Although goldenseal root is one of the most popular herbs sold today, it is taken almost entirely for the wrong reasons. Originally, it was used by Native Americans both as a dye and as a treatment for skin disorders, digestive problems, liver disease, diarrhea, and eye irritations. European settlers learned of the herb from the Iroquois and other tribes and quickly adopted goldenseal as a part of early colonial medical care.
In the early 1800s, an herbalist named Samuel Thompson created a wildly popular system of medicine that swept the country. Thompson spoke of goldenseal as a nearly magical cure for many conditions. His evangelism led to a dramatic upsurge in demand, followed by over-collection and decimation of the wild plant. Prices skyrocketed and then collapsed when Thompsonianism faded away.
Goldenseal has passed through several more booms and busts. Today, it is again in great demand, but now it is under intentional cultivation.
Goldenseal contains a substance called berberine that has been found to inhibit or kill many microorganisms, including fungi, protozoa and bacteria.1,2,10-14,22 On this basis, contemporary herbalists often use goldenseal as a topical antibiotic for skin wounds, as well as to treat viral mouth sores and superficial fungal infections, such as athlete’s foot. However, there is no direct scientific evidence that goldenseal is effective for any of these purposes.
Some studies have shown that goldenseal or berberine may be helpful in defeating bacteria associated with infections like MRSA, an infection resistant to many antibiotics, or viruses like the H1N1 flu virus, but these studies were done on cells in a laboratory setting and don't necessarily mean it would be effective treating an infection in the body.25, 26, 27 A large barrier is that the blood levels of berberine that can be achieved by taking goldenseal orally are far too low to matter so goldenseal probably is not likely to work as a systemic antibiotic or antiviral medication.3 However, goldenseal could theoretically be beneficial in treating sore throats and diseases of the digestive tract (such as infectious diarrhea) because it can contact the affected area directly. Similarly, since berberine is concentrated in the bladder, goldenseal could be useful for bladder infections. Nonetheless, again there is as yet no direct evidence that goldenseal is effective for any of these uses.
Extremely weak evidence (far too weak to rely upon at all) suggests that goldenseal or berberine may be helpful for various heart related conditions, including arrhythmias, congestive heart failure, high cholesterol, diabetes, and high blood pressure.15,16,21,24 Similarly, infinitesimal evidence hints that goldenseal could be helpful for conditions in which spasms of smooth muscle play a role, such as dyspepsia (nonspecific stomach distress) and irritable bowel syndrome, as well as various forms of pain caused by inflammation.17,18
Ironically, goldenseal’s most common uses are entirely inappropriate. Goldenseal is frequently combined with the herb echinacea to be taken as a "traditional immune booster" and "antibiotic" for the prevention and treatment of colds. However, there are three things wrong with this packaging:
The other myth that has helped drive the sales of goldenseal is the widespread street belief that it can block a positive drug screen. The origin of this false idea dates back to a work of fiction published in 1900 by a pharmacist and author named John Uri Lloyd. In Stringtown on the Pike, a dead man is found to have traces of goldenseal in his stomach. In fact, he had taken goldenseal regularly as a digestive aid, but a toxicology expert mistakes the goldenseal for strychnine, and deduces intentional murder.
This work of fiction sufficed to create a folkloric connection between goldenseal and drug testing. Although the goldenseal in the story actually made a drug test come out falsely positive, this has been turned around to become a belief that goldenseal can make urine drug screens come out negative. A word to the wise: it doesn't work.
When used as a topical treatment for minor skin wounds, a sufficient quantity of goldenseal cream, ointment, or powder should be applied to cover the wound. Make sure to clean the wound at least once a day to prevent goldenseal particles from being trapped in the healing tissues.
For mouth sores and sore throats, goldenseal tincture is swished or gargled. Goldenseal may also be used as strong tea for this purpose, made by boiling 0.5 to 1 g in a cup of water. The herb has a bitter taste. Goldenseal tea is also used as a douche for vaginal yeast infections.
Although there are no reports of severe adverse effects attributable to use of goldenseal, this herb has not undergone much safety testing.
One study suggests that topical use of goldenseal could cause photosensitivity (an increased tendency to react to sun exposure).20
Goldenseal should not be used by pregnant women because the herb has been reported to cause uterine contractions. Also, berberine may increase levels of bilirubin and cause genetic damage.5,7,8 The last of these effects indicates that individuals with elevated bilirubin levels (jaundice) should also avoid use of goldenseal. Safety in young children, nursing women, or those with severe liver or kidney disease is also not established.
Just as there are incorrect rumors regarding the benefits of goldenseal, there are popular but incorrect beliefs regarding its health risks. For example, it is often said that goldenseal can disrupt the normal bacteria of the intestines. However, there is no scientific evidence that this occurs. Another fallacy is that small overdoses of goldenseal are toxic, causing ulcerations of the stomach and other mucous membranes. This idea is based on a misunderstanding of old literature.6
Some evidence suggests that goldenseal might interact with various medications by altering the way they are metabolized in the liver.9,23 One study found that berberine impairs metabolism of the drug cyclosporine, thereby raising its levels.22 This could potentially cause toxicity. It is important, therefore, to speak with a physician before taking goldenseal with other medications.
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Scazzocchio F, Cometa MF, Tomassini L, et al. Antibacterial activity of Hydrastis canadensis extract and its major isolated alkaloids. Planta Med. 2001;67:561-564.
Soffar SA, Metwali DM, Abdel-Aziz SS, et al. Evaluation of the effect of a plant alkaloid (berberine derived from Berberis aristata) on Trichomonas vaginalis in vitro. J Egypt Soc Parasitol. 2001;31:893-904.
Stermitz FR, Lorenz P, Tawara JN, et al. Synergy in a medicinal plant: antimicrobial action of berberine potentiated by 5'-methoxyhydnocarpin, a multidrug pump inhibitor. Proc Natl Acad Sci U S A. 2000; 97:1433-1437.
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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;68:391-395.
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Kong W, Wei J, Abidi P, et al. Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins. Nat Med. 2004 Nov 07 [Epub ahead of print]
Wu X, Li Q, Xin H et al. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol. 2005 Aug 26 [Epub ahead of print].
Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessment 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 Jan 23.
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Last reviewed December 2015 by EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.