There are not enough data which show that huanglian can treat cancer, high blood pressure, infections, or any other medical condition.
Huanglian is a root extract that is used in traditional Chinese medicine. Laboratory experiments have been performed with huanglian to study its possible anticancer activity. A substance called berberine in huanglian has been found to slow the replication of liver cancer cells in the laboratory by interfering with the mechanisms of cell division. Berberine also halts the growth of bacteria by interfering with their metabolism. Scientists think that berberine may have antidiarrheal activity due to its ability to slow down intestinal peristalsis (motion), but they are unsure exactly how this effect happens. The ability of berberine to lower blood pressure is attributed to its effects in the body that resemble parasympathetic nervous system stimulation (e.g., impulses to “rest and digest” rather than “fight or flight”). Human studies are needed.
Purported Uses
To treat bacterial and viral infections
Laboratory studies show that berberine, a compound in huanglian, stops the growth of bacteria. Human data are lacking.
To treat diarrhea and other gastrointestinal symptoms
Laboratory studies support this use, but it has not been studied in clinical trials.
To lower high blood pressure
Laboratory and animal studies support this use, but human data are needed.
Do Not Take If
You are taking antihypertensive medications (for high blood pressure) (In theory, huanglian may lower your blood pressure even further. Use with caution).
You have severe underlying heart disease (Botanicals that contain berberine, such as huanglian, may cause QTc prolongation).
Huanglian displaces bilirubin and should not be administered to jaundiced neonates.
You are taking drugs that are substrates of Cytochrome P450 (Huanglian may increase the risk of side effects of these drugs). However, another study showed that huanglian can induce CYP3A4 by activating pregnane X receptor. This may decrease the concentration of drugs metabolized by CYP3A4.
Side Effects
Nausea
Vomiting
Shortness of breath
Toxicity from high doses of huanglian can cause seizures, liver toxicity, and cardiac toxicity.
Derived from the root of the plant, huanglian is used in traditional Chinese medicine for gastrointestinal complaints, diarrhea, hypertension, bacterial and viral infections. Berberine and berberine-like alkaloids are thought responsible for its activity (1). Studies show that berberine has hepatoprotective (9), anti-inflammatory (14) effects, and improves glucose metabolism in diabetic rats (10). Jatrorrhizine, a protoberberine, was shown to offset postoperative ileus-induced delayed gastric emptying, and intestinal transit in rats (15).
Berberine also inhibits the growth of hepatoma cancer cells (3); an aqueous extract of huanglian demonstrated potent antiangiogenesis activity in vitro (6). Preliminary data support the hypothesis that huanglian suppresses cyclin B1 protein and causes cell cycle arrest at G2 (5).
Purported Uses
Diarrhea
Ear infections
Hypertension
Microbial infection
Respiratory infections
Mechanism of Action
Berberine and berberine-like compounds in huanglian are thought responsible for its activity. Berberine inhibits human hep-62 hepatoma cell growth due to morphological changes and internucleosomal DNA fragmentation (3). It was shown to modulate gastric peristalsis resulting in antidiarrheal activity; modulate bacterial metabolism of carbohydrates, protein synthesis, and complex with nucleic acids resulting in growth inhibition. The herb’s hypotensive effects are thought to be mediated by muscarinic stimulation and inhibition of cholinesterase. In studies conducted on dogs, berberine showed positive inotropic effects and lowered peripheral vascular resistance.
Berberine also inhibits platelet aggregation and can antagonize thromboxane B2. It can cause potassium channel blockade resulting in prolongation of the action potential in cat ventricular monocytes (1).
Huanglian inhibits topoisomerase I and is thought to suppress cyclin B1 protein, and cause cancer cell arrest at G2 phase (2). It also has potent antiangiogenic activity (6), induces apoptosis and arrests cell growth by upregulating Interferon beta and tumor necrosis factor-alpha genes in breast cancer cells (7).
Contraindications
Huanglian displaces bilirubin and should not be administered to jaundiced neonates.
Berberine-containing botanicals may prolong QTc in patients with underlying heart disease. (4)
Herb-Drug Interactions
Cytochrome P450 substrates: Huanglian inhibits CYP2D6 (11)CYP2D6, CYP2C9, and CYP3A4 (13) and can affect drugs metabolized by these enzymes. However, prolonged use of huanglian can induce CYP3A4 by activating pregnane X receptor (12). This may reduce the effectiveness of drugs metabolized by this enzyme.
Dosage (OneMSK Only)
References
Huang KC. The Pharmacology of Chinese Herbs, 2nd ed. New York: CRC Press; 1999.
