St. John's wort risks: What you need to know before using it

When people look for natural ways to feel better, St. John's wort, a herbal supplement often used for mild depression and anxiety. Also known as Hypericum perforatum, it's sold in capsules, teas, and tinctures—but it’s not harmless just because it’s plant-based. Many assume herbal means safe, but St. John's wort can mess with your prescription meds in ways you won’t see coming.

This herb doesn’t just sit there. It forces your liver to break down other drugs faster, which means things like birth control, blood thinners, and antidepressants stop working right. If you’re on SSRIs like sertraline or fluoxetine, mixing them with St. John's wort can trigger serotonin syndrome, a dangerous condition caused by too much serotonin in the brain. Symptoms? Shaking, high fever, fast heart rate, confusion—sometimes it’s fatal. Even if you think you’re just taking it for "a little mood boost," your body doesn’t know the difference.

It also affects drug interactions, how medications behave when taken together in ways that aren’t obvious. People on HIV meds, cancer drugs, or heart medications like digoxin have ended up in the ER because they didn’t realize St. John's wort was cutting their treatment down to nothing. And it’s not just pills—this herb can make your skin super sensitive to sunlight, leading to bad burns even on cloudy days.

Doctors don’t recommend it for serious depression. Studies show it might help with mild cases, but only if you’re not taking anything else. And if you’re thinking of switching from a prescription to this herbal fix, stop. You’re not saving money—you’re risking your health. The FDA doesn’t regulate supplements like drugs, so what’s in the bottle might not match the label. One brand could have twice the strength of another, and there’s no standard for purity.

There are better, safer ways to manage low mood. Exercise, sleep hygiene, therapy, and FDA-approved meds have proven results without the hidden dangers. If you’re curious about supplements, talk to your pharmacist first—not a store clerk. They’ll check your current meds and tell you if something’s a red flag.

Below, you’ll find real-world breakdowns of how St. John's wort clashes with common drugs, what the research actually says about its effectiveness, and how to spot the early signs of trouble before it’s too late. This isn’t theory—it’s what people have lived through. Know the risks before you reach for the bottle.