Goldenseal (Hydrastis canadensis)

Side effects: Goldenseal tea and tincture are very bitter, and the disagreeable taste can cause nausea.

Adverse events: Reportedly, high doses of berberine (>500mg- corresponding to 8-100g of dried goldenseal root, depending on the amount of berberine) can cause stomach upset, nausea, vomiting, nervousness, depression, dyspnea, bradycardia, cardiac damage, hypotension, seizures, paralysis, spasms, and death. High doses of hydrastine can cause exaggerated reflexes, convulsions, paralysis, and respiratory failure.(²) If overdose occurs, induce vomiting and intestinal emptying, instill activated charcoal, and keep the patient quiet and warm. Use diazepam for spasms and correct acidosis with NaHCo3 and plasma to expand volume as necessary.(23)

Irritation of the mouth has occurred with the fresh plant and vaginal ulcers have occurred with use as a douche.(2)

Precautions/contraindications: Pregnant women, nursing mothers, and jaundiced infants should not take goldenseal.(4)

nteractions with disease states: Patients with acute gastrointestinal inflammation should avid goldenseal.⁽²²⁾

Any herb with purported immunostimulating effects should be avoided by those with any autoimmune or proinflammatory disorder, including rheumatoid arthritis and asthma.

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