Hydrasis: Goldenseal substitutes
by Paul Bergner
Medical Herbalism 01-31-97 8(4): 6-12
Most of the research that is popularly attributed to goldenseal has actually been into its constituent berberine. A number of other plants contain berberine in medicinal quantities. One of them, coptis (See MH, Summer 1996, volume 8, number 2) actually contains more berberine than goldenseal. The accompanying Table 1 shows the situations where they can best be used in place of goldenseal. All these plants, like goldenseal, have a characteristic bitter flavor, and may be used as bitter tonics. Don’t take berberine-containing plants during pregnancy. This caution applies to most plants containing alkaloids, including tobacco and coffee.
Rumors are circulating in scientific and regulatory circles that berberine may be toxic. In 1996, the committee of the European Union that regulates drugs placed Barberry (Berberis vulgaris) in a table of Herbal Drugs with Serious Risks without any Accepted Benefit because it contains berberine. This recommendation is so out of line with the long traditional use of barberry and other berberine-containing herbs that it must be taken with a grain of salt. The “serious risks” may refer to animal trials or human incidents using large amounts of isolated berberine. The lack of “accepted benefit” may be simply because these plants have not been studied in formal clinical trials, as is common with most medicinal plants.
I was able to find only a single report of potential adverse effects of berberis species, berberine-containing plants, or berberine itself in a computer search of the MEDLINE and TOXLINE databases of the U.S. National Library of Medicine. This was a study in China that showed that berberine sulfate is inappropriate for the treatment of newborn infants with prenatal jaundice (Chan 1993). I assume this is not a risk for the general public or for contemporary herbalists or general practice physicians, because such an infant will be hospitalized in this country. It does support traditional cautions about using berberine-containing plants in pregnancy.
In a recent review of potentially
hepatotoxic herbs, two French physicians state only that barberry has
been “suggested” as potentially hepatotoxic, with no specific clinical
evidence. He cites Vulto and De Smet (1988) as a source, but states
that no case has been confirmed, and that the problem, if there is one,
is rare (Larrey and Pageaux 1995). Another trial showed that a berberis
species from India protected the liver from damage by the drug
acetaminophen (Gilani and Janbaz 1992).
Barberry (Berberis vulgaris)
This quote at the beginning of this article doesn’t come from a modern-day herb conservationist, but from Dr. Harvey Felter in 1922. In his time, goldenseal had already become scarce due to overharvesting in areas of the country. The situation now, seventy five years later, is much worse, and barberry, as a substitute is just as effective. The table below shows some traditional uses of barberry. A tincture is usually taken. For external applications, sores in the mouth, or eye problems, make a tea, and, in the case of the eyes, dilute it (20 drops of the tea in a pint of water.). Contemporary researchers have used berberine successfully to treat eye infections. According to Felter, who was familiar with such treatments, barberry is more effective for this than the isolated berberine alkaloid (Felter and Lloyd 1898). Table [format table]
Traditional uses of barberry
Indigestion Chronic diarrhea
Laxative Eye problems
Mouth sores, ulcers Fevers
Oregon grape root (Mahonia aquifolium, Berberis aquifolium)
Ellingwood classifies Oregon grape not as a goldenseal substitute, but as an echinacea substitute. He calls it an antiseptic alternative. Historically it has been used, like echinacea, for “bad blood,” although it does not have the high reputation that echinacea does for this. It is probably not an immune-stimulant. Felter, on the other hand, did consider it a goldenseal substitute and said of it:
Like goldenseal, Berberis aquifolium is an excellent peptic bitter and tonic to the gastric function, and is, therefore, a drug of much value in atonic dyspepsia, with hepatic torpor. Upon the mucosa its effects are like those of goldenseal, controlling catarrhal outpouring and erosion of tissue.
His older medical terminology may be
translated to say that Oregon grape is effective in digestive
complaints that require a bitter tonic, sluggish liver complaints, and
chronic mucous membrane problems. If we put these two doctors’ opinions
together, Oregon grape alone could take the place of the
echinacea-goldenseal preparations so common now in health food stores.
Oregon grape is especially famous as a treatment for chronic skin
Table: Species and common names of Oregon grape Species:
Mahonia (Berberis) aquifolium
Yerba de Sangre
(Source: Moore 1993)
An herbalist’s testimony
Northwest herbalist Howie Brounstein has used Oregon grape as a substitute for echinacea and goldenseal, and his experience verifies the opinion of the Eclectic physicians that it is a worthy replacement for either. He has used it for intestinal and other bacterial infections for more than ten years. He considers it in cases that might otherwise call for a broad-spectrum antibiotic, although he does not consider Oregon grape to be an antibiotic itself. Brounstein uses internal doses of the tincture in doses of forty-five to sixty drops three or four times a day. If it is going to work, he says, there should be marked improvement within twenty-four hours. His observations are recorded as follows:
Antibiotic resistant ear infections Every case I have treated has cleared up. I usually add mullein flower oil externally to the ear.
Bacterial infection moving inward Excellent results
Colds Much better than Echinacea for the common cold. If echinacea is the light cavalry, Berberis is the heavy artillery.
Bronchitis Good results
Bladder infections Mixed results, I generally use other herbs first and move to Berberis in more stubborn cases.
This plant contains a number of alkaloids besides the more famous berberine. These alkaloids, some of which are found in other berberine-containing plants, may contribute to the sort of broad-spectrum effects that Brounstein notes.
Alkaloids in the various species of Oregon grape root:
Berberine, magnoflorine berbamine, jatrorrhizine canadine, oxycanthine mahonine, oxyberberine
Yerba Mansa (Anemopsis californica)
Yerba Mansa is a traditional Southwest herb which is growing in popularity as a goldenseal substitute, primarily on the authority and advice of Southwest herbalist Michael Moore (Moore 1989). It is one of the most-often prescribed herbs at our clinic in Boulder, Colorado. Moore, is well-known not only for his scholarship of the herbal scientific literature, but for knowledge of traditional plant use and hands-on knowledge the plants he writes about. His three volumes are among the most important herbal texts in American history. He didn’t come up with the idea of using yerba mansa as a goldenseal substitute out of thin air. You may not have heard of this herb, but don’t underrate it because it is not as famous as goldenseal. To the traditional residents of the desert areas where it grows, local residents consider it among the “royalty” of the local herbs.
Yerba mansa is very different from goldenseal. It contains no berberine or other related alkaloids, and it not a bitter tonic. It is hot and acrid, with a warming sensation, and is astringent. It may replace goldenseal as a mucous membrane tonic, when bitter tonics are contraindicated and the membranes are congested.
The Eclectics were aware of its
properties, but generally only those in the Western states used it
extensively. It was introduced into Eclectic use by Dr. W.H. George of
California in 1877 — about the same time as echinacea — and remained in
use by that profession until its decline in the 1930s. The homeopathic
school also used it (Boericke 1927). The chief Eclectic indication was
as a mucous membrane remedy, when there is full stuffy sensation in the
head and throat, cough with expectoration, or mucous discharges from
the bowels or urinary tract.
The eclectic uses of yerba mansa:
mucous membrane tonic
urinary organ tonic
Don’t throw out the goldenseal
The above herbs all either contain constituents in common with goldenseal, or have been used for similar conditions. The Eclectics described several of them as goldenseal substitutes more than seventy-five years ago. I don’t personally use them in the place of goldenseal in all conditions, however.
Try this experiment: Take some goldenseal and several of its substitutes: I’ve done this with barberry, Oregon grape root, and yerba mansa, and various mixtures of them, as tinctures. Take a dose, say a dropper-full of the tincture or the powdered herb in a little water, and hold it in your mouth. When I take the goldenseal, within a minute I can feel secretions moving in my nasal mucous membranes. In a short time, I can feel stimulation in my intestines and urinary tract membranes. I’ve never felt this with the goldenseal substitutes, although a combination of Oregon grape root and yerba mansa comes closest. The goldenseal does not have to come in contact with these membranes to have the effect.
For this reason, I still use
goldenseal in conditions where a cold, flu, or bronchitis seems to be
going deeper into the system, or becoming complicated by a bacterial
infection. In one case, a client with a chronic dry bronchitis had been
coughing up only slight amounts of clear phlegm for several weeks. Then
the discharges turned to yellow and green — a sign of the onset of
bacterial infection and the threat of pneumonia. A combination of
goldenseal and echinacea returned the phlegm to its normal clear color
within twelve hours. Goldenseal is simply the most effective and
fastest remedy for such a condition. I’ve consulted with two herbalists
who were suffering from a similar condition four or five days into a
cold. Each of these Southwest herbalists had tried yerba mansa for the
condition, without noticeable effect. When they used goldenseal, the
got rapid results.
Boericke, W. Pocket Manual of Homeopathic Materia Medica New Delhi: Jain Publishers, 1922. Reprint edition, 1984
Chan, E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63(4):201-8
Felter H.W. and Lloyd J.U. King’s American Dispensatory Cincinnati, Ohio, 1898. Reprinted 1983. Portland, Oregon: Eclectic Medical Publications
Felter, H.W. The Eclectic Materia Medica, Pharmacology, and Therapeutics. Cincinnati, Ohio, 1922. Reprinted 1985. Portland, Oregon: Eclectic Medical Publications
Gilani A.H. and Janbaz K.H. Prevention of acetaminophen-induced liver damage by Berberis aristata leaves. Biochem Soc Trans; 1992;20(4):347
Larrey, D. and Pageaux, G.P. Herbs and mushrooms that are toxic to the liver Seminars in Liver Disease 1995;15(3)183-188
Moore, M. Medicinal Plants of the Desert and Canyon West, Santa Fe: Museum of New Mexico Press, 1989
Moore, M. Medicinal Plants of the Pacific West Santa Fe: Red Crane Books, 1993
Vulto A.G. and De Smet P.A.G.M. Drugs
used in non-orthodox medicine. In: Dukes, M.G.N. Meyler’s side effects
of drugs 11th ed. Amsterdam: Elsevier, 1988