• Dear Guest, if you are new here please "sign up" at the top if you'd like to post messages. And if you have used this forum before note we upgraded to new forum software and couldn't transfer the passwords. To get into your account, click on the "log in" button, then click on "Forgot your password?" and reset your password. All previous posts were safely transferred to the new system but custom avatars and private messages unfortunately didn't get moved over. The upside is a newer, simpler, friendly forum.

side effects

#1
Hi,

Regarding St Johns Wort and eye photosensitivity, there are a number of
important and rather alarming aspects of SJW that your readers should be
aware of. (all information found from journals and research work, references
available if required)

1) SJW is easily transferred to both the lenses (front of the eye) and the
retinal pigment cells (back of the eye, below retina) at low therapeutic
doses

2) A number of pharmaceuticals, once accumulated in the eye may bind to
ocular tissues and stay in-situ for many years after the person has stopped
taking the drug. Some SJW users have complained of continued
photosensitization of the eye years after discontinuing use.

3) Hypericin, one of the ingredients of SJW is a potent photo oxidiser and
will cause cell death and DNA damage on activation by visible or UV light

4) As the lenses absorb much of the UV light, hypericin will potentially age
the lenses and lead to cataract formation. While bad, cataracts are
treatable, worse is the fact that hypericin is activated by visible light
which, of course reaches the back of the eye and the retina and can cause irreversible retinal degeneration

There is much talk of cataract formation, as mentioned of greater concern is the effect on the retina by this photosensitive agent, which is unusual in that it is activated by visible light not just UV light.

So if you're unlucky enough to have briefly tried SJW and found yourself to have become photosensitised, then simply stopping taking the herb may not be the end of it. This effect may continue, while you assume the sore eyes are caused by something else as your eyes are being damaged by SJW.

regards

Scott
 

shy1

Senior Member
#2
Hi Scott,

My Opthamologist (a friend) disputes many of your assertions. Wonder if you would mind supplying the research that reached these conclusions? I'd like to read the research.
 
#3
hypericin, not SJW

Scott,

I am also interested in all the informations and references you can post in this forum, regarding hypericin vs eye damage. I purposely write hypericin instead of SJW, since hypericin-free SJW extracts exist as well.

Vulpix
 
#4
side effects

Hi,

yes, there is much information coming to light as new research is ongoing, an example of the info is given below, apologies if its all abit untidy;

American Society for Photobiology Journal 72:200–203 (2000)

Photochemistry and Photobiology: Vol. 72, No. 2, pp. 200–203.

Photooxidation of Lens α-Crystallin by Hypericin (Active Ingredient in St. John's Wort)¶

K. L. Schey,1 S. Patat,1 C. F. Chignell,2 M. Datillo,3 R. H. Wang,3 and J. E. Roberts3, *
Hypericin is the active ingredient in the over the counter antidepressant medication St. John's Wort. Hypericin produces singlet oxygen and other excited state intermediates that indicate it should be a very efficient phototoxic agent in the eye. Furthermore it absorbs in the UV and visible range, which means it can potentially damage both the lens and the retina.
The potential for this phototoxicity depends upon its absorption spectrum, binding to ocular tissues and the rate of clearance from the eye, the transmission and absorption characteristics of ocular tissues and the properties of the light source. (2) The human cornea filters out all radiation below 295 nm, and in adults the lens absorbs most of the incident ultraviolet radiation (295–400 nm); only visible radiation (above 400 nm) reaches the adult human retina. (3) Therefore any drug that absorbs in these regions has the potential to damage the tissues of the human eye, leading to cataractogenesis and visual disturbances from retinal dysfunction.
Previous workers had determined that low concentrations of hypericin induce apoptosis in retinal pigment epithelial cells (11). We demonstrated here that there is light-induced damage to lens α-crystallin in the present of hypericin.

Focal Length Variability and Protein Leakage as Tools for Measuring Photooxidative Damage to the Lens¶

Judit Wahlman,1 Maurice Hirst,2 J. E. Roberts,3 Claire D. Prickett,1 and John R. Trevithick1, *
Hypericin is the ingredient used to standardize the popular over-the-counter antidepressant medication St. John's Wort. Because hypericin readily produces singlet oxygen and other excited state intermediates, it is a very efficient phototoxic agent in the eye that can potentially induce the development of the cataract photooxidative mechanism. Hypericin absorbs in the UV and visible ranges, binds to the lens crystallins (α, β and γ) and damages these proteins through a photooxidative mechanism
SADAssociation
Registered charity:
No. 800917

Press Release

6th October 2001

St John's Wort and SAD

1 Two thirds of respondents (c 200) had tried SJW, of whom 70% combined it with bright light treatment and 16% with antidepressant medication, over an average period of use of 18 weeks.
2 Just over 40% of users thought it effective or mostly effective.
3 Just over 30% reported adverse effects, most commonly headaches (13%), sore eyes (11%) and nausea (11%). As feared, some eye reactions caused the most serious adverse effects, lasting weeks, months or even years after, discontinuation of SJW, rendering users unable to use bright light treatment or face daylight.
4 59% said they would use SJW again while 34% said they would not.


Thioridazine (example of drug binding to ocular tissues)


Mellaril is known to induce retinal pigment changes. Acute toxic effects of thioridazine include blurred vision, night vision problems and color vision problems and typically become evident within 2 to 8 weeks after receiving doses in excess of 800 mg/d. Early fundus examination may be normal or may show fine salt-and-pepper pigmentary retinopathy involving both the posterior pole and periphery. The precise amount of drug needed to produce pigmentary retinopathy is unclear; however, dosages up to 800 mg/d are generally considered safe. Thioridazine can remain bound to melanin in the retinal pigment epithelial cells for many years with progressive visual loss despite discontinuation of their use. Geographic retinal pigment epithelial and choriocapillaris atrophy may occur.



We are very concerned about another interaction with St. John's Wort, with light rather than medication. Joan Roberts, Ph.D., of Fordham University, has been studying the effects of light and drugs on the eye for decades. She has discovered that hypericin, an ingredient in St. John's Wort, reacts to ultraviolet and visible light. When activated, hypericin becomes toxic to the lens and retina of the eye, increasing the risk of cataracts or macular degeneration over time. Because sunglasses don't screen out visible light, they can't protect people from this danger. We suggest that people taking St. John's Wort stay out of bright light completely."
 
#5
nature and level of risk ?

Scott,

Thank you very much for those informations. I have already handled the photosensitivity issue in the thread « Already positive results » under « The first 45 days », although less accurately than you. I have also discussed hypericin-free SJW extracts under the thread « Aphios Super Cool St John brand » under « General Q&A ».

As for photosensitivity, I found results similar to yours through Google. In vitro: hypericin may harm eye tissues. In vivo: hypericin may harm human eyes at therapeutic doses. I quoted the same source as you (http://www.sada.org.uk/press.htm), but unfortunately, this source fails to give a medical description of the eye damages found in the patients.

In june of this year, I suffered a superficial punctuate keratitis (snow blindness) after taking for seven days one half of the recommended dosage of a SJW extract containing hypericin. The snow blindness healed after two weeks of corticoid eye drops, but I still need to take maintenance eye drops from time to time, and after two months my feeling of recovery is 90% rather than 100%. I have no damage in retina, and my visual capacities have not changed.

By the way I found no case similar to mine, when I searched Google with English, French and German terms for « snow blindness » and « St John’s Wort ». As for a more insidious long-term threat on lens and retina, I cannot make my opinion so easily. I am sure that the risk exists, but I don’t know how long it will take to actualize on a standard person (= not me). One year? Ten years? One hundred years?

Vulpix
 

shy1

Senior Member
#6
Hi Scott,

I am on vacation and haven't been checking on the forum much. Thank you for the reference material! I'll check it out next week when I get back.

Hoping to see controlled studies/trials for the effect being measured rather than one that was looking for something else and now has a "see what I discovered" conclusion. The former provides good solid information and the latter only raises more questions. Either way, I'll be checking them out.

Since I have the photo sensitivity side effect I am obviously concerned.

Thanks!
 

shy1

Senior Member
#7
photo toxicity?

Vulpix & Scott,

I have finally checked your sources and for me they pose more questions than they provide answers. I would have preferred to see the amount of light quantified along with time exposure per day/longevity compared to the amount of hypericin ingested/absorbed. Was there a difference between sunlight and artificial light? Neither report was definitive in their conclusions. "SJW may cause photo toxicity?"

In other words, should I conclude that I am to avoid the use of SJW if ever in the presence of light? artificial light only? sunlight only? Does my dosage affect the results? How long can I be in light before photo toxicity manifests itself? Is it repeated exposure to light or a one time maximum exposure event that causes this? I'm really not sure the reports provide any real world answers.

This topic is of particular concern for me as I have already proven to have the photo sensitivty side effect. That coupled with the fact that my eye pressure is abnormally high (tested prior to the use of SJW) but without the sympoms or presence of glaucoma.

All that being said, my conclusion is that if you develp photo sensitivity or find that your eyes are more sensitive to sunlight because of your use of SJW you best take reasonable precautions. In my case I purchased the best pair of sunglasses I could find (lens are so good that I can almost look at the sun), I limit my exposure to "bright" sunlight and since I wear glasses (Isn't middle age wonderful?) I use the transitions lens.

Research in this area is almost nonexistant, and understandably so. It is a niche of a niche of a niche of a niche of scientific study. I do hope that if you discover other relavent studies that you either PM me or post them in a thread.

Wishing all of you the healing you are seeking.
 

shy1

Senior Member
#9
Hello Poncho 524 & welcome to the forum!

I can't speak for all of us, and like most things SJW your mileage (reaction) may vary, but you'll know you have photo sensitivity if:

You notice that your eyes are more sensitive to sunlight, especially bright sunlight
You begin to experience effects similar to snow blindness, much like Vulpix did.
You never had a problem getting sunburned but now you get sunburned, even on top of a tan.
You really don't notice any syptoms but you prefer to stay out of sunlight or away from windows where sunlight is coming in.

I'm sure there are other syptoms I have not listed. In my case I never had a problem getting sunburned until using SJW, now I even get sunburned on top of a base tan and it doesn't take that much sunlight to singe me. I consider it a small trade off for the wonderful curative effect it has had on me.

Hoping you never experience any of these symptoms. If you do, please be sure to protect not just your body, but your eyes as well. Afterall, they are irreplaceable! :glasses:
 

OnTrack

Regular Member
#10
So what have we learnt.
Dont use a light box with sjw, and dont take large doses just to be on the safe side. Also if possible avoid very long term use. (the last two statements are just my opinion)

The people in these serveys (yes thats right I said surveys) were exposing there eyes to very bright light, at least 10 times intensity of ordinary domestic light for 4 hours dayly, or combining it with other antidepresant medication. Both options are a no-no. These are also the people who reported that there symptoms (with eyes) persisted even after discontinuation of sjw. 13% had sore eyes, could it be that these people had sore eyes as a result of exposure to bright light and the effect it has on hypericin, or even the bright light itself ?? Could it be that these 13% were one of the 70% who combined it with bright light treatment, hmm I would think so. But, I on the otherhand am not using bright light treatment and I too have symptoms of photosensitivity, being slightly sore eyes. The feeling is like keeping them open for a while without blinking. Only slightly but enough to notice a differnce since sjw. I do spend spend time outside in the sun light and what makes it worse is working on tarmac, so maybe thats why. Never less we cant egnor the "potential" damage that may occur. Another symptom of mine would be looking at the computer monitor makes my eyes more sore than normal. I definatly have some photosensitivity, so with my up and delightful pleasant effect sjw and 5htp comes a side effect. Sounds pretty serious too.

Also dont be confused or put off by this, its not based on sjw or hyrericin
-------------------------------------------------------
"Thioridazine (example of drug binding to ocular tissues)

Mellaril is known to induce retinal pigment changes. Acute toxic effects of thioridazine include blurred vision, night vision problems and color vision problems and typically become evident within 2 to 8 weeks after receiving doses in excess of 800 mg/d. Early fundus examination may be normal or may show fine salt-and-pepper pigmentary retinopathy involving both the posterior pole and periphery. The precise amount of drug needed to produce pigmentary retinopathy is unclear; however, dosages up to 800 mg/d are generally considered safe. Thioridazine can remain bound to melanin in the retinal pigment epithelial cells for many years with progressive visual loss despite discontinuation of their use. Geographic retinal pigment epithelial and choriocapillaris atrophy may occur."
----------------------------------------------------


Also whats important to factor in is that sjw and s.a.d doesnt work as an effective antidepresant thats why it only worked for 40% and thats with combined treatments.

Heres a cut and paste from SADA
"In summary, there is clinical evidence that St John's Wort is an effective treatment for mild to moderate depression. Although SAD is a form of depressive illness, it is only sub-syndromal SAD (the mild version of SAD) that falls into the category of mild to moderate depression. The symptoms and features of SAD differ from those of other forms of depression and sensitivity to light is one characteristic of severe SAD, which may render use of SJW impossible."
 

shy1

Senior Member
#11
hello OnTrack and a belated welcome to the forum. my, my but you've been a busy lad. nice to see!

I was curious about the "surveys" you refer to. I wonder if you mind sharing your source as I would be interested in reading the report. I did not see a reference to the light being quantified in the reports referred to by Vulpix and Scott.

Glad to hear SJW is working for you and I wish you continued good health!
 

paulst

Regular Member
#12
I suffer from sad and can honestly say, that from my own experience sjw is very effective. I have read many reports about using a lightbox while taking sjw,the advice seems very mixed some say its ok, while others say its dangerous to your eyesight?:wobblyeyes:
paul
 

OnTrack

Regular Member
#13
Shy1 thanks for the best wishes, my information comes from this link http://www.sada.org.uk/press.htm and http://www.sada.org.uk/treat.htm . The first link is where the thread starter got his information.

Paulst if you reread the first page you will see that hyperofin in SJW in combination with light can cause cateracts and posibly even eye damage. In the first link it explains how sada conducted a survey of there 2000 members to find the effects of SJW on S.A.D since there where no clinical studys done. It also says on this site not to use a light box with SJW.

Here are the results
=====================================================
Two thirds of respondents (c 200) had tried SJW, of whom 70% combined it with bright light treatment and 16% with antidepressant medication, over an average period of use of 18 weeks.
Just over 40% of users thought it effective or mostly effective.
Just over 30% reported adverse effects, most commonly headaches (13%), sore eyes (11%) and nausea (11%). As feared, some eye reactions caused the most serious adverse effects, lasting weeks, months or even years after, discontinuation of SJW, rendering users unable to use bright light treatment or face daylight.
59% said they would use SJW again while 34% said they would not.
In summary, there is clinical evidence that St John's Wort is an effective treatment for mild to moderate depression. Although SAD is a form of depressive illness, it is only sub-syndromal SAD (the mild version of SAD) that falls into the category of mild to moderate depression. The symptoms and features of SAD differ from those of other forms of depression and sensitivity to light is one characteristic of severe SAD, which may render use of SJW impossible.
===================================================
Wow some couldnt even face sun light.:shocked: The thread originater (dont remember his username) recomends if you want to take sjw stay away from sun light. Now thats just rubbish, id recomend getting outside as much as possible. But, there is some truth to that, im finding my eyes a becoming more and more sore, taday I was out on the dirt bike with an open face helmet and sunglases and came back with very notacibly sore eyes and a burnt face. Maybe the wind from the movement contributed to the sore eyes. The sun was out and i do burn but seems like its more than ussual. When I say burn I mean tommorow I will have a nice color on my face :). Photosensitivity is a REAL side effect of SJW and I think its understated on lables and on the net and in general literature on SJW. The lables and information on the net will ussually say "may cause photosensitivity in fair skined people". The word photosensitivity means a sensitivity to light, comes from a Greek word Phoss which means light, not just the sun.
 

paulst

Regular Member
#14
I t really depends on how long you use the lightbox for, if you have brown eyes, dark hair, you are much less likely to be affected, if like me you only use the lightbox in the middle of winter and then only for 15-20 minute sessions, the risk is even less, also the brightness of my lightbox is about the same as a bright spring day, which is much less than an average summers day. Its true to say there is some risk, but for me at least, if used sensibly and for the minimum time the risk is very small:smile:
paul
 

shy1

Senior Member
#15
On Track,

Thanks for the links to the press releases. Tried to work backwards to find the forum threads you refer to but was unable to locate them. Also was not able to locate the surveys referred to. Perhaps you need to be a member of SADA to access?

PaulST,

Again, a belated welcome to the forum!

I am NOT fair skinned nor light haired. I have never been sensitive to the sun with only the occasional sun burn (once every 5-7 years or so), that is until I began using SJW. . I cannot speak to light box use, but based on my personal experience, be careful!
 

OnTrack

Regular Member
#16
Shy1 the thread I refer to is this one your reading. The surveys are in the first link and the results have been cut and pasted on my above post as well.
 

shy1

Senior Member
#17
Survey says..

Thanks, On Track. Now I understand.

Your cut/paste was the survey results which I did see. I was hoping to see the survey itself ... some times I draw different conclusions than the "experts" when I interpret the data. Always nice to see how the questions are worded and exactly what was asked. :read:
 

kelly

Administrator
Staff member
#18
This is interesting research to watch as the photosensitivity that comes with taking SJW is well known. I noticed it myself while in Mexico recently, taking SPF-30 and a small amount of SJW - I still got a sunburn after about two hours. Amazing. I keep thinking this function of hypericin is part of how it works (we all need sunlight) instead of just a side effect. But I'll leave it to the experts to decide.

Joan Roberts contacted me years ago about her research with SJW and eye problems. I wrote about it a long time ago in the Information part of this website as a general caution. So it's not necessarily new info. Good to see more research continues in this area however.

Kelly
 

OnTrack

Regular Member
#19
shy1;1602 said:
Thanks, On Track. Now I understand.

Your cut/paste was the survey results which I did see. I was hoping to see the survey itself ... some times I draw different conclusions than the "experts" when I interpret the data. Always nice to see how the questions are worded and exactly what was asked. :read:
Sorry dont have the actually survey you were looking for.
 

OnTrack

Regular Member
#20
The other day I went outside to the garage, it was very sunny and i only awoke about 2 hours earlier. The sun hurt my eyes almost made them sting as I was very briefly out there. Later that day I had someone ask "whats wrong with your eye its all bloodshot from the inside, looks like you burst a blood vessel in there". I went and had a look at it and got worried about it because its the second time its happend and id rather not give up the SJW yet. According to her she doesnt think it serious, and that burst blood vesles happen all the time. She said its when it happens it the back thats the problem. She got me thinking, how do I know whats going on in the back, maybe im slowly damaging my eyes. On a positive note, the slight soreness has disapated lately. I will get profesional advise about this.