GOLDENSEAL: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Goldenseal (Hydrastis canadensis) is an herb in the buttercup family. The dried root is very commonly used in supplements in the US.

Goldenseal contains berberine, which might have effects against bacteria and fungi. Berberine also has properties that can lower blood pressure and help irregular heartbeat. But many of the important chemicals in goldenseal aren't absorbed well when taken by mouth. So, it's not clear if goldenseal has the same effects as berberine.

People use goldenseal for the common cold and other upper respiratory tract infections, hay fever, diarrhea, constipation, and many other conditions. But there is no good scientific evidence to support any of these uses.

Uses & Effectiveness ?

Possibly Ineffective for

Masking illegal drugs in urine tests. Goldenseal is often advertised for masking illegal drugs in urine tests. But drinking one gallon of water with goldenseal or adding goldenseal tea to a urine sample doesn't seem to cause a false-negative result on drug tests for amphetamines, barbiturates, benzodiazepines, cocaine, opiates, phencyclidine, or tetrahydrocannabinol (THC).

There is interest in using goldenseal for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Goldenseal is possibly safe for most adults when taken as a single dose. There isn't enough reliable information to know if goldenseal is safe to use as more than a single dose.

Special Precautions and Warnings

Pregnancy and breast-feeding: Using goldenseal during pregnancy or breast-feeding is likely unsafe for the infant. A hazardous chemical in goldenseal can cross the placenta and can also find its way into breast milk. Brain damage has developed in newborn infants exposed to goldenseal. Do not use goldenseal during pregnancy or breast-feeding.

Children: Don't use goldenseal in newborn babies. It is likely unsafe for them. It might cause brain damage.

Bleeding conditions: Use goldenseal with caution. Taking goldenseal might increase the risk of bleeding in individuals with bleeding disorders.

High bilirubin levels in the blood in infants: Bilirubin is a chemical that is produced when the old red blood cells break down. Berberine, a chemical in goldenseal, may keep the liver from removing bilirubin fast enough. This can cause brain problems, especially in infants with high levels of bilirubin in the blood. Avoid using.

Surgery: Goldenseal might increase the risk for bleeding. People who take goldenseal should stop at least 2 weeks before surgery.

Interactions ?

Moderate Interaction

Be cautious with this combination

Digoxin (Lanoxin) interacts with GOLDENSEAL
Taking goldenseal with digoxin might cause slight increases in digoxin levels in the body. If you take digoxin, talk to your healthcare provider before taking goldenseal.
Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with GOLDENSEAL
Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with GOLDENSEAL
Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with GOLDENSEAL
Some medications are moved in and out of cells by pumps. Goldenseal might change how these pumps work and change how much medication stays in the body. In some cases, this might change the effects and side effects of a medication.
Dextromethorphan (Robitussin DM, and others) interacts with GOLDENSEAL
Goldenseal contains berberine, which might decrease how quickly the body breaks down dextromethorphan. Taking goldenseal while taking dextromethorphan might increase the effects and side effects of dextromethorphan.
Losartan (Cozaar) interacts with GOLDENSEAL
Goldenseal contains berberine, which might change how quickly the body breaks down losartan. Taking goldenseal while taking losartan might change the effects of losartan.
Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with GOLDENSEAL
Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates) interacts with GOLDENSEAL
Some medications are changed and broken down by the liver. Goldenseal might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.
Medications for diabetes (Antidiabetes drugs) interacts with GOLDENSEAL
Goldenseal might lower blood sugar levels. Taking goldeneal along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.
Medications for high blood pressure (Antihypertensive drugs) interacts with GOLDENSEAL
Goldenseal might lower blood pressure. Taking goldenseal along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.
Pentobarbital interacts with GOLDENSEAL
Sedative medications (CNS depressants) interacts with GOLDENSEAL
Goldenseal might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking goldenseal with sedative medications might cause breathing problems and/or too much sleepiness.
Tacrolimus (Prograf) interacts with GOLDENSEAL
Goldenseal contains berberine, which might decrease how quickly the body breaks down tacrolimus. Taking goldenseal with tacrolimus might increase the effects and side effects of tacrolimus.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with GOLDENSEAL
Goldenseal might slow blood clotting. Taking goldenseal along with medications that also slow blood clotting might increase the risk of bruising and bleeding.
Metformin (Glucophage) interacts with GOLDENSEAL
Goldenseal might decrease the amount of metformin in the body. Taking goldenseal with metformin might decrease the effects of metformin.

Minor Interaction

Be watchful with this combination

Oseltamivir interacts with GOLDENSEAL
Taking goldenseal with oseltamivir might prevent oseltamivir from being converted to its active form. However, it is not clear if this interaction is serious enough to reduce the effects of oseltamivir.

Dosing

There isn't enough reliable information to know what an appropriate dose of goldenseal might be. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult a healthcare professional before using.

View References

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Zeng, X. and Zeng, X. Relationship between the clinical effects of berberine on severe congestive heart failure and its concentration in plasma studied by HPLC. Biomed Chromatogr 1999;13(7):442-444. View abstract.

Zhang, H., Wei, J., Xue, R., Wu, J. D., Zhao, W., Wang, Z. Z., Wang, S. K., Zhou, Z. X., Song, D. Q., Wang, Y. M., Pan, H. N., Kong, W. J., and Jiang, J. D. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression. Metabolism 2010;59(2):285-292. View abstract.

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Zhang, Y., Li, X., Zou, D., Liu, W., Yang, J., Zhu, N., Huo, L., Wang, M., Hong, J., Wu, P., Ren, G., and Ning, G. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol.Metab 2008;93(7):2559-2565. View abstract.

Zhou, J. Y., Zhou, S. W., Zhang, K. B., Tang, J. L., Guang, L. X., Ying, Y., Xu, Y., Zhang, L., and Li, D. D. Chronic effects of berberine on blood, liver glucolipid metabolism and liver PPARs expression in diabetic hyperlipidemic rats. Biol Pharm Bull. 2008;31(6):1169-1176. View abstract.

Zhu B and Ahrens FA. Effect of berberine on intestinal secretion mediated by Escherichia coli heat-stable enterotoxin in jejunum of pigs. Am J Vet Res 1982;43(9):1594-1598.

Zhu, B. and Ahrens, F. Antisecretory effects of berberine with morphine, clonidine, L- phenylephrine, yohimbine or neostigmine in pig jejunum. Eur J Pharmacol 12-9-1983;96(1-2):11-19. View abstract.

Coughlan KA, Valentine RJ, Ruderman NB, Saha AK. AMPK activation: a therapeutic target for type 2 diabetes? Diabetes Metab Syndr Obes 2014;7:241-53. View abstract.

Abourashed EA, Khan IA. High-performance liquid chromatography determination of hydrastine and berberine in dietary supplements containing goldenseal. J Pharm Sci. 2001;90(7):817-22. View abstract.

Amin AH, Subbaiah TV, Abbasi KM. Berberine sulfate: antimicrobial activity, bioassay, and mode of action. Can J Microbiol 1969;15:1067-76. View abstract.

Ang ES, Lee ST, Gan CS, et al. Evaluating the role of alternative therapy in burn wound management: randomized trial comparing moist exposed burn ointment with conventional methods in the management of patients with second-degree burns. MedGenMed 2001;3:3. View abstract.

Anis KV, Rajeshkumar NV, Kuttan R. Inhibition of chemical carcinogenesis by berberine in rats and mice. J Pharm Pharmacol 2001;53:763-8. . View abstract.

Arinaga S, Karimine N, Takamuku K, et al. Enhanced induction of lymphokine-activated killer activity after lentinan administration in patients with gastric carcinoma. Int J Immunopharmac 1992;14:535-539. View abstract.

Bhide MB, Chavan SR, Dutta NK. Absorption, distribution and excretion of berberine. Indian J Med Res 1969;57:2128-31. View abstract.

Brown PN, Roman MC. Determination of hydrastine and berberine in goldenseal raw materials, extracts, and dietary supplements by high-performance liquid chromatography with UV: collaborative study. J AOAC Int. 2008;91(4):694-701. View abstract.

Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. View abstract.

Butcher NJ, Minchin RF. Arylamine N-acetyltransferase 1: a novel drug target in cancer development. Pharmacol Rev 2012;64(1):147-65. View abstract.

Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. View abstract.

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. View abstract.

Cicero, AF, Rovati LC, and Setnikar I. Eulipidemic effects of berberine administered alone or in combination with other natural cholesterol-lowering agents. A single-blind clinical investigation. Arzneimittelforschung. 2007;57:26-30. View abstract.

Cone EH, Lange R, Darwin WD. In vivo adulteration: excess fluid ingestion causes false-negative marijuana and cocaine urine test results. J Anal Toxicol 1998;22:460-73. View abstract.

Dong H, Zhao Y, Zhao L, Lu F. The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials. Planta Med 2013;79(6):437-46. View abstract.

Edwards DJ, Draper EJ. Variations in alkaloid content of herbal products containing goldenseal. J Am Pharm Assoc (2003). 2003;43(3):419-23. View abstract.

Fukuda K, Hibiya Y, Mutoh M, et al. Inhibition by berberine of cyclooxygenase-2 transcriptional activity in human colon cancer cells. J Ethnopharmacol 1999;66:227-33. View abstract.

Garber AJ. Long-acting glucagon-like peptide 1 receptor agonists: a review of their efficacy and tolerability. Diabetes Care 2011;34 Suppl 2:S279-84. View abstract.

Gupte S. Use of berberine in treatment of giardiasis. Am J Dis Child 1975;129:866. View abstract.

Gurley BJ, et al. Supplementation with goldenseal (Hydrastis canadensis), but not kava kava (Piper methysticum), inhibits human CYP3A activitiy In Vivo. Clin Pharmacol Ther. 2008;83(1):61-69. View abstract.

Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther 2005;77:415-26. View abstract.

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;35:240-5. View abstract.

Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63. View abstract.

Hou Q, Han W, Fu X. Pharmacokinetic interaction between tacrolimus and berberine in a child with idiopathic nephrotic syndrome. Eur J Clin Pharmacol 2013;69(10):1861-2. View abstract.

Hsiang CY, Wu SL, Cheng SE, Ho TY. Acetaldehyde-induced interleukin-1beta and tumor necrosis factor-alpha production is inhibited by berberine through nuclear factor-kappaB signaling pathway in HepG2 cells. J Biomed Sci 2005;12:791-801. View abstract.

Huang CG, Chu ZL, Wei SJ, Jiang H, Jiao BH. Effect of berberine on arachidonic acid metabolism in rabbit platelets and endothelial cells. Thromb Res 2002;106(4-5):223-7. View abstract.

Ivanovska N, Philipov S. Study on the anti-inflammatory action of Berberis vulgaris root extract, alkaloid fractions and pure alkaloids. Int J Immunopharmacol 1996;18:553-61. View abstract.

Jalloh MA, Gregory PJ, Hein D, et al. Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS. 2017 Jan;28(1):4-15. View abstract.

Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. View abstract.

Kaneda Y, Torii M, Tanaka T, Aikawa M. In vitro effects of berberine sulphate on the growth and structure of Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis. Ann Trop Med Parasitol 1991;85:417-25. View abstract.

Khosla PG, Neeraj VI, Gupta SK, et al. Berberine, a potential drug for trachoma. Rev Int Trach Pathol Ocul Trop Subtrop Sante Publique 1992;69:147-65. View abstract.

Kim SH, Shin DS, Oh MN, et al. Inhibition of the bacterial surface protein anchoring transpeptidase sortase by isoquinoline alkaloids. Biosci Biotechnol Biochem 2004;68:421-4.. View abstract.

Lan J, Zhao Y, Dong F, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015;161:69-81. View abstract.

Li B, Shang JC, Zhou QX. [Study of total alkaloids from rhizoma coptis chinensis on experimental gastric ulcers]. Chin J Integr Med 2005;11:217-21. View abstract.

Liu R, Tam TW, Mao J, et al. The effect of natural health products and traditional medicines on the activity of human hepatic microsomal-mediated metabolism of oseltamivir. J Pharm Pharm Sci 2010;13(1):43-55. View abstract.

Nguyen JT, Tian DD, Tanna RS, et al. An Integrative Approach to Elucidate Mechanisms Underlying the Pharmacokinetic Goldenseal-Midazolam Interaction: Application of In Vitro Assays and Physiologically Based Pharmacokinetic Models to Understand Clinical Observations. J Pharmacol Exp Ther. 2023. View abstract.

Nguyen JT, Tian DD, Tanna RS, et al. Assessing transporter-mediated natural product-drug interactions via in vitro-in vivo extrapolation: clinical evaluation with a probe cocktail. Clin Pharmacol Ther 2021;109(5):1342-52. View abstract.

Nishino H, Kitagawa K, Fujiki H, Iwashima A. Berberine sulfate inhibits tumor-promoting activity of teleocidin in two-stage carcinogenesis on mouse skin. Oncology 1986;43:131-4. View abstract.

Park KS, Kang KC, Kim JH, et al. Differential inhibitory effects of protoberberines on sterol and chitin biosyntheses in Candida albicans. J Antimicrob Chemother 1999;43:667-74. View abstract.

Rabbani GH, Butler T, Knight J, 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. View abstract.

Rehman J, Dillow JM, Carter SM, et al. Increased production of antigen-specific immunoglobulins G and M following in vivo treatment with the medicinal plants Echinacea angustifolia and Hydrastis canadensis. Immunol Lett 1999;68:391-5. View abstract.

Sandhu RS, Prescilla RP, Simonelli TM, Edwards DJ. Influence of goldenseal root on the pharmacokinetics of indinavir. J Clin Pharmacol 2003;43:1283-8.. View abstract.

Scazzocchio F, Corneta MF, Tomassini L, Palmery M. Antibacterial activity of Hydrastis canadensis extract and its major isolated alkaloids. Planta Med 2001;67:561-4. View abstract.

Sun D, Abraham SN, Beachey EH. Influence of berberine sulfate on synthesis and expression of Pap fimbrial adhesin in uropathogenic Escherichia coli. Antimicrob Agents Chemother 1988;32:1274-7. View abstract.

Sun D, Courtney HS, Beachey EH. Berberine sulfate blocks adherence of Streptococcus pyogenes to epithelial cells, fibronectin, and hexadecane. Antimicrob Agents Chemother 1988;32:1370-4. View abstract.

Tims M. Botanical adulternants bulletin on adulteration of Hydrastis canadensis root and rhizome. Botanical Adulterants Bulletin. 2016. Available at: https://cms.herbalgram.org/BAP/BAB/BAP-BABs-Goldenseal-v4.pdf (Accessed 30 March 2017).

Tsai PL, Tsai TH. Hepatobiliary excretion of berberine. Drug Metab Dispos 2004;32:405-12. . View abstract.

Winek CL, Elzein EO, Wahba WW, Feldman JA. Interference of herbal drinks with urinalysis for drugs of abuse. J Anal Toxicol 1993;17:246-7. View abstract.

Wu AH, Forte E, Casella G, et al. CEDIA for screening drugs of abuse in urine and the effect of adulterants. J Forensic Sci 1995;40:614-8. View abstract.

Xie, X., Meng, X., Zhou, X., Shu, X., and Kong, H. [Research on therapeutic effect and hemorrheology change of berberine in new diagnosed patients with type 2 diabetes combining nonalcoholic fatty liver disease]. Zhongguo Zhong Yao Za Zhi 2011;36(21):3032-3035. View abstract.

Yamaura K, Shimada M, Nakayama N, Ueno K. Protective effects of goldenseal (Hydrastis canadensis L.) on acetaminophen-induced hepatotoxicity through inhibition of CYP2E1 in rats. Pharmacognosy Res. 2011 Oct;3(4):250-5.

Zeng XH, Zeng XJ, Li YY. Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol 2003;92:173-6. View abstract.

Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. View abstract.

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CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

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GOLDENSEAL - Uses, Side Effects, and More

Overview

Uses & Effectiveness ?

Possibly Ineffective for

Side Effects

Special Precautions and Warnings

Interactions ?

Moderate Interaction

Digoxin (Lanoxin) interacts with GOLDENSEAL

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with GOLDENSEAL

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with GOLDENSEAL

Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with GOLDENSEAL

Dextromethorphan (Robitussin DM, and others) interacts with GOLDENSEAL

Losartan (Cozaar) interacts with GOLDENSEAL

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with GOLDENSEAL

Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates) interacts with GOLDENSEAL

Medications for diabetes (Antidiabetes drugs) interacts with GOLDENSEAL

Medications for high blood pressure (Antihypertensive drugs) interacts with GOLDENSEAL

Pentobarbital interacts with GOLDENSEAL

Sedative medications (CNS depressants) interacts with GOLDENSEAL

Tacrolimus (Prograf) interacts with GOLDENSEAL

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with GOLDENSEAL

Metformin (Glucophage) interacts with GOLDENSEAL

Minor Interaction

Oseltamivir interacts with GOLDENSEAL

Dosing

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