Millions Replace Fen-Phen With Herb But Many Doctors Doubt St. John’s Wort’s Power

For years, German doctors have prescribed an herb called St. John’s wort to lift sagging spirits. Now millions of Americans have started using it to lift drooping bellies and backsides as well.

St. John’s wort has soared in popularity as a weight-loss supplement since two diet drugs were pulled from the market last month.

Half the nearly 250,000 dieters at Nutri/System weight loss centers use the herb, which shows its golden flowers at their brightest around June 24 - St. John the Baptist’s birthday.

“I lost 46 pounds in about three and a half months,” said Kathie Spina of Collingdale, Pa., who at 5-foot-7 weighs 138 pounds after a Nutri/System doctor prescribed a St. John’s wort blend. “I’d tried over-the-counter products before and dieting and eating fruits and stuff like that. Nothing seemed to work.”

The sudden rise of St. John’s wort, or hypericum, is hard to miss. Health food store shelves are newly lined with Herbal Phen Fuel, Diet Phen and other St. John’s wort blends designed to sound like the nowunavailable diet cocktail “fen-phen.” And many doctors now enthusiastically prescribe the herbal remedy.

But many doctors who praise its depression-easing powers question its use as a weight-loss drug.

“I think it’s a lousy idea,” said Dr. Norman E. Rosenthal, a Rockville, Md., psychiatrist and researcher who is working on a book on St. John’s wort tentatively titled “Nature’s Prozac.” “There’s not a smidgen of evidence for it as a diet drug.”

Dr. Harold H. Bloomfield, a Del Mar, Calif., psychiatrist and author of “Hypericum & Depression,” said: “The only justification for it is for people who eat as a symptom of an underlying depression.”

Nutri/System uses St. John’s wort and another herb, ephedra, in a mixture called Herbal Phen-Fen. Dr. Joseph DiBartolomeo, a psychiatrist and a spokesman for Nutri/System, said the diet center doesn’t know exactly how the herbs work together, just that they do.

“We believe from using the products in our centers that there is a synergistic action with the St. John’s and the ephedra, when you put them together, that works to suppress appetite,” he said.

The FDA has linked ephedra to several deaths and about 800 adverse health reports from doctors. But no cause-and-effect relationship has been established.

St. John’s wort, native to Europe, North Africa, Asia and the western United States, has a 2,400-year history in folk medicine and is said to have been prescribed by Hippocrates, the father of modern medicine.

German psychiatrists prescribe the herb four times as often as the prescription anti-depressant Prozac. The German market for the herb this year is about $72 million, said Petra Mueller of herb seller Lichtwer Pharma GmbH. But Germans use it strictly as an anti-depressant, she said.

The biggest U.S. seller of St. John’s wort, Twin Laboratories of Ronkonkoma, N.Y., has sold the pills for 10 years at Wal-Mart and nutrition stores, promoting the herb vaguely as a diet supplement, or something akin to a vitamin pill.

But when the Mayo Clinic warned in May that Redux and fen-phen may cause dangerous heart valve problems, Twin launched its new Herbal Phen Fuel - a mixture of St. John’s wort and bitter orange - as a diet drug.

Twin’s marketing chief, Steve Blechman, said he expects it to be among the company’s top sellers. Because federal law bars companies from making health claims about dietary supplements, St. John’s wort packages make no mention of depression or weight loss. But Twin Laboratories’ ads in Fitness, Glamour, Self and other magazines tread the line: “The safe way to lose weight doesn’t come from a drug. It comes from a garden.”

St. John’s wort, like Prozac and the two recalled diet drugs, raises levels of serotonin, a chemical messenger in the brain. Short-term studies have found no serious health concerns.