goldenseal

Goldenseal is a perennial herb Hydrastis canadensis that is native to North America. The dried rhizomes/roots of goldenseal have been used as traditional medicine by indigenous Americans for many conditions including fevers, ulcers and skin disorders.

Goldenseal is now one of the most popular herbal supplements available in the U.S. over the counter (OTC), used to treat the common cold, respiratory infections, and many other conditions. Goldenseal is often used in combination with another herb, echinacea.

Goldenseal is available as liquid extracts and tinctures, tablets and capsules that contain the dried root powder, and as dried, powdered or whole root that may be brewed as tea. Goldenseal contains berberine, a compound that may have antimicrobial properties. Laboratory tests indicate that berberine kills some bacteria and fungus, however, no clinical trials have been conducted in humans. In addition, very little berberine may be absorbed from oral goldenseal, hence it may not have the same effects as berberine.

One of the reasons for goldenseal’s popularity is because of a rumor that the herb can help block a positive test for illegal drugs. Several studies report that goldenseal does not change the results of drug tests. There is no scientific evidence to support any of its purported benefits and uses. Wild goldenseal is now listed as endangered and the plant is grown commercially in the US. The suggested uses of goldenseal include:

• Common cold
• Respiratory infections
• Hay fever (allergic rhinitis)
• Eyewash for eye inflammation (conjunctivitis)
• Gas (flatulence)
• Diarrhea
• Ulcers
• Gastrointestinal inflammation (gastritis/colitis)
• Mouthwash for sore mouth and gums
• Painful menstruation (dysmenorrhea)
• Excessive menstruation (menorrhagia)
• Skin disorders such as rashes, ulcers, eczema and acne
• Ringworm infections
• Urinary tract infection
• Urine drug tests

• Do not use goldenseal if you are hypersensitive to any of its components.
• Do not use goldenseal if you have any of the following conditions:
  • High bilirubin levels (hyperbilirubinemia)
  • Infectious gastrointestinal (GI) conditions
  • Inflammatory GI conditions
• Do not take goldenseal if you are pregnant or breastfeeding.
• Do not administer goldenseal to newborns and infants.
• Use with caution if you have any cardiovascular disorders or high blood pressure (hypertension).
• Avoid concurrent use with medications that include:
  • Antihypertensive drugs
  • Antidiabetic drug (metformin)
  • Drugs that are metabolized by the liver enzyme CYP3A4
  • Sedative agents
• Use with caution if you have a bleeding disorder, goldenseal may increase the risk of bleeding. Stop taking at least 2 weeks before any scheduled surgery.

Common side effects of goldenseal include:

• Constipation
• Digestive disorders
• Mucous membrane irritation
• Excitability
• Hallucinations
• Delirium
• Brain damage from high bilirubin levels in infants (kernicterus)

Side effects from overdose of goldenseal may include:

• Nausea
• Vomiting
• Nervousness
• Depression
• Low blood pressure (hypotension)
• Slow heart rate (bradycardia)
• Cardiac damage
• Shortness of breath (dyspnea)
• Respiratory failure
• Spasms
• Seizures
• Paralysis
• Death

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There is insufficient reliable information on what might be an appropriate dose for goldenseal.

Suggested Dosing:

Dried Root/Rhizome/Tea

• 0.5-1 g orally three times daily

Liquid Extract

• 0.3-1.0 ml orally three times daily; 1:1, 60% ethanol

Tincture

• 2-4 ml orally three times daily; 1:10, 60% ethanol

Mouthwash, Topical

• Rinse three to four times daily; with 6 g dried herb/150 ml water

• Goldenseal overdose can cause nausea, vomiting, nervousness, depression, hypotension, bradycardia, cardiac damage, dyspnea, respiratory failure, spasms, seizures, paralysis and death.
• Overdose may be treated with symptomatic and supportive care.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Goldenseal has no known severe or serious interactions with other drugs.
• Moderate interactions of goldenseal include:
  • digoxin
  • cyclosporine
  • tetracycline
  • losartan
  • tacrolimus
  • anticoagulant and antiplatelet drugs
  • medications metabolized by the liver
  • antidiabetic drugs
  • antihypertensive drugs
  • central nervous system (CNS) suppressants
• Minor interactions of goldenseal include:
  • oseltamivir

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Do not use goldenseal if you are pregnant or breastfeeding. Goldenseal can harm the fetus and the breastfed baby.
• Check with your healthcare provider before taking any herbal supplement, including goldenseal, if you are pregnant or breastfeeding.

• Goldenseal is possibly safe for most adults when taken orally in recommended doses or used for topical application.
• Check with your healthcare provider before using any supplement, including goldenseal.
• Use goldenseal exactly as per label instructions.
• Herbal products often contain many ingredients. Check labels for the components in the goldenseal product you choose.
• Goldenseal is marketed as an herbal supplement and is not regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents; exercise caution in choosing your product.
• Store safely out of reach of children.
• In case of overdose, seek medical help immediately or report to Poison Control.