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Re: St Johns Wort Works! » Alara

Posted by Larry Hoover on November 26, 2002, at 9:32:18

In reply to Re: St Johns Wort Works! » Bill L , posted by Alara on November 26, 2002, at 5:27:33

> > Alara - just to be clear, I'm assuming that you are taking 600 mg three times a day for a total of 1800. Is that correct?
> >
> >
> Bill, I am actually taking 3 tablets a day, each of which contains:
>
> St John's Wort (Hypericum perforatum) extract equivalent to dry flowering herb top...1800mg
> Hyperforin..............................15mg
> Hypericin...............................990mcg

This is a non-standard format. They're comparing their tablets to raw herb mass.

> This preparation is made by Herron Pharmaceuticals. Indication: Take one tablet three times daily with food or as professionally directed. (Equals 5400mg Hypericum daily.)
>
> Judging from the case studies cited by Larry, I am taking more than the recommended dose. Is this too much?

Let's do some math. SJW products standardized on both hyperforin and hypericin typically contain 4% hyperforin and 0.3% hypericin, in a 300 mg capsule/tablet. With t.i.d. dosing, you get:

Hyperforin: 0.04 times 300 mg times 3 = 36 mg
Hypericin: 0.003 times 300 mg times 3 = 2.7 mg

Here's what you're getting:

Hyperforin: 15 mg times 3 = 45 mg
Hypericin: 990 mcg = 0.99 mg times 3 = 2.97 mg

You're getting 10-20% more than the recommended dose for mild to moderate depression. You can quite safely adjust the dose upwards (or downwards) according to your symptoms. If you get intolerable side effects, that will affect your personal upper dose limit.

> I am also wondering about the safety of eating matured cheese etc on my current dose as St John's Wort acts like a MAO inhibitor. There is information on the net suggesting that the original fears about SJW and food interactions have now been abandoned. Larry???

There is a mild and possibly reversible MAOI activity with certain extracts of SJW. The original report of this activity used concentrations 180 times the typical physiological concentration, and achieved only 60% inhibition (still safe, by the way). Only if you have a genetic trait which causes malformation of both the MAO enzymes might you be conceivably at risk. The risk is theoretical, not practical.

I just wish the nefazadone (Serzone) inhibition of the liver enzyme CYP3A4 got nearly as much press as the MAOI activity of SJW. Serzone nearly killed me.

Lar

 

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poster:Larry Hoover thread:128819
URL: http://www.dr-bob.org/babble/20021122/msgs/129398.html