Contraindicated in pregnancy and lactation.
In addition to the preceding concerns about bilirubin, berberine has caused uterine contractions in pregnant and non-pregnant experimental models. A recent in vivo study using 65-fold the average human oral dose of goldenseal investigated effects on gestation and birth and found no increase in implantation loss or malformation. The authors conclude that the low bioavailability of goldenseal from the gastrointestinal tract was likely to explain the differences between in vitro and in vivo effects in pregnancy. Hydrastine (0.5 g) has also been found to induce labour in pregnant women. Until more pharmacokinetic studies are done, goldenseal is best avoided in pregnancy.
Practice Points / Patient Counselling
• Goldenseal has been used traditionally as an antidiarrheal agent and digestive stimulant.
• It has been used topically as a wash for sore or infected eyes and as a mouth rinse.
• Goldenseal is a bitter digestive stimulant that improves bile flow and improves liver function.
• Most clinical evidence has been conducted using the chemical constituent berberine. This data has shown effectiveness against diarrhea, congestive heart failure, infection and cholesterol.
• Goldenseal is not to be used in pregnancy or during breastfeeding.
• Use with caution in patients who have hypertension or taking cyclosporin.
Answers to Patients’ Frequently Asked Questions
What will this herb do for me?
Goldenseal may be used in the treatment of diarrhea, dyspepsia, infection, diabetes and cholesterol. Most of the available research has been done on the alkaloid berberine. More clinical trials of the whole extract are needed to determine if the same effect will be seen.
When will it start to work?
Antibacterial and antidiarrheal activity should be apparent quite quickly. The lipid-lowering effects of goldenseal have been reported within 12 weeks.
Are there any safety issues?
The herb should not be taken during pregnancy or lactation and may interact with some medications.