St John's Wort - it's not all good

>>  Thursday, November 14, 2013

As the nights start to draw in, we drive to work in the dark, drive home in the dark and generally shut ourselves up inside, winter blues kick in.  'Take St John's Wort' the super market shelves cry and for years I have. 

I've taken it all year round for a long time, but last winter (the never ending one) I was having some really strange symptoms and as I searched around I thought it might be down to the St John's Wort and stopped taking it. Winter has returned, I take it again and the side affects seemed to have returned.

France have banned it completely, Ireland and Germany have banned non-prescriptive sales. The UK, Japan and Canada have put warnings on the packaging....although it appears to be tucked away in very small print.

Tucked away down in that small print there is a massive list of medications St John's Wort can have a bad affect on.  This website (whilst old) explains it very clearly.  The NHS website does have a list but it's not as clear to read, I had to read twice before I spotted a drug listed that is a 'relation' of the one I take.  It's actually not that obvious until you start digging.

I take Nortriptyline, it's a tricyclic antidepressant that has the fortunate side affect of being a great neuralgic pain killer.   This is from The University of Maryland Medical Centre:

"St. John's wort may interact with medications used to treat depression or other mood disorders, including tricyclic antidepressants, SSRIs, and monoamine oxidase inhibitors (MAOIs). Taking St. John's wort with these medications tends to increase side effects, and could potentially lead to a dangerous condition called serotonin syndrome. Do not take St. John's wort with other antidepressants, including:

  • SSRIs: Citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft)
  • Tricyclics: Amitriptyline (Elavil), nortryptyline (Pamelor), imipramine (Tofranil)
  • MAOIs: Phenelzine, (Nardil), tranylcypromine (Parnate)
  • Nefazodone (Serzone)"
Well that explains why I've been so totally exhausted, I've been struggling to function properly at all.  I've got my nortriptyline on a fine balance, if it goes wrong the sedative side affects knock me down flat.

I've also had worrying stomach pains, nausea, cramping.  That's there in the side affect list too. As is tiredness and anxiety.  But mostly I was concerned because I was having a never ending period.  It's what finally started me reading around, what was messing with my hormone balance?

I've stopped taking it and within 2 days, I've started to pick up already.  Less tired, no nausea and my never ending period has stopped. Coincidence? 

I know we have a personal responsibility for what we put inside our bodies but I would appreciate it if the risks were more transparent.

The Healthspan website does link off to the small print and buried in there is the poorly written information the same as the NHS website but there is no bold print warning.  No high visibility.  And more importantly to me, like the NHS, no direct mention of tricyclic antidepressants or nortriptyline.

The Sainsburys website is worse, Kira low mood relief, is not clearly shown as St Johns Wort.  You must read the photo of the box where it is the 3rd line down and the warnings are not available to read until after purchase and you open the box to get at the notes within.

Do you do that? Do you sit down and read the leaflet that comes with the medicines you are given, I try to now but they are rarely clear and I tend to have to start looking up references.  But things you have taken for years, you take them for granted.  The same vitamins, you take them year after year, then a new type is on special, you grab them....well, they are all pretty much the same, aren't they?  It's a dangerous game to play, but I suspect more people than me play it.

I'm going back to my light box now I've stopped taking the St John's Wort.  I'll let you know how the winter blues go.


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