AIDS InfoNet Logo
This website is certified by Health On the Net Foundation. Click to verify.
This site complies with the HONcode standard for trustworthy health information:
verify here.

The Henry J. Kaiser Family Foundation
Site of the Week
November 2003

The Health Leader Award 2006
The Health Leader Award 2006

The HOPE Reward

Med411.com Medical Award

HealthAtoZ.com Featured Site Award

BuscaSalud.com

IBS Tales Hope Award

HealingWell.com Editor's Choice Award

Listed in Listed in Treasures of the Internet


AIDS InfoNet Logo.  The AIDS InfoNet - Reliable, Up-to-Date AIDS Treatment Information
International Association of Providers of AIDS Care
Reviewed September 23, 2013

Fact Sheet 729

St. Johns Wort (Hypericin)


WHAT IS ST. JOHN'S WORT?
WHAT ARE THE BENEFITS OF ST. JOHN'S WORT?
WHY DO PEOPLE WITH HIV USE ST. JOHN'S WORT?
HOW IS ST. JOHN'S WORT USED?
WHAT ARE THE SIDE EFFECTS?
HOW DOES IT INTERACT WITH OTHER THERAPIES?
THE BOTTOM LINE
 


WHAT IS ST. JOHN’S WORT?

St. John’s Wort is a flowering plant. (“Wort” is an old English word for an herb or plant.) It grows in many parts of the world. Its scientific name is hypericum perforatum. All of the aboveground parts of the plant are used. They are collected while the plant is flowering.

St. John’s Wort has traditionally been used to treat bruises, burns, and mild depression or anxiety. St. John’s Wort contains many different substances that work together. A major compound is hypericin.


WHAT ARE THE BENEFITS OF ST. JOHN’S WORT?

Currently, the major use of St. John’s Wort is to treat mild depression or anxiety. In 1996, the British Medical Journal published a review of scientific studies on St. John’s Wort and depression. This review supports the herb’s use to treat mild or moderate depression. A study of 150 patients in 2006 showed similar results. Exactly how St. John’s Wort treats depression is unclear, although it may be similar to the action of some pharmaceutical products.

Hypericin is active against several viruses, including cytomegalovirus, human papillomavirus, hepatitis B, and herpes. This antiviral activity has been shown in the laboratory and animal studies, but not in human studies. The herb seems to work against viruses by oxidation. The herb’s antiviral effect is stronger when exposed to light.

St. John’s Wort was studied in 1991 in people with HIV disease. The doses were much higher than for treating depression. Patients were given intravenous doses of purified hypericin. The study was stopped when every white-skinned patient in the trial became very sensitive to light. They developed skin rashes and some could not go outside until after they stopped taking hypericin. The one black-skinned patient did not have this reaction.


WHY DO PEOPLE WITH HIV USE ST. JOHN’S WORT?

Although St. John’s Wort has some antiviral activity at high doses, there are no scientific studies to show that it can reduce people’s HIV viral load. However, it is effective against mild to moderate depression and anxiety. It is also useful for treating insomnia.  Many people with HIV have used St. John’s Wort for these purposes. Early in 2000, a study showed that St. John’s Wort causes a large drop in blood levels of indinavir. See “How Does It Interact With Other Therapies.”


HOW IS ST. JOHN’S WORT USED?

St. John’s Wort is used in several forms. The most common form is in capsules containing a powder of the dried plant. It is also used in oil-based preparations, especially for use on the skin. As mentioned earlier, a highly purified form of hypericin was used in research studies but caused serious sensitivity to light.

The British review of the use of St. John’s Wort to treat depression found that many different doses were used. The best dosage is not known.


WHAT ARE THE SIDE EFFECTS?

The only known side effect of St. John’s Wort is skin rash and sensitivity to light. This side effect is only seen with a purified extract or at extremely high dosages. St. John’s Wort has sometimes been used to increase women’s menstrual flow. It may have a negative effect on fertility for both men and women. Pregnant women should not use it.


HOW DOES IT INTERACT WITH OTHER THERAPIES?

There are very few studies of interactions between St. John’s Wort and medications or other herbs. Some bad reactions have been reported in people who combine St. John’s Wort with anti-depression medications. Do not use St. John's Wort with other antidepressants.

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. Even low doses of St. John’s Wort made the blood levels of indinavir go down by more than 50%. This could make indinavir ineffective against HIV and allow resistance to develop rapidly. St. John’s Wort probably also changes the blood levels of other drugs that are broken down by the liver, including non-nucleoside reverse transcriptase inhibitors and protease inhibitors. DO NOT USE ST. JOHN’S WORT IF YOU ARE TAKING ANTIRETROVIRAL DRUGS (ARVs). Be sure your health care provider knows if you are using St. John’s Wort.

However, most antidepressant drugs also change the blood levels of some ARVs. You and your health care provider should discuss the costs, risks, and benefits of different treatments for depression.

St. John’s Wort may also block the effects of birth control pills and may interfere with several other medications. Be sure your health care provider knows if you are taking St. John’s Wort while taking ANY medications.


THE BOTTOM LINE

St. John’s Wort is a flowering plant used for several health problems. It is mainly used to treat mild or moderate depression. It is active against viruses in the laboratory and in some animal studies. However, high doses of a purified extract used in human studies of its antiviral effect caused serious sensitivity to light.

St. John’s Wort interacts with the liver and speeds up the processing of some drugs, including protease inhibitors. Do not use St. John’s Wort if you are taking ARVs.

People with HIV may want to take St. John’s Wort to deal with mild or moderate depression, if they are not taking ARVs. Be sure your health care provider knows if you are taking St. John’s Wort while taking ANY medications.


 


Back to Fact Sheet Categories



New Mexico AIDS Education and Training Center The University of New Mexico Health Sciences Center International Association of Providers of AIDS Care

 

The AIDS InfoNet is a project of the New Mexico AIDS Education and Training Center at the University of New Mexico Health Sciences Center,
and the International Association of Providers of AIDS Care.
webmaster@aidsinfonet.org

 

United States National Library of Medicine

Partially funded by the National Library of Medicine



Search Our Site
Newest Fact Sheets
Print This Fact Sheet
You can print this fact sheet on a single page in Microsoft Word (.doc) format or Adobe Acrobat (.pdf) format. Click on the links below to open the document in your browser and then print it.
 Adobe Acrobat PDF
 Microsoft Word

You can print directly from your browser using the link below. The printout will probably go onto a second page.
 Print Version (Web)

Monthly E-mail Updates

The InfoNet updates its Fact Sheets frequently. A listing of each month's changes is posted to several e-mail lists.

If you would like to receive this monthly update by personal e-mail, please provide your e-mail address below, and click on the "Submit" button.



Subscribe
Unsubscribe