Also known as Berberine HCl
Isoquinoline plant alkaloid that activates AMP-activated protein kinase (AMPK); trials show blood-glucose-lowering effects in type 2 diabetes approaching those of metformin, though GI side effects are common.
Reported side effects:Gastrointestinal and muscle-related adverse events
Be careful if: pregnant, breastfeeding, certain health conditions
Ask first if you take: immunosuppressants, diabetes medicines, including insulin, other medicines, chemotherapy
Suspect a side effect? Report it to the MHRA Yellow Card scheme ↗
We link to relevant studies and leave interpretation to you and your healthcare professional.
The large figures are what the studies reported for each thing they measured. Open a card for every result.
Colour keyReported a benefitNo clear benefitUnclearPossible harmAmber is for highlights, such as where the most research is. It never means a result was good.
Also measured alongside: Fasting blood sugar (reported a benefit); Long-term blood sugar (HbA1c) (reported a benefit); Blood sugar after glucose test (reported a benefit); and 4 more.
1 more measureNo figure given: Blood sugar levels (unspecified) (reported a benefit).
Also measured alongside: Blood fats (general) (reported a benefit); Body measurements and composition (reported a benefit); Bowel polyps (adenomas) (reported a benefit); and 4 more.
1 more measureWhat sources report about side effects, who should be careful, and medicines to ask about first.
| Reported effect | How often | Basis | Sources |
|---|---|---|---|
| Gastrointestinal and muscle-related adverse events | unknown | Listed by PubMed corpus rows (PubMed 36941490) | Blais JE, Huang X, Zhao JV. Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: Systematic Review and Meta-Analysis of RCTs. Drugs 2023;83(5):403-427 (PMID 36941490) |
| Reported effect | How often | Basis | Sources |
|---|---|---|---|
| Potential multi-organ toxicity (liver, kidney, cardiovascular and immune systems, embryonic development) reported under specific doses, routes of administration or individual conditions (toxicological review of Berberis alkaloids) | unknown | Listed by PubMed corpus rows (PubMed 42731298) | Ma J, et al. Balancing efficacy and risk: A toxicological review and safety transformation of Berberis plants and their alkaloids. Phytomedicine 2026;162:158782 (PMID 42731298) |
Blais JE, Huang X, Zhao JV. Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: Systematic Review and Meta-Analysis of RCTs. Drugs 2023;83(5):403-427 (PMID 36941490)Ma J, et al. Balancing efficacy and risk: A toxicological review and safety transformation of Berberis plants and their alkaloids. Phytomedicine 2026;162:158782 (PMID 42731298)Khoshandam A, Imenshahidi M, Hosseinzadeh H. Pharmacokinetic of berberine, the main constituent of Berberis vulgaris L.: A comprehensive review. Phytother Res 2022;36(11):4063-4079 (PMID 36221815)Adiwidjaja J, Boddy AV, McLachlan AJ. PBPK model predictions of natural product-drug interactions between goldenseal, berberine, imatinib and bosutinib. Eur J Clin Pharmacol 2022;78(4):597-611 (PMID 35048143)
Audited published research for Berberine by condition. Drill into a pair page for the full breakdown.
What this means: Bars count reported findings, not treatment effectiveness or certainty.
One study may report several findings or appear in more than one pairing. Counts do not show the size of an effect. Comparable numerical estimates are not established for this summary.
| Compound and condition | Findings (count) | Studies (count) | Reported results (finding counts) | How sure? |
|---|---|---|---|---|
| High blood sugar | 14 | 3 | Benefit: 13; no benefit: 0; harm: 1; unclear: 0; not recorded / unrecognised: 0 | Not formally graded |
| Cholesterol | 17 | 3 | Benefit: 15; no benefit: 1; harm: 1; unclear: 0; not recorded / unrecognised: 0 | Not formally graded |
Where people report using it and what trials suggest
Common claims the trials do not support
Plant alkaloid with genuine glucose-lowering signals from mostly low-quality trials; 'nature's metformin' marketing overstates the case.
Evidence grades reflect study quality and consistency, not marketing claims.
Ordered by strength of evidence, then result direction.
01Adjunctive berberine for schizophrenia with metabolic syndrome: a systematic review and meta-analysisXie K, et al. · Frontiers in psychiatry · 2026PMID 42433212 ↗02Clinical Efficacy of Curcumin, Resveratrol, Silymarin, and Berberine on Cardio-Metabolic Risk Factors Among Patients With Type 2 Diabetes Mellitus: A Systemic Review and Bayesian Network Meta-AnalysisMiao R, et al. · Phytotherapy research : PTR · 2025PMID 40439602 ↗03Efficacy and safety of berberine on the components of metabolic syndrome: a systematic review and meta-analysis of randomized placebo-controlled trialsLiu D, et al. · Frontiers in pharmacology · 2025PMID 40740996 ↗04The Effect of Berberine Supplementation on Glycemic Control and Inflammatory Biomarkers in Metabolic Disorders: An Umbrella Meta-analysis of Randomized Controlled TrialsNazari A, et al. · Clinical therapeutics · 2024PMID 38016844 ↗05The clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver disease: a meta-analysis and systematic reviewNie Q, et al. · Journal of translational medicine · 2024PMID 38429794 ↗06Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled TrialsBlais JE, et al. · Drugs · 2023PMID 36941490 ↗Reported results grouped by condition. Values and units are preserved as recorded; missing information is not estimated.
How to read this table
Reported direction, numerical results and study design are separate. Certainty has not been formally graded in this table.
| What was measured | Reported findings | Result and units | Reported sample and duration | Study / source |
|---|---|---|---|---|
| fasting plasma glucose (FPG) | Fasting plasma glucose reduced by 0.54 mmol/L vs control in 2,313 patients. (95% CI: -0.77 to -0.30)Benefit seen | -0.54 mmol/L Recorded unit: mmol/L | Sample (as reported): 2,313 Follow-up: Not reported | Meta-analysis · 2019 Study detailsEffects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis. Meta-Analysis |
| postprandial plasma glucose (PPG) | Postprandial plasma glucose reduced by 0.94 mmol/L vs control in 2,313 patients. (95% CI: -1.27 to -0.61)Benefit seen | -0.94 mmol/L Recorded unit: mmol/L | Sample (as reported): 2,313 Follow-up: Not reported | Meta-analysis · 2019 Study detailsEffects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis. Meta-Analysis |
| blood glucose levels | Berberine significantly improved blood glucose levels compared to controls, though no specific effect size or sample count was reported.Benefit seen | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| blood lipids | Berberine significantly improved blood lipids compared to controls, though no specific effect size or sample count was reported.Benefit seen | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| body parameters and composition | Berberine significantly improved body parameters and composition compared to controls, though no specific effect size or sample count was reported.Benefit seen | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| colorectal adenomas | Berberine significantly improved colorectal adenomas compared to controls, though no specific effect size or sample count was reported.Benefit seen | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| gastrointestinal symptoms | Berberine caused common gastrointestinal side effects like constipation and diarrhea compared to controls, with no specific rates reported.Possible harm | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| Helicobacter pylori infections | Berberine significantly improved Helicobacter pylori infections compared to controls, though no specific effect size or sample count was reported.Benefit seen | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| inflammatory markers | Berberine significantly improved inflammatory markers compared to controls, though no specific effect size or sample count was reported.Benefit seen | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| insulin resistance | Berberine significantly improved insulin resistance compared to controls, though no specific effect size or sample count was reported.Benefit seen | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: Not reported | Systematic review · 2023 Study detailsBerberine and health outcomes: An umbrella review. Systematic Review |
| 2-hour oral glucose tolerance test (2 h-OGTT) | 2 h-OGTT decreased from 10.44 to 8.12 mmol/L vs placebo in 34 people over 12 weeks. (p<10- 5)Benefit seen | 10.44 ± 0.52 to 8.12 ± 0.40 mmol/L Recorded unit: Not reported | Sample (as reported): 34 Follow-up: 12 weeks | Randomised trial · 2023 Study detailsEfficacy and safety of HIMABERB® Berberine on glycemic control in patients with prediabetes: double-blind, placebo-controlled, and randomized pilot trial. Randomized Controlled Trial |
| Fasting insulin (FI) | Fasting insulin fell from 9.81 to 7.88 mmol/L vs placebo in 34 people over 12 weeks. (p<10- 5)Benefit seen | 9.81 ± 0.36 to 7.88 ± 0.52 mmol/L Recorded unit: Not reported | Sample (as reported): 34 Follow-up: 12 weeks | Randomised trial · 2023 Study detailsEfficacy and safety of HIMABERB® Berberine on glycemic control in patients with prediabetes: double-blind, placebo-controlled, and randomized pilot trial. Randomized Controlled Trial |
| Glycosylated hemoglobin (HbA1c) | HbA1c reduced from 6.40% to 5.43% vs placebo in 34 people over 12 weeks. (p<10- 5)Benefit seen | 6.40% ± 0.20-5.43% ± 0.21% % Recorded unit: % | Sample (as reported): 34 Follow-up: 12 weeks | Randomised trial · 2023 Study detailsEfficacy and safety of HIMABERB® Berberine on glycemic control in patients with prediabetes: double-blind, placebo-controlled, and randomized pilot trial. Randomized Controlled Trial |
| Homeostatic model assessment-insulin resistance (HOMA-IR) | HOMA-IR dropped from 3.61 to 2.41 vs placebo in 34 people over 12 weeks. (p<10- 5)Benefit seen | 3.61 ± 0.31 to 2.41 ± 0.14 Recorded unit: Not reported | Sample (as reported): 34 Follow-up: 12 weeks | Randomised trial · 2023 Study detailsEfficacy and safety of HIMABERB® Berberine on glycemic control in patients with prediabetes: double-blind, placebo-controlled, and randomized pilot trial. Randomized Controlled Trial |
| What was measured | Reported findings | Result and units | Reported sample and duration | Study / source |
|---|---|---|---|---|
| Gastrointestinal adverse events | Berberine caused more gastrointestinal adverse events (2-23%) than placebo (2-15%) over 4 to 24 weeks.Possible harm | 2-23% vs 2-15% Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: 4 to 24 weeks | Meta-analysis · 2023 Study detailsOverall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Meta-Analysis |
| HDL cholesterol (overall) | Berberine increased HDL cholesterol by 0.06 mmol/L vs placebo in 1471 participants over 4 to 24 weeks. (95% CI 0.00 to 0.11)Benefit seen | 0.06 mmol/L Recorded unit: mmol/L | Sample (as reported): 1471 Follow-up: 4 to 24 weeks | Meta-analysis · 2023 Study detailsOverall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Meta-Analysis |
| HDL cholesterol (women) | Berberine increased HDL cholesterol by 0.11 mmol/L vs placebo in women over 4 to 24 weeks. (95% CI 0.09 to 0.13)Benefit seen | 0.11 mmol/L Recorded unit: mmol/L | Sample (as reported): Not reported Follow-up: 4 to 24 weeks | Meta-analysis · 2023 Study detailsOverall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Meta-Analysis |
| Fasting plasma glucose | Berberine lowered fasting glucose from 7.0 to 5.6 mmol/L, with significantly greater improvement compared to placebo. (P < 0.0001)Benefit seen | 5.6 mmol/L Recorded unit: Not reported | Sample (as reported): One hundred sixteen Follow-up: 3 months | Randomised trial · 2008 Study detailsTreatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. Randomized Controlled Trial |
| Glucose disposal rate | Berberine did not significantly improve glucose disposal rate compared to placebo. (P = 0.063)No clear benefit | Not reported Recorded unit: Not reported | Sample (as reported): Not reported Follow-up: 3 months | Randomised trial · 2008 Study detailsTreatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. Randomized Controlled Trial |
| HbA1c | Berberine lowered HbA1c from 7.5 to 6.6%, with significantly greater improvement compared to placebo. (P < 0.0001)Benefit seen | 6.6 % Recorded unit: Not reported | Sample (as reported): One hundred sixteen Follow-up: 3 months | Randomised trial · 2008 Study detailsTreatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. Randomized Controlled Trial |
| Low-density lipoprotein cholesterol | Berberine lowered LDL cholesterol from 3.23 to 2.55 mmol/L, with significantly greater improvement compared to placebo. (P <0.0001)Benefit seen | 2.55 mmol/L Recorded unit: Not reported | Sample (as reported): One hundred sixteen Follow-up: 3 months | Randomised trial · 2008 Study detailsTreatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. Randomized Controlled Trial |
| Postload plasma glucose | Berberine lowered postload glucose from 12.0 to 8.9 mmol/L, with significantly greater improvement compared to placebo. (P < 0.0001)Benefit seen | 8.9 mmol/L Recorded unit: Not reported | Sample (as reported): One hundred sixteen Follow-up: 3 months | Randomised trial · 2008 Study detailsTreatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. Randomized Controlled Trial |
| Total cholesterol | Berberine lowered total cholesterol from 5.31 to 4.35 mmol/L, with significantly greater improvement compared to placebo. (P < 0.0001)Benefit seen | 4.35 mmol/L Recorded unit: Not reported | Sample (as reported): One hundred sixteen Follow-up: 3 months | Randomised trial · 2008 Study detailsTreatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. Randomized Controlled Trial |
| Triglyceride | Berberine lowered triglyceride from 2.51 to 1.61 mmol/L, with significantly greater improvement compared to placebo. (P = 0.001)Benefit seen | 1.61 mmol/L Recorded unit: Not reported | Sample (as reported): One hundred sixteen Follow-up: 3 months | Randomised trial · 2008 Study detailsTreatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. Randomized Controlled Trial |
| Fasting blood glucose in study A | Berberine lowered fasting glucose from 10.6 to 6.9 mmol/L compared to baseline. (P<.01)Benefit seen | 6.9 mmol/L Recorded unit: Not reported | Sample (as reported): 36 Follow-up: 3-month | Randomised trial · 2008 Study detailsEfficacy of berberine in patients with type 2 diabetes mellitus. Randomized Controlled Trial |
| Fasting plasma insulin in study B | Adding berberine reduced fasting plasma insulin by 28.1% compared to baseline. (P<.001)Benefit seen | 28.1% reduction Recorded unit: % | Sample (as reported): 48 Follow-up: 3-month | Randomised trial · 2008 Study detailsEfficacy of berberine in patients with type 2 diabetes mellitus. Randomized Controlled Trial |
| Hemoglobin A1c in study A | Berberine lowered hemoglobin A1c from 9.5% to 7.5% compared to baseline; its glucose-lowering effect was similar to metformin. (P<.01)Benefit seen | 7.5% post-treatment value Recorded unit: Not reported | Sample (as reported): 36 Follow-up: 3-month | Randomised trial · 2008 Study detailsEfficacy of berberine in patients with type 2 diabetes mellitus. Randomized Controlled Trial |
| Hemoglobin A1c in study B | Adding berberine lowered hemoglobin A1c from 8.1% to 7.3% compared to baseline in poorly controlled diabetes. (P<.001)Benefit seen | 7.3% post-treatment value Recorded unit: Not reported | Sample (as reported): 48 Follow-up: 3-month | Randomised trial · 2008 Study detailsEfficacy of berberine in patients with type 2 diabetes mellitus. Randomized Controlled Trial |
| Insulin resistance index in study B | Adding berberine reduced the insulin resistance index by 44.7% compared to baseline. (P<.001)Benefit seen | 44.7% reduction Recorded unit: % | Sample (as reported): 48 Follow-up: 3-month | Randomised trial · 2008 Study detailsEfficacy of berberine in patients with type 2 diabetes mellitus. Randomized Controlled Trial |
| Postprandial blood glucose in study A | Berberine lowered postprandial glucose from 19.8 to 11.1 mmol/L compared to baseline. (P<.01)Benefit seen | 11.1 mmol/L Recorded unit: mmol/L | Sample (as reported): 36 Follow-up: 3-month | Randomised trial · 2008 Study detailsEfficacy of berberine in patients with type 2 diabetes mellitus. Randomized Controlled Trial |
| Triglycerides in study A | Berberine lowered triglycerides from 1.13 to 0.89 mmol/L compared to baseline. (P<.05)Benefit seen | 0.89 mmol/L Recorded unit: mmol/L | Sample (as reported): 36 Follow-up: 3-month | Randomised trial · 2008 Study detailsEfficacy of berberine in patients with type 2 diabetes mellitus. Randomized Controlled Trial |
Associated conditions and community-reported outcomes, wrapped together on one page. Aggregates appear only once enough reports arrive.
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