Berberine, or berberine hydrochloride, is a compound in several plants. It may help to treat diabetes, high cholesterol, and high blood pressure, among other conditions. However, side effects can include upset stomach and nausea.

Berberine has been a part of Chinese and Ayurvedic medicine for thousands of years. It works in the body in multiple ways and is able to make changes within the body’s cells.

Studies of berberine have indicated that it can treat several metabolic health conditions, including diabetes, obesity, and heart problems. It may also improve gut health.

Although berberine appears to be safe and causes few side effects, a person should speak with a doctor before taking it.

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The following are conditions that berberine may help treat, according to research.

Bacterial infections

Berberine could be an effective antimicrobial agent. A 2022 study found that berberine helped inhibit the growth of Staphylococcus aureus.

S. aureus can cause many health problems, including:

Another study found that berberine has the ability to damage the DNA and protein of certain bacteria.

Inflammation

Inflammation is a key factor in several health conditions, including heart disease and diabetes.

Research suggests that berberine has anti-inflammatory properties, which means it could help treat diabetes and other inflammation-related health conditions.

Diabetes

Research has shown that berberine may work as a diabetes treatment. Studies have found that it can have positive effects on:

One literature review indicated that berberine was better than a placebo at lowering blood sugar.

The same analysis found that a combination of berberine and blood-sugar-lowering drugs is more effective than the drugs alone.

According to 2014 research, berberine shows promise as a potential diabetes treatment, especially for those who cannot take existing anti-diabetic drugs due to heart disease, liver failure, or kidney problems.

Another literature review found that berberine combined with lifestyle changes worked better to lower blood glucose than lifestyle changes alone.

Berberine appears to activate AMP-activated protein kinase, which can help regulate how the body uses blood sugar. Researchers believe this activation can help treat diabetes and related health issues, such as obesity and high cholesterol.

Another 2020 meta-analysis showed benefits in body weight and metabolic parameters, without significant elevation in liver enzymes.

However, scientists need to conduct more large, double-blind studies to fully determine berberine’s safety and efficacy.

Speak with a doctor before taking berberine for diabetes. It may not be right for everyone and could interact with other medications.

High cholesterol

High levels of low-density lipoprotein (LDL) cholesterol and triglycerides may increase the risk of heart disease and stroke.

Some evidence suggests that berberine could help lower LDL cholesterol and triglyceride levels. According to one review, studies in both animals and humans indicate that berberine has cholesterol-lowering effects.

It may help reduce LDL, or “bad” cholesterol, and increase high-density lipoprotein, or “good” cholesterol.

A literature review found that berberine combined with lifestyle changes works better than lifestyle changes alone in treating high cholesterol.

Researchers believe that the effects of berberine might be similar to those of drugs that reduce high cholesterol, while berberine does not cause the same side effects.

High blood pressure

High blood pressure is a leading cause of heart disease.

A literature review found that berberine combined with a blood-pressure-lowering drug was more effective than the drug alone.

Also, results of a study of rats indicate that berberine could delay the onset of high blood pressure and, when it does develop, help reduce its severity.

Obesity

Obesity is a common condition that can increase the risk of:

One review reported that people who took 750 milligrams (mg) of barberry twice a day for 3 months had a significant decrease in weight. Barberry is a plant that contains high amounts of berberine.

Also, a double-blind study found that individuals with metabolic syndrome who took 200 mg of barberry three times a day experienced decreases in their body mass index readings.

The team behind another study observed that berberine may activate brown adipose tissue. This tissue helps the body turn food into body heat, and increased activation may help treat obesity and metabolic syndrome.

Some research suggests that berberine works similarly to the drug metformin, which doctors often prescribe to treat type 2 diabetes. In fact, berberine may have the ability to change the bacteria in the gut, which could help treat both obesity and diabetes.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) occurs when a female has high levels of certain male hormones. The syndrome is a hormonal and metabolic imbalance that can lead to infertility and other health issues.

PCOS is linked with many issues that berberine may help address. For example, a person with PCOS may also have:

  • high levels of insulin, diabetes, or both
  • high blood pressure
  • high cholesterol
  • more body weight

Doctors sometimes prescribe metformin, a diabetes drug, to treat PCOS. As berberine appears to have similar effects to metformin, it may also be a good treatment option for PCOS.

A systematic review found that berberine has promise as a treatment for PCOS with insulin resistance. However, the authors state that confirming these effects will require further studies.

Cancer

Berberine can create changes within the molecules of cells, and this could have another potential benefit: fighting cancer.

One review found that berberine has “clear inhibitory effects” on the following cancers:

Another study states that berberine helps treat cancer by interfering with its progression and its typical life cycle. It may also play a role in killing cancer cells.

Based on this evidence, the authors state that berberine is “highly expected to be effective, safe, and affordable” as a cancer-fighting agent.

However, it is important to remember that researchers have only studied berberine’s effects on cancer cells in a laboratory, not in people.

Gut health

If berberine can help treat cancer, inflammation, diabetes, and other conditions, it may be because of a beneficial effect on gut microbiota, according to some research published in 2020. Scientists have found links between the gut microbiome — colonies of bacteria in the gut — and these conditions.

Berberine has an antibacterial action that seems to remove the harmful bacteria in the gut, and thus enhance the growth of healthy bacteria.

While studies in humans and rodents have suggested this could be true, scientists caution that more research is needed to confirm how berberine affects humans and whether it is safe to use.

The American Association of Naturopathic Physicians (AANP) notes that berberine supplements are available as supplements or capsules.

They add that many studies suggest taking 900–1,500 mg per day, but most people take 500 mg three times per day. However, the AANP urges people to speak with a doctor before taking berberine to check that it is safe to use and how much they can take.

If a doctor agrees that berberine is safe to use, the AANP says people should also check the product label for third-party certification, for example, from the National Science Foundation (NSF) or NSF International.

The authors of a 2018 study found wide variation in the content of various berberine capsules, which could lead to confusion about safety and dosages. They did not find that a higher cost necessarily reflected a higher quality product.

The Food and Drug Administration (FDA) does not regulate supplements. There is no guarantee of the safety or effectiveness of a supplement, and it is not always possible to verify the quality of the product.

Scientists say that berberine and metformin share many features, and both could be useful for treating type 2 diabetes.

However, if a person’s doctor has prescribed metformin, they should not consider berberine as an alternative without first discussing it with their doctor.

A doctor will prescribe the correct amount of metformin for an individual, based on clinical research. It is not possible to know how a supplement will match that amount.

Berberine can interact with metformin and affect blood sugar levels, making them harder to manage. In one study, taking berberine and metformin together led to a 25% drop in the impact of metformin.

One day, berberine may become a suitable alternative to metformin for managing blood sugar levels, but more research is necessary.

The National Center for Complementary and Integrative Health (NCCIH) notes that if adults take goldenseal, which contains berberine, by mouth it is unlikely to cause severe adverse effects in the short term. However, there is not enough information to show that long-term use is safe.

Berberine can cause digestive side effects, such as:

It can also cause a rash or headache in some people.

In animal studies, scientists have noticed the following effects, depending on the type of animal, how much they consumed, and for how long:

It is essential to speak with a doctor before taking berberine or other supplements, as they may not be safe or suitable for everyone to use. Anyone who develops an allergic reaction to any herbal product should stop using it at once.

The NCCIH advises people not to use goldenseal, which contains berberine, during pregnancy or while breastfeeding. They add that giving goldenseal to a newborn could trigger or worsen jaundice and increase the risk of kernicterus, a potentially life threatening condition.

There may also be a potential for hypoglycemia from taking goldenseal, depending on whether someone is taking other hypoglycemic prescription medications. Goldenseal may also interact with prescription medications.

People should speak with their doctor before taking products containing berberine.

Here are some possible risks, according to the NCCIH:

  • Berberine may interfere with other medications, such as metformin.
  • It is not always clear how much of an active ingredient is present in a supplement, which could lead to taking the wrong dose.
  • Adverse effects can occur if people take too much or if a person is susceptible.
  • There is not enough scientific information to prove that goldenseal and other berberine products are safe for long-term use.
  • Taking berberine during pregnancy or while breastfeeding could have a negative impact on the fetus or newborn.

Below are some commonly asked questions about berberine.

Is berberine used for weight loss?

Berberine is used by some people to support with weight loss.

This is validated by a 2020 study, which found that berberine intake is associated with a significant reduction in body weight, body mass index (BMI), and waist circumference.

Is berberine bad for kidneys?

According to a 2023 study, berberine has a positive effect on people with kidney problems. It does this by changing the types of friendly bacteria in the gut and stopping the production of bad substances in the gut that can make kidney disease worse.

Does berberine kill good bacteria?

Berberine does not kill good bacteria.

A 2020 study found that while berberine can induce cell death of harmful intestinal bacteria, it also increases the number and species of beneficial bacteria in the gut.

Research suggests that berberine could be a promising treatment for several conditions, including diabetes, heart disease, and obesity. However, more research is needed to show that it is safe to use as a treatment option.

Berberine is a natural remedy that could be as powerful as some prescription drugs. As such, people should use it with care and speak with a doctor before taking it.