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Printed from https://bottledhope.co/supplements/berberine/. Last reviewed 2026-10-07. Check the site for the latest version.

Berberine

A yellow compound found in plants such as barberry and goldenseal. People take it for blood sugar, cholesterol, weight and polycystic ovary syndrome.

Explained simply · Last reviewed

What it is

Berberine is a yellow compound found in some plants, such as European barberry, goldenseal and tree turmeric. NCCIH, the US agency that studies complementary medicine, names those plants among others. It says plants containing berberine have been used medicinally for thousands of years in Ayurvedic and traditional Chinese medicine. It says berberine is now often sold as an herbal dietary supplement, promoted for diabetes, high cholesterol, high blood pressure and canker sores, and most recently for weight loss.

More about Berberine

NCCIH, the US agency that studies complementary medicine, names those plants among others. It says plants containing berberine have been used medicinally for thousands of years in Ayurvedic and traditional Chinese medicine. It says berberine is now often sold as an herbal dietary supplement, promoted for diabetes, high cholesterol, high blood pressure and canker sores, and most recently for weight loss.

A 2024 review of diabetes trials describes berberine as a yellow crystalline alkaloid. It states that berberine has been widely used for metabolic diseases, among them obesity and polycystic ovary syndrome. It names the herb Coptis chinensis as the plant with the highest berberine content. LiverTox, the US government's liver-injury database, states that berberine is widely available over the counter, alone and in multi-ingredient dietary supplements. It adds that berberine has not been approved for any of the uses it lists in the United States.

The two cited meta-analyses report that most of the trials they included were conducted in China. Some trials tested berberine on its own, and others added it to other treatments. The summaries below keep the two apart where the sources do.

Also known as: berberine hydrochloride, berberine HCl, huangliansu

At a glance

Safety: known risks, 3 groups who should avoid it or take extra care and 2 documented interactions. See Safety ↓

Claims made about Berberine, and how strong the evidence is for each:

Each rating follows our published rules and the sources cited for it. We don’t add our own medical judgment. How we rate

Safety

Read this before the ratings below.

Risks

  • NCCIH, the US agency that studies complementary medicine, states that the most common adverse effects of berberine taken by mouth “include abdominal pain, constipation, diarrhea, nausea, and vomiting”, and that in general it is well tolerated but “not without its risks and side effects”.
  • The same authority states that exposure to berberine “has been linked to a harmful buildup of bilirubin in infants, which can cause brain damage”, and that berberine can cause or worsen jaundice in newborn infants and could lead to a life-threatening problem called kernicterus.
  • LiverTox, the US government's liver-injury database, gives berberine a likelihood score of E, which it defines as an “unlikely cause of clinically apparent liver injury”. It states that berberine “has not been linked to serum aminotransferase elevations during therapy nor to instances of clinically apparent liver injury”, and adds that few prospective studies in humans have reported its effects on laboratory tests in any detail.
  • A 2025 overview of 54 systematic reviews, many of which included trials in which berberine was added to or compared with other medicines, reports that the 40 reviews that reported adverse effects described gastrointestinal reactions, rash, headache, elevated transaminases, liver enzyme abnormalities and myalgia. That list differs from LiverTox, which states that berberine has not been linked to aminotransferase elevations; this page reports both. The overview’s authors describe berberine’s tolerability as favorable, with adverse events “predominantly limited to mild, self-limiting gastrointestinal disturbances”.
  • In a 2025 meta-analysis of purified berberine against placebo, 10 of the 12 trials reported adverse events; the reviewers state that the events most often reported were hypoglycemia, nausea, constipation and mild abdominal discomfort, and that overall incidence was generally low. The pooled risk of any adverse event, and of any gastrointestinal adverse event, did not differ significantly between berberine and placebo, which is too little evidence to show a difference either way rather than evidence of none. The reviewers state that the safety outcomes “necessitate further validation”.
  • In a 2024 meta-analysis of 50 trials in type 2 diabetes, 16 trials reported adverse events in detail, and the reviewers state that no serious adverse events were reported in any of the studies during treatment. Most trials did not report adverse events in detail, so this is not evidence that none occurred.

Who should avoid it or take extra care

  • Pregnancy and breastfeeding: NCCIH states that people who are pregnant or breastfeeding should not use berberine, and that it may be unsafe during pregnancy or breastfeeding because of possible effects on the fetus or infant.
  • Infants: the same authority states that berberine should not be given to infants, and that it is likely to be unsafe for them.
  • Anyone who takes medicine: the same authority advises talking with your health care provider before taking berberine.

Documented interactions

  • Cyclosporine (ciclosporin): NCCIH states that berberine has been shown to interact with cyclosporine, a drug used to prevent rejection of transplanted organs. Source [1]
  • Other medicines: The same authority states that berberine may interact with some medicines, possibly causing unwanted side effects, and that it might interact with medicines in negative ways. Source [1]Source [2]

Safety sources: Source [1]Source [2]Source [3]Source [4]Source [5]Source [6]Source [7]

What the evidence says

Each claim is rated on its own evidence. Ratings follow the scale on our methodology page.

  • Lowers blood sugar markers in type 2 diabetes Evidence rating: Limited

    People with type 2 diabetes take it hoping it will bring their blood sugar down.

    A 2024 review found lower fasting glucose and HbA1c with berberine alone against placebo, or added to diabetes medicines; an overview rated earlier reviews of these outcomes low to very low certainty.

    This claim is about laboratory measures of blood sugar, fasting glucose and HbA1c, not about diabetes complications. A 2024 meta-analysis pooled 50 randomized trials in type 2 diabetes. All but one were conducted in China, and 46 were published in Chinese. The reviewers kept berberine taken on its own apart from berberine added to diabetes medicines. In trials comparing berberine alone with placebo, they report lower fasting glucose and HbA1c with berberine. In trials adding it to diabetes medicines, they report lower fasting glucose and HbA1c than with the same medicines alone. Those trials tested the combination, not berberine on its own.

    The reviewers report limits of their own. Their results differed a lot from trial to trial (high heterogeneity). In 44 of the 50 trials, blinding was not described well enough for them to judge it. Unlike the overview below, the review did not grade certainty. A separate 2025 meta-analysis, limited to purified berberine against placebo in adults with at least one feature of metabolic syndrome, found lower fasting glucose from 6 trials. Its results also differed a lot from trial to trial.

    A 2025 overview graded how sure earlier reviews in type 2 diabetes could be (certainty), outcome by outcome. This page does not count reviews published in journals that have been delisted from Web of Science. Of the reviews this page counts, only one graded berberine alone against placebo or no treatment, and the overview rated its fasting glucose and HbA1c results very low. For berberine added to diabetes medicines against the medicines alone, the overview rated fasting glucose very low in eight reviews, one of them a master’s thesis. It rated HbA1c low in two and very low in five. Across all conditions, it judged 45 of the 54 reviews it assessed critically low in methodological quality.

    NCCIH, the US agency that studies complementary medicine, states that there is “some evidence that berberine may have a modest effect on lowering blood glucose levels in people with type 2 diabetes”. Elsewhere it groups berberine among supplements with “weak evidence of a possible benefit” for blood sugar control. There, it says studies with limitations in size that differ from each other lead to “no clear conclusions”. This page rates the claim on the lowest certainty, very low.

    Sources: Source [1]Source [2]Source [3]Source [4]Source [5]

  • Lowers cholesterol and triglycerides Evidence rating: Limited

    People take it hoping it will lower their cholesterol and triglycerides.

    A 2025 review of placebo-controlled trials found lower triglycerides, LDL and total cholesterol; an overview rated most earlier reviews of these outcomes very low certainty.

    This claim is about blood lipid levels, which are markers, not heart attacks or strokes. A 2025 meta-analysis tested purified berberine against placebo in adults with at least one feature of metabolic syndrome. It found lower triglycerides (9 trials), LDL cholesterol (8 trials) and total cholesterol (7 trials). For each, the trials disagreed with each other substantially. HDL cholesterol did not change significantly (9 trials), which is too little evidence to show an effect either way. The reviewers judged two of the 12 trials high quality, two low quality and the rest as raising some concerns about bias.

    A 2025 overview graded four earlier reviews that compared berberine with placebo or no treatment, outcome by outcome. It rated LDL cholesterol low in one and very low in three, and total cholesterol very low in all four. It rated triglycerides low in one and very low in three, and HDL cholesterol moderate in one and very low in three.

    NCCIH states that there is “some evidence” that berberine “may reduce cholesterol levels”. This page rates the claim on the lowest certainty, very low.

    Sources: Source [1]Source [2]Source [3]

  • Lowers body weight, BMI or waist size Evidence rating: Limited

    People take it hoping it will help them lose weight and reduce their waist size.

    A 2025 review of placebo-controlled trials found lower BMI and waist size, but BMI was no longer significant without two low-quality trials; NCCIH calls the evidence not conclusive.

    A 2025 meta-analysis tested purified berberine against placebo in adults with at least one feature of metabolic syndrome. It found a reduction in body mass index (BMI) from 8 trials. That reduction was no longer statistically significant when the reviewers left out the two trials they judged low quality. They also found a reduction in waist circumference from 4 trials. Asked whether berberine will help with weight loss, NCCIH answers: “Some studies suggest that it might, but the evidence is not conclusive.” It reports that a 2022 review “found significant decreases in both weight and BMI in people who took berberine”.

    A 2025 overview graded earlier reviews, outside PCOS, whose comparisons it labels as including placebo. This page does not count reviews published in journals that have been delisted from Web of Science, which leaves three. The overview’s grading table labels them as mixing placebo-controlled trials with trials in which berberine was compared with, or added to, other treatments. The overview rated body weight high in one review and low in two. It rated BMI high in two and low in one, and waist circumference low in one and very low in two.

    This page does not rely on the high ratings, which come from two reviews. For one of them, the overview’s table entry gives a confidence interval that does not contain its own estimate. The overview’s list of reviews also labels that review differently from its table, as berberine against placebo rather than a mixed comparison.

    NCCIH adds that many studies in the 2022 review had a high risk of bias and inconsistent results, and that the amounts and formulations of berberine varied widely. It notes that most studies were conducted in Asian countries. It adds that most participants had health problems, such as diabetes or fatty liver disease, that might have influenced the results. Elsewhere it states that some preliminary studies have suggested berberine may play a role in losing weight. But it says there have not been many clinical trials, so there is not enough rigorous scientific evidence to determine whether it is effective. This page rates the claim on the lowest certainty, very low.

    Sources: Source [1]Source [2]Source [3]Source [4]

  • Improves hormone or metabolic markers in polycystic ovary syndrome (PCOS) when added to other treatments Evidence rating: Insufficient

    People with polycystic ovary syndrome (PCOS) take it hoping it will improve their hormone and blood sugar levels.

    A 2026 review set aside all four trials it found over integrity concerns and says reliable conclusions cannot be drawn; an overview graded lower markers in two add-on reviews low to very low.

    This claim is about laboratory and body measures, not fertility, and about berberine added to other treatments, not berberine on its own. A 2025 overview graded earlier PCOS reviews outcome by outcome. This page does not count reviews published in journals that have been delisted from Web of Science. That leaves two reviews that compared berberine added to other treatments with those treatments alone; one of them is a master’s thesis.

    This page reports the outcomes the overview graded in both reviews. For each review, its grading table shows lower fasting glucose, fasting insulin, total cholesterol, triglycerides and total testosterone with berberine added. The overview rated fasting glucose low in one review and very low in the other. It rated total testosterone low in one and very low in the other. It rated triglycerides low or very low in one and very low in the other. It rated fasting insulin and total cholesterol very low in both.

    In neither review did BMI differ significantly (very low certainty), which is too little evidence to show an effect either way. The overview also found a high overlap of trials between the PCOS reviews it assessed, and it grades no fertility outcome for these comparisons.

    A 2026 systematic review reappraised berberine trials in PCOS, which it calls polyendocrine metabolic ovarian syndrome (PMOS). Searching English-language publications only, it found four randomized trials (452 participants), comparing berberine with metformin, placebo, myo-inositol or lifestyle interventions. It rated all four at high risk of compromised integrity, citing absent registration, implausible recruitment timelines and potential data duplication, and excluded them from synthesis. It states that the trials’ reported improvements in insulin resistance, lipid profiles and androgen markers “cannot be considered reliable”, and that “reliable conclusions regarding the efficacy of berberine in PMOS cannot be drawn from the current evidence base.” It does not name the overview’s two PCOS reviews. The sources differ, so this page takes the lower rating, insufficient.

    Sources: Source [1]Source [2]

How and when to take it

What the cited sources say about taking it. Ask your doctor or pharmacist what applies to you.

  • Do not use it in place of diabetes treatment

    NCCIH states that it is very important not to replace medical treatment for diabetes with an unproven health product or practice. Source [1]

  • Talk with your health care provider first if you take any medicine

    NCCIH states that berberine may interact with some medicines, possibly causing unwanted side effects, and that people who take medicines should talk with their health care providers before taking berberine. Source [1]Source [2]

Which form the evidence used

Supplements are sold in several forms. This is what the sources on this page say about them — which form the research used, and any comparison those sources themselves made. Where they made none, this page does not rank the forms.

  • Purified berberine tablets or capsules, What the sources supportDetails

    The cited placebo-controlled meta-analysis included only purified berberine, which it defines as berberine with a purity greater than 95% and not combined with other substances, taken as tablets or capsules. It excluded trials of Berberis plant or root extracts and of berberine-phospholipid complexes. The cited type 2 diabetes meta-analysis likewise excluded trials of Berberis root extract or stem powder. Neither review compared forms of berberine with each other, so this page cannot compare forms. Source [1]Source [2]

  • Goldenseal, Details

    NCCIH states that when people take goldenseal by mouth, very little berberine may be absorbed, so study results on berberine may not apply to goldenseal. It also states that goldenseal may change the way the body processes many medications, and that some commercial goldenseal products have been found to contain herbs or ingredients not listed on the label. Source [1]

Sources

  1. Effects of administering berberine alone or in combination on type 2 diabetes mellitus: a systematic review and meta-analysis
    Frontiers in Pharmacology, 2024 · Meta-analysis · Primary source
  2. Efficacy and safety of berberine on the components of metabolic syndrome: a systematic review and meta-analysis of randomized placebo-controlled trials
    Frontiers in Pharmacology, 2025 · Meta-analysis · Primary source
  3. Berberine and health outcomes: an overview of systematic reviews
    BMC Complementary Medicine and Therapies, 2025 · Systematic review · Primary source · Certainty: very low
  4. In the News: Berberine
    National Center for Complementary and Integrative Health, NIH, 2023 · Health authority summary · Primary source
  5. Diabetes and Dietary Supplements: What You Need To Know
    National Center for Complementary and Integrative Health, NIH, 2023 · Health authority summary · Primary source
  6. Berberine and Weight Loss: What You Need To Know
    National Center for Complementary and Integrative Health, NIH, 2023 · Health authority summary · Primary source
  7. Questionable Evidence for Berberine in Polyendocrine Metabolic Ovarian Syndrome: An Integrity-Based Reappraisal
    Advances in Therapy, 2026 · Systematic review · Primary source
  8. Berberine
    LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, National Institute of Diabetes and Digestive and Kidney Diseases, 2020 · Health authority summary · Primary source
  9. Goldenseal: Usefulness and Safety
    National Center for Complementary and Integrative Health, NIH, 2025 · Health authority summary · Primary source

Page history

Show all 4 changes to this page
  • — PCOS claim lowered from limited to insufficient. A 2026 systematic review rated all four trials it found at high risk of compromised integrity and states that reliable conclusions cannot be drawn; the page now reports it beside the overview and takes the lower reading.
  • — Rewritten to the content style guideline; ratings and sources unchanged.
  • — Published. The four claims, the safety section and every source passed the site's source and wording reviews over two revision rounds. By owner decision, the page cites only reputable sources and does not count reviews in journals delisted from Web of Science; the decisions are recorded in docs/08-open-decisions.md.
  • — First drafted. Blood sugar in type 2 diabetes, blood lipids, body weight and PCOS all rated limited, each on very low GRADE certainty from a cited overview of systematic reviews.