Goldenseal

Efficacy of goldenseal alone as a cold remedy has not been supported (1). In 2 relatively well-designed but small studies, berberine, the major alkaline constituent isolated from goldenseal, reduced diarrhea (2-3). Berberine has also reduced symptoms in diarrhea-predominant irritable bowel syndrome (4). There are few, if any, recent, large, randomized, blinded clinical trials of goldenseal extract.

Emerging evidence shows that in patients with diabetes, berberine can decrease fasting and postprandial glucose and hemoglobin A1C. A meta-analysis of berberine in 28 studies (2313 subjects) compared berberine to lifestyle modifications, diabetes medication monotherapy, or berberine combined with diabetes medications. In this analysis, berberine significantly lowered fasting glucose, postprandial glucose, and hemoglobin A1C and was more effective in combination with oral diabetes medications than the diabetes medications or berberine used as monotherapy (5). However, effects were attenuated with treatment duration > 90 days and in people older than 60 years.

For hyperlipidemia, a meta-analysis of 16 studies (2417 subjects) found that compared to placebo berberine significantly lowered total and low-density lipoprotein cholesterol and triglycerides, and increased high-density lipoprotein cholesterol (6). However, there was a high degree of heterogeneity in results and risk of bias.

Goldenseal can have many adverse effects, including nausea, anxiety, dyspepsia, uterine contractions, and jaundice in neonates. If taken in large amounts, goldenseal can cause seizures and respiratory failure and may affect contraction of the heart. Women who are pregnant or breastfeeding, neonates, and people who have seizure disorders or problems with blood clotting should not take goldenseal. A recent in vitro study of the active ingredients of goldenseal, specifically berberine, indicates an increased risk of DNA damage leading to tumorigenic effects (7).

8).

(See also table Some Possible Dietary Supplement–Drug Interactions.)

1. 1. 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 and Hydrastis canadensis. Immunol Lett 68(2-3):391-395, 1999. doi: 10.1016/S0165-2478(99)00085-1

2. 2. Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al: Clinical trial of berberine in acute watery diarrhoea. Br Med J (Clin Res Ed) 291(6509):1601-1605, 1985. doi:10.1136/bmj.291.6509.1601

3. 3. 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 155(5):979-984, 1987. doi:10.1093/infdis/155.5.979

4. 4. Chen C, Tao C, Liu Z, et al: A randomized clinical trial of berberine hydrochloride in patients with diarrhea-predominant irritable bowel syndrome. Phytother Res 29(11):1822-7, 2015. doi: 10.1002/ptr.5475

5. 5. Liang Y, Xu X, Yin M, et al: Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis. Endocr J 66(1):51-63, 2019. doi:10.1507/endocrj.EJ18-0109

6. 6. Ju J, Li J, Lin Q, et al: Efficacy and safety of berberine for dyslipidaemias: a systematic review and meta-analysis of randomized clinical trials. Phytomedicine 50:25-34, 2018. doi:10.1016/j.phymed.2018.09.212

7. 7. Chen S, Wan L, Couch L, et al: Mechanism study of goldenseal-associated DNA damage. Toxicol Lett 221(1):64-72, 2013. doi: 10.1016/j.toxlet.2013.05.641

8. 8. Guo Y, Chen Y, Tan ZR, Klaassen CD, Zhou HH: Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol 68(2):213‐217, 2012. doi:10.1007/s00228-011-1108-2

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

1. National Institutes of Health (NIH), National Center for Complementary and Integrative Health: General information on the use of goldenseal as a dietary supplement