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St. John's Wort and SAM-e?


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#1 What'sAllThisThen

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Posted 28 December 2010 - 06:45 AM


I can't seem to find much information on the ability to take St. John's Wort and SAMe together. I've seen it suggested that combining the two could cause serotonin syndrome, but not much real info. I've seen a few mention on forums/reviews of taking the combination, but I don't know of the dosing. Plus, I see contradicting info on the actual effects of SJW and SAMe, such as SJW not being an SSRI like it has been believed to be. I haven't seen any studies of the sort, but read an article that said two doctors that are experienced with SJW claim that SJW does not put one at risk of serotonin syndrome (I can't recall now if that had anything to do with SAMe combo, or just that SJW hasn't caused serotonin syndrome).

So does anyone have info on the subject? Experience with combining the two? What dosing?

I take 2-3 Amoryn (SJW standardized) a day. I probably don't need that much, but at times I have and just kept it at that amount. It has worked, but I'd like to achieve a brighter outlook which I think could also help with motivation. I'm not depressed, but feel motivated when I'm in a particularly good mood. So thought SAMe might be worth a try (think I'll do a little experimenting with L-Tyrosine earlier too). Plus, SAMe is good for the liver and since I have high histamine I'm likely an undermethylator.

I'm not saying I wouldn't reduce my SJW dosing, but wonder to what extent I must do it. Meaning if there's a great risk I'd reduce it for some time before trying SAMe. Either way, I'd start at the smallest SAMe dose I could find (likely 100mg).
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#2 vrain

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Posted 28 December 2010 - 07:04 AM

I can't seem to find much information on the ability to take St. John's Wort and SAMe together. I've seen it suggested that combining the two could cause serotonin syndrome, but not much real info. I've seen a few mention on forums/reviews of taking the combination, but I don't know of the dosing. Plus, I see contradicting info on the actual effects of SJW and SAMe, such as SJW not being an SSRI like it has been believed to be. I haven't seen any studies of the sort, but read an article that said two doctors that are experienced with SJW claim that SJW does not put one at risk of serotonin syndrome (I can't recall now if that had anything to do with SAMe combo, or just that SJW hasn't caused serotonin syndrome).

So does anyone have info on the subject? Experience with combining the two? What dosing?

I take 2-3 Amoryn (SJW standardized) a day. I probably don't need that much, but at times I have and just kept it at that amount. It has worked, but I'd like to achieve a brighter outlook which I think could also help with motivation. I'm not depressed, but feel motivated when I'm in a particularly good mood. So thought SAMe might be worth a try (think I'll do a little experimenting with L-Tyrosine earlier too). Plus, SAMe is good for the liver and since I have high histamine I'm likely an undermethylator.

I'm not saying I wouldn't reduce my SJW dosing, but wonder to what extent I must do it. Meaning if there's a great risk I'd reduce it for some time before trying SAMe. Either way, I'd start at the smallest SAMe dose I could find (likely 100mg).


There's no interaction. sam-e can be used to augment ssris as well. SJW isn't an ssri - its moa is still not fully understood. Its a good combo - I tried it out for a bit - 300mg sjw at night and 400mg sam-e in the morning.
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#3 What'sAllThisThen

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Posted 28 December 2010 - 04:07 PM

Thanks.

So there's no interaction at all? Neither of them affect serotonin in any way (boosting, receptors, uptake, etc.)?

I'm actually trying to remember now if that article I read wasn't about SJW but about SAMe as the use along with SSRIs seems familiar. I can't remember as it was a couple weeks ago and I have a suggestive memory.

Amoryn also has some 5-HTP in it. I'll have to check the bottle later tonight when I get home as I don't remember the amounts of SJW, 5htp, etc. I do know the usage says up to 4 a day.
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#4 The Human Meteorite

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Posted 28 December 2010 - 04:34 PM

Short answer: There won't be any contradictions.
Long answer: Despite the fact that they both elevate serotonin levels, they do this to such a small extent that it is really negligible. Plenty of people take ecstasy while on SSRIs and are perfectly fine, I wouldn't worry about a small does of a methionine analog and a medicinal herb.
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#5 Imagination

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Posted 28 December 2010 - 11:41 PM

Just switch to the sam-e and stop the st john wort if you are worried. You can feel it working within the hour, if you doesn't work then just switch back.

I wouldn't think you need to take both, I don't like st johns wort, didn't do anything for me, or made me feel worse, sam-e is good though, only downside is the expense. I only take 200mg and it is enough.
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#6 vrain

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Posted 29 December 2010 - 02:44 AM

Thanks.

So there's no interaction at all? Neither of them affect serotonin in any way (boosting, receptors, uptake, etc.)?

I'm actually trying to remember now if that article I read wasn't about SJW but about SAMe as the use along with SSRIs seems familiar. I can't remember as it was a couple weeks ago and I have a suggestive memory.

Amoryn also has some 5-HTP in it. I'll have to check the bottle later tonight when I get home as I don't remember the amounts of SJW, 5htp, etc. I do know the usage says up to 4 a day.



No interaction between SAM-E and SJW at all. They both have an affect on serotonin and some other nts (dopamine/gaba etc). But their moas are compatible.

However - 5htp and SJW - I have no idea if there's any interaction there.


I found the SAM-E /SJW combo great - the sjw by itself was too sedating over time and the sam-e by itself caused too much anxiety. Together in the doses I used they worked extremely well. Personally never liked 5htp - never got a good feel off of it - felt fuzzy and dull on it.
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#7 What'sAllThisThen

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Posted 29 December 2010 - 04:30 AM

Thanks everyone.

I do believe I'll add some SAMe to my next order to give it a try. I'll still probably drop my SJW down to 2 a day and use a small SAMe dose.

Imagination, switching to SAMe is a possibility if it works. I just didn't want to have to stop the SJW and go through withdrawal (or just lack of the affect it provides) to find out if it worked. SJW takes a few weeks to work and so if there were a contraindication I would think I'd have to stay off it for a while before trying the SAMe. The end goal wouldn't be to take both, but rather to see if I could switch or provide a lift when I wanted.

Vrain, supposedly there is interaction between 5htp and SJW, but since they're combined in products I'd guess it's not very substantial or at least require larger doses to run into problems.

Thanks again.
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#8 Thorsten

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Posted 31 December 2010 - 05:30 PM

I agree with the above advice. SAM was always stimulting to my body but never felt serotonergic based at all, but yeah it was dam expensive. SJW I have always wondered how stong it is on serotonin ... In comparison to ssri drugs it is nowhere near as strong. Some people have linked studies showing its action and it seems to interact with GABA, serotonin, norepiniphrine, glutamate and cortisol. In fact its main method of action may be linked to its NDMA antagonistic qualities. To be honest its MOA is all over the place and that's the reason I gave it up. It works for some people though.
In terms of how it feels on the body SJW does feel serotonin based to me though. But also feels kinda dirty and has a tendancy to increase stress in my body each morning (perhaps how it interacts with cortisol but who knows).

SSRI's + MDMA that's gotta be risky but it doesn't suprise me that people have done this.

Edited by Thorsten, 01 January 2011 - 01:06 PM.

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#9 What'sAllThisThen

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Posted 02 January 2011 - 07:54 AM

I agree with the above advice. SAM was always stimulting to my body but never felt serotonergic based at all, but yeah it was dam expensive. SJW I have always wondered how stong it is on serotonin ... In comparison to ssri drugs it is nowhere near as strong. Some people have linked studies showing its action and it seems to interact with GABA, serotonin, norepiniphrine, glutamate and cortisol. In fact its main method of action may be linked to its NDMA antagonistic qualities. To be honest its MOA is all over the place and that's the reason I gave it up. It works for some people though.
In terms of how it feels on the body SJW does feel serotonin based to me though. But also feels kinda dirty and has a tendancy to increase stress in my body each morning (perhaps how it interacts with cortisol but who knows).

SSRI's + MDMA that's gotta be risky but it doesn't suprise me that people have done this.


Thanks.

I've received some NOW brand 100mg SAMe as well as Tyrosine and NALT (got both to see which I prefer if either). So I'll be trying them soon, slowly, and on different days.

When you first said SJW may interact with cortisol, I assumed you meant reduced cortisol since SJW reduces stress. But then you mention it increasing stress in your body each morning, so do you mean it increases cortisol? I often have what I call morning anxiety or waking anxiety. It's an anxious feeling in my body that occurs around the last hour of my sleep. I'm asleep (though it wakes me to an extent that I'm not restfully sleeping), so it's not based on anxious thoughts. However, it waxes and wanes depending on if I'm in a stressful time so it does depend on my thoughts in that sense. Just not my thoughts at the exact moment. Since it happens during times of stress, I'd say it's not as a result of SJW though.
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#10 Thorsten

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Posted 03 January 2011 - 12:57 PM


I agree with the above advice. SAM was always stimulting to my body but never felt serotonergic based at all, but yeah it was dam expensive. SJW I have always wondered how stong it is on serotonin ... In comparison to ssri drugs it is nowhere near as strong. Some people have linked studies showing its action and it seems to interact with GABA, serotonin, norepiniphrine, glutamate and cortisol. In fact its main method of action may be linked to its NDMA antagonistic qualities. To be honest its MOA is all over the place and that's the reason I gave it up. It works for some people though.
In terms of how it feels on the body SJW does feel serotonin based to me though. But also feels kinda dirty and has a tendancy to increase stress in my body each morning (perhaps how it interacts with cortisol but who knows).

SSRI's + MDMA that's gotta be risky but it doesn't suprise me that people have done this.


Thanks.

I've received some NOW brand 100mg SAMe as well as Tyrosine and NALT (got both to see which I prefer if either). So I'll be trying them soon, slowly, and on different days.

When you first said SJW may interact with cortisol, I assumed you meant reduced cortisol since SJW reduces stress. But then you mention it increasing stress in your body each morning, so do you mean it increases cortisol? I often have what I call morning anxiety or waking anxiety. It's an anxious feeling in my body that occurs around the last hour of my sleep. I'm asleep (though it wakes me to an extent that I'm not restfully sleeping), so it's not based on anxious thoughts. However, it waxes and wanes depending on if I'm in a stressful time so it does depend on my thoughts in that sense. Just not my thoughts at the exact moment. Since it happens during times of stress, I'd say it's not as a result of SJW though.


No problem mate this is just my own experience with it, some other board members may be able to chip in as well. The morning type of effect was definitely there for me though. SJW can increase or decrease cortisol based on what doasge you use. Then you have a different variety of brands, some more stimulating, some more serotonergic. I was taking Perika if that's useful to know.

Yeah I totally understand that morning type of feeling, it could be related to cortisol you know although I wouldn't know for sure. My morning feeling is definitely more 'depression' based - I am my own worst enemy - things going around in my head - making myself more stressed.
I am currently in the process of thinking about going back on Agomelatine or maybe give Mirtzapine a try. When I was taking Agomelatine and it was working, it was great and I noticed how less stressed I was on it. I may even finally give a low dose escitalopram trial a go as SSRI's are probably the best in my experience in protecting your brain from stress. Everyone is different though so I can only give my opinion for what it is worth.
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#11 FadingGlow

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Posted 04 January 2011 - 10:56 PM

Short answer: There won't be any contradictions.
Long answer: Despite the fact that they both elevate serotonin levels, they do this to such a small extent that it is really negligible. Plenty of people take ecstasy while on SSRIs and are perfectly fine, I wouldn't worry about a small does of a methionine analog and a medicinal herb.


DO NOT take ecstasy while on SSRI's... It is not safe whatsoever... This is a horrible example to use. Sure, most people will survive. That doesn't mean its not very damaging/neurotoxic nor does it negate the risk whatsoever. You should refrain from using this example for the purpose of harm reduction.
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#12 What'sAllThisThen

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Posted 11 January 2011 - 05:32 AM

Titrated up L-Tryosine last week from about 250mg to 2500mg over 7 days. Might have noticed a slight more talkative nature at 2500mg. Will try again later (as well as NALT). Taking a break for now as I've heard tolerance builds, so now trying out the SAMe. Took 100mg yesterday, nothing noticed. 200mg today, nothing noticed. Will try 300mg tomorrow.

Questions...

As far as splitting SAMe doses, what's a good schedule? Does it cause insomnia if taken too late?


And hopefully enough people will peak in here so I don't have to start a new thread about some NALT/tyrosine q's...

How fast does tolerance build to L-Tyrosine? How fast to NALT? And is it a tolerance that just requires some cycling. Like 2 weeks on, 1 week off to keep the effects. Or is it more like if you build tolerance you're pretty much out of luck as you'll always have the tolerance from now on. A thread here suggested tolerance comes from depletion of the tyrosine hydroxylase enzyme. Is there any method to prevent that depletion?

Just looking for pointers on how to handle the two. I'd rather keep them for when I want to be social/outgoing or motivated (if I find they give me those effects) than build a tolerance and be without them.
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#13 What'sAllThisThen

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Posted 17 January 2011 - 04:44 AM

Any thoughts?? ^^^
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#14 What'sAllThisThen

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Posted 03 March 2011 - 04:09 PM

So after some further experimenting with SAMe it seemed to be working. I was sleeping better, feeling pretty good (nothing special, just a little lift from an almost ignorable depression/anxiety), and able to reduce my Amoryn (sjw) and Seredyn (l-theanine, passion flower,etc.) without really feeling it. Before reducing those two would bring about a little anxiety/depression or even a weird feeling in my head that could last a few days.

But after upping it to 2x400mg a day I started getting a little jittery. Anxious body, but not really anxious or anxiety feelings. Took a two day break over the weekend and now just take 400mg again, but the slight jittery feeling still comes on for awhile. Not bothersome really. It still could be the reduction of amoryn/seredyn, so further experimenting will need to be done.

My question is, does the jittery feeling go away, sort of like just something you need to get through? Or does it mean SAMe is just not for me? I thought I was a good candidate since I'm likely an undermethylator since I have high histamine.
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#15 Vaughan Elphick

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Posted 02 April 2013 - 01:38 AM

Sorry for the late post as I just found this, just wondering if you had any updates on this, I normally take St Johns wort , just the normally recommended dose of 900mg extract a day (but I also have ADD and I feel it makes things worse as it gives me a dulled down feeling which I need cause I suffer from anxiety otherwise) BUT prior to going back on it I was trying SAM-e, and found it really helped with concentration and energy (both which I lack on and off St Johns Wort) , I was trying 200mg for 10 days then I upped the dose to 200mg x2 a day and felt a bit of body anxiety also but I have terrible back pain which I noticed was actually gone on SAM-e (another huge plus) so I'm VERY curious to see how your combination went as there are not many posts about this combination even though so many people above said it should be fine.

I want to try St Johns Wort 900mg of extract (probably all at night cause I found helps me the most due to that's when serotonin etc gets produced) and either 200mg once or twice daily of SAM-e. REALLY do not want to get serotonin syndrome.

PS I forgot to mention that when taking the SAM-e for depression alone it did nothing at all and upping the dose too much I suspected would give me anxiety and did a little bit (common side effect I've read) is why I'm so interested in taking both.

Edited by Vaughan Elphick, 02 April 2013 - 01:42 AM.

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#16 What'sAllThisThen

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Posted 02 April 2013 - 02:03 AM

It's been a long time, so I can't be accurate in much that I say. I know I was using both simultaneously for awhile and experienced no issues in regards to conflict, just jittery from higher dose SAM-e. As the SAM-e seemed to take me out of a slight funk I started lowering my Amoryn (depression, sjw) and Seredyn (anxiety) dosage until I was not using them at all, and only SAM-e. I continued that for many months and not necessarily by design began taking less and less. I think I settled on 200mg 5x a week for some time and missing a dose here and there. I haven't taken any in several months and feel fine. I'm not particularly motivated, but I'm not depressed or anxious anymore either.
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#17 Vaughan Elphick

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Posted 02 April 2013 - 03:05 AM

Oh nice, glad to see your still around and could answer, thanks for that, how high a dose did you get up to with the SAM-e to make you jittery?
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#18 What'sAllThisThen

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Posted 02 April 2013 - 08:02 PM

I believe it was 2x400mg, so 800mg. The jitters weren't too bad or anxiety inducing, just a little too much without any extra benefit, like I would get with a cup of coffee (I don't drink coffee). My plan was to take it longer and work up to high doses again to see if jitters would remain or if any extra benefit was found. But I was pretty balanced at the low doses and so never did end up climbing in dose again.
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