Over the past 10 years, botanical dietary supplements containing goldenseal (Hydrastis canadensis) have become some of the best‐selling products on the American market. Traditionally used by Native Americans to treat digestive complaints, goldenseal is now recommended for the treatment of common cold, influenza, menstrual disorders, and traveler's diarrhea, as well as muscular pain. In spite of these claims, there is little scientific evidence to suggest that goldenseal is effective for the prevention or treatment of any ailment. While some published data suggest that berberine, one of the active chemical constituents of goldenseal, is of some benefit for the treatment of bacterially induced diarrhea, it is not as effective as some standard antibiotics. Furthermore, considering the low concentration of berberine in goldenseal extracts and the lack of quality control over botanical dietary supplements in general, the concentration of berberine in goldenseal extracts is too low to be therapeutically effective. The safety of extended use of goldenseal extracts is also questionable, as another chemical constituent of the plant, hydrastine, may cause hypertension, exaggerated reflexes, and respiratory failure if given in sufficient doses. Furthermore, extracts of goldenseal inhibit the activity of cytochrome P450 (CYP 3A4) in vitro, and, therefore, may increase the toxicity of concomitantly administered prescription drugs t metabolized by this enzyme. Thus, due to a lack of substantiating scientific and clinical data for either safety or efficacy, the use of goldenseal is not recommended for any therapeutic indication.