Goldenseal

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Hydrastis canadensis

Family: Ranunculaceae Genus: Hydrastis Species: canadensis

Synonyms: Warneria canadensis, Warneria tinctoria, Hydrastis trifolia, Warneria diphylla

Goldenseal
Goldenseal

Western Herbalism Properties

Actions:
bitterantimicrobialastringenttonicalterative

Traditional Uses

Goldenseal was an important medicine for several eastern tribes. The Iroquois and Cherokee used the yellow rhizome and root extensively as a bitter stomach and digestive tonic and stimulant, and to treat skin disorders, diarrhoea, fevers, sore eyes and ears, liver and heart complaints, pulmonary trouble and tuberculosis, whooping cough and even cancer, and as an emetic; the Cherokee and others also used the rhizome as a yellow dye (Herrick/Iroquois; Hamel & Chiltoskey, 1975). It was adopted from Native American practice into mainstream nineteenth-century Eclectic medicine as a celebrated mucous-membrane tonic.

Botanical Description

Hydrastis canadensis, goldenseal, is a low perennial herb of the buttercup family (Ranunculaceae) native to the rich, shady deciduous woodlands of eastern North America. It grows from a thick, knotty, bright yellow rhizome bearing numerous slender roots, the colour reflecting its content of the alkaloids berberine and hydrastine. Each plant typically produces a single hairy stem that forks near the top into two palmately lobed, sharply toothed, maple-like leaves; a single small, petalless flower with conspicuous greenish-white stamens is borne at the fork in spring. The flower is followed by a single raspberry-like cluster of inedible red berries. Once abundant, goldenseal has been heavily over-harvested from the wild for the herbal-medicine trade and is now a conservation concern, listed under CITES and considered threatened or vulnerable across much of its range; most ethical supply now comes from cultivation. It favours moist, humus-rich, well-drained forest soils under a hardwood canopy.

Native Region: Alabama, Arkansas, Connecticut, Delaware, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Masachusettes, Michigan, Minnesota, Mississippi, Missouri, New Jersey, New York, North Carolina, Ohio, Ontario, Pennsylvania, Tennessee, Vermont, Virginia, West Virginia, Wisconsin

Active Constituents

Berberine

Isoquinoline (protoberberine) alkaloid

Concentration: Major rhizome alkaloid, roughly 2-4.5% of dried root/rhizome

The bright-yellow quaternary alkaloid responsible for much of goldenseal's antimicrobial, antidiarrhoeal and metabolic activity; inhibits bacterial adhesion and has documented glucose- and lipid-lowering effects. Also a P-glycoprotein substrate/inhibitor.

Hydrastine

Phthalideisoquinoline alkaloid

Concentration: Major rhizome alkaloid, roughly 2-4%

A characteristic goldenseal alkaloid with vasoconstrictive and astringent properties historically used for mucosal and uterine bleeding; a potent inhibitor of CYP3A4 (more so than berberine) underlying goldenseal's herb-drug interaction potential.

Canadine (tetrahydroberberine)

Isoquinoline alkaloid

Concentration: Minor rhizome alkaloid

A reduced protoberberine alkaloid contributing to the alkaloid profile and antimicrobial/sedative activity of the root.

Berberastine

Isoquinoline alkaloid

Concentration: Minor rhizome alkaloid

A hydroxylated berberine analogue found characteristically in Hydrastis, used alongside berberine and hydrastine as a chemical marker for authentication.

Canadaline

Seco-isoquinoline alkaloid

Concentration: Minor constituent

A minor alkaloid contributing to the overall alkaloid fingerprint of goldenseal root.

Flavonoids (e.g. sideroxylin, 8-desmethyl-sideroxylin)

Methylated flavones

Concentration: Minor constituents of aerial parts and root

Flavonoids identified in goldenseal that show synergistic potentiation of berberine antibacterial activity by inhibiting bacterial multidrug-resistance efflux pumps.

⚠ Drug Interactions

CYP3A4 substrates (e.g. midazolam, cyclosporine, indinavir, some statins)

Major Evidence: Established

Goldenseal, chiefly via hydrastine and berberine, inhibits CYP3A4/5. In a controlled human study goldenseal reduced clearance of the CYP3A probe midazolam by roughly 40%, indicating clinically meaningful enzyme inhibition.

Clinical note: Avoid goldenseal with narrow-therapeutic-index CYP3A substrates; monitor for enhanced drug effect or toxicity.

CYP2D6 substrates (e.g. metoprolol, dextromethorphan, many antidepressants)

Moderate Evidence: Established

Human phenotyping studies show goldenseal significantly inhibits CYP2D6 activity, potentially raising levels of drugs cleared by this enzyme.

Clinical note: Use caution and monitor for exaggerated effects of CYP2D6 substrates when combined with goldenseal.

P-glycoprotein substrates (e.g. digoxin)

Moderate Evidence: Theoretical

Berberine and goldenseal extracts modulate intestinal P-glycoprotein; pharmacokinetic modelling predicts changes in exposure to P-gp substrates such as digoxin.

Clinical note: Monitor for altered response to digoxin and other P-gp substrates.

Antidiabetic drugs

Moderate Evidence: Probable

Berberine has well-documented glucose- and lipid-lowering activity, so combined use with antidiabetic agents may additively lower blood glucose.

Clinical note: Monitor blood glucose and adjust antidiabetic dosing as needed.

Preparation Methods

Tincture / hydroalcoholic extract

Parts: rhizome, root

Alcohol-water extract of the dried rhizome and root used as a bitter antimicrobial and mucous-membrane tonic. Because of potent CYP3A/2D6 inhibition, avoid with prescription medicines without professional advice.

Powdered root capsule

Parts: rhizome, root

Dried powdered rhizome in capsules, often standardized to hydrastine/berberine. Not for long-term or high-dose use.

Decoction / topical wash

Parts: rhizome, root

Root decoction historically used as an eyewash and mucosal wash. Safety warning: contraindicated in pregnancy and lactation (berberine is a uterine stimulant and can displace bilirubin, risking kernicterus in neonates); avoid in newborns. Goldenseal is listed on CITES Appendix II and is an at-risk species due to wild overharvest, so use only cultivated or sustainably sourced material.

Clinical Studies

Supplementation With Goldenseal (Hydrastis canadensis), but not Kava Kava (Piper methysticum), Inhibits Human CYP3A Activity In Vivo

Gurley BJ, Swain A, Hubbard MA, Williams DK, Barone G, Hartsfield F, et al. (2008) Clinical Pharmacology & Therapeutics Randomized human phenotyping (drug interaction) study

In healthy volunteers, 14 days of goldenseal supplementation significantly reduced clearance of the CYP3A probe midazolam (about 40% inhibition), providing direct clinical evidence that goldenseal inhibits human CYP3A.

In Vivo Effects of Goldenseal, Kava Kava, Black Cohosh, and Valerian on Human Cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 Phenotypes

Gurley BJ, Gardner SF, Hubbard MA, Williams DK, Gentry WB, Khan IA, Shah A (2005) Clinical Pharmacology & Therapeutics Human phenotyping (drug interaction) study

Goldenseal supplementation for 28 days produced marked inhibition (about 40%) of both CYP2D6 and CYP3A4/5 activity in healthy volunteers, identifying it as one of the most potent botanical CYP inhibitors tested.

Physiologically based pharmacokinetic model predictions of natural product-drug interactions between goldenseal, berberine, imatinib and bosutinib

Nguyen JT, Tian DD, Tanna RS, Arian CM, Calamia JC, Rettie AE, Thummel KE, Paine MF, et al. (2022) European Journal of Clinical Pharmacology PBPK modelling / drug interaction analysis

PBPK models integrating in vitro and clinical data quantified goldenseal- and berberine-mediated inhibition of CYP3A and P-glycoprotein, predicting the magnitude of interactions with substrate drugs.

Historical Texts

Cherokee and Iroquois ethnobotany (Native American traditional use)

Pre-Columbian and colonial era
Indigenous peoples of eastern North America used goldenseal root as a yellow dye and as a remedy for eye and skin inflammations, digestive complaints and ulcers, from whom European settlers adopted it.

King's American Dispensatory (Felter and Lloyd)

19th century (Eclectic medicine, 1898 edition)
Goldenseal (Hydrastis) is described in detail as a tonic and antiseptic remedy for catarrhal and mucous-membrane conditions, cementing its place in 19th-century North American materia medica.

References

  1. Mandal SK, Maji AK, Mishra SK, Ishfaq PM, Devkota HP, Silva AS, Das N. Goldenseal (Hydrastis canadensis L.) and its active constituents: A critical review of their efficacy and toxicological issues . Pharmacological Research (2020) [DOI]
  2. Gurley BJ, Swain A, Hubbard MA, Williams DK, Barone G, Hartsfield F, et al.. Supplementation with goldenseal, but not kava kava, inhibits human CYP3A activity in vivo . Clinical Pharmacology & Therapeutics (2008) [DOI]

This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.

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