The root and stem bark contain the medicinally active components of barberry. The barberry bush also produces small red berries. Although this particular species is native to Europe, it now also grows throughout North America. A closely related species, Oregon grape(Berberis aquifolium), is native to North America.
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3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
This supplement has been used in connection with the following health conditions:
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Berberine is an alkaloid found in various plants, including goldenseal, barberry, Oregon grape, and goldthread. Berberine exhibits a broad spectrum of antibiotic and antifungal activity in test tube, animal, and human studies.2, 3 Berberine has shown effective antidiarrheal activity in a number of diarrheal diseases,4, 5, 6 and it may offer the same type of relief for the diarrhea seen in patients with chronic candidiasis. Doctors familiar with the use of berberine-containing herbs sometimes recommend taking 2 to 4 grams of the dried root (or bark) or 250 to 500 mg of an herbal extract three times a day. While isolated berberine has been studied, none of these herbs has been studied in humans with chronic candidiasis.
Refer to label instructions
Due to of its supposed antimicrobial activity, goldenseal has a long history of use for infectious diarrhea. Its major alkaloid, berberine (also found in barberry and Oregon grape), has been shown to improve infectious diarrhea in some double-blind trials.7 Negative studies have generally focused on people with cholera, while positive studies investigated viral diarrhea or diarrhea due to strains of E. coli. These studies generally used 400–500 mg berberine one to three times per day. Because of the low amount of berberine in most goldenseal products, it is unclear how effective the whole root or root extracts would be in treating diarrhea.
Indigestion, Heartburn, and Low Stomach Acidity
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Bitter herbs are thought to stimulate digestive function by increasing saliva production and promoting both stomach acid and digestive enzyme production.8 As a result, they are particularly used when there is low stomach acid but not in heartburn (where too much stomach acid could initially exacerbate the situation). These herbs literally taste bitter. Some examples of bitter herbs include greater celandine, wormwood, gentian,dandelion, blessed thistle, yarrow, devil’s claw, bitter orange, bitter melon, juniper, andrographis, prickly ash, and centaury.9. Bitters are generally taken either by mixing 1–3 ml tincture into water and sipping slowly 10–30 minutes before eating, or by making tea, which is also sipped slowly before eating.
Some bitters widely used in traditional medicine in North America include yarrow, yellow dock, goldenseal, Oregon grape, and vervain. Oregon grape’s European cousin barberry has also traditionally been used as a bitter. Animal studies indicate that yarrow, barberry, and Oregon grape, in addition to stimulating digestion like other bitters, may relieve spasms in the intestinal tract.10
Berberine is derived from several plants, including barberry, Oregon grape, goldenseal, and goldthread (Coptis chinensis). Preliminary trials have shown that berberine can be used successfully to treat giardia infections.11, 12 In addition, test tube studies show that berberine kills amoebae, although it is not known whether this effect occurs in humans.13 The amount required is approximately 200 mg three times per day for an adult—a level high enough to potentially cause side effects. Therefore, berberine should not be used without consulting a healthcare provider.
Refer to label instructions
An ointment containing Oregon grape (10% concentration) has been shown in a clinical trial to be mildly effective against moderate psoriasis but not more severe cases.14 Whole Oregon grape extracts were shown in one laboratory study to reduce inflammation often associated with psoriasis.15 In this study, isolated alkaloids from Oregon grape did not have this effect. This suggests that there are other active ingredients besides alkaloids in Oregon grape. Barberry, which is very similar to Oregon grape, is believed to have similar effects. An ointment, 10% of which contains Oregon grape or barberry extract, can be applied topically three times per day.
Refer to label instructions
Teas of goldenseal, barberry, and echinacea are also sometimes used to treat infectious vaginitis. Although all three plants are known to be antibacterial in the test tube, the effectiveness of these herbs against vaginal infections has not been tested in humans. The usual approach is to douche with one of these teas twice each day, using 1–2 tablespoons (15–30 grams) of herb per pint of water. One to two pints (500–1,000 ml) are usually enough for each douching session. Echinacea is also known to improve immune function in humans.16 In order to increase resistance against infection, many doctors recommend oral use of the tincture or alcohol-preserved fresh juice of echinacea (1 teaspoon (5 ml) three or more times per day)—during all types of infection—to improve resistance.
Traditional Use (May Not Be Supported by Scientific Studies)
Traditionally, in European and American herbalism, barberry was used to treat a large number of conditions, particularly infections and stomach problems.1 It has also been used internally to treat skin conditions.
How It Works
How It Works
The alkaloid, berberine, receives the most research and widest acclaim as the active component of barberry and its relatives. Berberine is also a key constituent of goldenseal(Hydrastis canadensis). Berberine and its related constituents (such as oxyacanthine) are antibacterial17 and have been shown to kill amoebae in a test tube study.18 Berberine inhibits bacteria from attaching to human cells, which helps prevent infection.19 This compound treats diarrhea caused by bacteria, such as E. coli.20 Berberine also stimulates some immune system cells to function better.21 Berbamine is another alkaloid found in barberry. It may help reduce inflammation22 and is an antioxidant.23
The bitter compounds in barberry, including the alkaloids mentioned above, stimulate digestive function following meals.
How to Use It
For digestive conditions, barberry is often combined with other bitter herbs, such as gentian, in tincture form. Such mixtures are taken 15 to 20 minutes before a meal, usually 2–5 ml each time. As a tincture, 2–3 ml of barberry can be taken three times per day. Standardized extracts containing 5–10% alkaloids, with a total of approximately 500 mg of berberine taken each day, are preferable for preventing infections. Standardized extracts of goldenseal are a more common source of berberine, since goldenseal contains a higher concentration of berberine than barberry. An ointment made from a 10% extract of barberry can be applied topically three times per day for psoriasis. A tea/infusion can be prepared using 2 grams of the herb in a cup of boiling water. This can be repeated two to three times daily.24
Interactions with Supplements, Foods, & Other Compounds
At the time of writing, there were no well-known supplement or food interactions with this supplement.
Berberine, a chemical extracted from goldenseal(Hydrastis canadensis),barberry(Berberis vulgaris), and Oregon grape(Berberis aquifolium), has been shown to have antibacterial activity. One double-blind study found that giving 100 mg of berberine at the same time as 500 mg of tetracycline four times daily led to a reduction of the efficacy of tetracycline in people with cholera.25 Berberine may have decreased the absorption of tetracycline in this study. Another double-blind trial did not find that berberine interfered with tetracycline in cholera patients.26 Until more studies are completed to clarify this issue, berberine-containing herbs should not be taken simultaneously with tetracycline.
Berberine is a chemical extracted from goldenseal(Hydrastis canadensis),barberry(Berberis vulgaris), and Oregon grape(Berberis aquifolium), which has antibacterial activity. However, one double-blind study found that 100 mg berberine given with tetracycline (a drug closely related to doxycycline) reduced the efficacy of tetracycline in people with cholera.27 In that trial, berberine may have decreased tetracycline absorption. Another double-blind trial found that berberine neither improved nor interfered with tetracycline effectiveness in cholera patients.28 Therefore, it remains unclear whether a significant interaction between berberine-containing herbs and doxycycline and related drugs exists.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.
Berberine has been reported to interfere with normal liver function in infants, raising a concern that it might worsen jaundice.29 For this reason, berberine-containing plants, including barberry, goldenseal, and Oregon grape should be used with caution during pregnancy and breast-feeding. Strong standardized extracts may cause stomach upset and should be used for no more than two weeks continuously. Other symptoms of excessive berberine intake include lethargy, nose bleed, skin and eye irritation, and kidney irritation.30
9. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 425–6.
10. Tewari JP, Srivastava MC, Bajpai JL. Pharmacologic studies of Achillea millefolium Linn. Indian J Med Sci 1994;28(8):331–6.
11. Gupte S. Use of berberine in treatment of giardiasis. Am J Dis Child 1975;129:866.
12. Choudhry VP, Sabir M, Bhide VN. Berberine in giardiasis. Indian Pediatr 1972;9:143–6.
13. Kaneda Y, Torii M, Tanaka T, Aikawa M. In vitro effects of berberine sulphate on the growth and structure of Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis. Ann Trop Med Parasitol 1991;85:417–25.
14. Wiesenauer M, Lüdtke R. Mahonia aquifolium in patients with psoriasis vulgaris—an intraindividual study. Phytomed 1996;3:231–5.
15. Galle K, Müller-Jakic B, Proebstle A, et al. Analytical and pharmacological studies on Mahonia aquifolium.Phytomed 1994;1:59–62.
16. Melchart D, Linde K, Worku F, et al. Immunomodulation with Echinacea—a systematic review of controlled clinical trials. Phytomedicine 1994;1:245–54.
17. Amin AH, Subbaiah TV, Abbasi KM. Berberine sulfate: Antimicrobial activity, bioassay and mode of action. Can J Microbiol 1969;15:1067–76.
18. Subbaiah TV, Amin AH. Effect of berberine sulphate on Entamoeba histolytica. Nature 1967;215:527–8.
19. Sun D, Courtney HS, Beachey EH. Berberine sulfate blocks adherence of Streptococcus pyogenes to epithelial cells, fibronectin, and hexadecane. Antimicrob Agents Chemother 1988;32:1370–4.
20. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae.J Infect Dis 1987;155:979–84.
21. Kumazawa Y, Itagaki A, Fukumoto M, et al. Activation of peritoneal macrophages by berberine-type alkaloids in terms of induction of cytostatic activity. Int J Immunopharmacol 1984;6:587–92.
22. Wong CW, Seow WK, O’Callaghan JW, Thong YH. Comparative effects of tetrandrine and berbamine on subcutaneous air pouch inflammation induced by interleukin-1, tumour necrosis factor and platelet-activating factor. Agents Actions 1992;36:112–8.
23. Ju HS, Li XJ, Zhao BL, et al. Scavenging effect of berbamine on active oxygen radicals in phorbol ester-stimulated human polymorphonuclear leukocytes. Biochem Pharmacol 1990;39:1673–8.
24. Gruenwald J, Brendler T, Jaenicke C, et al. (eds). PDR for Herbal Medicines. Montvale, NJ: Medical Economics, 1998, 688–90.
25. Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. Br Med J 1985;291:1601–5.
26. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis 1987;155:979–84.
27. Khin-Maung-U, Myo-Khin, Nyunt-Nyunt-Wai, et al. Clinical trial of berberine in acute watery diarrhoea. BMJ 1985;291:160–5.
28. Rabbani GH, Butler T, Knight J, et al. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis 1987;155:979–84.
29. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201–8.
30. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 309–10.
The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2014.
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