What Is Goldenseal Used for Today?

Goldenseal contains a substance called berberine that has been found to inhibit or kill many microorganisms, including fungi, protozoa and bacteria.^1,2,10-14,22 On this basis, contemporary herbalists often use goldenseal as a topical antibiotic for skin wounds, as well as to treat viral mouth sores and superficial fungal infections, such as athlete’s foot. However, there is no direct scientific evidence that goldenseal is effective for any of these purposes.

Note that goldenseal probably is not likely to work as an oral antibiotic, because the blood levels of berberine that can be achieved by taking goldenseal orally are far too low to matter.³ However, goldenseal could theoretically be beneficial in treating sore throats and diseases of the digestive tract (such as infectious diarrhea) because it can contact the affected area directly. Similarly, since berberine is concentrated in the bladder, goldenseal could be useful for bladder infections. Nonetheless, again there is as yet no direct evidence that goldenseal is effective for any of these uses.

Extremely weak evidence (far too weak to rely upon at all) suggests that goldenseal or berberine may be helpful for various heart related conditions, including arrhythmias, congestive heart failure, high cholesterol, diabetes, and high blood pressure.^15,16,21,24 Similarly, infinitesimal evidence hints that goldenseal could be helpful for conditions in which spasms of smooth muscle play a role, such as dyspepsia (nonspecific stomach distress) and irritable bowel syndrome, as well as various forms of pain caused by inflammation.^17,18

Ironically, goldenseal’s most common uses are entirely inappropriate. Goldenseal is frequently combined with the herb echinacea to be taken as a "traditional immune booster" and "antibiotic" for the prevention and treatment of colds. However, as the noted herbalist Paul Bergner has pointed out, there are three things wrong with this packaging:

• There is no credible evidence that goldenseal increases immunity. Only one study weakly hints at an immune strengthening effect.¹⁹
• Colds are caused by viruses and don't respond to antibiotics, even if goldenseal were an effect systemic (whole body) antibiotic, which it almost certainly isn't.
• Goldenseal was never used traditionally for the common cold.

The other myth that has helped drive the sales of goldenseal is the widespread street belief that it can block a positive drug screen. The origin of this false idea dates back to a work of fiction published in 1900 by a pharmacist and author named John Uri Lloyd. In Stringtown on the Pike, a dead man is found to have traces of goldenseal in his stomach. In fact, he had taken goldenseal regularly as a digestive aid, but a toxicology expert mistakes the goldenseal for strychnine, and deduces intentional murder.

This work of fiction sufficed to create a folkloric connection between goldenseal and drug testing. Although the goldenseal in the story actually made a drug test come out falsely positive, this has been turned around to become a belief that goldenseal can make urine drug screens come out negative. A word to the wise: it doesn't work.

Dosage

When used as a topical treatment for minor skin wounds, a sufficient quantity of goldenseal cream, ointment, or powder should be applied to cover the wound. Make sure to clean the wound at least once a day to prevent goldenseal particles from being trapped in the healing tissues.

For mouth sores and sore throats, goldenseal tincture is swished or gargled. Goldenseal may also be used as strong tea for this purpose, made by boiling 0.5 to 1 g in a cup of water. The herb has a bitter taste. Goldenseal tea is also used as a douche for vaginal yeast infections.

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).²⁰

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.^5,7,8 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.⁶

Some evidence suggests that goldenseal might interact with various medications by altering the way they are metabolized in the liver.^9,23 One study found that berberine impairs metabolism of the drug cyclosporine, thereby raising its levels.²² This could potentially cause toxicity. It is important, therefore, to speak with a physician before taking goldenseal with other medications.

What Is Goldenseal Used for Today?

Goldenseal contains a substance called berberine that has been found to inhibit or kill many microorganisms, including fungi, protozoa and bacteria.^1,2,10-14,22 On this basis, contemporary herbalists often use goldenseal as a topical antibiotic for skin wounds, as well as to treat viral mouth sores and superficial fungal infections, such as athlete’s foot. However, there is no direct scientific evidence that goldenseal is effective for any of these purposes.

Note that goldenseal probably is not likely to work as an oral antibiotic, because the blood levels of berberine that can be achieved by taking goldenseal orally are far too low to matter.³ However, goldenseal could theoretically be beneficial in treating sore throats and diseases of the digestive tract (such as infectious diarrhea) because it can contact the affected area directly. Similarly, since berberine is concentrated in the bladder, goldenseal could be useful for bladder infections. Nonetheless, again there is as yet no direct evidence that goldenseal is effective for any of these uses.

Extremely weak evidence (far too weak to rely upon at all) suggests that goldenseal or berberine may be helpful for various heart related conditions, including arrhythmias, congestive heart failure, high cholesterol, diabetes, and high blood pressure.^15,16,21,24 Similarly, infinitesimal evidence hints that goldenseal could be helpful for conditions in which spasms of smooth muscle play a role, such as dyspepsia (nonspecific stomach distress) and irritable bowel syndrome, as well as various forms of pain caused by inflammation.^17,18

Ironically, goldenseal’s most common uses are entirely inappropriate. Goldenseal is frequently combined with the herb echinacea to be taken as a "traditional immune booster" and "antibiotic" for the prevention and treatment of colds. However, as the noted herbalist Paul Bergner has pointed out, there are three things wrong with this packaging:

• There is no credible evidence that goldenseal increases immunity. Only one study weakly hints at an immune strengthening effect.¹⁹
• Colds are caused by viruses and don't respond to antibiotics, even if goldenseal were an effect systemic (whole body) antibiotic, which it almost certainly isn't.
• Goldenseal was never used traditionally for the common cold.

The other myth that has helped drive the sales of goldenseal is the widespread street belief that it can block a positive drug screen. The origin of this false idea dates back to a work of fiction published in 1900 by a pharmacist and author named John Uri Lloyd. In Stringtown on the Pike, a dead man is found to have traces of goldenseal in his stomach. In fact, he had taken goldenseal regularly as a digestive aid, but a toxicology expert mistakes the goldenseal for strychnine, and deduces intentional murder.

This work of fiction sufficed to create a folkloric connection between goldenseal and drug testing. Although the goldenseal in the story actually made a drug test come out falsely positive, this has been turned around to become a belief that goldenseal can make urine drug screens come out negative. A word to the wise: it doesn't work.

Dosage

When used as a topical treatment for minor skin wounds, a sufficient quantity of goldenseal cream, ointment, or powder should be applied to cover the wound. Make sure to clean the wound at least once a day to prevent goldenseal particles from being trapped in the healing tissues.

For mouth sores and sore throats, goldenseal tincture is swished or gargled. Goldenseal may also be used as strong tea for this purpose, made by boiling 0.5 to 1 g in a cup of water. The herb has a bitter taste. Goldenseal tea is also used as a douche for vaginal yeast infections.

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).²⁰

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.^5,7,8 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.⁶

Some evidence suggests that goldenseal might interact with various medications by altering the way they are metabolized in the liver.^9,23 One study found that berberine impairs metabolism of the drug cyclosporine, thereby raising its levels.²² This could potentially cause toxicity. It is important, therefore, to speak with a physician before taking goldenseal with other medications.