Study
Reveals St. John's Wart
Excerpt
By Colette Bouchez,
HealthScoutNews
(HealthScoutNews) -- What you see may not be what you get, and
what you get may not be what you need -- when shopping for the
popular herbal supplement St. John's wort.
That's the finding of a new study that reports sizeable discrepancies
in label claims and compounds found in eight popular brands of the
popular yet controversial herb commonly used to treat mild-to-moderate
depression.
In research published in the new edition of the American
Journal of Health System Pharmacists, scientists from the
University of Southern California's School of Pharmacy report
that manufacturers of at least some versions of St. John's wort
may be concentrating their formulas on the wrong components of
the herb. Also, these same companies may not be so accurate in
listing the percentages of the compounds the products contain.
"Most manufacturers test their products for levels of hypericin,
while ignoring the compound hyperforin, even though there is good
evidence that hyperforin may have the most therapeutic benefits,"
says lead study author Gerlie de los Reyes, a researcher at USC's
Department of Pharmaceutical Sciences.
Complicating matters further, manufacturers that do test for
hypericin and put the results on the product label aren't always
accurate in their claims. The study also found that those that
significantly mislabeled hypericin levels were also more likely
to include too little hyperforin -- to the point where only two
of the eight products tested got the researchers' approval.
"We concluded that manufacturers need to accurately assay
[test levels] their products and ensure levels of both hypericin
and hyperforin if the product is going to be effective,"
de los Reyes says.
Alternative medicine specialist Dr. James Dillard says that
conclusion is important, if for no other reason that we still
don't know what it is about St. John's wort that helps us feel
better.
"The latest information is that we don't know whether hypericin
or hyperforin is the key ingredient. And, in reality, we don't
know if either one is having the effect independently, or if they
must work in harmony to achieve the results," says Dillard,
medical advisor at the Rosenthal Center of Alternative and Complementary
Medicine at Columbia University.
In fact, Dillard says, it may be that all the compounds found
in St. John's wort are necessary to combat depression.
"This is why products need to be standardized for as many
of the compounds as possible -- to ensure that the product is
of high quality and that it will yield the therapeutic effects,"
Dillard says.
The USC study examined eight brands of St. John's wort: PNC
(Pharmacists Nutrition Center, Wilsonville, Ore.); Brite Life
(Bergin Brunswig, Orange, Calif.); ShopKo (ShoptKo Stores, Green
Bay, Wisc.); Shurfine (Shurfine International, Northlake, Ill.);
Your Life (Leiner Health Products, Carson, Calif.); Nature's Balance
(Vitamin Classics, Calabasas, Calif.); and Natrol (Natrol, Chatsworth,
Calif.), and Hyperifin (Finzelberg, Birkenweg, Germany).
First the researchers checked the levels of hypericin and compared
them to the amounts printed on the label. The result: Only Hyperifin
(with 98 percent of its label claim) and Your Life (with 95 percent
of its label claim) were considered "accurate."
PNC contained approximately 80 percent of its label claim; Natrol,
approximately 82 percent, and Shurfine tested at just 56 percent
of its label claim. Nature's Balance, which had no label claim
for hypericin, came in with the lowest amount -- 0.03 percent.
While two of the products exceeded label claims -- Britelife
with 110 percent and ShopKo with 130 percent -- de los Reyes says
this isn't necessarily a good thing.
"The further away you get from the amount listed on the
label -- high or low -- the less likely that the product is being
carefully examined and tested," says de los Reyes. What's
more, she says, discrepancies in one compound often mean discrepancies
in ingredients that may not listed.
And that's what the researchers found when they tested for hyperforin.
While research shows hyperforin should be present in amounts ranging
from 1 percent to 6 percent, des los Reyes says few companies
standardize for this ingredient. Amounts found in the products
she tested ranged from a low of 0.01 percent (Nature's Balance)
to a high of 1.89 percent (Hyperifin).
Percentages of hyperforin found in the other products were:
ShopKo, 0.05; Your Life, 0.19; PNC, 0.20; Shurfine, 0.29; Natrol,
0.48; and Brite Life, 1.16.
"Only two of the brands we measured [for hyperforin] went
over the 1 percent mark -- Hyperifin and Brite Life," de
los Reyes says.
These were the same two products that came the closest in accuracy
to label claims for hypericin.
The product with the least hyperforin -- Nature's Balance --
also had the lowest level of hypericin, according to de los Reyes.
"The point of our study is that all St. John's wort products
should be standardized for both hypericin and hyperforin, in order
for consumers to get a product that really works," she says.
Dillard agrees: "The long answer is that we need better
regulations of herbal products with more standardization. The
short answer is to buy products from known manufacturers, with
supplements imported from Germany usually among the most reliable."
The Council for Responsible Nutrition is a science-based trade
organization of the dietary supplementary industry.
Asked to respond to the USC study, John Cardellina, vice president
of botanical science and regulatory affairs, says, "This
study has analyzed for content of components that aren't listed
or claimed on the label. Based on that, they are concluding that
the products are not appropriately manufactured. The flaw here
is that the researchers are not taking into account the continuing
debate regarding which of the components in St. John's wort are
responsible for providing the antidepressant activity.
"At best, hyperforin is one of three chemical components
of St. John's wort that contributes to the antidepressant activity
of the plant. So St. John's wort could very well be an effective
product without containing hyperforin. In fact, there is a substantial
evidence base derived from over 30 clinical trials of St. John's
wort that demonstrates its benefits for mild-to-moderate depression,
but what is not clear is whether that benefit comes from hyperforin,
hypericin or flavonoids or a combination of all three," Cardellina
added.
What to Do: To learn more about how to choose an herbal
product, visit The
Herb Research Foundation. To learn more about St. John's wort,
check the
National Center for Complementary and Alternative Medicine.
Reference
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