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St John's Wort

Real evidence for low mood — but one of the most interaction-prone supplements, especially with the pill and antidepressants.

Dose
Standardised extract ~300 mg × 3/day — medical supervision only
When to take
With meals, divided doses · Supervision required
Pairs well with
— (avoid combining due to interactions)
Avoid
Hormonal contraception (can fail); antidepressants (serotonin syndrome); warfarin, HIV and transplant drugs
Side effects
Sun sensitivity, stomach upset, dry mouth

What St John's Wort does

St John's Wort is a herb with real evidence for lifting mild-to-moderate low mood, sometimes used by women for mood dips around the menstrual cycle or menopause. It works on brain chemicals including serotonin. But it is also one of the most interaction-prone supplements sold — and that has to come first in any honest discussion.

Does it actually help? An honest answer

For mild-to-moderate depression, the evidence is good — in trials it can perform comparably to standard antidepressants. The problem isn't whether it works; it's what it does to your other medicines. For most women, the safety issues outweigh the convenience, and a safer option like saffron is a better first choice for premenstrual mood.

Signs you might consider it

Mild-to-moderate low mood — but only after reviewing every medication you take with a pharmacist or doctor.

How much to take

Trials use a standardised extract, often 300 mg three times a day. Because of the interactions, it should only be used under medical supervision, not self-started.

When and how to take it

With meals, in divided doses. Effects on mood build over several weeks.

Too much / what to watch for

It increases sun sensitivity (easier sunburn), and can cause stomach upset or dry mouth.

What to stack with

Nothing — because of its interaction profile, it should not be casually combined with other supplements or medicines.

What to avoid — supplements and medicines

This is the crucial part. St John's Wort speeds up a major drug-processing enzyme (CYP3A4). It can make hormonal contraception fail, risking unplanned pregnancy, and weaken many drugs. Combined with antidepressants (SSRIs) it can cause serotonin syndrome, a medical emergency. It also affects warfarin, some HIV and transplant medicines, and more.

Who should be cautious

Anyone on the contraceptive pill, antidepressants, or any prescription medication — which is most people. Avoid in pregnancy.

Quality — what to look for on the label

A standardised extract (often to 0.3% hypericin) — but only obtained and used with a doctor's oversight.

Bottom line

St John's Wort genuinely helps mild low mood, but its interactions — especially with the contraceptive pill and antidepressants — make it one to use only under medical supervision. For premenstrual mood, saffron is a far safer first choice.

Sources

Cochrane review of St John's Wort for depression; NHS and NCCIH guidance on St John's Wort interactions; reports on contraceptive failure and serotonin syndrome.

Chapter 7 · PMDD & Mood
If you'd like to try it

These are trusted places to buy. They're affiliate links — if you buy through them we may earn a small commission, at no extra cost to you. We only link to supplements with real evidence behind them.

Based on guidance from the NHS, NICE, Cleveland Clinic and peer-reviewed research.

By M. Videika, author of The Testosterone Blueprint · Reviewed June 2026

General information, not a substitute for personal medical advice — always consult your doctor or a qualified health professional before making health decisions. If you are pregnant, breastfeeding, trying to conceive, under 18, or taking medication, speak to your doctor before starting any supplement.