Sawbones: A Marital Tour of Misguided Medicine - St John's Wort

Episode Date: April 6, 2021

A somewhat invasive plant with yellow flowers named after John the Baptist has been used for centuries as a kind of cure all. Dr. Sydnee will lead you through a history of its many applications, what it’s used for today, and explain what exactly is a wort.Music: "Medicines" by The Taxpayers

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, two, three, four. Hello everybody and welcome to Sobhones, a marital tour of misguided medicine. I'm your co-host Justin McElroy.

And I'm Sydney McElroy. One of the thrill is to be here, said, so excited to be recording this episode with you. I am too, except the weather is starting to get nice again outside, so I do. Can we start recording outside, or will that interview you? You want to do it out in the quad? You want to go can we record out on the quad today? Hey, hey, hey, prof. Hey, prof. Can we do our podcast out on the quad? Because some of the problems that may start student double sticks three feet from you and you get a bunch of In the in the mics the whole time. That's not pleasant. That's true

I have somebody crewing cats in the cradle Five feet away from you, no thanks. Well, and I have to imagine that we're like hidden in this tiny room in our house with all of this like padding on the walls for a reason. Some sort of sound related, quality reason, and not just, this is not just like your design aesthetic. No, I have, no, they're foam, they're, they're a very important scientific purpose that I definitely would notice the absence of or these Sound panel them out here definitely. Okay, so that takes out exactly what they're doing. I wrote a book about podcasting

That's okay. Well, Justin I have a topic this week that I'm kind of surprised we've never done before I have a topic this week that I'm kind of surprised we've never done before. Yeah, I had heard of this one for a long time. So it was, you know, I feel like at this point got a lot of the low hanging fruit, if you will. So I want to thank Kayla for recommending this topic because I don't know, again, I don't know why we've never talked about it before. It's a very common old remedy that is still in use today. And it's made of warts. No. But it is called St. John's Wart.

Yeah, that's confusing. A lot of people are actually still confused about the difference between those. I'm going to tell you what the word Wart means. That's part of it. That's not, but that's later. That's in a minute. I won't give that. That's not that much later.

Don't get too excited. It is something I looked into because I realized that a lot of things are called WART, but we don't mean WART like WART, like WART, we mean WORT, and you know, if you use a word enough, you should probably know what it means. That's fair. I've in my experience, if you use a word a lot without knowing what it means, it can get in some hot water, maybe you've been saying something pretty stupid for a decade. So, yeah. Now, if you use a word a lot that you know what it means, but you mis been saying something pretty stupid for a decade. So, yeah.

Now, if you use a word a lot that you know what it means, but you mispronounce it regularly, that just means you read a lot. That's always been my excuse. I love that. Yes. I'm more of a reader than a speaker. Then a talker to other humans. So this is, like I said, one of the oldest and most common, I would think, herbal prescriptions

used globally, certainly, here in the US as well. There is actually a lot more use of it as a standard treatment of sorts, a standard therapy. Here, you would consider it like an alternative medicine and herbal supplement. It's regulated as a supplement. It is not regulated as a medicine, a drug, a cure, a treatment. It is not like that. Outside the US, it's not necessarily regarded that way, but here. It seems more than a supplement. Yes, exactly.

Over time, the diagnoses for which you could use St. John's word have changed dramatically. It was at one point and we'll get into this somewhat of a cure all. These days, we don't really consider it that whether you're using it as an alternative medicine, like a supplement here or somewhere else in the world, somewhere a lot of European countries, it would be a lot more standard to use either way. We sort of targeted what we use it for. Long time sub-hounds listeners, Either way, we sort of targeted what we use it for. Long time sub-ozlers and just like myself, probably have their funny baloney alarms going off pretty crazy right now.

Well, I don't know that that's not necessarily true because so many people are familiar with it. Yeah, yeah, but people are familiar with a lot of things, like colloidal silver. Let me see how that turned out. Well, okay, don't use colloidal silver. This one's a little different. Don't use colloidal silver.

This one's a little different. It's a little different. Hypericum perforatum is the name, the scientific name of the plant. This comes from a couple Greek roots, hyper and icon meaning over and either image or apparition to over and image over and apparition. It's because of the power that the plant was thought to have for a long time. It was thought that Hypericom had this sort of magical quality that allowed it to ward off evil spirits or demons or, you know, bad stuff.

So which is part of why I think there was a hesitance to accept it. Because we've talked about on the show, there are other like plants that we realized were medicine. That happens. I mean, plants got to come or medicine has come from somewhere. And sometimes it's a lab. No, not a field of Advil trees, but... So, there was this sort of mystical connection with it that it had this ability to protect you in some way. Part of it, and we'll get into this, and I think this probably does look magical. I've never had, I've never seen, I say John's work plant in the wild.

I guess you can, like you can find the wild. You may have seen one in the wild. I don you can, like you can find them. You may have seen one in the wild. I don't know. Would you recognize it? Are you? I've looked at pictures of it now. You can see it in hindsight. You mean you haven't seen it.

Yeah, and if I did, I didn't know that's what it was. But I don't recognize it around here. It could, one place I read that it could grow or like abandoned mining areas. So it's like we might have it. It's gotta be here. Yeah. It has to be here. Not a lot of that, I think it's still.

It's all anywhere that's temperate, it's there. Like it's all over the place. It's an invasive species in most of the planet now. That's not where it started, but nowadays you can see it a lot of places. The perforatum part of the name comes from these little translucent spots. You can see if you hold the leaf up, so it looks like it's been perforated, looks like

it's going to hold on it. But the mystical part, in part, might be because if you take the flowers and crush them, they give off this very dark red sort of oil or juice or something, and that looks cool. Like what? Looks pretty metal, I guess. The name, the colloquial St. John's Wart was given to it by Europeans who noted that the flowers tended to bloom around June 24th, which is the feast day of St. John the Baptist.

That is at least one thought as to how it transitioned from Hypericom perforatom, which of course everybody was. They're probably leading with that. Two St. John's Word, and there are a bunch of other names, but now a day St. John's Word is definitely the one that's stuck. I would guess in your name from transition from Hypericom perforatom, it probably transitioned from that plant with the weird flower. It's new sage on the word. There is also a legend about the name that maybe it is because so like I said, you can take the flowers and you can crush them and let out this sort of red.

Juice and and like if you just put them in oil eventually it will just sort of turn the oil red and that that was something you used to do is like You'd want to infuse like olive oil with it And so you would just put the flowers in olive oil and then after a certain number of days the oil turns red and you know It's in there and supposedly the first time that happened was on August 29th, which I guess is the day that John the Baptist was beheaded. Okay. Okay, sure. I'm looking at you because I like

like, I was just a no because I was Baptist for a while. And that's the Baptist is in the name, so I thought maybe. Okay, you thought maybe I'd be plugged into John the Baptist. I mean, I know some stuff about John the Baptist, but none of it relating to his words. If his name was John the raised Catholic, you know, you could look at me.

Yes, fair. So anyway, magical stuff. One way of it. I think the timing of when it blooms is the most likely. Probably, yeah. It sounds more logical. Right. But it does do that cool thing.

Wart is an old word for plant. Oh, man. Yes, comes from the old English word, W-O-Y-R-T, which means plant. Error is gearing up for some classic solbons, dinner, part of Serbia. And what we get is war means plant. It goes the so you know, there's a lot of there's some words in English and German that have common roots and overlap and the German word Wartis, which is from the word,

Wirtzel, which means root, and then Wirtis. And then, Wirt. And then, Wirt. Wirt means plant. And there you go. Now you have Wirt. This probably makes a lot more sense to you, a person who's looking at it on a page,

and someone who's listening to you say it. It kind of sounds like... It was like German and then Old English, and now it's Wirt, and it means plant. Got it. Done. It is, like I said, it was native to parts of Europe and some parts of Asia, but then it was transplanted all over the world

a long time ago. I mean, it's been here. I think the first time it was noted in the US was like the late 1700s. It's good to actually use transplant because that is 100% what is happening when you're moving from place to place. I love that.

And it was everywhere when it was sort of prized for its perceived medicinal benefits. I mean, everybody pretty much agreed like, this is a great medicine. I love this plant. Of the medicines we have available to us, this is top 10. This is a great one. There are two compounds in it that are mainly responsible for the activity that it has something called hypericin and then hyperferin. So there are two active compounds in it that can do stuff in your body. There's a lot of other stuff that

might have effects, but those are the main two things, right? And that's just important to know if you're going to have something that is going to be used as an herbal supplement, it needs to actually contain the things from the plant that actually do something, you know? Because we're talking about a whole plant. That's different than the idea of like a synthesized chemical that you take because you know exactly what is in that pill or the oral suspension or whatever. We're just talking about sort of crushing a flower

and eating it, you know? Hypocrity spoke of uses for hypericum. He mainly focused on things like anxiety, as well as like inflammation in general. It could also be applied topically so you could eat it or take it as part of like an oral preparation or you could just rub it on you. So he thought of it like Thai, CBV oil.

Yeah, I kind of like that. This quality is also advised. It's use as a diuretic and for wound healing, Galen said that it was good for that kind of stuff as well. So again, you see a lot of rubbing it on yourself, but I mean, that's not unusual with some of these herbal preparations of old that you would, I don't know, put it in some wine and drink it, but then also maybe make it into a tincture. And yeah, I mean or an appointment plenty the elder

Yes, I know I've missed him we haven't talked about it. We haven't talked about plenty for a while He wrote of several different uses for it. It was good as a diuretic again something that makes you pee a lot of people agree It could make you pee, but it wouldn't make you poop. It would stop that it would stop up the diarrhea That's kind of nice. It would turn the poop into pee basically. Can you make a list of these? No, no. It would turn the poop into pee.

You'd start your hair more pee. No. In addition, he said you should mix it with wine if you have a bite. A pair of endocens. Plenty always said you should mix it with wine. The plenty was also like, and if you're going to take it, you might as well. You're not feeling great. Just go ahead and hook yourself up. You might as well should mix it with wine. Plenty was also like, and if you're gonna take it, you might as well.

You're not feeling great. Just go ahead and hook yourself up. You might as well take it with some wine. You could also, so, you could use it to make you, like I said, make you pee, or you could use it to make you throw up. That was something that, in hydromel or in wine or in water.

I thought it was such a wide use case. It was like, this might maybe be in this might maybe throw up. He said it was good for getting rid of bile because again, we're talking for humor. So sometimes you got to bounce them out and get rid of some bile. It's good for sciatica. And then he said, also, you can prepare it different ways to rub it on yourself. For gout, for burns, for wounds, and if you're bleeding, you could just rub it on there and stop the bleeding. So many things again were recommended to stop bleeding.

And I wonder if it was just like, I mean, pressure is the number one thing to do when something's bleeding. So I guess whatever goop you have on your hand when you apply pressure, maybe you're just gonna think it was the goop. Right, it was the goop. Maybe it was the goop, but it was your hand. Yeah. You know, it's a shame we didn't just try that first

because the pressure we already had, I mean, we have that, it's pretty easy you don't have to get it from a bush or something. We should've led with that, try that first. But they had stuff on their hands. They go. Yeah. Celso's would also later include it in some urinary related sort of potions and things. And he credited as being part of, we've talked about before, mythredates, famous, all poison antidote, like all you every, every poison cure.

Yeah, we've talked about this before. Yes, every poison cure. You're a sense of iron. We've talked about this before. Yes, I remember this. Because you knew it from, you'd heard of it in like games. Yeah. Your games you play. Okay, yes. About magic. Yes, the games I play about magic, yes.

Yes. You'd heard about it there. And it's, but it was sort of like a famous mythical potion that supposedly could, you know, be used to cure or ward off or make you able to tolerate any sort of poison. And Hypericom was supposedly one of the many. I don't know that that's really, that makes it a standout that there were a lot of ingredients in that thing. But that was the whole thing. It was a big giant thing. But then it continued to be something that rose to more prominence and we found more uses for throughout the Middle Ages. And I want to tell you about that next. But before I do, let's go to the Billion Harman.

Let's go. Let my cops bar the mouth. Oh, Sid, it's never a good time when we have to dig into the middle ages. The worst time for medicine. I know I ride the middle ages pretty hard, but I feel like it just doesn't get worse to the middle ages. Oh, I know. You're always so hard on the middle ages. We were just about to actually make some headway and then everybody's like What let's try nights and stuff and then fiefdoms and whatever and then we just stopped medical progress and all what backwards the

Millages are the pits. I Mean there have been more recent times in human history that I think you could probably also Say that like we were heading in a good direction and then collectively as humans we went, why don't we just stop and go backwards for a while and really regress and take up some really dumb stuff for them. There's an upstroke and a downstroke for sure in culture. We two steps forward once that back I understand that, but never I think did we say, you know, it has been an entire age, nay, several ages since we have done anything good or worthwhile.

And you know what, it's been so bad. I don't even wanna call this like the before or after. This is just the middle, it's in the middle ages where we all just started to chill for a while and got worse and then we decided to try again later. Listen, we just lived through 2020. So that was one year.

These are ages entire ages. I don't even know how long an age is. There were four rough years there at Justin, but anyway, Paracelsus was a fan of the herb as well. Paracelsus of the very long name. Yeah. Remember that whole thing? Yeah.

There was the afrastus was in there. Bombastus. Paracelsis, we talked about right after celis, which I always love because paracelsis take the next day. Big this day because he's like me and celis. Von Hohenheim was at the end there. Yeah, that's where I that's where I rank. I love that guy. He's not that t-shirt, I think. Yeah, we did. That's probably why I remember t-shirt. I may have pieced together enough of the name. I don't know. He's not that t-shirt I think. Yeah, that's probably why I remember t-shirt. I may have pieced together enough of the name. I don't know. It's almost all there. Maybe sold out.

Uh-huh. That's great shirt. He noted that it specifically, and this is something that would continue as a theme with this specific herb, that it had specific useful effects on mental health. Hmm. The way he worded it, and this in the 1500s, each physician should know that God has placed a great arcaneum in the herb, just for the spirits and mad fantasies that drive people to despair. Which is his way of saying.

Yeah, well, it was his way of saying, this is good for depression. We just, back, like if you wrote that in a chart today, if you were that in a medical textbook, well they wouldn't let you write medical textbooks. No, you would be fired. Yeah, you would be fired for that. We don't really talk like that anymore. Now we say this medicine has been found useful in the treatment of depression.

He would, and so he wrote specifically about depression, melancholy, and over-excitation. So, I'm probably anxiety, probably what he's trying to say. Not just like you're excited. You're just like, you're just really, not like, I'm pumped any medicine for this. No, I'm so excited. I'm so excited. I'm so scared. Just, probably anxiety.

Other physicians at the time would continue to use it for other things, in addition to this, especially pain. St. John's work began to be prescribed for all different sorts of pain complaints. And again wound healing. A lot of history, it has been used. And that has been investigated since then. For like, was it, did it have some sort of maybe antibacterial properties or something, you know, antiviral property, something specifically that people kept using it for wound healing?

And it's like a lot of these compounds where, I mean, if you put things in a petri dish, a lot of things can kill germs. But that doesn't necessarily mean it did that in the human body. I've been, I've actually taken a softer view on curals that actually have an impact because I don't, I think that I would use to think of as like misdiagnosis, but really like everything so interconnected in the human body, especially with stuff like I could definitely see it having an effect on like, for example, anxiety or depression, but it's treating something else, but that stress or that, whatever is caught, like the two are connected. You know what I mean?

Like, treat one helps relieve the other rather than it being misapplied. Now, I keep in mind, I have no idea what Sanctuary on the work does actually do if anything, so. I'm gonna get to that. Okay. The plant is spreading across the globe at this point as people are selling. Culturally or just like, literally going all across the globe.

Well, it was physically being carried all over the globe and transplanted and grown and cultivated in different parts of the world. And as that happened, different regions, different cultures, different people would sort of bring it into their medical traditions and use it for different things. It began to be used not just for things like anxiety and depression, but also for, again, as a diuretic, if you were bloated for gastritis, there were more like sort of vegetable-based, like oil compounds that were made with it to be placed on things that were inflamed like a hemorrhoid. You could use it for your hemorrhoids. And then for more minor

injuries, like a burn or a cut or a sore or something, there was also a lot of belief that it was good for, especially in Germany, for like nerve damage, neuropathy, that kind of thing. And so like the topical application are taking it internally for that sort of nerve damage or pain or something was a very common use as well. It would become part of the traditional herbs that were used by cultures indigenous to the Americas as well as it showed up here.

I like I said, I think the first time that they found it in the US was in like Pennsylvania Pennsylvania sometime in the mid 1700s and then it continued to grow and spread around here and everywhere that it went. It's an invasive plant, it just does a done thing. Like Cudzifire? Yes, except I don't think it has any medicinal. Valley Noof.

Yeah. I remember when I tore a ton of that off the back of our house. Yeah. It was like a whole day. I appreciate you doing that by the way. I meant to tell you earlier. Well, me live that was yeah, we don't even live there anymore. Yeah, but I meant to tell you earlier. I do appreciate you doing that. I bet the people who live there now appreciate it. Yeah. Like many herbal medicines, especially in this country, I should say at this point, it began to fall at favor in the 19th century. As we turn more and more to sort of a scientific, like an empiric tradition of medicine where

if something's going to work, you have to be able to test and prove why and how and that it works. Multiple people. And like also separating the last vestiges of this sort of spiritual tradition of medicine from the scientific, physical, you know, literal world tradition of medicine. Herbs like this, like St. John's word, who, I mean, the name speaks to its sort of magical mystical properties and these beliefs associated with it. Because of that, herbs like this, especially were discounted by a lot of physicians out

of hand because, well, the idea was, well, the only reason this is a folk medicine. The only reason people believe in it is because they think that it wards off magical spirits and all this kind of stuff. Things like that were dismissed by a lot of like mainstream medical practitioners. Right. Now in the US, like I said, outside of the US, this wasn't always necessarily the case, especially for this medicine in Germany. There was a strong tradition of using it in Germany, and this would spread to other parts of Europe. But the eclectics in the US really kept it alive. We talked about the eclectic

medical tradition that really heaked in the late 1800s. They were sort of like online with the Tom Soneans and other alternative medicine traditions that basically looked at mainstream medicine and said, you guys don't know what you're doing, which was true in many cases. We don't know what we're doing either, but we're just gonna take a shot at it. Well, and some of this was, the mainstream doctors don't know what they're doing, and the things they're doing are hurting and killing people. And those are all valid things to say.

Yeah, for sure. So this was more like, let's try to do things that help people, again, without any sort of rigorous scientific effort, but maybe we won't try things that are so, again, without any sort of rigorous scientific effort, but maybe we won't try things that are so harsh. Yeah, let me sense it. Let's drink an herbal tea and worst case, it makes you, you know, have diarrhea or something. That's the worst case.

Which I compared to what some of the, you know, mainstream physicians at the time were doing. Not bad. You know, it didn't seem as drilling holes in heads, it didn't seem as bad. However, the eclectics kept it alive, even though it had sort of these magical things, because they didn't mind that. That was also part of the eclectic thing, is we don't mind if it kind of has this magic thing to it, if it works, it works. You know, we're okay with that. If it kind of has this magic thing to it if it works it works

You know We're okay with that And so like I said it continued to be used here Mainly again for the things that it's stuck I think the reasons that it stuck for these certain conditions is probably because they saw more effectiveness just like out there person to, for things like anxiety and depression. And in Europe, it became a lot more standardized. My understanding is that it would not be unusual for a patient who was being treated for one of those mood disorders

to be on St. John's Word. And I believe the production of what you're actually taking, the pill or tablet itself, is a lot more standardized. Yeah, that's a problem. As a result, sorry, I know. In the US, it is still considered, like I said, an herbal supplement. So it is not regulated in that same fashion that we would a prescription drug.

So what you're getting in a pill, the way that it is made and how what it's compounded with and all those different things can be a lot, a lot more variable. Now, even though I'm going to get into the actual studies that have been done on it, because there are a lot of people on it here in the U.S. there are probably people listening who take this on a regular basis. Like many curals, it has been tried for a lot of stuff that we've never really seen good solid evidence it works for. As I mentioned, there was a lot of interest in it as some sort of antibacterial agent or antiviral agent.

We've said this many times, a lot of things can kill something in a petri dish. That doesn't mean we can put it in a human body and it'll do the same thing. Although we do have the advantage of knowing that St. John's work doesn't, it's not the same thing as bleach, right? Where it's like totally bad.

Yeah, where you can't put it in a human body because it'll also kill the human body. But it was, there were studies trying to say that it could cure cancer and HIV, all the usual things. Any of those big, I hate to say it this way, but if it's a big ticket diagnosis, one that the cure could come with, well, that the cure could come with a lot of money and fame, and also there are going to be a lot of people who are scared and willing to seek out alternatives because they might feel that they are out of other options, traditional mainstream options. You're always going to find this kind of thing.

So it's been tried for a lot of these different things, anti-inflammatory type purposes, and none of those studies have ever really shown anything interesting. You've been hinting about the fact that it might actually have some effect on time. The one area in which it has been much more rigorously tested, and again, not to the level of a lot of the prescription drugs we use in this country, but it has been more rigorously tested is when it comes to anxiety and depression and specifically depression that is that is the main area where St. John's War has been tested in those trials The results have been kind of mixed

There was one in 2011 where they sort of compared it to a traditional SSRI that's a selective serotonin reuptake inhibitor, which is sort of the mainstay treatments we use for depression. So they compared it to one of those medicines and basically they found that nobody got any better. The people on placebo, the people on the SSRIRI the people on St. John's word There was no difference. Okay, so they didn't find any of it effective. So that was an interesting study Wow, that's a whit so they said the SSRIs were effective the SSR in this particular study It was a lot of it was a 73 person study. All right. There you go There was another one that was done

depressing There was another one that was done. Maybe it was in the very depressing time. It was in like the middle of 2016. It was like, no, I don't feel better on it. I feel better. There was another one that was done. It was a bunch of data that was collected in 2002, and then they finally analyzed it in 2012. And it suggested that it was similarly effective, in effectiveness to an SSRI, a different one,

a different antidepressant. They tried to... We said that is what the first study said, too. They tried Cetalapram and the first study. They tried Certulean in the second. At 2008, a much larger review of 29 studies from all over the place. So not just in the US now they took like these were international studies. They said that they think it might be better than placebo and

on the same level as some prescription antidepressants from looking at these 29 studies. It was really interesting because specifically studies in Germany showed them to be more effective than other places, which the question there, what you have to start asking is, one, there's a much longer tradition of it being used in Germany. So is it like... Well, and cultural acceptance of it, like, we know this is a treatment for depression here, we don't question that. But the other thing is the thing I mentioned, I wonder, I don't know from study to study

where they were getting their St. John's work. I mean, they're buying it somewhere. It's not like you would grow the plants and crush them. You're still for the study. Is that right, though? Well, I don't know. I mean, it doesn't speak to that in this that I'm reading, but it would be really interesting to see if maybe is it more effective in Germany because maybe they're using a more purified

version of the plant. Of the actual active substrates in the plant, you know, not just like the whole plant with all the other crap that's in there that your body doesn't need. And there is another study that was a little larger that said it was no no more effective than placebo that kind of threw a wrench in that. But anyway, and this information, by the way, all comes from the National Center for Complementary and Integrative Health. So these are the people whose job it is to look at alternative and herbal things outside of the mainstream of medicine and see where the evidence is. They're not.

They're pretty impartial. Well, what I mean is yes, they should be impartial, yes, but they also would be the first to say if something worked. These are not people who are just going to naysay because it's an herbal man. You know, like if the evidence is there, they say it. If it's not, they say it.

So it pretty even handed review from the people that are supposed to do these sorts of reviews. Basically, their bottom line is it's not consistently effective for depression. Maybe it is for some people, but we can't consistently say that it is always effective for depression is, you know, basically what they say. They don't recommend that you self-treat with it because you can buy it over the counter, right, in this country. Yeah, of course. So they don't recommend that if you think you're depressed or if your doctor tells you

you're depressed, that you just go buy some at the local drug store and take it on your own. But that's why it's a nanocontrolled substance, right? Yeah, but what they're saying is that depression is serious and you shouldn't just try to self-treat with something that we can't promise you would work. We would rather we recommend that you continue to see professionals for treatment of depression. I mean, it's the same as anything. If I diagnosed a patient with hypertension and they said, okay, well, I'm going to go try to manage this on my own.

Bye. I would say, oh, I don't recommend that I let's work together Let me help you let's talk about how you're going to manage it. Yes, of course you are ultimately going to manage it, but The council I could provide and the monitoring in such will help you with this endeavor and it's the same for depression Let's work together to do this either as your physician or your counselor or psychologist or whoever you're seeing. Their big point is we don't recommend you just go try to handle your depression without seeking any sort of professional help, which I think is good advice.

That's reasonable. Right. Now, the other reason that they say this though is products in the U.S. that are sold like this, as I have mentioned, are not uniformly regulated. So you might not be getting what you think you're getting. That's the other important point to just trying to self-treat with something like St. John's word. Even if you might be one of the people in whom it could be effective, maybe it would be if you were actually taking the right thing. Maybe they're cutting with baking soda or something like that.

Well, I mean, you say that in jest, but I mean, there have been plenty of studies that was actually the listener who recommended this topic, Kayla. That was one of the things that they sent along with their email is that there have been studies that have shown that when we take Over-the-counter herbal products in the US and just test them to see Is the thing that's on the bottle actually in there? Not always oh good. Yeah They were in in this study they were able to authenticate about half of the products

That's great sure and but one third also They were, in this study, they were able to authenticate about half of the products. That's not great. Sure. And, but one third also contained contaminants and fillers that were not listed. Great, even better. And some of those can pose serious health risks. That's the best thing with a brand that sounds healthy, like pure life or true leaf or something like that.

It's really interesting because what it speaks to is, if St. John's Whart may be an effective treatment for depression and a patient, the thing you're buying over the counter, we just don't regulate it that way. You can't be reassured that you're actually buying something that one will contain the active components of St. John's Whart and two won't contain other possibly harmful contaminants. That's just a problem. And this is not me saying, so don't ever use Saint Johns word.

It's just, you need to know you're getting the real thing. Maybe in Germany, it would be better. And the only other thing I'll throw out there, and this is really important to know about Saint Johns word. And this is true for any sort of, again, unregulated herbal supplement, it can interact with other medications you're on. We know it can do that. We have tested that. Specifically, it's broken down. The pathway that it

uses is called cytochrome P450. It's a liver, it's a pathway through the liver that the things are broken down and enzymatic pathway that is used by a lot of Medications that you might take and specifically the way that St. John's war interacts with cytokrome p450 is it induces it meaning it can make it go faster Make it break things down quicker and more efficiently, which sounds good. No, because what will happen is it could decrease the blood levels of other medicines you're on lower than what we want them to be. Because your body is too busy with the same amount of work. Because it breaks it down too fast. So it makes you break down a medicine you need in your body faster than you should.

And as a result, you don't have the right levels of it. So for instance, just some examples, it can decrease the effectiveness of birth control. No, no, no, that's a big one. Yes, and so it can also affect the way that certain blood thinners like warferin, the levels of those in your body. So you should never take this or any herbal supplement without talking to your doc about what else you're on and are there interactions because these things are easy to look up and check and this definitely can't interact with other meds. In addition, if you're already on antidepressants, it can negatively interact with those medications

to increase your serotonin levels too high and you can get something called serotonin syndrome which can be deadly. So the point is St. John's word does appear to have clinical activity in the human body. And there have been some studies to suggest that it could help with depression. For sure, I'm not saying that that's not true. But the problem is in the US, if you're just buying it at a drug store, you don't know that you're getting what they say you're getting buying it at a drug store, you don't know that you're getting what they say you're getting. Anything, yeah.

Yeah, for sure. You just don't know. Two, it can interact with other medications you're on, not for depression, so you really need to talk to your primary care provider about that first. And three, it can interact with other antidepressants you might be on. So whoever prescribes you those, you really need to talk to him about all that first. Don't take it and don't try to treat mental illness or any illness on your own

without consulting with a professional please. That's never a good idea. Or based on what you're gonna podcast. No. That part goes that side. And that's why I always say, go talk to your doctor. Hey, thank you so much for listening to Saul Buns. We hope you have enjoyed yourself.

We sure have enjoyed being with you. Thanks to the taxpayers for the use of their own medicines as the intro and outro of our program. And thanks to you for listening. We sure appreciate it. Oh, we got a book. It's on Amazon. It's a Solbund's book now in paperback

with expanded material. So go, go, go get it. Thought you were going to say explosive material. Explosive, ford heating, earth shattering. Oh, Sydney's got a TikTok at Sydney, McHeroi on TikTok. And you didn't have to know. Go follow Sydney's TikTok. Don't get that on here.

You'll love it. If you like Salmon's, you'll love Sydney's TikTok. This is a different Sydney. Thanks for listening. Let's get to do it for us until next time. My name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head.

Yes. Alright!