st john's wort and tamoxifen

althea

Since the beginning of tamoxifen treatment, my top two complaints in the past have been fatigue and hot flashes. Now my top two complaints are fatigue and depression.

I know effexor is an antidepressant and expensive. I don't have prescription insurance coverage. I'm wondering if St John's Wort is ok to take while I'm on tamoxifen? Anyone know?

Rosemary44

I can't say that I know about St. John's with tamoxifen but I do read a lot of reports and it's usual to see don't take St. John's with different types of drugs.

What complaint is St. John's suppose to work on? The depression or the fatigue? I just read good things about ginseng and fatigue. I don't know if it interacts with tamoxifen though. And after reading this, I still don't know:

http://www.ncbi.nlm.nih.gov/sites/entrez...Pubmed_RVDocSum

What the heck is that saying?

And this might be of some help with depression:

http://www.ncbi.nlm.nih.gov/sites/entrez...Pubmed_RVDocSum

roseg

I took St John's wort for awhile and eventually went onto Paxil. It had a very mild action, and gave me headaches. In comparison Paxil was stronger AND cleaner, i.e. no headache.

Since it has a similar action to SSRI drugs I think it would not be prudent to self-medicate with it because you don't want to impair tamoxifens' action.

Perhaps if you discuss your symptoms with your PCP he/she can suggest other treatments that aren't as expensive as Effexor that might help.

NativeMainer

It should be safe to take St. John's Wort with tamoxifen--according to this source it works on different enzymes than tamoxifen.

http://medicine.iupui.edu/flockhart/table.htm

L8895

If you get a chance, read through the most recent transcript from the online conference on this site. They did not talk about St John's Word and Tamoxifen, but did mention the AI interaction with it. Here is a little clip.

"Dr. Deng: Arimidex is in a class of drugs called aromatase inhibitors. Aromatase is an enzyme that is closely related to drug metabolizing P450 enzyme system in our body. We know several herbs interact with P450 enzyme, the most prominent one being St. John's wort. Therefore, people should avoid herbs that are known to interact with the P450 system."

- Linda

althea

I'm tring to read the information at all the links, but I don't seem to be absorbing it very well. nativemainer, I get the opposite impression from the link you provided. St john's wort is listed as an inducer in relation to the P450 enzyme, and the description says "Inducers stimulate the production of the enzyme thus increasing the rate of metabolism causing the substrate drug to clear out of the system faster. This will also affect the individual's response to the medication, i.e. making he drug ineffective because it has not been in the system long enough to have an effect." I understand this to say that it's not a good idea to mix tamoxifen and st johns wort.

I took St John's Wort years ago for depression and I think it helped. I've read that people on birth control pills are cautioned against using this herb. Since tamoxifen is hormone therapy, it got me wondering if St john's wort would be contraindicated. I was also reading information saluki provided on the paxil thread, and I got the impression from there that the experts are undecided about whether st johns wort as an inducers is actually a bad thing.

rosemary, thanks for that link about the magnesium. I see my oncologist next week. Is there a bloodwork test for determining if I need more magnesium?

Rosemary44

Althea,

Not really, unless you're severly depleted. The blood will usually show that all is fine because it's taking what it needs from the muscles and bones to keep it at a certain level.

You just try it at the amount suggested in the research report, and give it a chance to work, if you are depleted you'll have to get that right first, then you'll notice the depression is not there one day. If you take a low dose B6 (50 mgs) with it, you'll get it absorbed faster.

Give it a try, there's always time to take a drug later if this doesn't do it for you.

althea

Thank you rosemary. I just went to the store and got some magnesium. I'll definitely give it a try.

NativeMainer

You're right, I was reading hte chart wrong. My apologies. We should avoid St. John's Wort.

Valerie_R

You should avoid St. John's Wort. It was on all of my surgeon's and oncologist's lists of what NOT to take!
Valerie

Rosemary44

Althea, That's good, just start off at a low dose to see how you do with it then you can add to the dose the researcher recommends. Let me know when you start to feel better.

althea

rosemary, I am feeling better after 7 days of taking magnesium. My lack of energy was really turning into a dark place. I'm so glad to feel better.

Rosemary44

I'm happy to hear that Althea. I knew it would work. You have to keep taking it, but find a low dose that works for you. My low dose is 600, I seem to need that much for restless leg syndrome. You'll have to start taking some calcium at a different time, if you aren't eating foods with calcium. You don't want too much of one mineral without the other.

althea

The bottle of magnesium I purchased last week contains tablets of 250 mg's each. Rosemary, when you say a low dose of 600, what measurement is the 600? I consume loads of dairy, probably too much for my own good, but I can't imagine that I'm deficient in calcium.

Rosemary44

Althea,

It's milligrams. As long as your getting enough calcium in foods, you should be fine then.

althea

Sorry to keep harping on this rosemary, but are you typing the right number when you say you're taking 600 milligrams of magnesium? The bottle I purchased says to take 250 mg's a day. Something seems incongruous when you say you're taking a low dose of 600 milligrams. I'm wondering if I could take two each day and feel even more better? ...having a gramatical conflict here... more better can't be right but heck if I can rephrase it

lvtwoqlt

the printout from the Pharmacy said not to take St John's Wart with Tamox. I stopped taking the St John's Wart but did not know the reasoning until now. thanks.

Rosemary44

I can see where your confused. 600 mgs is my low dose for the day cause sometimes I take even more. I go up to 800 mgs if I need it.

For yourself, just start low, like the 250 mg, and if all is well, stay there. After time, if you think you need more, then go for it. You'll find that happy place-correct dose for yourself eventually. My friend started her dose at 250 mgs and is now at 400mg, which works better for her.

Misspamella1

I was doing some reading on st John's wart. But I can't make any sense out of it. I've heard yes we can and no we shouldn't. I'm unclear. I'm currently on tamoxifen. Can you enlighten me?

Misspamella1

How much are you taking? I am currently a freaking zombie. Always wore out. Oh, and can't sleep either. I'd give anything for a decent nights sleep.