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Hydrasis: Goldenseal substitutes

by Paul Bergner

Medical Herbalism 01-31-97 8(4): 6-12

Berberine-containing herbs

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.

Potential toxicity

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]

Table 1

Traditional uses of barberry

Blood purifier

Indigestion Chronic diarrhea

Jaundice Dysentery

Laxative Eye problems

Mouth sores, ulcers Fevers

Bitter tonic

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.

(Felter 1922)

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 conditions.

Table: Species and common names of Oregon grape Species:

    Mahonia (Berberis) aquifolium

    M. Nervosa

    M. Repens

    M. Pinnata.

Common names

    Barberry

    Creeping barberry

    Mahonia

    Mountain holly

    Odostemon

    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

Abscessed tooth                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:

diarrhea

dysentery

intestinal tonic

mucous membrane tonic

nasal catarrh

respiratory tonic

skin ulcers

tuberculosis

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.

References

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
 

Copyright 2001 Paul Bergner