How It Works
Bottom Line: There is no proof that goldenseal itself can treat medical conditions. The active compound in goldenseal is berberine, which has been shown to be helpful in certain medical conditions, including chronic gall bladder inflammation and liver cirrhosis.
Not much laboratory research has been performed with goldenseal. Scientists think that two compounds are responsible for goldenseal's activity, berberine and hydrastine, and these compounds have been studied more comprehensively. In animal studies, berberine was found to lower fevers, kill many strains of bacteria, fungi, and protozoa, and slow the growth of tumors. It also stimulated contraction of the uterus, increased blood flow to the heart, and blocked some of the molecules involved in inflammation. In studies in humans, berberine was able to treat acute diarrhea (probably due to its antibacterial properties) and improve the conditions of patients with chronic gall bladder inflammation and liver cirrhosis. Hydrastine has been found to constrict blood vessels in the extremities. Although an extract of goldenseal was found to cause muscle relaxation in animal tissues, berberine and hydrastine are known to simulate contraction of the uterus muscles, so it is unclear which of these effects dominates.
Purported Uses
As an appetite stimulant
No scientific evidence supports this use.
To control muscle spasms
Laboratory data support this use, but there is no proof from clinical trials that this effect occurs in humans.
To treat cancer
Laboratory studies show that berberine, a compound in goldenseal, inhibits the growth of a variety of tumors in rats, but there is no proof from clinical trials that this effect occurs in humans.
To stimulate the heart and increase blood pressure
Laboratory studies show that berberine, a compound in goldenseal, stimulates the heart and increases blood flow to it, but results concerning blood pressure are mixed. There is no proof from clinical trials that this effect occurs in humans.
To treat cirrhosis of the liver
Some clinical trials show that berberine, a compound in goldenseal, improves the condition of patients with cirrhosis.
To treat gastrointestinal disorders such as colitis and peptic ulcers
Laboratory studies show that a goldenseal extract causes relaxation of smooth muscle like that found in the gastrointestinal tract, but it is not known if goldenseal helps treat gastrointestinal disorders. There is no proof from clinical trials that this effect occurs in humans.
To treat conjunctivitis
Laboratory data shows that berberine, a compound in goldenseal, has antibacterial properties, but there is no proof from clinical trials that this effect occurs in humans
To treat diabetes
No scientific evidence supports this use.
To manage painful and heavy menstruation
Laboratory evidence regarding goldenseal's ability to relax uterus muscle is mixed. There is no proof from clinical trials that this effect occurs in humans.
Topically, to treat infections
Laboratory studies show that berberine, a compound in goldenseal, has wide antibacterial and antifungal properties. There is no proof from clinical trials that this effect occurs in humans
To lower fevers
Laboratory studies support this use, but there is no proof from clinical trials that this effect occurs in humans.
To reduce swelling and edema
Laboratory studies show that berberine, a compound in goldenseal, blocks some of the molecules involved in inflammation. There is no proof from clinical trials that this effect occurs in humans.
To cover signs of marijuana use in urinalysis
No clinical evidence supports this use.
Research Evidence
No clinical trials have been conducted with goldenseal.
Warnings
- This product is regulated by the FDA as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Do Not Take If
- You have high blood pressure (Goldenseal may increase your blood pressure).
- You have heart disease (Goldenseal may be a cardiac stimulant).
- You are pregnant or nursing (Goldenseal may stimulate the muscles of the uterus to contract. Also, it is not known whether the compounds in goldenseal pass into the breast milk).
- You are taking warfain or other blood thinners (Berberine, a compound found in goldenseal, may lessen their effects).
Side Effects
Stomach upset
Rarely, nervousness can occur
Signs of goldenseal toxicity include: Stomach ulcers, constipation, convulsions, hallucinations, nausea, vomiting, depression, nervousness, bradycardia (slow heart rate), slowed breathing rate, and seizures.
Scientific Name
Hydrastis canadensis
Common Name
Eye root, yellow Indian plant, turmeric root, yellow paint root, orange root, goldenroot
Clinical Summary
Derived from the root of the plant. Primary active components are hydrastine, berberine, and canadine. No published clinical studies evaluate its efficacy but studies have been performed with berberine. Patients with hypertension, cardiovascular disease, or are pregnant should not take this herb. Minimal adverse events have been reported at recommended doses, but nausea, vomiting, hallucinations, or seizures may be signs of toxicity
(1). Potential drug interactions include reduced effect of anticoagulants, and altered response to antihypertensives and inhibition of cytochrome p-450 3A4/5
(7) (10) and CYP2D6
(12). A small clinical trial could not confirm such effects
(11). Goldenseal supplementation did not affect P-Glycoprotein activity in vivo
(13).
Purported uses
- Anorexia
- Cancer treatment
- Cirrhosis
- Colitis
- Common cold
- Conjunctivitis
- Diabetes
- Edema
- Fever
- Infections
- Menorrhagia
Constituents
Alkaloids: Hydrastine (1.5-4%), berberine (0.5- 6%), canadine, beta-hydrastine, canadaline
(1)
Mechanism of Action
Goldenseal is claimed to have anti-inflammatory, astringent, antimicrobial and laxative properties
(2). The pharmacological action of goldenseal is attributed to both hydrastine and berberine. The majority of clinical studies are not performed on goldenseal, but are focused on berberine and hydrastine. Berberine has been shown to have anti-microbial activity against certain pathogens such enterotoxigenic E. coli and V. cholera. The hydrastine component induces constriction of peripheral blood vessels
(3).
Warnings
Berberine-containing botanicals may cause QTc prolongation in patients with severe underlying heart disease.
Contraindications
Patients who have hypertension or cardiovascular disease or women that are pregnant or nursing should not consume goldenseal.
Adverse Reactions
Common: GI complaints
Rare: Nervousness
Toxicity: Stomach ulcerations, constipation, convulsions, hallucinations, nausea, vomiting, depression, nervousness, bradycardia, respiratory depression, seizures
(1)
Herb-Drug Interactions
Antihypertensives: Goldenseal may interfere with blood pressure control.
Anticoagulants / Antiplatelets: Berberine may inhibit anticoagulant effects.
Barbiturates: Goldenseal may potentiate effects.
Cytochrome P-450: Goldenseal may inhibit the 3A4 isoenzyme resulting in increased levels of certain medications.
Vitamin B Complex: Goldenseal may decrease gastric absorption resulting in possible deficiency.
Lab Interactions
Berberine may increase bilirubin levels due to displacement of bilirubin from albumin
(5).
Delta-9-Tetrahydrocannabinol (THC, marijuana): Goldenseal may interfere with THC detection in urinalysis
(6).
PT / PTT / INR: Goldenseal may alter anticoagulation test results
(7).
Literature Summary and Critique
There are no clinical studies reported in Medline using goldenseal. The following studies concern berberine, an active component of Goldenseal.
Werbach MR, et al. Botanical Influences on Illness: A Sourcebook of Clinical Research. Tarzana, California: Third Line Press; 1994.
Berberine alkaloids produced an average of 91% tumor inhibition against 6 malignant brain tumor cell lines both in vivo in mice and in vitro against human brain tumors. The berberine alkaloids have shown potent macrophage-activating activity for inducing cytostatic activity against tumor cells.
Zhang RX, et al. Laboratory studies of berberine use alone and in combination with 1,3-bis(2-chloroethyl)-1-nitrosourea to treat malignant brain tumors. Chin Med J 1990;103:658-65In vitro studies were performed on a series of human malignant brain tumor cells and rat brain tumor cells. Berberine used alone at a dose of 150 mcg/ml had an average cancer cell kill rate of 91%. BCNU had a cell kill rate of 43%. Rats treated with berberine at 10 mg/kg had an 81% kill rate. The combination of both berberine and BCNU had additive effects on killing cancer cells.
References
- Newall C, et al. Herbal Medicines: A Guide for Health-Care Professionals. London; Pharmaceutical Press; 1996.
- Gruenwald J, et al. PDR for Herbal medicines, 2nd ed. Montvale (NJ): Medical Economics Company; 1998.
- Rabbani G, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and vibrio cholerae. J Infect Dis 1987;155:979-84.
- DeSmet PA. Adverse Effects of Herbal Drugs, Vol. 3. Soquel (CA): Springer-Verlag; 1996.
- Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8.
- Mikkelsen SL, Ash KO. Adulterants causing false negatives in illicit drug testing. Clin Chem 1988; 34:2333-6.
- Budzinski JW, et al. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82.
- Werbach MR, et al. Botanical Influences on Illness: A Sourcebook of Clinical Research. Tarzana, California: Third Line Press; 1994.
- Zhang RX, et al. Laboratory studies of berberine use alone and in combination with 1,3-bis(2-chloroethyl)-1-nitrosourea to treat malignant brain tumors. Chin Med J 1990;103:658-65
- Chatterjee P,.Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos. 2003;31:1391-7.
- Sandhu RS, Prescilla RP, Simonelli TM, Edwards DJ. Influence of goldenseal root on the pharmacokinetics of indinavir. J Clin Pharmacol. 2003;43:1283-8.
- Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77(5):415-26.
- Gurley BJ, Swain A, Barone GW, et al. Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 2007;35(2):240-5.
