What Is Goldenseal?

Goldenseal is a perennial herb that's native to the eastern United States. Its scientific name is Hydrastis canadensis (H. canadensis).

Goldenseal contains a complex mixture of substances and chemicals, such as berberine. It's thought to work through these chemicals. In particular, berberine might be effective for several uses, such as relieving canker sore symptoms.

This article will cover what you should know about goldenseal—its potential uses, side effects, and interactions.

Uses of Goldenseal

There is currently limited research to support goldenseal for any health benefits. But like many natural products, people may use goldenseal for various reasons.

Canker Sores

Some people may use goldenseal for canker sores (ulcers in the mouth). And according to the National Library of Medicine (NLM), berberine in goldenseal might effectively relieve canker sore symptoms. In fact, results from a small clinical trial suggest that topical berberine may relieve canker sore symptoms. But in general, only a small amount of berberine is absorbed into the bloodstream—when you take goldenseal by mouth.

This means there may not be enough berberine from goldenseal for the plant to be effective. So, while there are studies on berberine, these results might not apply to goldenseal. Well-designed studies in humans are necessary to evaluate goldenseal's effects on canker sores better.

Diabetes

Goldenseal might be used for diabetes (high blood sugar). Berberine in goldenseal may slightly lower blood glucose (sugar) in people with diabetes.

In fact, a review including randomized controlled trials (RCTs) suggested berberine may reduce blood sugar levels in multiple ways—like blocking glucose absorption from your intestines. Berberine may encourage your pancreas to secrete more of a naturally-occurring hormone called insulin. And berberine may make your muscle and fat cells more sensitive to insulin's effects, decreasing sugar levels.

But when you take goldenseal by mouth, only a small amount is absorbed into the bloodstream.

For this reason, results from berberine studies may not apply to goldenseal. High-quality studies in humans are needed to assess goldenseal's effects on blood sugar better.

What Are the Side Effects of Goldenseal?

Like many medications and natural products, side effects are possible with goldenseal.

Common Side Effects

Little information is known about goldenseal's safety. Short-term oral (by mouth) goldenseal use is likely safe for many adults. But since goldenseal contains berberine, common side effects might be similar to this chemical, typically related to the digestive system. For example, you may experience the following:

• Constipation
• Diarrhea
• Gas
• Upset stomach
  

Severe Side Effects

Serious side effects may include:

• Severe allergic reaction: A severe allergic reaction is a possible serious side effect of any medication. Symptoms may include breathing difficulties, itchiness, and rash.
• Blood sugar effects: Berberine in goldenseal may slightly lower your blood sugar. If you have excessively low blood sugar, symptoms may include tremors, sweating, and a rapid heartbeat.
• High bilirubin in babies: When old red blood cells (RBCs) in your blood break down, they also make a substance called bilirubin, usually cleared from the body by the liver. But goldenseal might block the liver and prevent the removal of bilirubin. And high bilirubin levels may result in severe jaundice (yellowing of eyes or skin), leading to a life-threatening condition called kernicterus (brain damage from elevated bilirubin).
  

If you're having a severe allergic reaction or if any of your symptoms feel life-threatening, call 911 and get medical help right away.

Precautions

Goldenseal may pose risks in the following situations:

Severe allergic reaction: Avoid goldenseal if you have a severe allergic reaction to it or its components (parts or ingredients).

Pregnancy: According to the National Center for Complementary and Integrative Health (NCCIH), pregnant people shouldn't use goldenseal. Berberine in goldenseal may reach the unborn fetus and have adverse effects. There are reports of newborns having kernicterus (brain damage from high bilirubin) due to berberine exposure. Discuss with your healthcare provider the benefits and risks of goldenseal during pregnancy.

Breastfeeding: The NCCIH recommends against goldenseal while breastfeeding. While breastfeeding parents have used goldenseal for sore nipples, the National Library of Medicine (NLM) states that berberine in goldenseal might be present in breastmilk and harm the nursing infant. Reach out to your healthcare provider to discuss the benefits and harms of goldenseal while breastfeeding.

Children: The NCCIH recommends avoiding goldenseal in infants. Infants—particularly newborns—might get kernicterus from goldenseal. As for older children, safety and effectiveness data is limited.

Older adults over 65: Some older adults may be more sensitive to the side effects of medications if they are using multiple medications. For this reason, use caution with goldenseal.

Diabetes: Berberine in goldenseal may affect your blood sugar levels. If you have diabetes, you may need to monitor your blood sugar frequently. And based on your blood sugar levels and symptoms, your healthcare provider may need to adjust your medications.

Dosage: How Much Goldenseal Should I Take?

There are very few studies on goldenseal. For this reason, there are no guidelines on the appropriate dosage to take goldenseal for any condition.

If you take goldenseal, follow your healthcare provider's suggestions and product label instructions.

What Happens if I Take Too Much Goldenseal?

With very few available studies, there is little information about goldenseal toxicity and overdoses in humans.

Overdoses with goldenseal, however, might be similar to its potential common or severe side effects, which might be exaggerated or excessive. If you suspect you're experiencing life-threatening side effects, seek immediate medical attention.

Interactions

Use caution when taking goldenseal with the following:

Blood sugar medications: Berberine in goldenseal might lower your blood sugar. So, taking it with blood sugar medications—like insulin—may further lower your blood sugar. Excessively low blood sugar symptoms may include tremors, sweating, and rapid heartbeat.

Certain cytochrome P450 (CYP450) substrate medications: Berberine of goldenseal may affect how specific CYP450 proteins work—particularly the CYP2C9, CYP2D6, and CYP3A4 proteins.

CYP2C9 substrate examples may include a blood pressure medication called Cozaar (losartan), a blood thinner called Coumadin (warfarin), and an anti-seizure medication called Dilantin (phenytoin).

And CYP2D6 substrates may include a beta-blocker blood pressure medication called Bystolic (nebivolol) and a cough medication called Delsym (dextromethorphan).

Examples of CYP3A4 substrates may include Zocor (simvastatin) for high cholesterol and cyclosporine or Prograf (tacrolimus) to prevent organ transplant rejection.

If you take any of these medicines, talk to your healthcare. They'll monitor for side effects and effectiveness issues and might adjust your medications.

It is essential to carefully read a supplement's ingredient list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications. 

How to Store Goldenseal

Since storage instructions may vary for different natural products, carefully read the directions and packaging label on the container. But in general, keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet. Try to store your medicines in a cool and dry place.

Discard after one year or as indicated on the packaging. Avoid putting unused and expired medicines down the drain or in the toilet. Visit the FDA's website to know where and how to discard all unused and expired medicines. You can also find disposal boxes in your area.

Ask your pharmacist or healthcare provider if you have any questions about how to dispose of your medications or supplements.

Similar Supplements

Potential uses of goldenseal may include canker sores (ulcers in the mouth) and diabetes. Potentially similar supplements may include the following:

• Calendula: Calendula contains plant chemicals that may relieve swelling in the mouth and throat. These chemicals might also help with wound healing. However, the scientific data doesn't support calendula for any use.
• Roman chamomile: Roman chamomile has plant chemicals that may affect blood sugar. But presently, there isn't enough data to support Roman chamomile.

Don't combine multiple natural products until you first talk with your healthcare provider or pharmacist. They can help prevent possible interactions and side effects. They can also ensure you’re giving these supplements a good trial at appropriate doses.

Sources of Goldenseal & What to Look For

There are several different sources of goldenseal.

Food Sources of Goldenseal

Goldenseal is naturally available, grown as an herb.

Goldenseal Supplements

Goldenseal is available in various forms, including capsules and tablets. If you have difficulties swallowing pills, goldenseal might also be available in other dosage forms, which may include:

• Liquid
• Lozenge
• Powder

There may also be vegan and vegetarian options. Your specific product will depend on your preference and what you hope to get in terms of effects. Each product may work a bit differently, depending on the form. So, following your healthcare provider's recommendations or label directions is essential.

Summary

Goldenseal is an herb native to the United States. Similar to many natural products, people may use goldenseal for various reasons. But with very few studies on goldenseal, there isn't enough data to currently support goldenseal for any use.

Goldenseal contains a complex mix of substances and chemicals, such as berberine. And while there are more studies on berberine, they may not always apply to goldenseal. Like many medications and natural products, it's possible to have side effects and medication interactions with goldenseal.

Well-designed and long-term clinical trials are necessary to assess goldenseal's effectiveness and safety better. Before taking goldenseal, contact your pharmacist or healthcare provider to help you safely achieve your health goals.