St. John’s Wort and Goldenseal: Why You Should Avoid Taking Them with Medications

Herbal supplements are often perceived as “safe” because they are natural, but some can have serious interactions with prescription or over-the-counter medications. Two of the most notable herbs in this category are St. John’s Wort and Goldenseal.

St. John’s Wort

St. John’s Wort is commonly used for mild depression, anxiety, and mood support. However, it is a powerful enzyme inducer, meaning it can accelerate the metabolism of many drugs in your body. This can lead to:

  • Reduced effectiveness of medications such as antidepressants, birth control pills, blood thinners, and certain heart medications

  • Unexpected side effects or withdrawal symptoms if drug levels drop too quickly

  • Potentially dangerous interactions with medications that affect serotonin levels

Because of its extensive interactions, St. John’s Wort should not be taken with any prescription medications without medical supervision.

Goldenseal

Goldenseal is often marketed for immune support or digestive health, but it contains berberine, a compound that can interfere with liver metabolism and blood pressure regulation. Potential issues include:

  • Altering the way the liver breaks down certain medications, leading to higher or lower drug levels

  • Interactions with blood thinners, blood pressure medications, and antibiotics

  • Gastrointestinal side effects and potential liver strain when combined with other drugs

Why Caution Is Crucial

Both St. John’s Wort and Goldenseal have a long list of contraindications. Even over-the-counter or herbal medications can interact with prescription drugs in dangerous ways. The problem is compounded because many people do not mention their supplement use to their doctors, leaving interactions unnoticed.

Safe Practices

  1. Always consult your healthcare provider before starting any herbal supplement, especially if you are on prescription medications.

  2. Disclose all supplements to your pharmacist or doctor to avoid hidden interactions.

  3. Research thoroughly: Not all “natural” remedies are benign, particularly when combined with other medications.

Bottom Line

Natural does not always mean safe. St. John’s Wort and Goldenseal are powerful herbs, but their potential for medication interactions makes them high-risk. When it comes to supplements, knowledge and caution are key. Always prioritize safety and professional guidance before adding any herbal product to your regimen.

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Prescription Medications Can Deplete Nutrients—Why Supplements Are Often Necessary