Phototoxic photosensitivity from hypericum preparations appears to be due to the naphthodianthrones, hypericin, and pseudohypericin. Accessed Sept. 20, 2017. 6. I started taking St. Johns wort for depression over the winter. 218-221. Hypericin itself, however, is clearly phototoxic. St. John's wort and anxiety are connected mostly as a possible remedy to help people with anxiousness. Photocytotoxic effect of pseudohypericin versus hypericin. You may want to consider exercise, fish oil or light therapy once the herb is out of your system. Schedule your appointment now for safe in-person care. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. St. John's wort is an herb frequently used for treating depression. 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. Intravenous administration of high-dose hypericin results in severe phototoxicity that precludes its clinical use. St. John's wort may cause a number of side effects. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. It can make it hard to get to sleep and may lead to undesirably vivid dreams when you do. These hypericins are photoactive quinones that produce singlet oxygen and free radicals when exposed to light. 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). Schempp CM, et al. 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. Photochem Photobiol 1999;69: Check with your doctor before using St. John's wort in combination with any prescription drug. However, the supplement interacts with many medications and can cause serious side effects. Maximum plasma concentration of hypericins was approximately 44 mcg/mL. 8. All rights reserved. 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. 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%). https://naturalmedicines.therapeuticresearch.com. St. John's wort is generally considered safe when used orally in appropriate doses. The results demonstrated an inhibitory effect of both hypericum extract and hyperforin on the MECLR and on the proliferation of T lymphocytes. There's some evidence to suggest that St. John's wort, combined with black cohosh, helps improve mood and anxiety during menopause. https://nccih.nih.gov/health/stjohnswort/sjw-and-depression.htm. Gulick RM, et al. Lee DW, Downum KR. For more information on the pros and cons of St. John’s wort and alternative. Because of this, France has banned the use of St. John’s wort in products. 16. [Reversible increase in photosensitivity to UV-B caused by St. John’s wort extract]. 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. St. John's wort is thought to be possibly safe for children ages 6 to 17 years old when taken for up to 8 weeks. Two case reports of photoactivated toxicity with St. John’s wort have been reported. 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. Bove GM. Increased sensitivity to sunlight (photosensitivity). Advertising revenue supports our not-for-profit mission. 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 … Hypericin levels in human serum and interstitial skin blister fluid after oral single-dose and steady-state administration of Hypericum perforatum extract (St. John’s wort). J Photochem Photobiol B 1998;45:87-94. 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). But albino cows definately have a problem with St. John's Wort. At baseline and then four hours after drug intake, subjects were exposed on small areas of their back to increasing doses of solar simulated irradiation (SSI, containing both UVA and UVB); another part was exposed to selective UVA irradiation. Possible interactions include: Mayo Clinic does not endorse companies or products. However, it can cause: There isn't enough information about the safety of using St. John's wort topically. However, it can cause: 1. These levels are far below hypericin levels that are estimated to be phototoxic by these investigators (> 100 mcg/mL). sensitive hands and feet from St. John's Wort - posted in Recovery Stories: St.John's Wort really helps keep my DP manageable but I think it may be the reason my hands and feet recently feel super sensitive. Dr. Cott is Scientific Director and Chief Science Officer at Scientific Herbal Products, Inc. in College Park, MD. 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). No change was apparent in visual erythema score after application of either hypericum oil or ointment. The study was conducted in winter. I am 33 and grew up on the beach and never had this before in 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. Don't use St. John's wort if you take prescription medications. 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. It gets its name from the fact that it often blooms on the birthday of the biblical John the Baptist. 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. SSI sensitivity was the same in both groups after hypericum treatment. Photosensitivity rarely is reported in St. John’s wort clinical trials; however, pale patients who burn easily may not realize they burn more easily. And so the authorities that be in charge (of cows and bugs, anyway) in … This is especially important if you are also currently taking a medication that can cause Sensitivity to selective UVA light was increased slightly (approximately 20%) after the highest dose of hypericum. 2. In a single-dose segment, 13 volunteers received placebo or a standardized hypericum extract (900, 1,800 or 3,600 mg, containing 0, 2.8, 5.6, and 11.3 mg of total hypericins [sum of hypericin and pseudohypericin]) in a double-blind, crossover design. 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. Some evidence even shows it can be used safely for over one year. The spectral distribution of biologically active solar radiation at Miami, Florida, USA. Sun sensitivity has been noted in some, but not all, clinical trials of St. John’s wort, but generally only at doses that went above the recognized 900 mg daily levels and even then, only rarely. 11. Schempp CM, et al. Maximum total hypericin plasma concentrations were observed about four hours after drug administration, and were 0, 28, 61, and 159 mcg/mL, respectively. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. 200-203. St. John's wort and depression: In depth. 5. Dry mouth 7. There is a wide range of susceptibility to phototoxic effects of drugs, and there is clearly a dose-related effect. Even low doses of St. John’s Wort made the blood levels of indinavir go down by more than 50%. Mayo Clinic does not endorse any of the third party products and services advertised. If you have sun sensitivity due to the cutanea tarda form of porphyria, you should avoid consuming alcohol. Seasonal affective disorder (SAD). 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. St. John's wort is often used to treat depression and menopausal symptoms. Burning or prickling sensation 4. 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. Topical St. John’s wort preparations appear to have low potential for photosensitization. Staffeldt B, et al. Br J Dermatol 2000;142:979-984. 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%). Used alone, St. John's wort has improved mood in people with SAD, a type of depression that … Johnston N. "Sun Trap." Acute neuropathy after exposure to sun in a patient treated with St. John’s wort. After steady-state administration (300 mg/d tid for seven days) the mean serum level of hypericins was 12.5 mcg/mL. Low blood sugar levels (hypoglycemia) 13. The clinical implications of this are unclear. Phototoxic effects of hypericum extract in cultures of human keratinocytes compared with those of psoralen. St. John's wort should not be given to a child younger than 6 years old. Schulz V, et al. Tierarztl Prax 1989;17:257-261. Although hypericin clearly is linked to photosensitivity reactions, pseudohypericin also may be involved. Schey KL, et al. St. John’s wort might cause serious interactions with some drugs. A few hours after sunbathing she developed symptoms on her arms and legs (again confined to sun-exposed skin). The authors conclude that the results confirm a phototoxic effect of hypericin on human keratinocytes, but note that blood levels achieved with normal therapeutic use would be too low to induce phototoxic skin reactions. Restlessness 14. Two weeks ago, I spent the day at the beach and ended up with severe heat rash. I wanted to start out slow on it, so I only take one pill @ 300 mg. per day. Vandenbogaerde AL, et al. Anxiety 3. It seems to be about as effective in treating depression as many prescription drugs. St. Johns wort (both oral or topical) can increase the sensitivity of your skin and eyes to sunlight. It’s now May. Regular usage of St. John’s wort is known to cause excess hair loss, just like several other antidepressants (). 7. There was no correlation between total hypericin plasma concentrations and photosensitivity. Hypericin and pseudohypericin: Pharmacokinetics and effects on photosensitivity in humans. St. John's wort is available as a supplement in teas, tablets, liquids and topical preparations. The authors suggest that this may provide a rationale for the traditional treatment of inflammatory skin disorders with hypericum extracts. It can influence your mood, making you restless, anxious, agitated and irritable. 13. 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. 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. New York: Springer Verlag; 1998:50-65. First noted in animals that grazed in fields dotted with St. John’s wort, an early report was about a case of St. John’s wort poisoning in German Blackface sheep. Accessed Sept. 20, 2017. Available at: http://www.newscientist.com/ns/19990724/itnstory199907249.html. Agitation 2. From SURVIVING RADIATION THE WISE WOMAN WAY ~2002, Susun S Weed "~ St. Joan’s/John's wort oil protects my skin from radiation damage. If I stub my toe or jam my fingers it hurts much more than it used to! Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Examination was consistent with allodynia; St. John’s wort was withdrawn and symptoms began to improve in two weeks and disappeared over two months. Do not use this product without medical advice if you are breast-feeding a baby. St. John's wort (Hypericum perforatum) is a flowering shrub native to Europe. 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. Natural Medicines. 1121-1122. Alternative Therapies in Women's Health Archives. Diarrhea 6. 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. Anxious, agitated and irritable over the next 360 days evaluated photometrically or. John the Baptist hypericin clearly is linked to photosensitivity reactions, pseudohypericin may! The birthday of the hypericum perforatum ) is a flowering shrub native Europe... While breast-feeding even low doses of St. John 's wort should not be given to a child than! Because of this site constitutes your agreement to the naphthodianthrones, hypericin, and there is a! My fingers it hurts much more than 50 % in all of these materials be. 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