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St. Johns Wort and the Dangers of “Alternative” Medicine

alternative medicine

Grapefruit juice, I hate the stuff. But did you know that if you drink as little as 8 oz. of it when you take certain medications it could dramatically increase the effectiveness of the medicine? Sounds like a great thing, sure, until you realize that the dose of medication you are taking is specific to you and that increasing it can have serious side effects and in some cases cause death. This discovery led to the inclusion on the labels of certain medications to be cautions about grapefruit juice [and grapefruit] consumption.

Grapefruit juice isn’t the only thing that can have this effect. In fact, milk for example can have the exact opposite effect, causing medications to become less effective. That one is a little known fact and you probably won’t see it on any medication labels because you can’t overdose from less of a medication.

First a little disclaimer, I hate the “alternative” medicine idea in general. I’m not a “natural” medicine person or “alternative” medicine kind of person; if it is medicine, it has been proven. If it’s not then it doesn’t work or works worse than its medical component. So when I stumbled upon an article in the Journal of Alternative and Complementary Medicine I was more than a little skeptical, but then I read the title and felt a little better.

The team did a research study on the effects of St. Johns wort and its effects on other medications. To do this they looked at the national medical database, across 17 years to assess how often, St. John’s wort is prescribed and taken with other medications that may result in adverse reactions. Other medications included things such as oral contraceptives, selective serotonin reuptake inhibitors [SSRIs], blood thinners, chemotherapy medicines, digoxin, statins, immunosuppressants’, or HIV medicines, for example.

The results showed that a whopping twenty-eight percent [28%] of hospital visits involved a drug that has potentially dangerous interaction with St. Johns wort. Also, for reference these medications included selective serotonin reuptake inhibitors [antidepressants], benzodiazepines, warfarin [blood thinner], statins, verapamil [blood pressure medication], digoxin, and oral contraceptives [aka birth control].

Which further proves that seeking alternative therapies can, not only be a waste, but can be hazardous to an individual’s health. Creating a controversy or offering false hope is one thing. Don’t get me wrong, I am not okay with people selling a dream and raking in a profit, but I am vehemently against people pushing quack ideas that land others in the emergency room. There is a moral to all of this somewhere, something along the lines of a fool and his money are soon parted. On the other hand, maybe it’s just because something is “mainstream”, like medicine for example, that does not mean that there is a conspiracy to hide some “real” truth.

The truth is that people go into the sciences to help people. Don’t get me wrong, not everyone has good intentions, look at Wakefield and more recently Dr.Oz who just wanted to make a quick buck no matter the cost to the people around them. However, in general, people go into the sciences to make a difference and sometimes they really manage to do it. Take for example Jonas Salk [If you don’t know whom he is, then that is just a testament to whom we idolize and whom we forget]. At a time where people were more afraid of polio then they were of even the atomic bomb, he found a vaccine for it, something that could have made him rich beyond belief. Instead of patenting his vaccine and buying a small [or large] island in the Bahamas he decided to let everyone have it, free of charge so that children living in poverty could get the vaccination, if only we could all be that selfless.

The man, the myth, the legend.

The man, the myth, the legend.

As for St. Johns wort, well this isn’t particularly new information. Last year USA today even published an article entitled Grapefruit not only food that can affect medication where it does indeed show St. Johns wort can have a negative impact on people taking certain medications. Apparently, the naturopaths did not get the memo from the FDA on that one, but then again if they knew anything worthwhile they would be MD’s now wouldn’t they?

I know how tempting it is to reach out and want to believe that there is a cure or treatment for something that has none. I know what it feels like to be helpless and desperate; I even know what it’s like to have no hope. If there ever was a take away message from all of my writing — please do not let someone sell you false hope, it really isn’t better than no hope. Because false hope can, on occasion, make things much worse.

Davis SA, Feldman SR, & Taylor SL (2014). Use of St. John’s Wort in Potentially Dangerous Combinations. Journal of alternative and complementary medicine (New York, N.Y.) PMID: 24956073

Bailey, D., Malcolm, J., Arnold, O., & David Spence, J. (2002). Grapefruit juice-drug interactions British Journal of Clinical Pharmacology, 46 (2), 101-110 DOI: 10.1046/j.1365-2125.1998.00764.x

Rao TS, & Andrade C (2011). The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Indian journal of psychiatry, 53 (2), 95-6 PMID: 21772639

Corti N, & Taegtmeyer AB (2012). [Clinically important food-drug interactions: what the practitioner needs to know]. Praxis, 101 (13), 849-55 PMID: 22715076

9 responses

  1. Jack

    I find it somewhat strange that you don’t acknowledge that there’s a decent evidence base that St. Johns Wort actually works as an anti-depressant. This puts it in a rather different category to the almost all other “alternative” medicines.

    See, for example, the Cochrane review ( http://summaries.cochrane.org/CD000448/st.-johns-wort-for-treating-depression. ) which concludes “The available evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants.”


    July 1, 2014 at 3:43 pm

    • No, the mayo clinic: http://www.mayoclinic.org/drugs-supplements/st-johns-wort/evidence/hrb-20060053 admits that there is good evidence to support that it helps with mild depression and nothing more serious, the key to science is having repeatable conclusions to a study, one study wont do anything for you.

      As for the the rest, you still need to be careful with contraindications because let’s face it, that was the main point of my post. More people are put into the hospital every year for over the counter supplements than antidepressants. Furthermore, yes side effects bad, but that is over simplifying the problem. Depression is a serious medical condition and treatment for it is tough, you aren’t going to find a cure from anything “natural” or anything from the alternative medicine group… because lets be real, if anything worked better than the mainstream treatments we would be using them!


      July 2, 2014 at 8:49 am

      • Jack

        I linked to a Cochrane review. It is not a single study; it is a systematic review of multiple of multiple studies.

        I agree with you that contraindications are important and that they should be a real concern about drugs like St. Johns Wort that exist outside of the medical setting. However, lines such as “If there ever was a take away message from all of my writing — please do not let someone sell you false hope, it really isn’t better than no hope. Because false hope can, on occasion, make things much worse.” seem inappropriate for St Johns Wort since it seems likely it does actually do something.

        It’s also the rare counter-example to Tim Minchin’s quote.


        July 3, 2014 at 3:12 am

      • Well that’s what I get for replying to comments on my phone. Sorry it’s been a busy week or so,well month. But that’s besides the point.

        I think the misunderstanding comes from what you quoted. I was, in that particular instance referring to alternative medicine as a whole. Now that might not seem better, but I do understand that there are exceptions to blanket statements like that.

        Mostly I’m just heartbroken about all the money that gets funneled to alternative medicine by parents trying to treat things like autism or cancer, things that are terminal or have no cure. False hope can give people a false sense of security and keep them from looking for actual treatments. Or in the case of autism the actual cause.

        But as with all things I appreciate your input, opinion, and knowledge. So thanks for keeping civil what typically turns nasty (at least on the internet).


        July 3, 2014 at 10:15 am

      • Jack

        Well, I’m with you there. It’s disgusts me more when you get otherwise reputable organisations backing this nonsense 😦


        July 3, 2014 at 2:22 pm

      • Well thank you, I’m glad we are in agreement 🙂 Glad to have you around by the way. I always enjoy a good conversation.


        July 3, 2014 at 7:31 pm

  2. Interesting. More information/testing of alternative medicines would be useful. Some may be effective however, or work via a placebo benefit, so it is a complex topic for me.


    July 1, 2014 at 6:34 pm

    • I agree, it is a very complex topic. Placebo can be accounted for in studies to test alternative medicine though, which is handy. A lot of alternative medicine has been looked at for actual medical use. Things like cranberry [extract, juice, etc.] is recommended by doctors and that is “alternative medicine-ish”.

      Things like acupuncture however, have been disproven using some of the best experimental methods that I could think of to overcome the placebo effect and account for it.

      In any case, thank you for the comment and for sharing your opinion, that is always welcome here!


      July 2, 2014 at 8:52 am

      • Thanks you too.


        July 2, 2014 at 9:23 am

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