Is Goldenseal safe?
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Safety of Goldenseal (Hydrastis canadensis): A Comprehensive Review
Introduction to Goldenseal and Its Uses
Goldenseal (Hydrastis canadensis L.) is a medicinal plant traditionally used by Native Americans for various ailments, including digestive disorders, skin infections, and cancer. It has gained popularity as a dietary supplement in the USA and other regions due to its purported health benefits1. The primary bioactive component in goldenseal is berberine, which has demonstrated antimicrobial, anti-inflammatory, and neuroprotective properties1.
Potential Therapeutic Benefits
Goldenseal contains several alkaloids, including berberine, hydrastine, and canadine, which contribute to its therapeutic effects. Berberine, in particular, has shown promise in treating bacterial infections, reducing inflammation, and protecting against neurodegenerative diseases1. Despite these potential benefits, the concentration of berberine in goldenseal supplements is often too low to be therapeutically effective4.
Toxicological Concerns
Neurotoxicity, Hepatotoxicity, and Phototoxicity
While goldenseal has various health-promoting effects, some studies have raised concerns about its safety. There is evidence suggesting that goldenseal and its alkaloids may have neurotoxic, hepatotoxic, and phototoxic activities1. These findings highlight the need for more extensive clinical studies to confirm the safety of goldenseal supplements.
DNA Damage and Carcinogenicity
Research has shown that goldenseal can induce DNA damage, particularly through the action of berberine and palmatine, which inhibit topoisomerase II activity. This DNA damage has been linked to an increased risk of liver tumors in animal studies, suggesting a potential carcinogenic risk associated with goldenseal use7.
Reproductive Toxicity
Goldenseal has traditionally been contraindicated during pregnancy due to concerns about its safety. However, studies on rats have shown that goldenseal does not significantly increase the risk of fetal malformations or growth retardation when administered at doses much higher than those typically consumed by humans. These findings suggest that goldenseal may not be as harmful during pregnancy as previously thought, although further pharmacokinetic studies are needed to confirm this3.
Herb-Drug Interactions
Goldenseal has been shown to inhibit the activity of cytochrome P450 (CYP3A4), an enzyme involved in the metabolism of many prescription drugs. This inhibition can lead to increased toxicity of drugs metabolized by CYP3A4, posing a significant risk for herb-drug interactions4 6. Additionally, goldenseal interacts with ABCB1 transporters, which can affect the bioavailability of certain medications2.
Conclusion
While goldenseal has demonstrated various therapeutic benefits, its safety profile is concerning due to potential neurotoxic, hepatotoxic, and carcinogenic effects. The risk of herb-drug interactions further complicates its use, particularly for individuals taking prescription medications. More extensive clinical studies are needed to fully understand the safety and efficacy of goldenseal supplements. Until then, caution is advised when considering goldenseal for therapeutic use.
Sources and full results
Most relevant research papers on this topic
Goldenseal (Hydrastis canadensis L.) and its active constituents: a critical review of their efficacy and toxicological issues.
Goldenseal has health-promoting effects, but large randomized, double-blind clinical studies are needed to confirm its efficacy and safety.
Literature Review
Rigorous JournalUnlocking the Goldenseal Reveals the Complexities of Natural Product–Drug Interactions
Goldenseal has complex natural product-drug interactions, with potential for therapeutic use, but more diverse populations are needed for future studies.
A reproductive screening test of goldenseal.
Goldenseal at the prescribed human dose is unlikely to be unsafe for pregnancy, despite its cytotoxic effects in vitro.
Non-RCT
Animal StudyGoldenseal (Hydrastis canadensis): Is There Enough Scientific Evidence to Support Safety and Efficacy?
Goldenseal is not recommended for any therapeutic indication due to a lack of substantiating scientific and clinical data for safety and efficacy.
Chemical comparison of goldenseal (Hydrastis canadensis L.) root powder from three commercial suppliers.
Goldenseal root powder from three commercial suppliers contains the same alkaloids, but a single supplier's material may contain adulterants like palmatine, coptisine, and jatrorrhizine.
Supplementation With Goldenseal (Hydrastis canadensis), but not Kava Kava (Piper methysticum), Inhibits Human CYP3A Activity In Vivo
Goldenseal supplementation significantly inhibits human CYP3A activity, potentially causing significant herb-drug interactions when combined with CYP3A substrates.
RCTRigorous Journal
Highly CitedMechanism study of goldenseal-associated DNA damage
Goldenseal's alkaloid constituents berberine and palmatine may contribute to liver carcinogenicity by inhibiting Topo II, a key enzyme involved in DNA damage and genotoxicity.
In Vitro StudyGoldenseal-Mediated Inhibition of Intestinal Uptake Transporters Decreases Metformin Systemic Exposure in Mice
Goldenseal reduces metformin systemic exposure by inhibiting intestinal uptake transporters, potentially impacting patients taking both drugs.
Non-RCTAnimal StudyTHERAPEUTIC ASPECTS OF GOLDENSEAL
Goldenseal, commonly known as yellow puccoon has wide therapeutic activity. The bioactive components present are isoquinoline alkaloids, hydrastine, berberine and canadine. Berberine is used to treat heart failure also have sedative actions, anti secretory, anti parasitic, anticancerous actions. Hence an attempt was taken to review the pharmacological actions of Goldenseal with respect to its role in dental practice.
Photochemistry and photocytotoxicity of alkaloids from Goldenseal (Hydrastis canadensis L.). 2. Palmatine, hydrastine, canadine, and hydrastinine.
Goldenseal's phototoxicity is likely due to berberine, not the minor alkaloids hydrastine, hydrastinine, or canadine, as they are present in small amounts in root powder.
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