25 November 1999 Edition

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Healing plant faces restriction

St. John's Wort is an effective herbal treatment for depression and many other ailments. Robert Allen argues that plans to make this extraordinary healing plant available only on prescription from 1 January next will severely restrict its use, as so few medical doctors in Ireland have herbal medicine knowledge

St. John's Wort is a bright yellow, five petaled flower, with a sturdy green two-foot-high stem most of us would regard as a weed. Commonly found in open woodland, on waste ground and by the road side, we would, if we choose to dig it out of our garden, be destroying one of nature's most beneficial healers, a healer that is now being recognised as a safer, cheaper and effective method of treating depression, among many other illnesses and ailments.*

For more than 2,000 years, the flowers, leaves and stem have been used to treat wounds, aches, infections and repair skin. The active ingredient in St. John's Wort is hypericin - an antiseptic now common in homeopathic medicines. It also contains flavonoids, essential oils, carotene, vitamin C, tannin, resin and small amounts of antibiotic substances.

St. John's Wort (hypericum perforatum) is said to honour the Knights of Saint John of Jerusalem, who used it to treat battlefield wounds. Because the hypericin produces a bright red hue, the herb is associated with blood and is often collected on 24 June, the feast day of John the Baptist (the date he was beheaded). The genus name hypericum is Greek for ``over an apparition'' because its aroma caused evil spirits to depart. The species name, perforatum, refers to the tiny oil-filled perforated holes in the plant.

The use of St. John's Wort in herbal medicine is now recognised as essential
Its use in herbal medicine is now recognised as essential. St. John's Wort calms and sedates. It is an anti-inflammatory and astringent. It may be used to treat anxiety, coughs, diarrhea, dysmenorrhea, fatigue, flu, gout, grief, herpes, hydrocephalus, insomnia, irritability, jaundice, menopausal problems, neuralgia, rheumatism, ulcers and viral infections.

The oil, used internally and topically, can help heal damaged nerves. The young leaves make a rich nutritional addition to salads. In recent years, it has been researched as an antiviral agent to relieve the symptoms of AIDS.

Few side effects have been noted. Like anti-depressant drugs, anyone taking it internally can become sensitised to the sun. Over-handling of the plant can cause dermatitis, so gloves are recommended when harvesting it.

Freely available in the woods or gardens for millennia and in recent decades in health food stores, this cheap and effective herbal medicine will - from 1 January 2000 - only be available with a prescription. Much of the reason for this has been the discovery that St. John's Wort is an effective anti-depressant.

German scientists, who studied 300 herbs, concluded in the mid-'80s that one of the most promising is St. John's Wort. Subsequent studies of the efficacy of St. John's Wort as an anti-depressant show that this abundant herb has none of the side effects associated with the prescribed drugs.

Drugs like Prozac act on a nerve chemical messenger in the brain called serotonin. The studies suggest that St. John's Wort acts not only on serotonin, but on two other key chemical messengers.

With such exalted claims for its use and the testimony of thousands of people who have benefited from St. John's Wort, it isn't surprising that the Irish Medical Board decided in its `Guide to the Definition of a Medicinal Product' - published in May - that the herb is a substance capable of ``restoring, correcting or modifying physiological functions in human beings''. This EC definition of a medicinal herbal substance (``a substance with medicinal activity derived exclusively from plant material or extracts'' and a ``known significant pharmacological effect'') will push St. John's Wort oils, tablets and products containing the herb (along with 68 other herbal products) to the back of the pharmacy.

This definition would mean nothing to the consumer if EU law did not require all ``drugs'' to be licensed - which costs thousands of pounds. Many of the health supplement manufacturers have said that the added costs will force them to take their products off the market or increase the price to the consumer. Add the cost of a prescription and St. John's Wort may become hard to find.

That's the view of the Health Consumers for Choice Ireland group, which was formed to lobby politicans and the media about the government's decision to implement the IMB's guidelines last month. ``We would see St. John's Wort to be the first one to go,'' says Gabrielle McAuley of HCC. ``We want to see it stay on the shelves. This will push it underground. I have it on good authority that people are stockpiling it.''

McAuley's fears go beyond the extra cost. ``My understanding is that doctors could be reprimanded for perscribing something they are not qualified to prescribe. They could be seriously reprimanded.

``We would say please find another way of licensing these products, because they are different to pharmaceutial drugs. I have raised my children using natural medicines and I would like them to do the same.''

In fact, if products containing St. John's Wort have a drug authorisation code from the National Drug Advisory Board, GPs will be able to prescribe it. The likelihood is that they won't because there are so few medical doctors with herbal medicine knowledge. Quentin Gargin of the Health Trade Alliance says ignorance will also feature. ``I would say it is more of a problem that the IMB is made up of people who are cynical about herbal medicines. They are set up as judge, jury and executioner of a system of medicine they don't believe in, and the history of this goes back to the middle ages and the burning of witches.

``The point is that GPs do not have a monopoly on treating depression. People have a fundamental right to choose whatever system of health-care they choose. St. John's Wort offers a safe and effective way for people who are feeling down to get back on their feet again quickly and without recourse to conventional drugs. The medical profession do not have the exclusive right to deal with people's inner lives.''

There is also a real fear that people will substitute herbal tablets and tinctures with little bags of herbs from unknown sources. It is Gargin's argument that the Department of Health should make sure that herbal tablets and tinctures are produced to the pharmaceutical GMP (Good Manufacturing Practice). ``Poor identification of herbs has been the principle cause of side-effects with herbal medicine, and this is an aspect which can and must be controlled. Proposed bans on certain herbs actually endanger public health by pushing herbal medicine underground into an arena in which mistakes will almost certainly be made,'' says Gargin.

* The genus commonly found in Ireland is not hypericum perforatum and should not be used under any circumstances.

For further information contact Gabrielle McAuley at (01) 4518681; email: [email protected]

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