Bbr9.0

Berberine Research

55 peer-reviewed studies · Evidence score: 9/10

Clinical 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-Analysis

Miao R et al. • Phytotherapy research : PTR (2025)

However, further validation of these findings is necessary through extensive clinical studies with larger sample sizes.

For HbA1c, silymarin was more effective than resveratrol (MD -2.08, 95%Cl -3.50 to -0.72) (P < 0.05).
For body mass index (BMI), curcumin was more effective than resveratrol (MD -1.27, 95%Cl -2.43 to -0.03) (P < 0.05).
Curcumin, resveratrol, silymarin, and berberine can effectively improve cardio-metabolic risk factors in T2DM, and different herbal phytochemicals have different clinical advantages.

Meta-Analysisn=1,337

DOI

Effects of berberine and barberry on selected inflammatory biomarkers in adults: A systematic review and dose-response meta-analysis of randomized clinical trials

Vahedi-Mazdabadi Y et al. • Phytotherapy research : PTR (2023)

However, more investigation and high-quality evidence must be conducted to obtain more comprehensive and generalizable results.

In addition, the non-linear analysis showed a significant lowering effect of berberine/barberry on IL-6 and TNF-α levels in doses <1000 mg/day and less than 5 weeks of intervention.
There are limitations to our findings, including low-quality studies and significant heterogeneity.
These interventions might be considered adjunct therapy to managing inflammation status.

Meta-Analysisn=1,600

DOI

Effects of administering berberine alone or in combination on type 2 diabetes mellitus: a systematic review and meta-analysis

Wang Y et al. • Frontiers in Pharmacology (2024)

Berberine alone significantly reduced FPG, 2hPBG, LDL-C, TC, and triglycerides in 50 RCTs.

50 studies with 4,150 participants analyzed
Significant reductions in FPG (-0.59 mmol/L)
Safe with no increased adverse events

Meta-Analysisn=4,150

DOI

Impact of Berberine or Berberine Combination Products on Lipoprotein, Triglyceride and Biological Safety Marker Concentrations in Patients with Hyperlipidemia: A Systematic Review and Meta-Analysis

Hernandez AV et al. • Journal of dietary supplements (2024)

Berberine, alone or with other nutraceuticals, can provide a modest positive impact on lipid concentrations.

Products with berberine alone had less robust effects on TC (MD -12.08 mg/dL [95%CI: -21.79 to -2.37]), LDL (MD -9.26 mg/dL [95%CI: -20.31 to 1.78]), and HDL (MD 1.38 mg/dL [95%CI: -1.27 to 4.03]) but TG effects were similar (MD -17.40 mg/dL [95%CI: -32.57 to -2.23]).
Berberine, alone or with other nutraceuticals, can provide a modest positive impact on lipid concentrations.
Further research warranted to confirm findings

Meta-Analysisn=4,838

DOI

The Effect of Berberine Supplementation on Glycemic Control and Inflammatory Biomarkers: An Umbrella Meta-analysis

Zarezadeh M et al. • Clinical Therapeutics (2023)

Umbrella meta-analysis confirms berberine improves glycemic parameters and inflammatory markers.

Improvements in FBG, insulin, HbA1c, HOMA-IR
Reduced inflammatory markers IL-6, TNF-α, CRP
Consistent benefits across multiple meta-analyses

Meta-Analysisn=5,000

DOI

Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials

Yang L et al. • Phytomedicine : international journal of phytotherapy and phytopharmacology (2023)

This study suggests that berberine may be a promising alternative for CVDs with no serious adverse reactions.

Berberine alone significantly reduced National Institute of Health Stroke Scale (NIHSS) score, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and intima-media thickness (IMT) levels than routine therapy.
Berberine plus statins significantly reduced TC, TG, LDL-C, NIHSS score, hs-CRP, TNF-α, IMT, Crouse score, and number of unstable plaques levels than routine or statins.
This study suggests that berberine may be a promising alternative for CVDs with no serious adverse reactions.

Meta-Analysisn=4,606

DOI

Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

Blais JE et al. • Drugs (2023)

Berberine produces small reductions in LDL cholesterol, triglycerides, and apolipoprotein B, with potential sex-specific effects on HDL cholesterol.

Eighteen studies (n = 1788 participants), conducted mainly in mainland China and Hong Kong (15 studies [83%]), were included with treatment durations ranging from 4 to 24 weeks.
Berberine increased HDL cholesterol by 0.06 mmol/L (95% CI 0.00 to 0.11, 15 studies, n = 1471).
Notably, the effect on HDL cholesterol was different in women (0.11 mmol/L, 95% CI 0.09 to 0.13) from that in men (- 0.07 mmol/L, 95% CI - 0.16 to 0.02).

Meta-Analysisn=1,788

DOI

The clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver disease: a meta-analysis and systematic review

Nie Q et al. • Journal of translational medicine (2024)

This meta-analysis demonstrates berberine's efficacy in improving liver enzymes, lipid profile, and insulin sensitivity in NAFLD patients.

This meta-analysis demonstrates berberine's efficacy in improving liver enzymes, lipid profile, and insulin sensitivity in NAFLD patients.
These results indicate that berberine shows promise as an adjunct therapy for NAFLD.
Trial registration The protocol was registered with PROSPERO (No.

Meta-Analysisn=811

DOI

Efficacy and safety of berberine plus 5-ASA for ulcerative colitis: A systematic review and meta-analysis

Li J et al. • PloS one (2024)

BBR demonstrates substantial efficacy in treating UC without causing severe adverse reactions and may serve as a viable complementary therapy.

BBR considerably improved the clinical efficacy rate (RR = 1.22, 95% CI [1.15, 1.30], P < 0.00001), attenuated the Baron score (SMD = -1.72, 95% CI [-2.30, -1.13], P < 0.00001) and reduced the DAI score (SMD = -2.93, 95% CI [-4.42, -1.43], P < 0.00001).
Additionally, it ameliorated clinical symptoms (SMD = -2.74, 95% CI [-3.45, 2.02], P < 0.00001), diminished inflammatory responses (SMD = -1.59, 95% CI [-2.14, 1.04], P < 0.00001), and modulated immune reactions (SMD = 1.06,95% CI [0.24,1.87], P <0.00001).
Nonetheless, the impact of BBR on reducing adverse reactions was not statistically significant (RR = 0.75, 95% CI [0.42, 1.33], P > 0.05).

Meta-Analysisn=952

DOI

Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis

Zhang M et al. • Frontiers in Pharmacology (2022)

Berberine reduced FPG, HbA1c, and 2hPBG without increasing adverse events or hypoglycemia risk.

37 studies with 3,048 patients included
FPG reduced by 0.82 mmol/L
HbA1c reduced by 0.63%

Meta-Analysisn=3,048

DOI

A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults

Osadnik T et al. • Pharmacological research (2022)

Evidence for bergamot effect was based on relatively small study group and may require further investigations.

Evidence for bergamot effect was based on relatively small study group and may require further investigations.
Policosanols have no effect on the lipid profile.

Meta-Analysisn=13,062

DOI

Comparative efficacy of oral insulin sensitizers metformin, thiazolidinediones, inositol, and berberine in improving endocrine and metabolic profiles in women with PCOS: a network meta-analysis

Zhao H et al. • Reproductive health (2021)

Ours is the first study to report that for women with PCOS, myo-inositol combined with D-chiro-inositol and metformin combined with thiazolidinediones appear superior to metformin alone in improving insulin resistance and decreasing total testosterone.

Compared with metformin, treatment with myo-inositol + D-chiro-inositol was associated with a greater improvement in menstrual frequency (odds ratio 14.70 [95% confidence interval (CI) 2.31-93.58]).
Ours is the first study to report that for women with PCOS, myo-inositol combined with D-chiro-inositol and metformin combined with thiazolidinediones appear superior to metformin alone in improving insulin resistance and decreasing total testosterone.
Myo-inositol combined with D-chiro-inositol is particularly efficacious in menstrual recovery.

Meta-Analysisn=1,079

DOI

Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis

Liang Y et al. • Endocrine journal (2019)

The dosage and treatment duration of Berberine and patients' age may modify the effect.

We calculated weighted mean differences (WMD) and 95% confidence interval (CI) for fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and glycated haemoglobin (HbA1c) levels.
The pool data showed that Berberine treatment was associated with a better reduction on FPG (WMD = -0.54 mmol/L, 95% CI: -0.77 to -0.30), PPG (WMD = -0.94 mmol/L, 95% CI: -1.27 to -0.61), and HbA1c (WMD = -0.54 mmol/L, 95% CI: -0.93 to -0.15) than control groups.
Subgroup-analyses indicated that effects of Berberine on blood glucose became unremarkable as the treatment lasted more than 90 days, the daily dosage more than 2 g/d and patients aged more than 60 years.

Meta-Analysisn=2,313

DOI

Efficacy and Safety of Berberine Alone or Combined with Statins for the Treatment of Hyperlipidemia: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

Zhang LS et al. • The American journal of Chinese medicine (2019)

Higher quality studies are needed to provide more high quality evidence.

The results of meta-analysis showed that compared with the placebo group, berberine could significantly reduce the total cholesterol and low-density lipoprotein levels and elevate the high density lipoprotein level ( P<0.05 ).
Compared with the simvastatin group, berberine was effective only in reducing the level of triglyceride ( MD=-0.37 , 95% CI: - 0.66, - 0.07, P=0.02 ).
Compared with the simvastatin group, berberine plus simvastatin was more effective in reducing the level of triglyceride ( MD=-0.33 , 95% CI: - 0.46, - 0.20, P<0.00001 ) and total cholesterol ( MD=-0.36 , 95% CI: - 0.60, - 0.12, P=0.003 ).

Meta-Analysisn=1,386

DOI

Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials

Ju J et al. • Phytomedicine : international journal of phytotherapy and phytopharmacology (2018)

Berberine improves lipid profiles in dyslipidaemias with satisfactory safety.

Berberine also increased the level of high-density lipoprotein cholesterol (HDL-C) when used alone (MD = 0.08  mmol/l 95% CI [0.03, 0.12], p = 0.001).
No significant differences were found between groups in terms of incidence of adverse events (RR = 0.64 95% CI [0.31, 1.30], p = 0.22).
Berberine improves lipid profiles in dyslipidaemias with satisfactory safety.

Meta-Analysisn=2,147

DOI

Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension

Lan J et al. • Journal of ethnopharmacology (2015)

This study indicates that berberine has comparable therapeutic effect on type 2 DM, hyperlipidemia and hypertension with no serious side effect.

This study indicates that berberine has comparable therapeutic effect on type 2 DM, hyperlipidemia and hypertension with no serious side effect.
Considering the relatively low cost compared with other first-line medicine and treatment, berberine might be a good alternative for low socioeconomic status patients to treat type 2 DM, hyperlipidemia, hypertension over long time period.
Due to overall limited quality of the included studies, the therapeutic benefit of berberine can be substantiated to a limited degree.

Meta-Analysisn=2,569

DOI

Systematic Review and Network Meta-Analysis of the Effects of Plant Extracts on Cognitive Function and Quality of Life in Stroke Patients

Li J et al. • Phytotherapy research : PTR (2025)

Future longer follow-up, larger samples, and more methodologically rigorous randomized controlled trials are recommended to clearly establish the effects of different dosages on cognitive function and quality of life in stroke patients.

John's Wort extract (SUCRA 71.2%) was the most effective in reducing NIHSS scores, Berberine (SUCRA 84.1%) was most effective in reducing mRS scores, and St.
John's Wort extract (SUCRA 99.1%) showed the highest efficacy in enhancing ADL scores.
Ginsenosides were the most effective in improving Barthel Index (SUCRA 74.7%), MMSE (SUCRA 93%), and MOCA (SUCRA 79.7%) scores.

Meta-Analysis

DOI

Effects of berberine and barberry on anthropometric measures: A systematic review and meta-analysis of randomized controlled trials

Amini MR et al. • Complementary therapies in medicine (2020)

We found a significant reduction in WHR following berberine consumption in adults.

We found a significant reduction in WHR following berberine consumption in adults.
Further clinical trials with high quality according to challenges mentioned seem to be helpful to use berberine and barberry as a supplement for certain health conditions, efficiently.
Further research warranted to confirm findings

Meta-Analysisn=849

DOI

Berberine and health outcomes: an overview of systematic reviews

Shi L et al. • BMC complementary medicine and therapies (2025)

Current evidence suggests that berberine has beneficial effects on a range of health outcomes for people with chronic diseases.

There was a high overlap of primary studies (CCA > 15%) in the SRs of PCOS, NAFLD, obesity, and schizophrenia.
Current evidence suggests that berberine has beneficial effects on a range of health outcomes for people with chronic diseases.
Specifically, berberine significantly improves type 2 diabetes, gastrointestinal disorders, schizophrenia, metabolic syndrome, and dyslipidemia outcomes.

Systematic Review

DOI

Berberine derivatives as inhibitors of acetylcholinesterase: A systematic review

Singh YP et al. • Chemical biology & drug design (2023)

Structure-activity relationship (SAR) and biological activity provide highlights on the new derivatives used for the management of AD.

Due to the complex pathophysiology of AD, no specific treatment is available in the market, and treatment is only limited to the symptomatic relief.
So, there is an urgent need for the development of new drug candidate, which can have disease-modifying effect and improve learning and memory in AD patient.
Therefore, berberine-based multifunction compounds with potential cholinesterase inhibitory properties were reviewed in this article.

Systematic Review

DOI

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