Can you take St John’s Wort and ashwagandha? (7 tips)

This article will discuss whether St. John’s Wort and Ashwagandha can be taken together. It will mention the benefits and risks of taking them together. Finally, the article will provide suggestions on how to safely take St. John’s Wort and Ashwagandha.

Can you take St John’s Wort and Ashwagandha?

Yes, you can take Saint John’s Wort (SJW) and Ashwagandha together. Both of these botanicals have multiple health benefits, and combining them can help improve mental health, sleep, and immune reactions. Moreover, there aren’t any known significant interactions between the two.

St. John’s Wort has shown efficacy in managing depression and treating certain infections. On the other hand, ashwagandha is also effective for enhancing mood and reducing stress. It also improves one’s immunity.

People respond to medications differently, and not everyone will experience the same benefits or risks of combining these herbs. Thus, it is recommended to consult with a healthcare professional before taking them together, especially if you are taking other medications.

What are the benefits of SJW and Ashwagandha on mood?

Taking Saint John’s Wort and Ashwagandha together may be beneficial in various cases or indications. Both medications can offer combined benefits for enhancing mood in people with both depression and anxiety.

The main active constituents of St. John’s Wort are hyperforin and hypericin. These chemicals inhibit the reuptake of serotonin, norepinephrine, and dopamine in the cells, increasing their availability in the synaptic cleft and increasing their actions. This helps improve mood and treat depressive symptoms [1].

On the other hand, Ashwagandha is mainly effective for anxiety. It suppresses the production of both cortisol and DHEA in response to stress. Both of these chemicals are elevated when a person is stressed, and they play a role in anxiety. Thus, suppressing their release helps reduce stress and worry [2].

Moreover, Ashwagandha acts as an anti-inflammatory and antioxidant; it decreases the inflammation and oxidative state that are usually increased during stress and anxiety [2]. 

Depressed individuals who are anxious or under a lot of stress may benefit from taking St. John’s Wort and Ashwagandha together, as they can work together to enhance mood and decrease worry.

What are the benefits of SJW and Ashwagandha for infections?

Since Saint John’s Wort has antiviral and antibacterial properties and Ashwagandha has immunity-boosting effects, taking them together may be very beneficial for managing certain infections.

Saint John’s Wort can help treat viral infections, such as herpes infections or HIV infections, via various mechanisms. For instance, hypericin prevents viruses from attaching to and entering the cells. It also interferes with the replication of viruses and prevents their spread [3]. 

Furthermore, SJW helps in killing certain bacteria that have developed resistance to antibiotics, such as methicillin-resistant Staphylococcus aureus and penicillin-resistant Staphylococcus aureus. It acts as an efflux pump inhibitor, allowing the antibiotics to enter the resistant bacterial cells again and kill them [3].

On the other hand, Ashwagandha helps strengthen the immune system so it can fight infections and kill microbes more effectively. It increases antibody-producing cells, antibodies, and phagocytes. Thus, people who are suffering from an infection or are immunodeficient may benefit from this combination [2].

What are the side effects of combining SJW and Ashwagandha?

Both herbs can be taken together safely without worrying about the risk of interaction. There are no reported or studied interactions between them. Furthermore, the table below compares the potential side effects of SJW and Ashwagandha:

Ashwagandha St. John’s Wort

Ashwagandha has a very good safety profile; it was tolerated and didn’t cause side effects in most of the trials. Moreover, one study found that giving rats doses as high as 2000 mg/kg did not lead to any toxicity [4].

It is mostly associated with GI and skin side effects. However, it can also cause vision and hearing problems, as well as liver injury, kidney injury, and reproductive problems. SJW can also increase the metabolism and reduce the potency of multiple drugs [5].

It is also necessary to mention that combining SJW and Ashwagandha with antidepressants can be very dangerous, as SJW increases serotonin and can lead to serotonin syndrome if taken with antidepressants. Furthermore, these medications shouldn’t be used by pregnant or breastfeeding women.

Considerations before taking St. John’s Wort and Ashwagandha

If you’re thinking about taking both of these herbs together, multiple factors should be considered:

  • You should consult with a doctor before taking these herbs; they will assess your medical and medication history to determine whether this combination is safe for you.
  • While the risk of experiencing serotonin syndrome while taking ashwagandha is lower, it is still possible. Taking ashwagandha with SSRIs like Celexa, however, can increase this risk. Thus, you should discuss this with your doctor.
  • Due to Ashwagandha’s immune-boosting effects and blood sugar-lowering effects, it may interact with certain prescription drugs like immunosuppressants and hypoglycemics. Thus, you must inform your doctor about your concurrent medications before taking it.
  • If you are already taking antidepressant medications, such as Celexa or sertraline, you shouldn’t take St. John’s Wort, as it may cause serotonin syndrome. 
  • Since both herbs enhance mood and reduce stress, you may consider dose adjustments. Combining them can allow you to reduce the dose of St. John’s Wort to reduce the risk of side effects without reducing effectiveness.
  • It is advisable to begin with low doses of each herb, especially if you’re combining them for the first time. You can then gradually increase their dosage if needed, under the supervision of a doctor.
  • You shouldn’t take SJW if you’re already taking warfarin, digoxin, immunosuppressants, benzodiazepines, or theophylline. SJW interacts with these drugs and reduces their effectiveness. Thus, in this case, you can only take Ashwagandha.
  • Pregnant women and breastfeeding women should not take SJW and Ashwagandha together.

Understanding the risks and benefits of taking SJW and Ashwagandha

Based on my research, I have concluded that it is possible to safely take St. John’s Wort and Ashwagandha together. Both herbs offer various health benefits, including improving mood, reducing stress, enhancing immunity, and treating certain infections.

While there are no reported interactions between the two, I recommend consulting with a healthcare professional before combining them, especially if you are taking antidepressants, insulin, oral hypoglycemics, warfarin, digoxin, theophylline, or oral contraceptives.

Additionally, based on my knowledge, pregnant and breastfeeding women should avoid this combination.

Overall, I believe that taking St. John’s Wort and Ashwagandha together can be a beneficial option, but it is important to consider certain factors and consult with a doctor to ensure a safe and effective treatment.

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References

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Butterweck V. Mechanism of action of St John’s wort in depression : what is known? CNS Drugs. 2003;17(8):539-62. doi: 10.2165/00023210-200317080-00001. PMID: 12775192. https://pubmed.ncbi.nlm.nih.gov/12775192/

2.-

Mikulska P, Malinowska M, Ignacyk M, Szustowski P, Nowak J, Pesta K, Szeląg M, Szklanny D, Judasz E, Kaczmarek G, Ejiohuo OP, Paczkowska-Walendowska M, Gościniak A, Cielecka-Piontek J. Ashwagandha (Withania somnifera)-Current Research on the Health-Promoting Activities: A Narrative Review. Pharmaceutics. 2023 Mar 24;15(4):1057. doi: 10.3390/pharmaceutics15041057. PMID: 37111543; PMCID: PMC10147008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147008/

3.-

Klemow KM, Bartlow A, Crawford J, et al. Medical Attributes of St. John’s Wort (Hypericum perforatum) In: Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. Chapter 11. Available from: https://www.ncbi.nlm.nih.gov/books/NBK92750/

4.-

Prabu, P. C., S. Panchapakesan, and C. David Raj. “Acute and Sub‐Acute Oral Toxicity Assessment of the Hydroalcoholic Extract of Withania somnifera Roots in Wistar Rats.” Phytotherapy Research 27, no. 8 (2013): 1169-1178.

5.-

Canenguez Benitez JS, Hernandez TE, Sundararajan R, Sarwar S, Arriaga AJ, Khan AT, Matayoshi A, Quintanilla HA, Kochhar H, Alam M, Mago A, Hans A, Benitez GA. Advantages and Disadvantages of Using St. John’s Wort as a Treatment for Depression. Cureus. 2022 Sep 22;14(9):e29468. doi: 10.7759/cureus.29468. PMID: 36299970; PMCID: PMC9587902. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9587902/