Berberine is a compound found in various plants that has been used in traditional medicine for many years. It was used in Ayurveda and other traditional medicine systems for its anti-inflammatory, antimicrobial, and fever-reducing properties, as well as for gut health and other uses.
Currently, berberine is often used to improve blood sugar levels and metabolic health, as well as for heart and liver function.
In this article, we’ll outline the potential health benefits of berberine, as well as the optimal dosage, safety considerations, and suggested usage.
Table of Contents
Overview
Berberine is a plant alkaloid found in the bark, leaves, twigs, roots, and other parts of various plants, including Oregon grape, goldenseal, barberry, and tree turmeric, among many others.
These plants can be found in many parts of the world, depending on the species, including North America and various parts in Asia, such as China, India, and the Middle-East.
As an alkaloid, berberine is naturally produced by plants to protect them from predators and to encourage growth. Human consumption of alkaloids can lead to various health benefits, mainly because these compounds have bioactive effects in the body. For example, these alkaloids can act as natural anti-inflammatories, pain relievers, and they also have effects in the central nervous system, gut, heart, and several other areas.
Health Benefits of Berberine:
Recent research has discovered many potential health benefits of berberine, especially those related to metabolic health. Listed below are the most well-supported health benefits of berberine.
1. May Improve Blood Sugar Levels
The most well-researched benefit of berberine is improved blood sugar levels and insulin sensitivity. This is evidenced by several clinical trials.
Based on current evidence, berberine likely improves blood sugar levels based on its ability to stimulate insulin release from the beta-cells in the pancreas. Importantly, this effect is only observed in people with high glucose levels, so it offers a very symptom-specific mechanism.
In a pilot clinical study on individuals with type 2 diabetes, researchers discovered that 1,500mg of berberine had a hypoglycemic (blood sugar-lowering) effect similar to metformin, which is a popular drug. Additionally, berberine improved insulin function as well as cholesterol and triglyceride levels.
In a clinical trial on individuals with type 2 diabetes and dyslipidemia, berberine led to marked reductions in glucose and HbA1C (a marker of blood sugar levels) compared to the control group. These individuals also experienced improvements in cholesterol levels compared to the placebo.
A clinical trial on individuals with type 2 diabetes showed that those who took 500mg of berberine twice daily for one month experienced much lower levels of fasting glucose, post-meal glucose, and fructosamine (which is used as an estimate of blood glucose in people with diabetes).
In a clinical study on individuals with metabolic syndrome, supplementing with berberine significantly reduced insulin and glucose levels, while also improving insulin sensitivity.
Lastly, a clinical trial on pre-diabetic individuals showed that berberine supplementation for 12 weeks led to improvements in fasting blood sugar, glucose tolerance, HbA1C, and insulin resistance compared to the control group. These all suggest the benefits of berberine on glycemic control.
Summary:
Clinical research indicates that berberine may improve blood sugar levels by lowering glucose and supporting insulin function.
2. May Improve Blood Lipids
Several studies also show that berberine improves blood lipid profiles, such as cholesterol and triglycerides.
This is likely due to a few mechanisms. For example, berberine seems to be able to improve LDL receptor function and activity, especially in liver cells. Second, berberine influences various enzymes that essentially lead to balanced cholesterol levels and decreased LDL concentrations.
In a clinical trial on patients with high cholesterol, researchers implemented berberine and simvastatin, either alone or in combination. They found that the combination of berberine and simvastatin had the greatest on lowering LDL cholesterol, total cholesterol and triglycerides. However, when comparing the two in isolation, berberine had a greater (23.8%) reduction in LDL compared to simvastatin (14.3%).
In a clinical trial on individuals with low cardiovascular risk, supplementing with 1,000mg of berberine (500mg 2x/day) led to notable reductions in low-density lipoprotein (LDL) cholesterol and total cholesterol, as well as an increase in high-density lipoprotein (HDL) cholesterol compared to the placebo group.
A clinical trial on patients with elevated cholesterol levels showed that berberine (500mg) was able to significantly reduce total cholesterol levels. When combined with bezafibrate (a lipid-lowering drug), berberine also markedly reduced triglycerides, LDL cholesterol, and very-low-density lipoprotein (VLDL).
One clinical study on individuals with type 2 diabetes and dyslipidemia revealed that berberine supplementation decreased total cholesterol, triglycerides, and LDL cholesterol levels.
Last, a clinical trial on type 2 diabetic patients showed that berberine decreased levels of 13 different free fatty acids. This is important because, when left unchecked at high levels, free fatty acids can increase the risk of obesity, insulin resistance, and type 2 diabetes.
Summary:
Clinical trials have also found that berberine may benefit blood lipid profiles by decreasing LDL cholesterol and increasing HDL cholesterol levels.
3. May Support Heart Health
Berberine also has several potential benefits for heart health. This is due to its effects on blood pressure, endothelial function, inflammation and a few other aspects of cardiovascular function.
In a clinical trial on patients with acute coronary syndrome, berberine alongside standard therapy led to greater reductions in inflammatory markers, such as C-reactive protein (C-RP) and interleukin-6 (IL-6) compared to standard therapy alone. This may help control inflammation in the vessel walls, which is in turn associated with a decrease in the risk of atherosclerosis and its associated heart problems.
In a clinical study on individuals with poor heart health, berberine coupled with conventional treatment led to a decrease in ventricular abnormalities, as well as improved heart function. Those who were given berberine also experienced improvements in exercise capacity and reduced fatigue.
A clinical trial also looked into the effects of berberine on the endothelium (a thin membrane that lines the heart and blood vessels) of healthy subjects. The researchers showed that berberine (at 1.2g/day) notably decreased circulating endothelial micro-particles, which are associated with endothelial dysfunction. Berberine also improved blood vessel dilation, which leads to decreased blood pressure and better blood flow.
In a clinical study on patients with severe congestive heart failure, researchers discovered that high-dose berberine infusions led to reductions in systemic vascular resistance, which is the resistance that must be overcome in order to properly circulate blood around the body. The researchers also noted improvement in a number of other markers of cardiac function and performance.
In a clinical trial on individuals who underwent coronary bypass surgery, researchers found that treatment with berberine reduced the rate of post-operative atrial fibrillation (a common complication) compared to the control group. Additionally, the patients who took berberine had lower levels of inflammatory markers. Also, they didn’t need to take as much amiodarone (an arrythmia-preventive medication) compared to the placebo.
Summary:
Clinical research has found that berberine may benefit heart health by reducing cardiac inflammation, increasing blood flow, and improving overall cardiovascular function.
4. May Benefit Non-Alcoholic Fatty Liver Disease
There are several clinical trials which show that berberine may reduce symptoms of non-alcoholic fatty liver disease (NAFLD), which is characterized by excess fat build-up in the liver.
Researchers believe that berberine has the ability to decrease fat formation in the liver, regulate fat metabolism, control glucose levels, and improve LDL receptor activity in liver cells .
In one clinical trial on patients with NAFLD, researchers administered either a lifestyle intervention alone or in combination with pioglitazone (an NAFLD medication) or berberine (500mg). Compared to lifestyle intervention alone, berberine alongside the lifestyle intervention led to a significant reduction in liver fat content. Plus, berberine was better than the medication at reducing body weight and improving lipid profiles.
In a clinical study on patients with NAFLD, berberine added to a lifestyle intervention for 16 weeks showed greater positive effects on fat and lipid metabolism compared to the lifestyle intervention alone. Additionally, the berberine group had markedly lower levels of ceramide and other lipid species that are indicative of NAFLD severity.
One clinical study analyzed the effects of dietary modification and tai chi exercise alone or in combination with either berberine or bicyclol (a drug typically for hepatitis). Berberine was shown to improve lipid profiles, liver function, and body composition, beyond what normally occurred in tai chi exercise and dietary modifications alone.
However, in another clinical trial on NAFLD patients, researchers discovered no significant differences between berberine and placebo on lipid levels, triglycerides, cholesterol, or liver enzymes. One possible reason for this lack of effectiveness is that the patients were merely recommended to also engage in a healthy lifestyle, as compared to the other studies which made sure that the patients carried out a specific lifestyle intervention.
This points to the importance of a healthy diet, exercise and lifestyle in managing chronic conditions.Supplementation certainly can help, but it is never ideal to solely rely on supplementation without addressing other prominent factors.
Summary:
Clinical studies indicate that berberine may benefit symptoms of non-alcoholic fatty liver disease. Additional human studies would be useful for further confirming this finding.
5. May Reduce Diarrhea & Other Gut Symptoms
There is some evidence that berberine may also reduce diarrhea and other unpleasant gut symptoms, especially ones associated with bacterial or viral infections.
In a clinical trial on patients with diarrhea-predominant irritable bowel syndrome (IBS-D), berberine (at 400mg 2x daily) led to a greater reduction in diarrhea frequency, abdominal pain frequency, and frequency of bathroom urges compared to the placebo. Additionally, berberine showed a trend towards improved quality of life, decreased depression and anxiety, and reduced IBS symptoms.
In a clinical trial on individuals with intestinal infection of Escherichia coli and Vibrio cholerae, the patients were given either berberine, a placebo, tetracycline, or berberine plus tetracycline. The researchers found that berberine alone led to significantly less stool volume as well as improved diarrhea remission rates compared to the control group. In the individuals with cholera infection, berberine plus tetracycline didn’t have any significant benefits over tetracycline alone. Overall, though, berberine still showed benefits against diarrhea.
In one clinical study on IBS-D patients, supplementation with berberine decreased a variety of common IBS-D symptoms, such as stomach pain, diarrhea frequency, and discomfort, compared to the control group.
Summary:
Clinical trials have found that berberine may work to benefit symptoms of diarrhea and irritable bowel syndrome.
6. May Help with Schizophrenia
Recent clinical research also shows that berberine may help improve symptoms of schizophrenia, which is a severe psychiatric condition characterized by many troubling symptoms, such as delusions, hallucinations, confused thoughts, and behavioral changes.
In particular, the anti-inflammatory effects of berberine seem to help combat brain inflammation and oxidative stress, which are often associated with an increased risk of schizophrenia, particularly in vulnerable individuals. There are other likely mechanisms, such as action on various neurotransmitters but more research is needed before definitive conclusions can be drawn.
In a clinical trial on patients with chronic schizophrenia, treatment with berberine for three months notably improved schizophrenia symptoms and cognitive function compared to the placebo. This included improvements in both positive symptoms (e.g. hallucinations and delusion) as well as negative symptoms (e.g. low motivation,). Additionally, the berberine group showed lower levels of inflammatory markers that are often related to schizophrenia, such as tumor necrosis factor-alpha and IL-6.
In a clinical study on schizophrenic patients, berberine supplementation (900mg for 8 weeks) notably reduced negative symptoms of schizophrenia, which include disinterest, lack of initiative, and trouble speaking. Furthermore, berberine led to lower levels of CRP, an inflammatory marker, compared to the control group.
However, in another clinical trial on patients with schizophrenia, those who took berberine alongside risperidone (a drug for schizophrenia) showed improvements in schizophrenia symptoms. However, these improvements were not significantly better than those who took risperidone alone. This is likely due to the fact that risperidone has more specific mechanisms related to the abnormalities seen in schizophrenia compared to berberine. Also, the dosage of berberine was on the lower end, so it’s possible that a higher amount may have led to more pronounced effects.
Summary:
Berberine may work to benefit cognition and symptoms of schizophrenia, but additional human clinical research is needed for verification of these findings.
7. May Improve Polycystic Ovary Syndrome
A number of clinical studies also show that berberine may improve polycystic ovary syndrome (PCOS) as well as some of its related symptoms and issues. PCOS is primarily a hormonal disorder that causes enlarged ovaries with cysts on the edges. Women with this condition may also have fertility issues and menstrual irregularities.
Researchers have discovered that berberine may improve PCOS mainly due to its ability to improve insulin function, which is critical since many women with PCOS have insulin resistance. Berberine may also help regulate testosterone, estrogen, and other hormones involved in PCOS.
In one clinical trial on women with PCOS and lack of ovulation, berberine helped some of the women regain regular menstrual cycle after four months. Ovulation rate also improved significantly. Additionally, berberine led to decreases in cholesterol, triglycerides, insulin resistance, and sex-hormone binding globulin.
In a clinical trial on PCOS patients, berberine alongside letrozole (a drug used to improve ovulation) improved the odds of conception, pregnancy, and live birth. However, these rates were lower in berberine alone. Thus, from this study, berberine didn’t seem to have any added benefits.
In a clinical trial on women with PCOS undergoing in vitro fertilization (IVF) therapy, patients received either berberine, metformin, or a placebo. Berberine and metformin offered significant benefits for women’s hormonal levels and also decreased insulin resistance and fasting insulin compared to the placebo. And while they both also improved pregnancy rates, berberine was associated with a higher birth rate and greater improvements in metabolic factors, as well as fewer gastrointestinal side effects.
A clinical study on PCOS patients compared the effects of either berberine, metformin, or myoinositol on various metabolic, hormonal, and clinical factors. The researchers found that berberine had the greatest improvements in hormonal function and lipid parameters. Berberine also significantly decreased blood sugar levels and improved insulin function.
Summary:
Clinical trials indicate that berberine may help improve PCOS by balancing hormone levels and improving insulin function. More clinical studies would be beneficial in further confirming these findings.
Berberine Safety:
In general, research shows that berberine is safe and well-tolerated, with few adverse effects reported in the literature.
Some people may experience mild side effects, such as nausea, constipation, stomach pain, and other gastrointestinal side effects. The risk of these effects increases as one increases the dosage, so it’s recommended to stay within the normal amounts.
Also, due to the blood sugar-lowering and lipid-lowering effects of berberine, it should be used with caution in people already taking medications for those purposes. Although it seems to be fine even for people taking these medications as long as the dose isn’t too high.
As always, we recommend speaking to your doctor before taking berberine, especially if you have chronic medical conditions and/or take prescription drugs.
Dosage:
Clinical research indicates that an effective dosage is anywhere from 500mg to 2.7g per day. For most purposes, sticking to a range of 500mg to 2g seems sufficient and effective.
It is important to not go above the maximum dose as this increases the risk of side effects. When staying within this range, the chance of side effects is low.
Also, if one is taking medications for blood sugar, it seems that berberine can still be used concurrently as long as it is used at a dose of 600mg or lower.
History & Traditional Use:
Berberine has a long history of use in Ayurveda, Traditional Chinese Medicine (TCM), and other traditional medicine systems.
The oldest evidence of berberine use dates back to 650 BC in the Assyrian empire, where it was used as a blood-purifying agent.
Healers in traditional medicine systems extracted berberine from many parts of different plants, such as the stems, leaves, roots, and bark.
In Ayurveda, berberine has been used for wound-healing, infections, dysentery, and obesity, among other conditions. In traditional medicine more generally, berberine has also been used for anti-microbial effects, inflammation, ulcers, jaundice, inflamed liver, skin diseases, and several other conditions.
Conclusion:
Berberine is a plant compound that has been used for many ailments in traditional medicine. It is also one of the most well-researched medical compounds out there.
Modern research shows it may have benefits for blood sugar, fat metabolism, heart health, NAFLD, gut health, and potentially schizophrenia.
Importantly, berberine is also deemed very safe when used in the appropriate doses. When dosed at anywhere from 500 to 2,700mg, berberine may prove beneficial and is easy to take regularly.
