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Safety Issues
Although there are no reports of severe adverse effects attributable to use of goldenseal, this herb has not undergone much safety testing.
One study suggests that topical use of goldenseal could cause photosensitivity (an increased tendency to react to sun exposure). 1 Goldenseal should not be used by pregnant women because the herb has been reported to cause uterine contractions. Also, berberine may increase levels of bilirubin and cause genetic damage. 2 The last of these effects indicates that individuals with elevated bilirubin levels (jaundice) should also avoid use of goldenseal. Safety in young children, nursing women, or those with severe liver or kidney disease is also not established.
Just as there are incorrect rumors regarding the benefits of goldenseal, there are popular but incorrect beliefs regarding its health risks. For example, it is often said that goldenseal can disrupt the normal bacteria of the intestines. However, there is no scientific evidence that this occurs. Another fallacy is that small overdoses of goldenseal are toxic, causing ulcerations of the stomach and other mucous membranes. This idea is based on a misunderstanding of old literature. 3 Some evidence suggests that goldenseal might interact with various medications by altering the way they are metabolized in the liver. 4 One study found that berberine impairs metabolism of the drug cyclosporine , thereby raising its levels. 5 This could potentially cause toxicity. It is important, therefore, to speak with a physician before taking goldenseal with other medications.
References
- Inbaraj JJ, Kukielczak BM, Bilski P, et al. Photochemistry and photocytotoxicity of alkaloids from Goldenseal ( Hydrastis canadensis L. ). Chem Res Toxicol. 2001;14:1529-1534.
- Pasqual MS, Lauer CP, Moyna P, Henriques JA. Genotoxicity of the isoquinoline alkaloid berberine in prokaryotic and eukaryotic organisms. Mutat Res. 286(2):243-52.
- Foster S. Botanical Series No. 309: Goldenseal. Austin, TX: American Botanical Council, 1991:5-6.
- Budzinski JW, Foster BC, Vandenhoek S, et al. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine. 2000;7:273-282.
- Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol. 61(8):567-72.
