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By Melissa G. Marko, PhD, Senior Clinical Scientist, Nestle Nutrition
Ara DerMarderosian, PhD, Professor Emeritus of Biology and Pharmacognosy, University of the Sciences

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Goldenseal, an endangered US plant, is related to the buttercup (Hydrastis canadensis). Its active components are hydrastine and berberine, which have antiseptic activity. Goldenseal is available in liquid, tablet, and capsule forms standardized to the active components.


Various preparations of goldenseal are used as an antiseptic wash for mouth sores, inflamed and sore eyes, and irritated skin and as a douche for vaginal infections. It has been combined with echinacea as a cold remedy. Goldenseal is also used as a remedy for indigestion and diarrhea.


Efficacy of goldenseal alone as a cold remedy has not been supported (1). In 2 relatively well-designed but small studies, berberine isolated from goldenseal reduced diarrhea (2-3). However, there are few, if any, recent, large, randomized, blinded clinical trials of goldenseal extract.

Adverse effects

Goldenseal can have many adverse effects, including nausea, anxiety, dyspepsia, uterine contractions, jaundice in neonates, and worsening of hypertension. 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 (4).

Drug interactions

Goldenseal may interact with warfarin, and berberine may reduce the anticoagulant effect of heparin. In addition, a recent review of herbal extracts indicates that goldenseal, particularly berberine, is a weak inhibitor of CYP3A4 and CYP2D6 enzymes, which are important in the metabolism and elimination of many drugs (5).

Goldenseal references