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InflammationSignificant improvements in blood sugar and lipids · 4-12 weeks
Mostly mechanism / observational5 studies
Cognitive function
Mostly mechanism / observational3 studies
By the numbers
Pulled from 47 studies with measurable effects
Likely real effects
80%
across studies
People studied
66k
typical study: 849 people
Strongest designs
42
25 pooled, 17 randomised
Showed benefit
76%
13/17 studies
How long studies ran
1–4 weeks
2
1–3 months
5
3+ months
3
Populations Studied
Type 2 diabetes patients5
Patients with Type 2 Diabetes Mellitus1
Adults1
Patients with hyperlipidemia1
Active research area
79 studies in the last 5 years · Latest meta-analysis: 2025
200820172026
1HbA1c reductionMeta-Analysisn=1,337 · large study2025
However, further validation of these findings is necessary through extensive clinical studies with larger sample sizes.
Miao R et al. · Phytotherapy research : PTR (2025)
Noticeable benefit
← WorseNo effectBetter →
Borderline
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.
2Inflammatory biomarkers reductionMeta-Analysisn=1,600 · large study2023
However, more investigation and high-quality evidence must be conducted to obtain more comprehensive and generalizable results.
Vahedi-Mazdabadi Y et al. · Phytotherapy research : PTR (2023)
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.
4Total cholesterol reductionMeta-Analysisn=4,838 · very large study2024
Berberine, alone or with other nutraceuticals, can provide a modest positive impact on lipid concentrations.
Hernandez AV et al. · Journal of dietary supplements (2024)
Noticeable benefit
← WorseNo effectBetter →
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.
This study suggests that berberine may be a promising alternative for CVDs with no serious adverse reactions.
Yang L et al. · Phytomedicine : international journal of phytotherapy and phytopharmacology (2023)
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.
7LDL cholesterol reductionMeta-Analysisn=1,788 · large study2023
Berberine produces small reductions in LDL cholesterol, triglycerides, and apolipoprotein B, with potential sex-specific effects on HDL cholesterol.
Blais JE et al. · Drugs (2023)
No clear effect
← WorseNo effectBetter →
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).
9Clinical efficacy rate improvementMeta-Analysisn=952 · large study2024
BBR demonstrates substantial efficacy in treating UC without causing severe adverse reactions and may serve as a viable complementary therapy.
Li J et al. · PloS one (2024)
Noticeable harm
← WorseNo effectBetter →
Likely real
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).
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.
Zhao H et al. · Reproductive health (2021)
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.
The dosage and treatment duration of Berberine and patients' age may modify the effect.
Liang Y et al. · Endocrine journal (2019)
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.
Higher quality studies are needed to provide more high quality evidence.
Zhang LS et al. · The American journal of Chinese medicine (2019)
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 ).
This study indicates that berberine has comparable therapeutic effect on type 2 DM, hyperlipidemia and hypertension with no serious side effect.
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.
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.
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.
Li J et al. · Phytotherapy research : PTR (2025)
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.
We found a significant reduction in WHR following berberine consumption in adults.
Amini MR et al. · Complementary therapies in medicine (2020)
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.
20Dementia preventionSystematic Reviewn=120 · medium study2020
Berberine could impede the development of dementia via multiple mechanisms: preventing brain damages and enhancing cognition directly in the brain, and indirectly through alleviating risk factors such as metabolic dysfunction, and cardiovascular, kidney and liver diseases.
Shinjyo N et al. · Journal of integrative medicine (2020)
Berberine could impede the development of dementia via multiple mechanisms: preventing brain damages and enhancing cognition directly in the brain, and indirectly through alleviating risk factors such as metabolic dysfunction, and cardiovascular, kidney and liver diseases.
This study provided evidence to support the value of berberine in the prevention of dementia associated with MetS.