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Western herbalism

GoldensealHydrastis canadensis

A North American root long used for digestive complaints. NCCIH finds no rigorous health trials; in volunteers it raised midazolam exposure 1.43-fold.

Botanical name
Hydrastis canadensis
Part used
rhizome and root
Also called
Yellow root, Goldenroot, Yellow puccoon, Orangeroot
Used in
Western herbalism
Taken for
Antimicrobial use, Indigestion, Loose stools and diarrhea
Sold as
capsules, tincture, tea, powder, liquid extract

Goldenseal, the plant and the part used

Goldenseal is a perennial of the buttercup family native to the northeastern United States and southeastern Canada. The part used is the bright yellow underground stem, or rhizome, with its roots. Wild plants have been heavily harvested, so wild-collected supply is limited and cultivation is expensive, according to NCCIH.

The root is sold dried and powdered in capsules, as a liquid extract or tincture, as a tea, and in combination products. Its yellow color comes from its alkaloids, chiefly berberine, hydrastine and canadine. Because the alkaloids are the usual quality marker, labels often state a berberine or hydrastine percentage; a chemical comparison of goldenseal root powders from three commercial suppliers found that alkaloid content was the most suitable biomarker for the plant.

Goldenseal should not be confused with berberine itself. The isolated alkaloid is a different product with its own trials, and NCCIH notes that very little berberine may be absorbed when goldenseal is taken by mouth, so berberine results may not apply to goldenseal. The two are covered on separate pages.

Traditional uses, in their own terms

Western herbalism

NCCIH records that Native Americans used goldenseal for digestive disorders, wounds, skin and eye conditions, and cancer. The National Toxicology Program describes the root powder as used in folk medicine for gastrointestinal disturbances, urinary disorders, hemorrhage, inflammation, and skin, mouth and eye infections. In more recent herbal practice it has been sold for colds and other upper respiratory infections, hay fever, diarrhea and constipation. These are descriptions of use, not findings from trials of goldenseal.

Compounds, and what the laboratory says about them

The main alkaloids are berberine, hydrastine and canadine, and commercial root powders also contain minor alkaloids such as hydrastinine and berberastine. Berberine has antimicrobial and antisecretory activity in lab and animal work and, in a 1987 trial, in people with toxin-producing E. coli diarrhea. Goldenseal extract inhibits the liver enzymes CYP3A and CYP2D6 in human volunteers (see interactions). The alkaloids are the plant’s identifying chemistry, which is why authentication work looks for them and for palmatine, an alkaloid native to Coptis species that is a known adulterant.

Trials in people, with the numbers

We could find no randomized trial of goldenseal on a gut outcome. NCCIH states that there is not enough evidence to determine whether goldenseal is useful for any health condition, and that no rigorous studies have evaluated its effects on health conditions in people. The digestive reputation rests on traditional use and on trials of isolated berberine, which are a separate question: the berberine page covers a randomized IBS-D trial and a systematic review of 38 diarrhea trials, none of which tested goldenseal.

What exists in humans is pharmacokinetic work, which measures how the body handles other drugs when goldenseal is taken. In 12 healthy volunteers given a goldenseal extract for 28 days, probe-drug ratios showed about 40 percent inhibition of CYP2D6 and of CYP3A4/5. In 16 volunteers given goldenseal for 14 days, the AUC of midazolam, a CYP3A probe, rose from 107.9 to 175.3 ng·h/ml and its half-life from 2.01 to 3.15 hours. A cocktail study in another 16 volunteers found a midazolam AUC ratio of 1.43 and a metformin AUC ratio of 0.77, with no effect on rosuvastatin or furosemide.

Animal safety data come from the National Toxicology Program’s two-year feed study, which found clear evidence of liver tumors in male and female rats and some evidence in male mice. We found no human data on long-term use. The studies listed in the table are therefore interaction and safety studies, not tests of benefit.

StudyDoseWhat it found
Crossover study in 16 healthy volunteers (interaction study, no gut outcome) PMID 17495878Goldenseal supplement for 14 days, then midazolam 8 mgMidazolam AUC 107.9 to 175.3 ng*h/ml; half-life 2.01 to 3.15 h
Study in 12 healthy volunteers (interaction study) PMID 15900287Goldenseal extract for 28 daysAbout 40% inhibition of CYP2D6 and CYP3A4/5 activity
Probe-cocktail study in 16 healthy volunteers PMID 33174626Goldenseal product standardized to berberineMidazolam AUC ratio 1.43; metformin AUC ratio 0.77; no effect on rosuvastatin or furosemide
NTP two-year feed studies in rats and mice (animal, not human) PMID 21372858Goldenseal root powder in feedClear evidence of carcinogenic activity in male and female rats; some evidence in male mice

The doses on record

No trial has set a dose of goldenseal for a gut outcome. NCCIH notes that small, short-term studies using about 3 g a day caused no serious harmful effects, and that safety for longer use is uncertain. The interaction studies above ran for 14 and 28 days. Traditional preparations are the dried root powder in capsules or as a tea, a tincture, or a liquid extract, and products are often labeled by their berberine or hydrastine content, which varies from brand to brand. Quantities in herbal practice are set by the practitioner or the label and are not backed by dose-finding trials.

None of this is a dose recommendation. It is what the literature used, set down so a label can be compared with it; a pharmacist or clinician decides what applies to you.

The safety record

NCCIH advises that pregnant or breastfeeding women should not use goldenseal and that it should not be given to infants, because the berberine in it can be harmful to newborns. The National Toxicology Program found clear evidence of hepatocellular tumors in rats fed the root powder for two years; the relevance to people taking capsules is unknown. We found no published human cases we could use to put a number on liver or other harm.

Quality is a stated concern. NCCIH says some commercial products contain other herbs or ingredients not listed on the label, and the 2003 chemical comparison found palmatine and coptisine, alkaloids characteristic of Coptis, in material from one of three suppliers. Short-term use of about 3 g a day was without serious harm in small studies, according to NCCIH.

Medicines it can interact with

Goldenseal inhibits CYP3A and CYP2D6 in people, so medicines cleared by those enzymes can reach higher levels; midazolam exposure rose 1.43-fold in one study and 62 percent in another (AUC 107.9 to 175.3 ng·h/ml). It also lowered metformin exposure (AUC ratio 0.77), and NCCIH describes about a 25 percent drop in metformin levels, which could affect glucose control in type 2 diabetes. Cyclosporine and digoxin are other substrates of these pathways whose levels rise with berberine, the major alkaloid, in lab and small human studies.

The interaction rules the quiz applies to goldenseal

These are the medicines the quiz pairs with a caution or an exclusion for this herb, taken from published interaction references:

Where goldenseal turns up in the catalog

Goldenseal appears on the labels below, alone or inside a blend; each product page gives the printed amount, the evidence for that product and the review picture.

Biocidin Botanicals Biocidin Broad-Spectrum Liquid Formula 4.5 out of 5 from 1,079 ratings from Amazon · ~$1.41 per day at the full 15-drop dose

Want to know which products fit your symptoms?

The quiz weighs your symptoms and medicines against every product researched here, goldenseal products included, and shows its working.

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Read next

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Questions people ask

Does goldenseal have trials for diarrhea or digestion?

We could find none. NCCIH says there is not enough evidence to know whether goldenseal helps with any condition. The diarrhea trials people cite were done with berberine, not with goldenseal root.

Is the berberine in goldenseal well absorbed?

NCCIH notes that very little berberine may be absorbed when goldenseal is taken by mouth. That is one reason berberine trial results may not carry over to the whole root.

Which medicines does it change?

In healthy volunteers, goldenseal slowed the breakdown of midazolam and other substrates of the CYP3A and CYP2D6 enzymes. It also lowered metformin exposure by about 23 percent in a probe-cocktail study (AUC ratio 0.77). The sources advise talking to a prescriber if you take any regular medicine.

Why do the sources advise against it in pregnancy?

NCCIH says the berberine in goldenseal can be harmful to newborns, and that pregnant or breastfeeding women should not use it. A laboratory study of berberine found it displaced bilirubin from albumin, which is the concern behind that warning.

Do goldenseal products always contain goldenseal?

Not always. NCCIH says some products contain other ingredients not on the label, and a chemical comparison found Coptis-type alkaloids in one of three suppliers’ root powders. Alkaloid content is the usual quality check.

Sources