Better understanding the relationship between plant specialized metabolism and human traditional medicinal use has great potential in aiding bioprospecting and untangling cross-cultural patterns of plant use. However, given the limited information available for specialized metabolites in most plant species, and specific bioactivity for most metabolites, the ability to associate a medicinal use and a metabolite is limited. The order Caryophyllales has a unique pattern of tyrosine- or phenylalanine-dominant specialized metabolism, represented by the mutually exclusive anthocyanin and betalain pigments, making the group ideal to work around the lack of specific metabolite knowledge. In this study, we compiled a list of medicinal species in selected tyrosine- or phenylalanine-dominant families of Caryophyllales, and tested for over- and underrepresented medicinal uses in a clade using a “hot nodes" approach. We hypothesized that families with a Tyr-enriched metabolism type would see different types of medicinal use compared to the ancestral Phe-enriched metabolism. Instead, the same clades are overrepresented across types of medicinal use. To further explore this pattern, we used species occurrence records and compared medicinal clades to those with less medicinal use to see how geographic range and availability to humans may have driven species selection for medicinal use.