Kratom Guides

Kratom & St. John’s Wort: Differences, Similarities & Interactions

Does Kratom Interact With St. John’s Wort?

Yes, these herbs may result in an increased risk of side effects. But is this combination dangerous? 

Likely not, but it’s important to separate the dose of both herbs by about two hours and start with a lower dose of both substances than they would on their own. 

St John’s wort can induce the cytochrome P450 enzymes CYP3A4 and CYP1AS and pregnane-X-receptor (PXR) [3]. This is significant since CYP3A4 is one of the main enzymes responsible for metabolizing kratom [4]. By speeding up metabolism, this combination could reduce the duration of the effects of kratom, place more strain on the kidneys and liver, and potentially reduce the effectiveness of both substances.

It’s especially important to speak to a doctor about either of these herbs if you’re using any other medications. 

Both kratom and St. John’s Wort can increase the risk of side effects from other medications. Taking both in combination increases this risk even further. For example, St. John’s Wort and acetaminophen are known to produce severe side effects [1,2]. 

St. John’s Wort Chart

Drug Name St John’s wort
Classification Herbal extract
CYP MetabolismCYP3A4 and CYP1AS
Interaction With Kratom St John’s wort induces kratom’s metabolism
Risk of InteractionLow

Is it Safe to Take Kratom With St. John’s Wort?

Kratom and St. John’s should be fairly safe to take together. However, it’s always best to check with your doctor before starting or combining medications of any kind, even natural ones.

If you’re currently taking St. John’s wort as an antidepressant, you can also consume kratom with the knowledge that it’s not likely to interact in a way that places you at risk. Just remember: kratom might be less effective.

Nevertheless — if you’re trying out this combination for the first time — make sure to start with a lower dose of kratom. There is still much to learn about kratom, and drug interactions are complex.

Suggested Reading: Exhaustive List of Kratom Drug Interactions

What is St. John’s Wort?

Hypericum perforatum — also known as St. John’s wort — is a commercially cultivated flowering plant species.

The name “St. John’s wort” can signify any species of the genus Hypericum, but this specific one is commonly called “perforate St. John’s wort.” The species was native to some regions of Europe and Asia but can now be found in temperate areas around the globe.

St. John’s wort has a long history of medicinal use that stretches back into classical antiquity. Hyperforin, one of the main active compounds in St. John’s wort, is being studied for its possible benefits. However, hyperforin is possibly the reason why St. John’s interacts with a wide variety of drugs [5].

What is St John’s Wort Used for?

It’s long been used as part of concoctions said to cure all sorts of maladies —  St. John’s wort is now regarded as having legitimate antidepressant properties.

Many studies have found St. John’s wort to be as effective as pharmacological antidepressants. It also appears to have fewer adverse effects when compared to SSRI antidepressants [6, 7]. 

However, there are still doubts as other studies have shown large variations in performance.

St. John’s wort can be prescribed for depression in Germany. In the United States, however, it is usually not recommended as a replacement for more standard treatments. 

According to the United States National Center for Complementary and Integrative Health, St. John’s wort is as effective as a standard antidepressant for mild to moderate depression but uncertain against severe depression.

What’s the Dose of St. John’s Wort?

Studies suggest that 900 mg daily of St. John’s is needed to reduce symptoms of depression. Plasma levels rise gradually over the course of several weeks — so the effect of the plant usually takes a couple of weeks to appear [8].

St. John’s wort can be taken in liquid or in capsules, or the dried leaves can be used to make tea.

What Are the Side Effects of St John’s Wort?

St John’s wort has certain adverse effects you need to be aware of [9]:

It can cause allergic reactions and reacts with several prescription medications, either hampering their functioning or possibly causing harm to the user. 

The plant may also cause the following side effects:

  • Nausea
  • Abdominal pain
  • Loss of appetite 
  • Diarrhea
  • Dizziness
  • Confusion
  • Fatigue
  • Sedation
  • Dry mouth 
  • Headache

What is Kratom?

Kratom is the common name for the Mitragyna speciosa plant. It’s a tropical evergreen tree native to Southeast Asia. It is known for having a vast number of psychoactive benefits.

The kratom community in the United States is growing fast as thousands of people are discovering kratom’s benefits and abandoning their traditional pharmacological medications for it.

However, since kratom is currently an unregulated substance in the US and there’s a lot of research still to be done.

If you want to learn more about kratom, you’ve come to the right place. Keep reading in order to find out all that you need to know about this remarkable compound.

What is Kratom Used for?

There are two basic types of kratom users: those who enjoy the stimulant or relaxant aspects of the kratom spectrum and those who use kratom as a treatment.

Depending on the dosage, kratom can offer a variety of cognitive benefits. It can make users feel more relaxed or more energized and focused. Kratom can also cause feelings of euphoria.

Kratom has also become a treatment for many types of conditions. The analgesic properties have made it a go-to for those who are suffering from chronic pain, and it may provide anxiety relief. It can also help treat the symptoms of opiate withdrawal and is becoming popular as a weight-loss supplement.

What’s the Dose of Kratom?

Finding the right dose might take a little experimenting. It varies from person to person and depends on what you’re using it for. However, here is the common dosing, but remember to start low.

The average kratom dosages are:

  • Low dose (1 – 5 g)
  • Medium dose (5 – 10 g)
  • High dose (10 – 15 g)

Low doses are preferable if you want to experience the nootropic aspect of kratom. The more you ingest, the more you slide over into the analgesic, sedative-like properties.

Furthermore, it’s important to understand that formulaic dosage prescriptions can never be totally accurate. They are best taken with a grain of salt.

The best option is to experiment with small doses first and then work your way up. 

What Are the Side Effects of Kratom?

If you keep the amounts small, you’ll likely never experience kratom’s side effects. Still, some people are more sensitive, so it’s best to be aware that they do exist.

Kratom is known to be able to cause the following side effects:

  • Constipation
  • Dizziness
  • Insomnia
  • Nausea

More serious side effects include:

  • Itchiness in the skin
  • Loss of muscle coordination
  • Low blood pressure
  • Low libido
  • Nausea
  • Poor appetite
  • Seizures
  • Tremors
  • Physical dependance
Kratom leaf and flower.

What Are the Different Types of Kratom?

Kratom can be found in four types of strains. 

How are the strains different? Glad you asked.

Kratom’s many strains all share the same properties. However, each strain is better at manifesting a different area of the kratom spectrum.

It’s thought that the area of Southeast Asia also has an effect on the alkaloid profile due to factors like soil composition.

A) White Vein Kratom

White vein kratom is known to be the best option if you’re looking to experience the nootropic benefits of kratom. It’s a great option for a mid-morning booster.

B) Red Vein Kratom

Red vein kratom strains are popular with those who suffer from chronic pain or have anxiety. Some even use it as a form of sleep support.

C) Green Vein Kratom

Green vein kratom is best thought of as a mixture of red and white kratom. It has a great balance of benefits and can exemplify the whole breadth of the kratom spectrum.

D) Yellow Vein Kratom

Yellow vein kratom is quite similar to green-veined strains. Its main attribute is the fact that it’s milder than the other three strains. 

Key Takeaways: Is it Safe to Mix Kratom & St. John’s Wort?

Yes. As long as responsible levels of both compounds are consumed, there should be minimal risk. But again, it’s best to talk with your doctor since these two tend to cause drug interactions.

Nonetheless, if you take kratom daily as a treatment for some condition (chronic pain, withdrawal symptoms, anxiety, etc.), then you should be aware that the concomitant use of St. John’s wort will lower the effectiveness of kratom and thus interfere with your treatment.

Also, if you happen to be on any prescription medication, call your doctor before taking St. John’s wort or kratom; your medication could potentially have a dangerous reaction with either herb.

References

  1. Guo, G. L., Moffit, J. S., Nicol, C. J., Ward, J. M., Aleksunes, L. A., Slitt, A. L., … & Gonzalez, F. J. (2004). Enhanced acetaminophen toxicity by activation of the pregnane X receptor. Toxicological Sciences, 82(2), 374-380.
  2. Beerhues, L. (2006). Hyperforin. Phytochemistry, 67(20), 2201-2207.
  3. Wenk, M., Todesco, L., & Krähenbühl, S. (2004). Effect of St John’s wort on the activities of CYP1A2, CYP3A4, CYP2D6, N‐acetyltransferase 2, and xanthine oxidase in healthy males and females. British journal of clinical pharmacology, 57(4), 495-499.
  4. Kamble, S. H., Sharma, A., King, T. I., León, F., McCurdy, C. R., & Avery, B. A. (2019). Metabolite profiling and identification of enzymes responsible for the metabolism of mitragynine, the major alkaloid of Mitragyna speciosa (kratom). Xenobiotica, 49(11), 1279-1288.
  5. Mai, I., Bauer, S., Perloff, E. S., Johne, A., Uehleke, B., Frank, B., … & Roots, I. (2004). Hyperforin content determines the magnitude of the St John’s wort–cyclosporine drug interaction. Clinical Pharmacology & Therapeutics, 76(4), 330-340.
  6. Chrubasik-Hausmann, S., Vlachojannis, J., & McLachlan, A. J. (2019). Understanding drug interactions with St John’s wort (Hypericum perforatum L.): impact of hyperforin content. Journal of Pharmacy and Pharmacology, 71(1), 129-138.
  7. Müller, W. E., Singer, A., & Wonnemann, M. (2000). Mechanism of action of St. Johns wort extract. Praxis, 89(50), 2111-2121.
  8. Lawvere, S., & Mahoney, M. C. (2005). St. John’s wort. American family physician, 72(11), 2249-2254.
  9. Ernst, E., Rand, J. I., Barnes, J., & Stevinson, C. (1998). Adverse effects profile of the herbal antidepressant St. John’s wort (Hypericum perforatum L.). European journal of clinical pharmacology, 54(8), 589-594.