Herb

    Goldenseal

    Hydrastis canadensis

    TL;DR

    Goldenseal is a berberine-containing root sold for colds, sinus infections and gut complaints. Human evidence for those uses is essentially absent, and its real-world significance is as a potent inhibitor of CYP3A4 and CYP2D6 drug metabolism.

    Ideal For

    • People specifically seeking a traditional herbal bitter under practitioner guidance

    Avoid If

    • You take any prescription medication metabolized by CYP3A4 or CYP2D6
    • You are pregnant — berberine can cross the placenta and displace bilirubin in newborns
    • You are breastfeeding
    • You have jaundice or are treating a newborn

    Frequently Asked Questions

    Overview

    Goldenseal (Hydrastis canadensis) was a Native American and Eclectic-medicine staple that survived into the modern supplement aisle mostly on tradition. Its main alkaloids are berberine and hydrastine. The berberine content is what marketers point to, but goldenseal root typically delivers far less berberine per capsule than a dedicated berberine supplement, so the metabolic benefits documented for berberine do not transfer cleanly. There are no adequately powered randomized trials showing goldenseal shortens colds, clears sinus infections or treats diarrhea in humans. Berberine is also poorly absorbed orally, so the folk claim that goldenseal acts as a topical-strength antimicrobial on mucous membranes throughout the body is not supported by pharmacokinetics. What is well documented is the interaction risk: controlled human studies show goldenseal meaningfully inhibits CYP3A4 and CYP2D6, raising blood levels of a wide range of prescription drugs. Goldenseal is also heavily wild-harvested and CITES-listed, so sourcing and adulteration are ongoing problems. For most people looking for berberine effects, standardized berberine is the rational choice; goldenseal is a traditional remedy with an unfavorable evidence-to-risk ratio.

    How It Works

    • Berberine and hydrastine alkaloids show antimicrobial activity in vitro at concentrations rarely reached in blood after oral dosing
    • Berberine activates AMPK in cell models, the mechanism behind dedicated berberine supplements, but goldenseal delivers far lower doses
    • Inhibits intestinal and hepatic CYP3A4 and CYP2D6, slowing clearance of many prescription drugs
    • Astringent action on mucous membranes is the likely basis for its traditional topical use

    Benefits & Outcomes

    No linked outcomes yet. Research is ongoing.

    Health Concerns Addressed

    No linked health concerns yet.

    Supporting Research
    6 studies

    Supplementation with goldenseal (Hydrastis canadensis), but not kava kava (Piper methysticum), inhibits human CYP3A activity in vivo

    Score: 8/10
    2008
    rct
    n=16

    Gurley BJ, Swain A, Hubbard MA +3 more

    Goldenseal supplementation produced significant inhibition of CYP3A activity, increasing midazolam exposure in healthy volunteers.

    View source

    In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4 phenotypes

    Score: 8/10
    2005
    rct
    n=12

    Gurley BJ, Gardner SF, Hubbard MA +4 more

    Goldenseal produced significant inhibition of both CYP2D6 and CYP3A4/5 activity, indicating a high potential for herb-drug interactions.

    View source

    Berberine in the treatment of type 2 diabetes mellitus: a systematic review and meta-analysis

    Score: 7/10
    2015
    meta_analysis
    n=2569

    Lan J, Zhao Y, Dong F +4 more

    Berberine lowered fasting blood glucose, HbA1c and LDL cholesterol comparably with standard oral hypoglycaemic agents.

    View source

    Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans

    Score: 7/10
    2007
    rct
    n=20

    Gurley BJ, Swain A, Barone GW +3 more

    Neither goldenseal nor kava kava significantly altered digoxin pharmacokinetics.

    View source

    Berberine and berberine-containing botanicals: safety in pregnancy and neonatal kernicterus risk

    Score: 6/10
    1993
    observational
    0

    Chan E

    Berberine displaces bilirubin from albumin, posing a risk of kernicterus in neonates and warranting avoidance in pregnancy.

    View source

    Hydrastis canadensis (goldenseal) extracts and antibacterial synergy: mechanistic and safety review

    Score: 5/10
    2020
    systematic_review
    0

    Mandal SM, Chakraborty D, Dey S

    Goldenseal alkaloids show in vitro antibacterial and efflux pump inhibitory activity, but no controlled human trials support use for infections.

    View source

    Safety Information

    Potential Side Effects

    Nausea, mouth and throat irritation, and digestive upset at higher doses. The dominant risk is not the herb itself but elevated levels of concurrent medications.

    Contraindications

    Pregnancy, breastfeeding, neonates, and concurrent use of narrow-therapeutic-index drugs.

    Drug Interactions

    • CYP3A4 substrates (statins, many immunosuppressants, some anticoagulants)
    • CYP2D6 substrates (many antidepressants, beta-blockers, tamoxifen)
    • Metformin — additive glucose lowering possible

    Pregnancy & Breastfeeding

    Pregnancy: likely_unsafe

    Breastfeeding: likely_unsafe

    Dosage Guidelines

    Dosage Used in Studies

    Consult healthcare provider

    Forms Compared

    Food & Timing

    Taken with food to reduce stomach upset.

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.