ST. JOHN'S WORT: Benefits, Side Effects, Uses, Dosage, Warnings?
The Real St. John's wort ( Hypericum perforatum ), also Genuine St. John's wort , real-hypericum , hypericum ordinary , Perforated St. John's Wort , wort, Hypericum or dot-Hartheu called, is a plant from the family of Hypericaceae (formerly hard hay ). Folk it is also called Lord blood called.  It is used as a medicinal plant . Even the Germans revered St. John's Wort as a light bearer and symbol of the sun. Harvested, it became the summer solstice on 21 June, and Midsummer celebrations women and girls wear wreaths of St. John's wort. With the Christianization of the ritual significance shifted to John the Baptist .    The English name St John's wort or the Spanish name hierba de San Juan as well as the German name refer to this as the plant to the St. John (June 24) around flowers.
Contents [ Hide ]
2 distribution and habitat requirements
6 Medical Application
6.1 efficacy in the treatment of depression
6.2 Mechanisms of action and latency
6.3 Undesirable effects
6.5 Use in Pregnancy and Lactation
7 use in folk medicine
8 used in food
9 External links
11 Notes and references
Description [ Edit ]
Features [ Edit ]
H. perforatum : The leaves appear by their oil glands punctured
The Real St. John's Wort is a perennial plant with very ramified, spindle-shaped, up to 50 cm depth reaching root. The 15 cm to one meter tall erect stems is continuous two-edged inside and pithy filled (not hollow). Thus, the real St. John's Wort St. John's Wort from other types is different. At the upper part of the stem is branched bushy plant.
The oval-ovate to oblong-linealischen leaves are more or less sessile, disposed on opposite sides. They are up to 3 cm long and densely covered with transparent oil glands. At the edge of the leaves are dotted with black translucent glands. With the numerous punctures are schi coated oil container, in which the bright essential oil of the plant is concentrated.
The inflorescence is a cyme . The flowers are homogeneous "pollen-disk flowers" in composite dichasia with (easily recognizable for fruit time) Schraubeln . The five sepals are up to 5 mm long, longer than the ovary , (ei) -lanzettlich, finely pointed grannenartig, with bright and black glands. The five golden petals are up to 13 mm long, serrated on one side and black dots on the edge. They contain tissue defects in the blood-red hypericin , which (ideally several flowers when crushed buds take) on the fingers leaves a red color. The petals are slightly asymmetric, so that the whole flower resembles a pinwheel in the open state.
The 50-60 sometimes up to 100 stamens surrounded in three clusters located above the permanent oval ovary. For three stamen systems creates three clusters with up to 80 individual stamens: a centrifugal Dedoublement, see Secondary polyandry . 
The Upper constant ovary is divided into three compartments, which are shorter than the sepals. Instead of nectar a anbohrbares tissue of uncertain ecological significance is present. The fruit is a narrow-ovate, to 10 mm long, grooved dreifächrige gap capsule .
The seeds are oblong, curved and finely reticulate, with a length of about one millimeter. The flowering time is June to August.
The chromosome number is n = 16,24. 
Ecology [ Edit ]
Flower of Hypericum perforatum . The petals form a Wildrad.
Inflorescence of Hypericum perforatum . In pollination, the petals are rolled sideways.
The species occurs mainly in larger groups, but these are rarely forming stands. As ecological indicator values according to Ellenberg the type is specified as a semi shade plant for moderately warm to warm locations in temperate maritime climate. The displayed soil is then uniformly dry to moderately moist and low in nitrogen, but never strongly acidic. The Real St. John's wort is a deciduous plant stem (overwintering plant without rosette) and is one of the hemicryptophytes .
Cross-pollination is effected by pollen-seeking insects. Visitors are particularly Bombus typologies and bees - and hoverflies typologies. selfing is complicated by the spatial separation of style branches and dust bag bundles, but when closing the flowers possible when the shrinking petals envelop the flower again. In the evening and during pollination, the petals curl at the sides in the longitudinal axis.
The small seeds of the open in dry capsules of animals abducted ( Zoochorie ) or by the wind spread ( balloonists ). Vegetative propagation is done by root sprouts .
The plant is mildly toxic. The dried flowers of St. John's wort Hairy contain up to 1.4% of the red dye hypericin . The hypericin-intake results in non-pigmented (white) grazing animals (horses, sheep, goats, etc.) after irradiation by sunlight to Hämolyseerscheinungen .
Distribution and habitat requirements [ Edit ]
The Real St. John's Wort is the most widespread species in Europe and its genus native to Europe, West Asia and North Africa. In East Asia, North and South America and in Australia it has been naturalized. It is found in low to medium altitudes. It grows widely in the bushes hems, forest edges, roads and embankments, in dry meadows and calcareous grasslands, in gorse and heather heathen, in wastelands and Waldverlichtungen or on railway ballast as a pioneer plant .
Due to the use as a medicinal plant St. John's wort is the real grown agriculturally.  At the same time it is in other agricultural cultivation as "weeds".
Systematics [ Edit ]
There are four variants:
Rosebay St John's wort (var. angustifolium ): It has narrower leaves and smaller flowers. This variant contains virtually no rutin, making them largely unsuitable for pharmaceutical exploitation. 
Broad St John's wort (var. latifolium ): It has broader leaves and larger flowers.
Kleinblättriges John's wort (var. microphyllum ): It has smaller leaves and smaller flowers.
Ordinary John's wort (var. perforatum )
Ingredients [ Edit ]
When grinding the buds hypericin exits ("blood of St. John")
St. John's wort good quality containing an average of 0.1-0.15% total hypericin (Ph. Eur. 5.0, p 2485), which especially in the Exkretblättern the flowers and buds are located. These consist of an average of 0.2-0.3% hypericin , pseudohypericin and similar substances together. The effectiveness of the addition, 2-4% are flavonoids and bioflavones responsible. Which have been detected so far only in this type antibiotic effective hyperforin and the Adhyperforin in the flowers (2%) and fruits (4%).
After the hypericin content to 1995 to determine the efficacy of the drug was used Hyperici herba, one now assumes that the therapeutic efficacy comes together through a combination of several active ingredients and mechanisms of action. Drug manufacturing hypericin levels required by 0.15% and high flavonoid contents, also limits for cadmium (0.5 mg / kg) and lead (5.0 mg / kg) must be respected.
Another medically active ingredient is up to 7.2% content in the essential oil , the sesquiterpene spathulenol . 
Cultivation [ Edit ]
For the production of various preparations on St. John's Wort St. John's wort base cultivars grown under field conditions. Increasing demand, by the wild collection could not be met, led to an expansion of cultivation since the 1990s. The type is one of the most important cultivated and processed in Germany medicinal plants. 1999 St. John's wort was grown in Germany on 630 hectares, mainly in Thuringia. In Austria (Waldviertel) in 1999 to 240 hectares were cultivated. Currently, there are still about 50 hectares (2009). Even in Poland and South America, the plant is cultivated.
For cultivation is lean, humous soils are in a sunny location, ideal weed are poor areas with good water absorption. Because St. John's wort enhances absorbs the toxic for human cadmium in acidic soil reaction and therefore as Akkumulatorpflanze counts, the pH of the soil should be neutral or slightly alkaline, also locations with elevated cadmium contamination (eg: slate floors) are unsuitable.
In the breeding of suitable varieties susceptibility plays against the fungal disease Rotwelke an essential role. There are several varieties available (as of April 26, 2004  ): Anthos, Hyperixtrakt, motif, Uperikon, Hyperimed, Hyperiflor, Vitan, Hyperipharm and Hyperisol.
Sow the seeds in spring or autumn, a planting of early seedlings in spring is possible. Fertilizers are little, especially large amounts of nitrogen reduce the hypericin content in the drug. Weeds must be controlled by Striegel and with machine and hand hoe, against the Rotwelke a must after harvest fungicide used.
The culture takes place over two to three years, is harvested one to two times a year. The buds, flowers and twigs are harvested during the flowering season. For fresh produce, the cabbage by hand or with a picking machine is harvested. For drying, provided material is introduced with special machines or converted conventional harvesting equipment (combines, forage harvesters). The herb yields fluctuate widely and are 4-26 t fresh matter per hectare.
The crop immediately after the harvest at 40-60 ° C for typographical, Horde or belt dryers , water is removed down to 10% moisture.
Diseases [ Edit ]
Rotwelke (pathogens: Colletotrichum gloeosporioides )
Pests [ edit ]
St. John's wort leaf beetle ( Chrysomela hyperici)
Schattenwickler ( Cnephasia sp.)
Sawfly larvae (Tenthredinidae)
Medical applications [ Edit ]
St. John's Wort herb in the form of the drug (Hyperici herba)
Even in ancient times St. John's wort was as a medicinal plant used. Today it is used as herbal medicines for the treatment of mild to moderate depressive moods or nervous restlessness used. Externally oily preparations are applied.
Efficacy in the treatment of depression [ Edit ]
The German Association for Psychiatry and Psychotherapy, Psychosomatics and Neurology leads to the use of St. John's wort in the S3 guideline Unipolar Depression as a possibility of a first treatment attempt at a mild to moderate depression as a degree-0 recommendation ("Can" recommendation: Reports of expert groups or expert opinion and / or clinical experience of respected authorities (evidence category IV) or extrapolation of evidence level IIa, IIb or III. This classification indicates that directly applicable clinical studies of good quality were not available or not available.). 
The efficacy of St. John's wort in the treatment of depression is controversial. There are both clinical studies which prove efficacy, as well as those who have no superiority over placebo show. A Cochrane review in 2008 evaluated from 29 trials involving more than 5000 patients in whom according to DSM - or ICD-10 Criteria a depression ( major depressive disorder was present). The authors see evidence in the studies, which suggests that the effectiveness of St. John's wort extracts is superior in studies versus placebo and was comparable to synthetic antidepressants in better tolerability and lower dropout rates. Since the established in the efficacy trials by the country of origin of the study, and their accuracy depends, can not be excluded that some smaller studies from German-speaking countries were flawed and reported to optimistic results.  closes A recent meta-analysis , the effect of St. John's wort is still best demonstrated mild to moderate depression, but also have a significant potential for side effects. 
The Institute for Quality and Efficiency in Health Care believes that St. John's wort has an effect on mild depression. In general, however, there was a clear dependence of the effect estimate of study quality: the poorer the quality of the studies, the greater is presented, the extent of the indicated effects, and vice versa. When considering only those studies with the best methodological quality St. John's Wort shows only a very small effect. The institute believes that St. John's wort does not help for severe depression. It proved for severe depression, no study superior to placebo. 
The present studies do not yet provide sufficient data to compare different hypericum extracts with each other or to determine the optimal dose.  In mild depression, however, a dose-response relationship was demonstrated experimentally in a study. 
Mechanisms of action and action latency [ Edit ]
As the main active ingredient of St. John's wort is considered hyperforin . Standardized St. John's Wort extract increased by a reuptake inhibition of neurotransmitter serotonin and norepinephrine concentration thereof at the synapses . Also increases the concentration of gamma-aminobutyric acid (GABA), dopamine and L-glutamate to what can no antidepressant in this form. As a result, reduces the number of (noradrenergic) β receptors , it also causes a down regulation of the 5-HT2 receptors . 
The effect of St. John's wort preparations should the chemically defined substances hyperforin and hypericin be due. This can cause a mild to moderate cerebral reuptake inhibition of serotonin , norepinephrine and dopamine ; these are known mechanisms of action of synthetic antidepressants . The ratio of reuptake inhibition is in animal studies serotonin: dopamine: noradrenaline: GABA: glutamate = 2: 1: 5: 1: 11th  A MAO inhibition was often claimed, but could never be proven. Other receptors are not affected.
As synthetic antidepressants also show St. John's Wort drugs a certain latency period, ie, one senses only after several weeks of taking an improvement in depressive symptoms.
The alleged antiviral activity against the hepatitis C virus in humans exists at least in the usual doses not, instead, a new injury to the liver caused that at higher doses for acute liver failure can result. Since effective drugs are approved for the disease caused by viruses, all experiments were discontinued in diseased people as unacceptable.
Side Effects [ Edit ]
St. John's Wort drugs are generally well tolerated, adverse side effects are low or rarely occur.  In some cases of manic episodes reported, which were induced by St. John.  In addition, St. John's wort low gastrointestinal complaints , headache , excitement and fatigue and a phototoxic reaction cause the skin (sunburn inclination), as hypericin sensitivity to UV light increases ( photosensitivity reaction ). In high doses it acts as a strong phototoxic u. U.. Fair-skinned people are taking St. John's wort regularly and want to tan in tanning beds or on holiday trips should consider discontinuation of St. John's wort preparation 14 days before the first light / sunlight into consideration. With a known photosensitivity St. John's Wort should be avoided. Rarely, it can cause allergic skin reactions. Also, cattle and horses that eat too much St. John's wort, show the symptoms mentioned. At very high doses it can cause mild forms of a serotonin syndrome occur. Symptoms include dizziness, flu feeling depressed level of consciousness, involuntary muscle twitching and anxiety. Overdose symptoms may readily be confused with depressive symptoms and induce a further increase of the dose.
Interactions [ Edit ]
End of the 1990 years, it was found that St. John's Wort leads to increased catabolism of other agents. Therefore, the previously freely available St John's Wort 2003 was Pharmacies obligation assumed. Except in pharmacies are preparations in a daily dose of up to 1 g equivalent drugs and up to 1 mg hyperforin contain tea and for external application of certain fresh plant juice or oily preparations (red oil). Due to the interactions St John's wort was in the Republic of Ireland a few years before the prescription subject. St. John's wort preparations with the indication "moderate depression" are also in Germany prescription since April 1, 2009.
St. John's wort induces the degradation enzyme cytochrome P450 subtype 3A4 in the liver . The degradation rate of a variety of active ingredients thus increases, and they can lose their effectiveness.  cytochrome P450 subtype 3A4 metabolized inter alia hormones . So St. John's wort may increase the effects of the birth control pill affect and other hormonal contraceptives.  There are also interactions with certain AIDS -Medikamenten ( HIV-protease inhibitors ), antibiotics such as clarithromycin and some antidepressants . The HIV protease inhibitor and the antibiotic can lose their effectiveness in whole or in part, which may have serious consequences in the underlying serious diseases. And immunosuppressants , for example, by grafting are added to the rejection reaction of the body are alleviated. There are at St John's wort intake with simultaneous deaths immunosuppression have been described. St. John's Wort lowered in a Swedish study at a dose of 600 mg per day with a (comparatively high) hyperforin content of 4% after 14 days, the peak plasma concentration, the area under the curve and the half-life of finasteride by about 50%.  affected are also the As carbamazepine , valproic acid ), benzodiazepines (eg. B. diazepam , alprazolam , lorazepam ) and benzodiazepinähnliche substances (eg. B. zolpidem and zopiclone ) and a number of other drug groups. 
With serotonin reuptake inhibitors such as fluoxetine , paroxetine , citalopram etc. there is the possibility of a gain serotonergic -related side effects (nausea, diarrhea, blood pressure changes, agitation) to the release of life-threatening serotonin syndrome (severe blood pressure fluctuations, fever, depressed level of consciousness, confusion, convulsions).  On the other hand, some of serotonin reuptake inhibitors by the acceleration of their degradation are attenuated in their effect. Taking such combinations the effect is hard to predict.
Use in pregnancy and lactation [ Edit ]
When used in pregnancy and lactation caution.  St. John's Wort has been used in folk medicine as an abortifacient used. 
Use in folk medicine [ Edit ]
Pickled inflorescences in olive oil, the right glass has a longer maturation period behind and has a darker color ( Thassos , Greece)
Production of red oil in Soglio , Grisons
Folk medicine St John's Wort is as tea and tincture even with menstrual cramps and puberty-related uses upsets.
The "red oil" is as liniment for lumbago , gout , rheumatism , to relieve pain and wound healing after dislocations and sprains , with bruises and shingles used, but can also be used internally. Also, sunburn and burns are relieved. The red oil is considered to be non-irritating, "cold oil".  It is obtained by St. John's wort flowers for two months in cold-pressed olive - or sunflower oil inserts, sometimes vigorously shaken and left to stand in the sun. This process is called maceration .
Using an approach brandy from flowers and herbs falling asleep and anxiety are treated.
Use in foodstuffs [ Edit ]
St. John's wort preparations are also isolated in dietary supplements to find: there as St. John's wort oil ("red oil"), which, however, the inner medicinal effects can not be attributed.
The locust herbs ( Hypericum ), also Hartheu called, are a genus of flowering plants within the St. John's wort plants (Hypericaceae). The genus includes about 450 species.  is known especially the medically used Real St. John's wort ( Hypericum perforatum ).
Contents [ Hide ]
3 types (selection)
4.1 Notes and references
5 External links
Description [ Edit ]
Among the species of the genus, there are both annual, perennial and perennial herbaceous plant with plant height 5-10 inches, as well as shrubs and small trees with growth heights of up to 12 meters. The leaves are opposite, simple, ovate and 1-8 inches long.
Blood St. John's wort ( Hypericum androsaemum ), flowering fruit un
The hermaphrodite flowers have a diameter between 0.5 and 6 cm. There are five (rarely four) sepals and petals available. The many, usually 70, rarely up to 120 stamens are usually grouped into three to five bundles. The fruit is usually a capsule fruit that opens after its dehydration and dismisses numerous small seeds. In a few species, the fruit is fleshy like beer.
Distribution [ Edit ]
The locust herbs are distributed almost worldwide, they are missing only in deserts, arctic regions and in the tropical lowlands.
Egyptian St. John's wort ( Hypericum aegypticum )
Balearic St. John's wort ( Hypericum balearicum )
Olympus St. John's wort
( Hypericum olympicum )
Types (selection) [ edit ]
Hypericum aciferum (Greuter) N.Robson : It occurs only in southwestern Crete.
Hypericum adenotrichum Spach : It occurs only in Anatolia.
Egyptian St. John's wort ( Hypericum aegypticum L. ): It occurs in Sicily, Sardinia, Greece, Crete, Morocco, Algeria and Libya. 
Hypericum aegypticum subsp. webbii (Spach) N.Robson : The subspecies occurs in Sicily, Sardinia, Greece and Crete. 
Hypericum amblycalyx Coust. & Gand. : It is an endemic of Crete. 
Hypericum amblysepalum Hochst. : It occurs in the territory of Israel, Jordan, Syria, Lebanon and Turkey. 
Hypericum andjerinum font cross & Pau : It occurs only in Morocco.
Blood St. John's wort , man blood ( Hypericum androsaemum L. )
Hypericum annulatum Moris : It occurs on the Balkan Peninsula and in Sardinia. 
Hypericum armenum Jaub. & Spach . It occurs in Turkey and in Armenia 
Hypericum athoum Boiss. & Orph. : It occurs only in northern Greece.
Hypericum atomarium Boiss. : It occurs only in the Aegean and western Anatolia.
Hypericum aucheri Jaub. & Spach : It occurs in Bulgaria, Greece and Turkey. 
Hypericum australe Ten. : It comes in Spain, the Balearic Islands, France, Corsica, Italy, Sardinia, Sicily, Morocco, Algeria and Tunisia. 
Hypericum aviculariifolium Jaub. & Spach : It occurs only in Turkey.
Balearic St. John's wort ( Hypericum balearicum L. ) comes originally only available in the Balearic Islands.
Hypericum barbatum Jacq. : It comes only in Southern Italy, Austria, Hungary and the Balkan Peninsula ago
Hypericum bithynicum Boiss. : It occurs in Turkey. 
Großkelchiges St. John's wort , Evergreen St. John's wort ( Hypericum calycinum L. )
Hypericum canadense L. : It occurs in Canada and the United States.  . It is naturalized on heathland in Ireland and the Netherlands.
Hypericum capitatum Choisy : It comes only in the Middle East before.
Hypericum caprifolium Boiss. : It comes only in southeastern Spain before.
Hypericum cardiophyllum Boiss. : It occurs only in the Middle East.
Hypericum cerastoides (Spach) N.Robson : It occurs in Bulgaria, Macedonia, Greece and Turkey. 
Hypericum confertum Choisy : It comes in Cyprus, in the territory of Syria and Lebanon and Turkey before. 
Whorled St. John's wort ( Hypericum coris L. ): It occurs only in south-eastern France, Italy and Switzerland.
Hypericum cuisinii W.Barbey : It occurs only in Crete and in the Aegean. 
Hypericum delphicum Boiss. & Heldr. : It occurs only in the Aegean.
Petite St. John's wort ( Hypericum elegans Stephan ex Willd. )
Marsh St. John's wort ( Hypericum elodes L. ) comes in Western Europe from the Azores, Portugal and Scotland to Germany and Italy.
Krähenbeerenblättriges St. John's wort ( Hypericum empetrifolium Willd. )
Hypericum ericoides L. : It occurs only in Spain, Morocco and Tunisia. 
Hypericum foliosum Aiton : It just comes down to the Azores before.
Hypericum fragile Heldr. & Sart. ex Boiss. : It occurs only in eastern Greece.
Hypericum gentianoides (L.) Britton : It comes in the USA and is naturalized in France and in South America. 
Hypericum gymnanthum Engelm. & A. Gray : It is native to North America and is naturalized before in Poland.
Hypericum haplophylloides Halácsy & Bald. : It occurs only in southern Albania.
Bocks-St. John's wort ( Hypericum hircinum L. )
Haired St. John's wort ( Hypericum hirsutum L. )
Lying down St. John's wort ( Hypericum humifusum L. )
Hypericum hyssopifolium Chaix : It occurs in Spain, France, Italy, on the Balkan Peninsula, in Armenia and Ukraine. 
Hypericum jovis Greuter : It is an endemic of Crete. 
Hypericum juniperinum Kunth : It occurs in Colombia and Venezuela.
Hypericum Kelleri soon. :. It is an endemic of Crete 
Hypericum linarifolium Vahl : It occurs in Madeira, Spain, Portugal, France and the United Kingdom. 
Hypericum linarioides bosses : It comes on the Balkan Peninsula in Turkey, Armenia and the Ukraine. 
Spotted St. John's wort ( Hypericum maculatum Crantz , Syn .: H. dubium Leers )
Hypericum majus (A. Gray) Britton : It is resident in Canada and in the USA and comes in Central Europe in France and Japan naturalized before.
Mexicanum Hypericum L.
Mount St. John's wort ( Hypericum montanum L. )
Hypericum montbretii Spach . It occurs on the Balkan peninsula in Western Asia and in the Ukraine 
Hypericum mutilum L. : It occurs in Canada and the United States. 
Hypericum myricariifolium Hieron.
Pfennigblättriges St. John's wort ( Hypericum nummularium L. ): It occurs only in the Pyrenees in northern Spain and the French Alps.
Olympus St. John's wort ( Hypericum olympicum L. ): It occurs on the Balkan peninsula, in the Aegean Sea, Turkey and Ukraine. 
Great Flowery St. John's wort ( Hypericum patulum Thunb. ):., the homeland is China 
Durchwachsenblättriges St. John's wort ( Hypericum perfoliatum L. )
St. John's Wort ( Hypericum perforatum L. ): It is often used medicinally.
Hypericum pubescens Boiss. : It occurs in Portugal, Spain, Sardinia, Sicily, Morocco, Algeria, Tunisia and Libya. 
Beautiful St. John's wort ( Hypericum pulchrum L. )
Richer St John's wort ( Hypericum richeri Vill. ) comes in the mountains of Southern Europe and Central Europe to the Balkan peninsula and the Carpathians
Hypericum rochelii Griseb. & Schenk : It occurs only in Romania, Bulgaria and Yugoslavia.
Hypericum rumeliacum Boiss. : It occurs only on the Balkan Peninsula and in Southern Romania.
Hypericum spruneri Boiss. : It occurs only in Italy and the Balkan Peninsula.
Hypericum taygeteum Quezel & Contandr. : It occurs in southern Greece only in the Taygetos Mountains.
Winged St. John's wort ( Hypericum tetrapterum Fries )
Hypericum thasium Griseb. : It occurs only in the southeastern Balkan Peninsula.
Hypericum thuyoides Kunth : It occurs in Colombia.
Hypericum tomentosum L. : It occurs in Portugal, Spain, the Balearic Islands, France, Corsica, Italy, Sardinia, Morocco, Algeria and Tunisia. 
Hypericum Trichocaulon Boiss. & Heldr. : It occurs only in Crete.
Krausblättriges St. John's wort ( Hypericum triquetrifolium Turra )
Hypericum umbellatum A.Kern. : It occurs in Bulgaria, Romania and Yugoslavia.
Hypericum undulatum Schousboe ex Willd. : It occurs in the Azores, Madeira, Portugal, Spain, France, Great Britain, Algeria and Morocco. 
Hypericum vesiculosum Griseb. : You only happens in Greece.
Hypericum xylosteifolium (Spach) N. Robson (Syn .: Hypericum inodorum Mill. ): It occurs in Turkey.