Welcome back, everyone. You are enjoying another episode of Fast Facts: Pharmacology Edition, brought to you by A Tale of Two Hygienists in partnership with Elevate Oral Care. And now, please welcome your host, Tom Viola. Hi, I'm Tom Viola, a certified pharmacist, dental educator, and author. Stick with me, and I promise to make the next few minutes the best pharmacology learning experience you've ever had. Hi, everybody. Tom Viola with Pharmacology Declassified. We get another Fast Facts: Pharmacology Edition. Can you believe it? For past 80 episodes, and we're still going. Well, this episode is also about supplements, the last in our series on supplements, and why not save the best for last when you think about it. Of course, we're talking about St. John's Wort. I don't know. I saw a lot of paintings of St. John. I didn't see any warts. Okay, we're not talking about W-A-R-T. He was talking about W-O-R-T, a flower named after St. John, right? St. John's Wort.

Okay, what is it about this supplement that makes it so special? Well, I can tell you this much. If you were to say to me, Hey, Viola, give me the name of a dietary supplement that's actually been proven to work, I'd have to give you St. John's Wort. Why? Because it has been proven. Numerous studies have proven that hypericin, the active ingredient in St. John's Wort, actually does the job. It actually treats things like depression, PMS, OCD, due to the fact that it can inhibit the uptake of key neurotransmitters like serotonin, dopamine, and even norepinephrine. Hey, that sounds familiar. Yeah, like SSRIs, SNRIs, and so on. Great, that sounds wonderful. Then what's wrong with that? Well, if you said to me, Hey, Viola, give me the name of a dietary supplement that causes weird drug interactions, I'd have to tell you St. John's Wort. Why St. John's Wort? It's thought to cause more drug interactions with drugs than most drugs. Like what? Like drugs that are used to

treat HIV, uh, drugs that are used to treat all sorts of conditions, and what's really important to us in dentistry is that St. John's wort can interact with a drug like Tramadol, which we use for dental pain, uh, and therefore increase the risk of serotonin syndrome. And St. John's wort can interact with other drugs that patients use, let's say for anticoagulation, uh, anti-platelet drugs, and increase the risk of bleeding. Wait, so St. John's wort causes bleeding, especially when it's combined with those other drugs? Well, that's a lot of drug interactions to keep in mind, right? And then if you said to me, Hey, Viola gave me the name of a dietary supplement that causes weird adverse effects, I have to say St. John's wort. Why photosensitivity? What's photosensitivity? You take a selfie and you're sensitive about it later. Now photosensitivity, sunlight burning, freckling. Wait, so I take this dietary supplement and I get burned and freckled?

more easily, yes, and of course xerostomia. And maybe some people think clenching and grinding your teeth. Why doesn't anybody just know for sure? Well, because we really don't do large clinical trials on dietary supplements. So there's a lot about supplements that we don't know, that we don't know. So my friends, St. John's Wort, good dietary supplements, got a lot of great positive things about it, but it does have some negatives. And that's why you listen to this podcast, right? That's why you paid attention to everything we said in this last episode. Because St. John's Wort's probably one of the most popular dietary supplements that people use. Well, that's it for this episode of Fast Facts, my friends. Tune in next time when we start going down a different road altogether. But until then, my friends, be well. Oh, and one more thing. If you want to hear more from me, be sure to follow me on Instagram, Facebook, or visit my website at www.tombiola.com. Thank you for listening to another

episode of fast facts pharmacology edition brought to you in part by elevate oral care, creators of the innovative and proven prevention-focused oral care products, from advantage arrest silver diamine fluoride to fluormax sodium fluoride varnish. Learn more by visiting www.elevateoralcare.com and schedule your free CE staff meeting today. We'll see you next time for another fast fact. [Music]

Fast Facts: Pharmacology Episode 80 "Supplements 8 St. John's-Wort"

Fast Facts: Pharmacology Episode 80 "Supplements 8 St. John's-Wort"