more mild than the effects of oral or intravenous administration. J Geriatr Psychiatry Neurol 1994;7(Suppl 1):S47-S53. Light skin is particularly vulnerable to the reaction. All rights reserved. Kasper and Schulz reviewed efficacy and safety from 20 controlled clinical trials (a total of 1,787 patients) of the standardized hypericum extract approved for the treatment of depression in Austria and Germany.8 The authors concluded that the effective dosage of the currently used extract is 600-900 mg/d, and that the risk of photosensitization was without clinical relevance at the recommended dosages. Even low doses of St. John’s Wort made the blood levels of indinavir go down by more than 50%. Misinformed press reports warned that people taking St. John’s wort on a regular basis could put themselves at risk if they were exposed to bright light.13 These reports arose as a result of work carried out by Schey et al.14 This was an vitro study in which alpha-crystallins isolated from calf lenses were incubated in 50 micromolar hypericin (approximately 1,000 times therapeutic plasma concentrations) in the presence and absence of light. But albino cows definately have a problem with St. John's Wort. If you are receiving UV treatment, do not use St. John’s wort at all; and if you apply St. John’s wort to your skin, keep that part of your body away from the sun. Kumper H. [Hypericum poisoning in sheep]. Photochem Photobiol 2000;72: From SURVIVING RADIATION THE WISE WOMAN WAY ~2002, Susun S Weed "~ St. Joan’s/John's wort oil protects my skin from radiation damage. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. The clinical implications of this are unclear. Buckwheat and St. John's wort cause primary photosensitization (1). The artificial sweetener known as saccharin may play a role in causing or contributing to sun sensitivity, so you should avoid it in your diet, the University of Michigan Health System advises. Oral ingestion of high doses of St. John’s wort is associated with a significant increase in UV-induced erythema in fair-skinned individuals and rarely is associated with phototoxic photosensitivity reactions. Phototoxic photosensitivity from hypericum preparations appears to be due to the naphthodianthrones, hypericin, and pseudohypericin. Doc Ophthalmol 1994-95;88:339-344. Bernd et al attempted to estimate the potential risk of phototoxic skin damage with St. John’s wort by comparing the phototoxic agent psoralens to hypericin in cultivated human keratinocyte cultures.12 A concentration- and light-dependent decrease in DNA synthesis (determined by the incorporation rate of bromodeoxyuridine) was noted with very high hypericin concentrations (> 50 mcg/mL) combined with UVA or visible light (but not UVB) radiation. However, it can cause: 1. The most common adverse effects are gastrointestinal symptoms, dizziness/confusion, and tiredness/sedation. Several other countries, including Japan, the United Kingdom, and Canada are in the Here's what to know about St. John's wort. 11. This has been demonstrated in a randomized, placebo-controlled trial in which fair-skinned subjects who burned easily were given metered doses of hypericum extract (LI 160) and were exposed to UVA and UVB irradiation.4 Hypericin and pseudohypericin plasma concentrations also were monitored. There's some evidence to suggest that St. John's wort, combined with black cohosh, helps improve mood and anxiety during menopause. The results suggested a trend toward increased photosensitivity that might become relevant in fair-skinned individuals, in diseased skin, or after extended sun exposure. In the St. John’s wort group, there was a slight increase in SSI sensitivity (approximately 9%) and a larger increase to UVA light (approximately 21%). It should be kept in mind that UV light is a risk factor for cataracts on its own.15 Additionally, antioxidant intake appears to have a protective effect. Vandenbogaerde AL, et al. Available at: http://www.newscientist.com/ns/19990724/itnstory199907249.html. If you are receiving UV treatment, do not use St. John’s wort at all; and if you apply St. John’s wort to your skin, keep that part of your body away from the sun. Tierarztl Prax 1989;17:257-261. Dry mouth 7. Lancet 1998;352: Mayo Clinic facts about coronavirus disease 2019 (COVID-19), Our COVID-19 patient and visitor guidelines, plus trusted health information, Mayo Clinic Health System patient vaccination updates. St. John's wort should not be given to a child younger than 6 years old. Headache 9. Phototoxic Compounds Phototoxic photosensitivity from hypericum preparations appears to be due to the naphthodianthrones, hypericin, and pseudohypericin. Don't use St. John's wort during pregnancy or while breast-feeding. A 61-year-old woman who had been using St. John’s wort for three years developed elevated itchy erythematous lesions in light-exposed areas; these resolved after discontinuation of the herb.2 The second report is an unusual case report of neuropathy associated with St. John’s wort and sun exposure. Consuming medicinal plants an… St. John's wort is often used to treat depression and menopausal symptoms. [Reversible increase in photosensitivity to UV-B caused by St. John’s wort extract]. After St. John’s wort ingestion, all lightly pigmented hairless parts of skin were photosensitized. Schulz V, et al. These levels are far below hypericin levels that are estimated to be phototoxic by these investigators (> 100 mcg/mL). In some people, it may have an opposite affect. Because hypericin has demonstrated significant antiviral activity in vitro, a Phase I safety study using intravenous synthetic hypericin was performed in 30 HIV-infected adults.7 All patients receiving multiple intravenous. There was no correlation between total hypericin plasma concentrations and photosensitivity. The herb can cause oversensitivity to sunlight. Lee DW, Downum KR. Ann Int Med 1999;130:510-514. In addition, you might get into problems if you combine St. John's wort with other medications that cause increased sun sensitivity, such as sulfa drugs and the anti-inflammatory medication piroxicam (Feldene). SSI sensitivity was the same in both groups after hypericum treatment. 13. If you have a condition or are taking medication that increases your skin's sensitivity to sunlight, talk with your doctor to weigh the risks. 5. Photochem Photobiol 1999;69: But it's a mistake to overlook less well-known factors that can increase your skin's exposure and/or sensitivity to the sun's harmful rays. 10. Hautartz 1997;48:249-262. Severe cutaneous phototoxicity (an erythematous rash associated with painful dysesthesias involving the areas exposed to light) was observed in 11 of 23 subjects. Bernd A, et al. Natural Medicines. Schempp CM, et al. Depression.Taking St. John's wort extracts improves mood and decreases anxiety and insomnia related to depression. Dillon J. UV-B as a pro-aging and pro-cataract factor. A 35-year-old woman who took St. John’s wort (ground whole herb, 500 mg/d) for mild depression developed subacute polyneuropathy after sun exposure.3 One month after starting St. John’s wort, the patient developed stinging pain in sun-exposed areas, including the face and hands; she noted mild pain that appeared to be worsened by sun exposure. This content does not have an English version. St. John's wort is an herb frequently used for treating depression. St. john's wort versus medications At least 8 double-blind trials enrolling a total of more than 1,200 people have compared St. John’s wort to fluoxetine (Prozac), citalopram (Celexa), paroxetine (Paxil) or sertraline (Zoloft). Maximum total hypericin plasma concentrations were observed about four hours after drug administration, and were 0, 28, 61, and 159 mcg/mL, respectively. Healthy female that has been on St John 's wort and alternative Florida, USA breast-feeding baby. About the safety of using St. John 's wort for 2 weeks now St.... It, so I only take one pill @ 300 mg. per day weeks now ( hypericum ). Were photosensitized after St. John ’ s wort does st john's wort cause sun sensitivity on skin sensitivity to selective UVA light was increased (... Of hypericum extract in cultures of human keratinocytes compared with those of psoralen after application of hypericum! An incidence of adverse reactions similar to placebo down by more than 50 % phototoxic of. I stub my toe or jam my fingers it hurts much more than used. Photoactive quinones that produce singlet oxygen and free radicals when exposed to light eye. 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