Beyond Insomnia--Nutrition

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Beyond Insomnia

Until recently, St. John's wort was best known for its sedative properties, and used to alleviate anxiety and insomnia. The effects of St. John's wort on the nervous system are reflected in its use as the homeopathic remedy Hypericum perforatum. Homeopathically, Hypericum is used for injury to any tissue rich in nerve endings, like finger tips.

Hypericum comes from the Greek and means "above an ikon," and sprigs Were once set above images to drive off malevolent spirits. In today's world, one of the most important uses of St. John's wort is to drive away depression. In Germany, nearly 1600 patients with mild to moderate depression have been studied in double-blind controlled studies. Fifteen of these studies were compared to placebo, and the other 10 with tricyclic antidepressant drugs. St. John's wort was effective in 65- 80 percent of cases, and the antidepressants in 60-75 percent. The important difference is in recorded side effects. One-half of one percent of patients using St. John's wort reported only mild gastric irritation. Side effects are a major concern of prescription antidepressants with most patients experiencing moderate drowsiness, light-headedness, blurred vision, dry mouth, constipation, and impaired urination. In addition, many experience impaired sexual function: 43 percent of the men complained of impaired erection and 27 percent of women of inhibited orgasm. In these studies, 300 mg of St. John's wort extract standardized at 0.3% hypericin (the active constituent) was given three times per day. (It is not suitable for depressions linked with psychotic symptoms and/or serious risk of suicide.)

In the U.S., Prozac(TM) is the most commonly prescribed drug for depression. Over 6 million Americans take Prozac regularly. Prozac is a bicyclic drug and no direct comparisons have been made with St. John's wort. However, using the results of the placebo studies, the herb compares quite favorably, again showing about five percent more people finding relief, and essentially no side effects. On the other hand, Prozac is associated with increased nervousness, anxiety, insomnia, allergic reactions, and nausea. Prozac can also cause a condition called akathisia, a drug-induced state of agitation which can result in violent and destructive outbursts in some individuals.

St. John's wort has more surprises. Historically, it has been used for healing burns and wounds. In addition, it has antibacterial and antiviral activity. Research on the antiviral activity of St. John's wort indicates that it may be useful as an adjunct in the treatment of herpes simplex, mononucleosis, influenza, and chronic fatigue syndrome (where the associated depression can be devastating). St. John's wort has also demonstrated antiretroviral activity.

Excitement about the possible use of St. John's wort against the AIDS virus was kicked off by the results of animal research at New York University Medical Center and the Weizmann Institute of Science in Israel. Once the word was out, infected individuals began taking St. John's wort on their own. These patients reported feeling a more positive outlook, more energy, and less fatigue. However, it was not known whether this was placebo effect or a marker of physiological changes. Although later studies confirmed some good results, the amount of hypericin concentration needed in the blood to replicate the HIV antiviral activity demonstrated in vitro was impossible to achieve using standardized St. John's wort extract either orally or intravenously. Preliminary studies are proceeding now using intravenously administered synthetic hypericin.

St. John's wort has three possible side effects. First, although St.John's wort is unlikely to be toxic in recommended doses, photosensitivity can occur when the herb is taken in large amounts. It is recommended that fair-skinned individuals avoid exposure to strong sunlight or other sources of ultra-violet rays while using the herb. Second, because it has been known to cause mild gastric upset in one-half percent of people, ingesting it with food is a prudent measure.

Last, like chemical antidepressants, St. John's wort works to correct or lessen suspected imbalances in particular compounds in the brain known as monoamines. These are serotonin, melatonin, dopamine, epinephrine, and norepinephrine. Overall one could say that these compounds are mood elevators. St. John's wort has an effect on an enzyme, monoamine oxidase (MAO), which breaks down monoamines. It also breaks down a substance called tyramine which is found is large concentrations in aged foods. When MAO production is inhibited by St. John's wort, it cannot interfere with the action of tyramine in the body. The result is that tyramme can cause headaches, nausea, and heightened blood pressure. A list of foods to be avoided is provided on the previous page.

Nutrition News.

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