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Miriam
Hello, new student here. I have a question about topical use of St Johns wort – how problematic is that for potential drug interactions?
My mother-in-law has a painful bunion that her doctor said is nerve-related (but also arthritic) and there’s nothing he can do to help (the ongoing theme of medical care for her). I have a recipe for a st johns wort / arnica / cayenne pepper salve that is supposed to be great for all kinds of aches and pains, including nerve pain, so I was hoping to make that for her. However, I am concerned about potential drug interactions for medications she may be on.
I don’t know the exact list of meds she is taking, but she is on a diuretic (for mild high blood pressure – dr clearly thought that was better than cleaning up the diet and getting some body movement), some kind of medication to reduce the chronic dry mouth side effect from the diuretic (isn’t helping), and probably a blood thinner since she’s had a couple of TMI / mini strokes. I know SJW is likely to be problematic when taken internally if there is a drug that would interact, and I know at least some herb would be absorbed through the skin, but how problematic is it for topical use? Totally avoid to be safe?
I tried making a salve with just the cayenne pepper and some essential oils (skipped the wintergreen in case she is on a blood thinner), but when testing it on myself I felt it wasn’t strong enough.
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Herb Thyme
This is regarding the bunion. Have you ever heard of “toe seperators?” They are foam or gel and go over the toes. You can buy online or even at CVS. Check out some videos. you start wearing them for a short amount of time and work up. They can help with lots of different situations.
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Dawn
Hi Miriam, I’ve been a student here for a while, maybe 2 yrs, and my understanding is that topical use is safe, on unbroken skin, for people with underlying health concerns (pregnant, nursing, etc). And Arnica is toxic for everyone and should only be used externally on unbroken skin. There are other nervines that you could try rather than St John’s Wort if you want to be extra cautious; Doc Jones mentions Skullcap, Valerian, Chamomile in his Pain Management video (final thoughts or a title similar). He also suggests in that video that a tincture will absorb more rapidly through the skin than a salve, offering near immediate results in some instances. If you want to take a look at some potential interactions with St John’s Wort, or others, you can try RxList.com. I gave it a quick look to find that some heart medications (one being a blood thinner) do interact with that herb and some people complain of dry mouth after using it, interesting I thought. I hope you find this helpful until Doc Jones or other school mentor responds. I will follow to see how they respond … it’s a good question to ask 😉
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Very interesting, thanks Dawn!
I’ve read in some places that SJW is safe topically but in other places that it’s not. I think I would like a mechanistic explanation for whether it is actually safe when there are potential drug interactions. I’ll check PubMed for studies when I have more time.
That’s so funny though – I have made relaxation teas that called for SJW and replaced it with chamomile for some friends on blood pressure meds, but didn’t think to try that with a salve. I’ll have to learn more about best applications (topical vs internal) before tackling this issue I think.
I wonder why tinctures absorb more quickly than salve – guessing the beeswax dilutes things and slows down absorption?
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Yes, it is very important to do your own research and know all the drugs that may be used at this time. I think one of the distinctions between using as a salve is open skin or not. As some research as pointed to open skin allowing too much of the toxin from Arnica to be drawn into the body. Closed skin doesn’t seem to allow for as much absorption. Definitely, refer to the doctor or pharmacist.
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This is regarding the bunion. Have you ever heard of “toe seperators?” They are foam or gel and go over the toes. You can buy online or even at CVS. Check out some videos. you start wearing them for a short amount of time and work up. They can help with lots of different situations.
Thanks for the suggestion, Herb. My MIL has toe separators and has even purchased orthopedic shoes for better support. While toe separators can certainly be helpful for bunions, arthritic nerve pain in the joint is unlikely to be cured with just postural improvements.
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Dr. Patrick Jones
Dawn is right. I don’t worry much about pharmaceutical interactions with topically applied herbs.
Don't use herbs or combine herbs with medications or use them during lactation or pregnancy without talking with your healthcare provider.
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