Q. I have been taking St. John’s wort and black cohosh to relieve symptoms of hot flashes and night sweats associated with menopause. This combination works really well. Are there any negative effects that should concern me?
A. The combination of St. John’s wort and black cohosh is often used in Europe to treat menopausal symptoms. There are, however, a few potential pitfalls.
Black cohosh has been linked to rare cases of elevated liver enzymes. You should ask your doctor to monitor you.
St. John’s wort can interact with many medications. Do not take it with any drugs unless you verify with your pharmacist that there is no interaction.
More disconcerting is the possibility of eye damage. St. John’s wort contains hypericin. When this compound is exposed to visible light it is activated and creates dangerous chemicals called free radicals. Joan Roberts, PhD, of Fordham University has found hypericin can harm lens tissue and might also damage the retina (Photochemistry and Photobiology, May/June, 2007).
Anyone taking St. John’s wort for depression or menopausal symptoms should avoid sunlight and even bright indoor light. Sunglasses cannot protect the eye adequately against this possible side effect.
