Berberine is an active compound in a variety of plants that are used in traditional medicine. People claim it’s beneficial for diabetes, high cholesterol, and parasite infections. Check out this post to learn which of its purported benefits are supported by science.
What is Berberine?
Where Does it Come From and How is it Used?
Berberine is a compound found in several different plants, including Barberry (Berberis vulgaris), Oregon Grape (Mahonia aquifolium), Goldenseal (Hydrastis canadensis), and Chinese goldthread (Coptis chinensis). It has a 3000-year history of use in traditional Chinese and Indian medicine [1, 1].
Berberine has been studied for heart failure, diarrhea, infections, and other health conditions. But according to the National Center for Complementary and Integrative Health (NCCIH), very little berberine is absorbed when people take goldenseal orally (by mouth). Therefore, study results on berberine may not apply to goldenseal .
Berberine itself has many purported beneficial effects. It is often used for diabetes or cholesterol issues, and some evidence supports these uses. However, few quality, large-scale studies of berberine have been carried out so far.
Alleged Health Benefits of Berberine
Remember to speak with a doctor before taking berberine supplements. Berberine should never be used as a replacement for approved medical therapies.
1) Canker Sores
A topical application of Berberine gelatin (5 mg/g) reduced pain and ulcer size in 84 people with canker sores.
According to one meta-analysis, berberine may be beneficial in people with type 2 diabetes. However, the authors emphasized that the evidence is weak overall since the included trials were few, had low methodological quality, small sample size, and unidentified risks of bias .
In one study, berberine (0.5 g, 3x/day for 3 months) performed similarly to metformin (a diabetes medication). It reduced hemoglobin A1c (HbA1c) levels, fasting blood glucose, blood glucose following a meal, and triglycerides levels in 36 patients with type 2 diabetes .
In another study, 1 g/day berberine reduced fasting and post-meal blood glucose and HbA1c, triglyceride, total cholesterol, and LDL levels (116 patients with type 2 diabetes) .
Scientists have raised numerous hypotheses about the ways in which berberine may help with diabetes on a cellular level, including all the following:
- Directly increasing AMPK, which stimulates glucose uptake in muscle cells and helps balance high blood sugar (rat and cell studies) [9, 10, 11]
- Delay the breakdown of carbohydrates into simple sugars (rat study) 
- Enhancing glucagon secretion (rat study) 
- Mimics insulin action by increasing the ability of the body to take up glucose (cell study) 
- Decreasing glucose transport through the intestinal lining (cell study) 
- Increasing adiponectin, a protein which helps regulate blood sugar levels (through AMPK) (cell study) 
- Activating the blood sugar transport activity of glucose transporter 1 (GLUT1) (cell study) 
- Activating the fatty acid receptor GPR40 (cell study) 
- Protecting the beta-cells of the pancreas against cell death (cell study) 
- Inhibiting production of glucose in the liver (rat study) 
- Improving the gut microbiota (rat study) 
- Inhibiting NF-kappaB (NF-kB) (cell study) 
- Increasing insulin receptor expression (cell study) 
However, larger trials are needed to verify the effectiveness of berberine in people with type 2 diabetes.
3) High Cholesterol Levels
Both berberine and a multi-ingredient berberine supplement (berberine, policosanol, red yeast extract, folic acid, and astaxanthin) given daily for 4 weeks reduced total cholesterol, LDL, and triglycerides and increased HDL (40 subjects with moderate cholesterol issues) .
In another study with 32 patients with high cholesterol, berberine supplementation for 3 months greatly reduced cholesterol, triglycerides, and LDL-cholesterol .
A supplement containing berberine (500 mg berberine, 10 mg policosanol, 200 mg red yeast rice, 0.2 mg folic acid, 2.0 mg coenzyme Q10, and 0.5 mg astaxanthin) lowered total cholesterol, LDL, and insulin resistance but didn’t affect HDL levels (SB-RCT with 80 patients with cholesterol issues) [26, 27, 28].
This cholesterol-lowering effect was also investigated in mice .
Although plausible, the overall evidence for its beneficial effects on cholesterol is weak. Further large-scale studies are needed.
Based on lab experiments, scientists believe berberine might lower LDL via:
- Increasing activity at the LDL receptor in the liver .
- Reducing hepatocyte nuclear factor 1alpha .
- Inhibiting lipid synthesis through activation of AMPK .
4) High Blood Pressure
As An Add-On to Drug Therapy
According to a large meta-analysis of clinical research, berberine supplements in combination with conventional therapy (amlodipin) reduces systolic blood pressure after 2 months .
The combination lowered systolic blood pressure (upper reading) by 5 mmHg and diastolic blood pressure (lower reading) by 2 mmHg when compared to treatment with drug treatment alone .
For Other Heart-Related Problems
Despite some promising findings, evidence is lacking to support the use of berberine in people with heart disease. Large-scale clinical studies should be encouraged.
Berberine (1.2 – 2.0 g/day) combined with several conventional therapies increased the quality of life (exercise capacity and reduced fatigue) and decreased death rates (156 patients with chronic congestive heart failure) .
Berberine showed potential to improve aspects of cardiovascular health in rat studies. It was also researched for possibly protective effects on heart muscle cells injured by the return of blood flow after blood flow restriction (such as after a stroke) in rats [35, 36, 37].
Some evidence suggests that berberine may improve metabolic health in women with PCOS and insulin resistance.
In clinical trials, berberine taken for 3 months prior to ovarian stimulation for in vitro fertilization (IVF) reduced fasting blood sugar, insulin resistance, total cholesterol, LDL cholesterol, triglycerides, testosterone levels, and waist-to-hip ratio [38, 39].
However, it’s still uncertain whether berberine improves the chance of pregnancy in women with PCOS who are trying to conceive.
In one study, it was as effective as metformin but with fewer side effects. In another study, it didn’t improve outcomes when added to a new drug that stimulates ovulation (letrozole). Further research is needed to clarify these mixed findings [39, 40].
The following purported benefits are only supported by limited, low-quality clinical studies. There is insufficient evidence to support the use of berberine for any of the below-listed uses.
6) As a Weight Loss Supplement
Berberine is a popular weight-loss supplement, but evidence is lacking to support its weight-reducing effects.
Berberine inhibited the production of body fat cells through up-regulation of C/EBP inhibitors, CHOP and DEC2 (cell study) .
More research is needed.
7) Anti-Parasitic Potential
Berberine combined with malaria medication (pyrimethamine) was more effective against getting rid of the infection than other combinations of drugs (pyrimethamine and tetracycline or pyrimethamine and cotrimoxazole) (215 patients) .
The anti-parasitic effects of berberine are being researched in anaerobic protozoa (Giardia lamblia, Trichomonas vaginalis, and Entamoeba histolytica) as well as dog roundworm (Toxocara canis) in cell studies [45, 46, 47].
Much more research is needed.
Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts.
However, the studies listed below should not be interpreted as supportive of any health benefit.
No valid evidence supports the use of berberine for gut issues, inflammatory disorders, liver problems, learning difficulties, mood disorders, or any of the conditions listed in this section.
8) Gut Issues
Berberine-containing plants are traditionally used as anti-diarrhea agents in Chinese and Indian medicine.
Berberine was able to inhibit secretions of toxins produced by intestinal bacteria (E. coli and Vibrio cholerae) in animal models .
Some scientists believe berberine might reduce “leaky gut” (intestinal epithelial tight junction damage), based on research on a mouse model of endotoxemia .
It also preferentially increased short-chain fatty acid (SCFA) producing bacteria in rat guts. Its normalizing effect on gut bacteria was able to improve symptoms of fatty liver disease in mice, in another study [50, 51].
Berberine may have anti-inflammatory activity .
Inflammation of the blood vessels was improved by berberine .
It also reduced inflammation of the liver and of the fat tissues in an animal model of non-alcoholic fatty liver disease .
10) Learning & Memory
Researchers hypothesize that berberine may improve memory by:
- stimulating cholinergic enzyme activity and reducing inflammation .
- preventing the cell death of neurons with reduced blood flow (low oxygen) to the brain .
11) Liver Health
Berberine protected against toxin-induced liver damage in rats via antioxidant effects .
It also protected against infection-related liver damage in mice .
In rats with ulcerative colitis, berberine reduced inflammation but also killed the commensal (good) bacteria in the gut. In another study, berberine reduced inflammation in the gut of mice with colitis and intestinal damage [67, 68].
13) Diabetic Complications
15) Effect on Brain Cells
Berberine reduced brain cell death in rats that were given strokes via reduced blood flow to the brain .
In a cell study, berberine increased levels of enzymes associated with the regulation of inflammation of brain cells .
16) Mitochondrial Function
17) Research in Bacteria, Yeast & Viruses
Berberine was researched against the following microbes in a cell study :
Scientists are investigating whether berberine has any effect on cancer cells. No conclusions can be drawn from their findings. Many compounds seem to have “anti-cancer” effects in dished but fail to pass further animal or human studies due to a lack of efficacy or safety [84, 85, 86].
Berberine is being researched on the following types of cancer cells:
- Brain Cancer [87, 88].
- Breast Cancer [89, 90].
- Cervical Cancer [91, 92].
- Colon Cancer [93, 94].
- Liver Cancer [95, 96].
- Lymphoma .
- Oral Cancer [98, 99].
- Thyroid Cancer [100, 101].
Repeated doses of berberine inhibit cytochromes P450 in humans, altering the normal breakdown of drugs .
Mild adverse digestive effects were observed among a few subjects in studies, such as abdominal discomfort (nausea, distension, diarrhea) .
Several people commented that berberine supplementation helped them with their blood sugar levels. A few people commented that berberine is great.
One person lost a significant amount of weight from taking it but another user said there was no change in their weight.
One user said they didn’t see any changes in their health.
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Berberine is a compound found in many plants, including goldenseal and barberry. Although these plants have a long history of traditional use, their health benefits remain uncertain.
Modern science focused mostly on berberine as an isolated plant compound. Evidence suggests it may be beneficial for people with caker sores, type 2 diabetes, high cholesterol, high blood pressure, and PCOS.
All other purported health benefits and uses of berberine are still unproven.
Berberine is likely safe when used at the recommended doses, but mild digestive side effects are possible. Be sure to consult your doctor before supplementing.