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A study from Italy warns that mixing the herbal preparation, St John's wort, with prescription drugs may cause side effects.

More than 12 studies in Europe show that St John's wort can treat depression. The Boston Globe, LA times and a web site called analyzed samples and found that many brands of St. John's wort do not contain what the label claims. The Boston Globe found that only Nature's Resource had what it claimed. found that only Nature's Way Standardized Extract and Natrol Mood Support contained what they claimed.

There is no regulatory agency today to separate honest businessmen from frauds because of a law passed by Congress in 1994 forbidding the Food and Drug Administration from regulating products sold as food. St John's wort is broken down by the same cytochrome P450 enzyme that breaks down many commonly prescribed drugs and it can lower blood levels of anticlotting drug, warfarin; the heart drug, digoxin; the asthma drug, theophylline; the cancer drug, cyclosporin, oral contraceptives and others. Also several common foods such as broccoli and red wine lower blood levels of St John's wort, to prevent that herbal from treating depression.

The bottom line: There is no evidence that St. John's wort raises mood of normal people. There is evidence that St John's wort helps to elevate mood in depressed people. Many commercial preparations of St John's wort have labels that lie about their content. Herbals can be a dependable and safe part of medical treatment, but only if the industry stops fighting regulation, weeds out it's frauds and has severe penalties for the fraudulent manufacturers who masquerade as honest herbal manufacturers. For a report on treatment of depression with prescription antidepressants see #G214

"Although evidence is growing on the effectiveness of Hypericum in mild to moderate depression, and its safety has been established in double-blind, randomized clinical trials, pharmacovigilance is needed for all herbal medicines, and a tighter regulatory framework is desirable. Regulatory agencies in the United States and Europe have already issued warnings about Hypericum drug interactions. PM Biffignandi, AR Bilia. The growing knowledge of St. John's wort (Hypericum perforatum L) drug interactions and their clinical significance. Current Therapeutic Research - Clinical and Experimental, 2000, Vol 61, Iss 7, pp 389-394Address Biffignandi PM, Soc Italiana Attivita Farmaceut, Corso Re Umberto I, 44, I-10128 Turin, ITALY

Checked 8/9/05

June 1st, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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