Get Your Personalized Supplement StackSupplement Stack Quiz

Goldenseal Herbal Extract

Also known as: Goldenseal, Yellow root, Hydrastis canadensis

Overview

Goldenseal (*Hydrastis canadensis*) is a perennial herb native to eastern North America, historically used by Native Americans for various inflammatory conditions. Its extract is rich in isoquinoline alkaloids, predominantly berberine and hydrastine, which are believed to confer antimicrobial, anti-inflammatory, and astringent properties. While commonly marketed for respiratory infections, digestive issues, and immune support, direct clinical research on goldenseal extract itself is limited. Most scientific evidence for its purported benefits stems from studies on berberine, its primary active constituent. The overall quality of evidence for goldenseal as a whole is considered moderate to low, with a scarcity of large, well-controlled randomized controlled trials (RCTs) specifically on the extract, relying more on traditional use and berberine research.

Benefits

The primary benefits associated with goldenseal are largely attributed to its main active compound, berberine, which has been more extensively studied: - **Glycemic Control:** A meta-analysis of 28 RCTs involving 2313 patients with type 2 diabetes indicated that berberine significantly reduced fasting glucose, postprandial glucose, and HbA1c. These effects were enhanced when berberine was combined with standard diabetes medications, though benefits attenuated after 90 days and in older adults. - **Lipid Profile Improvement:** Another meta-analysis of 16 studies (2417 subjects) found that berberine improved lipid profiles by reducing total cholesterol, LDL cholesterol, and triglycerides, while increasing HDL cholesterol. However, this finding was associated with high heterogeneity and a risk of bias. - **Weight Management:** A meta-analysis of 12 studies (1040 patients) reported modest reductions in body weight, BMI, waist circumference, and the inflammatory marker CRP with berberine supplementation. - **Antimicrobial and Anti-diarrheal Effects:** Berberine has shown promise in reducing diarrhea symptoms in small RCTs for conditions like cholera and irritable bowel syndrome. For goldenseal extract itself, there are no well-designed, large RCTs confirming its efficacy for common colds or respiratory infections. While traditional use suggests astringent and anti-inflammatory effects, robust clinical evidence is currently lacking. Most evidence on berberine's benefits comes from adults with metabolic syndrome or diabetes, with less clarity on its efficacy and safety in other populations.

How it works

Goldenseal's therapeutic actions are primarily mediated by its alkaloid constituents, particularly berberine and hydrastine. Berberine exerts its effects through multiple pathways, including the activation of AMP-activated protein kinase (AMPK), which plays a crucial role in glucose and lipid metabolism. It also demonstrates anti-inflammatory and broad-spectrum antimicrobial activities. Hydrastine may contribute to immunomodulatory effects and smooth muscle relaxation. A significant mechanism of action involves the inhibition of cytochrome P450 enzymes, notably CYP3A, and drug transporters. This inhibition can lead to altered metabolism of other drugs, potentially increasing their plasma levels and effects. The bioavailability of berberine is inherently low due to extensive first-pass metabolism, which limits its systemic exposure.

Side effects

Goldenseal is generally considered possibly safe for short-term oral use in adults at recommended doses, but insufficient data exist regarding its long-term safety. Common side effects are not extensively documented but may include gastrointestinal discomfort. Goldenseal is not recommended during pregnancy or breastfeeding due to a lack of safety data and potential risks. A critical concern is its potential for significant drug interactions: goldenseal inhibits several drug-metabolizing enzymes, particularly CYP3A, and drug transporters. This inhibition can increase the plasma concentrations of drugs metabolized by these pathways, such as dextromethorphan and losartan, potentially leading to increased side effects or toxicity. Rare allergic reactions or other forms of toxicity are possible but have not been well characterized. Due to its impact on drug metabolism, individuals on any prescription medications should exercise extreme caution and consult a healthcare professional before using goldenseal.

Dosage

There is no standardized dosing for goldenseal extract due to the variability in preparations and the absence of large-scale clinical trials specifically on the extract. For berberine, the primary active constituent, clinical trials typically use doses ranging from 500 mg to 1500 mg daily, often administered in divided doses. The timing of administration and the specific formulation can influence absorption and bioavailability. Co-administration with food or other agents may also impact its absorption. Due to goldenseal's potential for significant drug interactions, careful monitoring is strongly advised when it is used concurrently with other medications. Upper limits and safety thresholds for goldenseal extract itself are not well established, underscoring the need for caution and professional guidance.

FAQs

Is goldenseal effective for colds or flu?

No strong clinical evidence supports goldenseal alone for respiratory infections. While traditional use exists, it lacks rigorous scientific validation through modern clinical trials.

Is goldenseal safe long-term?

The safety of goldenseal beyond short-term use is unknown. Caution is advised, especially for pregnant or breastfeeding women, due to insufficient safety data.

Can goldenseal interfere with medications?

Yes, goldenseal can inhibit drug-metabolizing enzymes (like CYP3A), potentially increasing the levels and side effects of many prescription medications. Consult a doctor before use.

Does goldenseal help with diabetes?

Berberine, a key component of goldenseal, has demonstrated glucose-lowering effects in type 2 diabetes. However, evidence for isolated goldenseal extract specifically for diabetes is limited.

Research Sources

https://pmc.ncbi.nlm.nih.gov/articles/PMC7119334/ – This meta-analysis of 28 RCTs (2313 patients) found that berberine significantly reduced fasting glucose, postprandial glucose, and HbA1c in type 2 diabetes patients, with additive effects when combined with standard medications. It also noted benefits in lipid profiles and modest weight reduction. The study highlighted heterogeneity and potential attenuation of effects over time.
https://rex.libraries.wsu.edu/view/pdfCoverPage?instCode=01ALLIANCE_WSU&filePid=13413327070001842&download=true – This review discusses the pharmacology of berberine and hydrastine, the main alkaloids in goldenseal. It details their multiple pharmacologic effects, including metabolic and antimicrobial actions, and emphasizes goldenseal's significant inhibition of CYP3A and drug transporters, which can lead to clinically relevant drug interactions.
https://www.nccih.nih.gov/health/goldenseal – This source provides an overview of goldenseal, noting its traditional uses and the lack of strong scientific evidence for many of its purported benefits, especially for colds and infections. It highlights safety concerns, particularly regarding its use during pregnancy and breastfeeding, and potential drug interactions due to enzyme inhibition.
https://www.merckmanuals.com/professional/special-subjects/dietary-supplements/goldenseal – This professional medical reference provides a concise summary of goldenseal, its active constituents, and traditional uses. It underscores the limited clinical evidence for its efficacy and emphasizes the importance of potential drug interactions, particularly with medications metabolized by CYP3A enzymes.