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St. John's Wort (Hypericum perforatum L.), also known as Hypericum, is a perennial medicinal plant belonging to the Hypericaceae family.
This plant, characterized by its beautiful yellow flowers, is widely used in traditional medicine for its many beneficial properties. St. John's Wort is primarily used to treat depression and associated disorders such as anxiety, fatigue, loss of appetite, and sleep problems. Additionally, due to its properties, it is used to treat mood swings, palpitations, and other typical menopausal disorders.
The parts of the plant used for therapeutic purposes are the dried flowering tops, which include the buds, fresh flowers, and aerial parts collected during flowering.
Also well-known is St. John's Wort oil, obtained by macerating the flowers in vegetable oil, which is used to treat bruises, skin lesions, inflammations, muscle pain, and other skin issues.
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St. John's Wort (Hypericum perforatum L.) is a semi-evergreen perennial plant, native to the temperate regions of Eurasia and now widespread throughout Italy and the rest of the world.
The plant prefers sunny or semi-shaded and dry locations, such as abandoned fields and ruderal environments, adapting to all types of soil up to an altitude of 1600 meters.
St. John's Wort is characterized by its erect stem, glabrous and marked by two longitudinal ridges, and its opposite oblong leaves which, when viewed against the light, appear "perforated" due to the presence of small oil vesicles. These glandular structures, containing the red oil hypericin, are especially present in the petals of the delicate golden-yellow flowers, grouped in corymbs. The plant is also easily recognizable when not in bloom due to the black dots visible on the edges of the leaves.
Also appreciated as an ornamental plant for decorative borders in gardens, St. John's Wort requires little water, except during drought periods, but is sensitive to waterlogging and is not afraid of frost.
St. John's Wort boasts a long history of use in traditional medicine. The scientific name Hypericum perforatum derives from the small leaves that, when held up to the light, appear perforated due to the presence of translucent glands. This characteristic also gave rise to the term "pilatro," probably derived from the Greek pylê, meaning "meatus." The more common epithet, St. John's Wort, is linked to the plant's peak blooming period around June 24th, the feast day of St. John. Rubbing the petals produces a red juice reminiscent of St. John's blood.
In the past, St. John's Wort was also known as "devil's scourge," as it was believed to be effective against all kinds of evil and was used to protect against witches and demons. Another evocative name is "herb of the flagellation," due to the transparent holes on the leaves, resembling wounds, symbolizing the scourged body of Christ. Traditionally, preparations made from St. John's Wort have been used to treat various ailments, including nervous restlessness, skin conditions, and bacterial infections.
Today, this plant is especially valued for its effectiveness in combating mild to moderate depressive disorders, confirming its role as a valuable ally for mental and physical well-being.
St. John's Wort is a plant with multiple beneficial properties, thanks to the presence of various chemical constituents. Among the main active components are:
Flavonoids:
Dianthrones:
Xanthones
Acyl-phloroglucinols:
Essential Oil:
Procyanidins
Catechin Tannins
Caffeic Acid Derivatives:
These components work synergistically to contribute to the plant's multiple therapeutic properties.
It is important to emphasize that the effectiveness of St. John's Wort is due to the combined action of all these constituents, with a primary role played by hypericin and hyperforin.
These two components are considered the main contributors to the pharmacological activity of St. John's Wort, particularly in the treatment of mood disorders and mild to moderate depression.
St. John's Wort boasts numerous health benefits, thanks to the presence of various active components.
One of the main properties of this plant is its antidepressant action, mainly due to hypericin and hyperforin. According to some studies, these constituents act on the brain's neurotransmitters, promoting mood improvement and relief from mild to moderate depressive symptoms.
St. John's Wort can also help reduce anxiety and improve sleep quality, making it one of the best herbs for sleep.
In addition to its antidepressant effect, St. John's Wort possesses anti-inflammatory and healing properties. St. John's Wort oil, obtained by macerating the flowers in vegetable oil, is often used for the treatment of skin inflammations, wounds, burns, and bruises. Thanks to the synergistic action of flavonoids and hypericin, St. John's Wort seems to promote tissue regeneration and accelerate the healing process.
St. John's Wort has also demonstrated antibacterial and antiviral properties, particularly against antibiotic-resistant strains of Staphylococcus aureus.
This activity is mainly attributed to hyperforin, which can interfere with the life cycle of certain encapsulated viruses. Additionally, St. John's Wort presents antioxidant properties, mainly due to the flavonoids present in the plant. These components help counteract the action of free radicals, protecting cells from oxidative stress and promoting the maintenance of healthy skin.
Therefore, the main properties of St. John's Wort include:
These multiple properties make St. John's Wort a valuable ally for psychophysical well-being, which is now used in the treatment of mood disorders and skin issues. In the next paragraph, we will delve into the specific role of St. John's Wort in combating depression.
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St. John's Wort is best known for its effectiveness in treating mild to moderate depression, as confirmed by numerous scientific studies.
Although already known in ancient medicine, the most interesting use of St. John's Wort in this field is a relatively recent discovery. A review of studies conducted in 2008 by the Cochrane Collaboration concluded that evidence suggests the superiority of St. John's Wort extracts over placebo in the treatment of major depression, with efficacy similar to classic antidepressant drugs but with fewer side effects.
The antidepressant mechanism of action of St. John's Wort's active ingredients is complex: initially, it was believed that the active ingredient was hypericin, but recent developments have clarified that other compounds present in the extracts also contribute synergistically to its effectiveness. Among these, hyperforin plays a key role, inhibiting the reuptake of serotonin in a manner different from SSRIs (selective serotonin reuptake inhibitors). While SSRIs block the activity of the serotonin transporter by competitive inhibition, hyperforin seems to increase the intracellular sodium and calcium gradient, influencing the Na+/Cl- pump and thus reducing the activity of the transporter. Additionally, hyperforin acts on a wide range of other transporters, inhibiting the reuptake of dopamine, glutamate, norepinephrine, and GABA.
Hypericin, on the other hand, has shown a strong affinity for sigma receptors, which regulate dopamine levels, and acts as an antagonist on adenosine, GABA-A, GABA-B, and inositol triphosphate receptors, which regulate the action potentials caused by neurotransmitters.
St. John's Wort extracts also have notable antioxidant and neuroprotective properties, as well as improvements in vascular properties, suggesting their use in certain neurological disorders. For these qualities, some researchers claim that St. John's Wort extracts should be a first-choice treatment for depression in the elderly with high oxidative stress.
It is important to emphasize that the antidepressant efficacy of St. John's Wort is related to specific standardized dry extracts of the aerial parts of the plant, with a well-defined composition of hypericin, flavonoids, and hyperforin. In Italy, a regulation by the Ministry of Health limits the amount of hypericin present in herbal products, making it necessary to use pharmaceutical preparations to fully exploit the potential of St. John's Wort in treating depression.
Before concluding, we want to remind you that, although St. John's Wort can offer significant benefits, it is always essential to consult a doctor before starting any treatment, especially for medical conditions like depression. The information provided in this article is for informational purposes and does not replace professional medical advice. Make sure to discuss the use of St. John's Wort with your doctor, especially if you are taking other medications or have pre-existing health conditions.
St. John's Wort can be taken in various forms, depending on individual needs and preferences. The parts of the plant used to produce herbal remedies are mainly the flowers and leaves, which are dried and processed to obtain standardized dry extracts, capsules, tablets, or tinctures.
In Italy, the only St. John's Wort preparation recognized as a medicinal product due to clinical evidence of efficacy against mild to moderate depression is the standardized dry extract, dispensed under the name Nervaxon® upon presentation of a medical prescription.
Other St. John's Wort preparations, characterized by a lower hypericin content, are used for various issues, such as skin diseases, digestive system disorders, and central nervous system conditions. These are supported by traditional use but lack sufficient clinical evidence.
St. John's Wort is also present in dietary supplements, with physiological indications related to normal mood, relaxation, and mental well-being. These products must indicate on the label the daily intake of hypericin, which must not exceed 0.7 mg, and the hyperforin/hypericin ratio, which must not be higher than 7. Additionally, they must include supplementary warnings regarding possible interactions with medications and contraindications in pediatric and adolescent ages.
For topical use, St. John's Wort oil, obtained by macerating the flowers in vegetable oil, is often used for treating dry and inflamed skin. Thanks to its soothing, astringent, and stimulating properties, it is a valuable cosmetic aid in cases of burns, abrasions, sores, bruises, hematomas, erythema, and stretch marks. St. John's Wort oil stimulates cell regeneration, provides skin elasticity, and has an antioxidant effect.
In summary, St. John's Wort can be taken orally in the form of standardized dry extracts, capsules, tablets, or tinctures, with specific dosages and indications depending on the formulation. For topical use, St. John's Wort oil is a valuable ally for skin care and beauty, thanks to its multiple beneficial properties.
The use of St. John's Wort is contraindicated in cases of confirmed hypersensitivity to St. John's Wort or its components. Additionally, it is not recommended during pregnancy and breastfeeding and is not advised for children. The intake of St. John's Wort should be avoided in conjunction with antidepressants or other pro-serotonergic drugs.
At high doses, it can cause photosensitization, so it is advised to avoid sun exposure or tanning lamps.
Before starting to take St. John's Wort, it is essential to consult a doctor and inform them of any allergies, medications, herbal products, and supplements being taken, as well as any past or current health issues, and special conditions such as pregnancy or breastfeeding.
Although it is an effective natural remedy and generally well-tolerated, St. John's Wort requires caution and awareness in its use, considering the possible contraindications, side effects, and drug interactions. An open dialogue with your doctor is crucial to ensure the safe and beneficial use of this valuable medicinal plant.
Despite being generally well-tolerated, it is important to be aware of the possible side effects and drug interactions for the safe and informed use of this plant.
Among the most common undesirable effects, especially at high doses, are:
In rare cases, allergic reactions such as skin rashes, hives, and breathing difficulties may occur. St. John's Wort can interfere with numerous medications due to its ability to induce cytochrome P450 enzymes, which are responsible for the metabolism of many active ingredients. Specifically, hyperforin is a potent inducer of CYP3A4, which metabolizes about 80% of drugs on the market. This can lead to a reduction in plasma concentrations and therapeutic efficacy of medications such as:
Additionally, the concurrent use of St. John's Wort and antidepressants (SSRIs, MAOIs) or other pro-serotonergic drugs can increase the risk of serotonin syndrome, a potentially dangerous condition characterized by agitation, confusion, hyperthermia, tremors, and blood pressure changes.
St. John's Wort can also reduce the effectiveness of oral contraceptives, increasing the risk of unwanted pregnancies. It is crucial to inform your doctor about taking St. John's Wort before starting any pharmacological treatment and to pay attention to any changes in the effectiveness of the medications being taken.
Regarding topical use, St. John's Wort oil is generally well tolerated, but it can cause photosensitivity reactions in predisposed individuals. It is advisable to avoid prolonged exposure to the sun or tanning lamps during the application of the oil on the skin.
Although it is an effective natural remedy, St. John's Wort is not without side effects and potentially significant drug interactions. An open dialogue with your doctor and a thorough understanding of possible contraindications are essential for the safe and informed use of this medicinal plant, both orally and topically. Only in this way will it be possible to fully exploit the benefits of St. John's Wort, minimizing the risks associated with its use.
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