St. John’s Wort: Good for More than Depression

Healthnotes Newswire (October 21, 2004)—A new study finds that St. John’s wort (SJW) is a helpful treatment for somatoform disorders (SDs), according to Psychosomatic Medicine (2004;66:538–47). SDs are a group of conditions characterized by several ongoing physical symptoms that cannot be explained by any identifiable illness.

People with SDs may experience symptoms such as nausea, sexual dysfunction, widespread pain, and neurological problems like difficulty swallowing and impaired coordination. These feelings of illness can cause them to spend as much as one week of every month in bed. People affected by SDs generally do not seek psychiatric help for their condition; instead, they often see primary care physicians and specialists. Despite medical testing and expert opinions confirming no underlying physical ailment, these people have a strong belief that they are physically sick. Treatment options for SDs are limited, mainly focusing on improving coping skills. Little is known about the effectiveness of medications for SD treatment.

Numerous studies have shown (St. John's Wort (SJW) to be effective for treating mild to moderate depression. Some trials using SJW for depression have reported an improvement in associated somatic (physical) symptoms. The current study used several different rating systems to determine SJW’s efficacy for SD treatment in 173 men and women. The participants were assigned to receive either 300 mg of SJW (standardized to contain 0.3% hypericin) two times per day, or placebo for six weeks. Assessments of response to the treatment and side effects were made at two-week intervals throughout the study.

By all of the rating systems that were used to assess SD symptoms, people taking SJW had significantly better outcomes than those taking placebo. Among those participants receiving SJW, 44% reported being completely improved, compared with only 25% in the placebo group. In contrast, 45% of the participants in the placebo group felt unchanged or worse compared with 17% in the SJW group. By the end of the study, one half of the participants taking SJW had improved so much that they were no longer considered to have SD. The tolerability and safety of SJW was essentially the same as that of placebo.

The results of this study indicate that SJW is a safe and effective treatment for SDs, and confirm similar results of a previous trial. Exactly how SJW works is not clear, although it does contain compounds that influence various aspects of human biochemistry. The fact that an herbal remedy is able to relieve a wide range of physical symptoms that most doctors consider psychological in nature suggests that SDs are not just “in the mind.”

Kimberly Beauchamp, ND, received her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She is a co-founder and practicing physician at South County Naturopaths, Inc., in Wakefield, RI. Dr. Beauchamp teaches holistic medicine classes and provides consultations focusing on detoxification and whole-foods nutrition.