Quick Navigation

Berberine

Berberine is a plant alkaloid with a long history of use in Ayurvedic and traditional Chinese medicine for the management of various health conditions. Its seemingly potent ability to reduce blood sugar rivals that of some anti-diabetic drugs.

Our evidence-based analysis on berberine features 329 unique references to scientific papers.

Research analysis led by and reviewed by the Examine team.
Last Updated:

Summary of Berberine

Primary information, health benefits, side effects, usage, and other important details

What is berberine?

Berberine is an alkaloid found in the barks, leaves, twigs, rhizomes, roots, and/or stems of various plants, such as the barberry, Oregon grape, and tree turmeric. Traditionally, berberine has been used as an antimicrobial, antiprotozoal, and antidiarrheal agent in Ayurvedic medicine and traditional Chinese medicine. Most research in humans has examined berberine’s effects on markers of glycemic control, blood lipids, markers of liver function, and anthropometric parameters in people with metabolic disorders.

What are berberine’s main benefits?

Evidence from clinical trials conducted in people with type 2 diabetes suggests that berberine is able to reduce blood sugar to a similar extent as some anti-diabetic drugs. In people with metabolic disorders, limited research suggests that berberine may improve blood lipids and liver enzymes, and reduce body weight and fat mass. However, most of the available trials examining the effects of berberine on the aforementioned outcomes are of poor methodological quality.

What are berberine’s main drawbacks?

Although berberine appears to be generally safe in normal doses, more long-term research on its safety is needed. In some people, supplementation with berberine has been reported to cause gastrointestinal side effects, including diarrhea, constipation, flatulence, and stomach pain. Due to its ability to reduce blood sugar, berberine may increase the risk for hypoglycemia in high doses. Berberine has a high potential of interacting with a number of drugs, with some of these interactions increasing the chances of serious complications.

How does berberine work?

The main mechanism through which berberine exerts its effects appears to be the stimulation of the enzyme adenosine monophosphate-activated protein kinase (AMPK), a master regulator of cellular energy homeostasis that is involved in a wide range of biological processes, including the regulation of glucose, lipid, and protein metabolism.

Access the latest research

Did you know about 80% of people with diabetes live in low- and middle-income countries? Of these people, less than 10% are aware of their condition and/or have adequate access to care.

Learn more about insulin and related information by visiting the insulin topic page on Examine, and stay up to date on the latest findings on this topic with an Examine Membership — try free for 14 days!

How to Take

Recommended dosage, active amounts, other details

The standard dose of berberine is 900-2,000mg a day, divided into three to four doses.

Berberine should be taken with a meal, or shortly after, to take advantage of the blood glucose and lipid spike associated with eating.

Too much berberine at once can result in stomach upset, cramping, and diarrhea.

Easily stay on top of the latest nutrition research

Become an Examine Member to get access to the latest research. Get 150+ studies summarized for you across 25 different categories every month.

Members also have access to the Examine Study Database of 400+ supplements and their effects on 600+ health outcomes, as well as in-depth research analyses. Understand the whole body of nutrition and supplement evidence at a glance.

Get instant access — start your free 14-day trial

Already a Member? Click here to log in.


Human Effect Matrix

Unlocked for Examine Members

Easily stay on top of the latest nutrition research

Become an Examine Member to get access to the latest research. Get 150+ studies summarized for you across 25 different categories every month.

Members also have access to the Examine Study Database of 400+ supplements and their effects on 600+ health outcomes, as well as in-depth research analyses. Understand the whole body of nutrition and supplement evidence at a glance.

Get instant access — start your free 14-day trial

Already a Member? Click here to log in.


The Human Effect Matrix summarizes human studies to tell you what effects Berberine has on your body, how much evidence there is, and how strong these effects are.

Full details are available to Examine Members. Not a Member? Try Examine Membership completely free for two weeks.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-b Strong Very High See all 4 studies
The usage of berberine in reducing blood glucose, according to the most recent meta-analysis, is comparable to the oral hypoglycemic drugs Metformin or Glibenclamide; this suggests berberine is one of the more effective supplements for blood glucose reductions.
grade-b Strong Very High See all 3 studies
The reduction of HbA1c associated with berberine, according to a meta-analysis of diabetics using 1,000-1,500mg berberine daily, was −0.72% (95% CI −0.97 to −0.47) more than placebo. This reduction appears to be one of the more significant reductions associated with dietary supplements.
grade-b Notable Very High See all 4 studies
Total cholesterol appears to be decreased by around −0.58mmol/L (95% CI −1.02 to −0.14), which is not overly potent. The reduction in notable as if this mechanism is via PCSK9 inhibition then it would work very well with statin drugs.
grade-b Minor Very High See all 4 studies
Degree of improvement was 0.07mmol/L (95% CI 0.04 to 0.10) according to the meta-analysis, not remarkably effective
grade-b Minor Very High See all 4 studies
Degree of reduction of fasting insulin according to meta-analysis was SMD −0.50mU/L (95% CI −0.96 to −0.03) which is not overly remarkable.
grade-b Minor Very High See all 3 studies
The reduction of LDL-C when berberine was paired with lifestyle changes was −0.58mmol/L (95% CI −0.78 to −0.39) in diabetics, suggesting a significant benefit but not remarkably potent. However, another study in people with nonalcoholic fatty liver disease showed no benefit over lifestyle changes alone.
grade-b Minor Very High See all 5 studies
Degree of reduction according to meta-analysis was −0.48mmol/L (95% CI −0.57 to −0.39) which was not overly remarkable.
grade-c Minor - See study
Was able to reduce canker sores when topically applied, but was not compared to a reference compound.
grade-c Minor - See study
A positive effect, but the potency thereof was not overly remarkable
grade-c Minor - See all 3 studies
One study in people with NAFLD has shown mild increases in HOMA-IR when berberine is added to lifestyle changes compared to lifestyle changes alone.
grade-c Minor - See study
Minor effect in persons with cardiomyopathy, but it is unsure if berberine has a per se benefit on quality of life.
grade-d Minor - See study
One study showed a slight decrease in systolic blood pressure only in people with the metabolic syndrome who were given berberine 0.5g three times a day for three months.

Studies Excluded from Consideration

Stay on top of the latest research

To unlock the full archives of our Study Database and research analyses, become an Examine Member today.

Start your 14-day free trial

Frequently Asked Questions and Articles on Berberine

5 supplements (and foods) for a stronger heart
Cardiovascular diseases (CVDs) are the #1 cause of death globally. But a mix of the right foods and complementary supplements can help decrease your risk factors.

Things to Note

Is a Form Of

Primary Function:

Do Not Confuse With

Piperine (Black Pepper extract), Berberol (Brand name), Berberrubine (Metabolite)

Goes Well With

  • P-glycoprotein (P-Gp) inhibitors increase absorption rate, with Milk Thistle demonstrated in humans and Stephania tetrandra being promising

  • Sodium caprate (increases absorption, not related to P-Glycoprotein)

  • Atrogin-1 inhibition (theoretically reverses the possible degradation of lean mass associated with AMPK activation into synthesis)

Caution Notice

Known to interact with enzymes of Drug Metabolism. Also may interact with macrolide antibiotics such as azithromycin and clarithromycin at hERG channels on the heart, leading to serious cardiotoxicity.

  • High doses of berberine taken acutely, due to their poor intestinal uptake rate, may cause cramping and diarrhea; for this reason, berberine should be taken in multiple doses throughout the day

  • Berberine is known to inhibit CYP2D6, CYP2C9, and CYP3A4, which can lead to a host of drug interactions, some of which can be serious

  • Berberine is known to induce the protein concent of P-glycoprotein

  • Berberine interacts with organic anion transporter proteins, which may limit tissue uptake of metformin

  • Berberine may interact with microlide antibiotics such as azithromycin and clarithromycin at hERG channels on the heart, leading to serious cardiotoxicity

Get our free 5-day course on the essentials of supplementation.

At Examine, our incentives line up with yours — getting unbiased information. That's why we don’t sell any advertising or supplements.

Join over 250,000 people who have learned about effective versus overrated supplements, tips for buying supplements, and how to combine supplements for safety and efficacy.

Click here to see all 329 references.