Berberine is a botanical extract found in about 450 to 500 different plant species within the Berberis genus (where the name “berberine” is derived). It is an alkaloid found in the root, rhizome, stem, and bark of several plants commonly used in botanical and Chinese medicine, such as goldenseal, Oregon grape, and barberry. Berberine has become increasingly popular for its potential to help promote heart health and healthy blood sugar metabolism. 

According to the World Health Organization (WHO), cardiovascular disease (CVD) causes approximately 32% of all deaths globally. Common cardiovascular risk factors include dysregulated blood sugar and abnormal lipid panels, primarily influenced by modifiable lifestyle and dietary factors. According to the Centers for Disease Control (CDC), a person with diabetes is twice as likely to have heart disease. Research indicates that berberine may support pathways related to blood sugar and lipid metabolism in the human body. It may also help promote normal insulin function. Berberine may help support healthy blood vessels, cardiovascular function, and a normal response to inflammation. Evidence suggests that berberine may help support the body’s healthy inflammatory responses, which may in turn help support cardiovascular and metabolic health.

The results of a systematic review and meta-analysis were studied on individuals who received berberine supplementation. Beba and colleagues found that the individuals in these randomized controlled trials exhibited the reduction of serum C-reactive protein, which is an inflammatory marker.

A systematic review and meta-analysis by Yang and colleagues included 44 randomized controlled trials and 4,606 participants who were investigated for the effects of berberine supplementation for patients who had CVD (who were taking the supplement alone or in combination with statins). The patients receiving berberine alone displayed numerous clinical benefits, including significantly reduced National Institute of Health Stroke Scale (NIHSS) scores, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and intima-media thickness. However, there were no statistically significant differences between study groups, and more research is needed. 

In an in-depth review of 49 clinical studies, the participants who were administered berberine supplementation exhibited improved lipid status (triglyceride, total cholesterol, and low-density lipoprotein cholesterol), blood sugar metabolism, and systolic blood pressure. Specifically related to blood sugar metabolism, the review observed significantly reduced fasting blood glucose, insulin, hemoglobin A1C, and homeostatic model assessment for insulin resistance in participants receiving berberine supplements. The researchers pointed out that berberine may be clinically beneficial to those with impaired metabolic health, in particular.

Berberine may also support healthy weight and normal body composition. A systematic review examining in vitro, human, and animal models to evaluate the efficacy of berberine for weight management revealed various mechanisms through which it may support the treatment and prevention of obesity. In diet-induced obese mice, berberine administration increased serum growth differentiation factor 15 (GDF15) and upregulated GDF15 mRNA expression in brown adipose tissue. GDF15 is a stress-response cytokine that can reduce food intake and lower body weight. Similarly, in a review of 1,078 women with polycystic ovary syndrome (PCOS), berberine was found to reduce visceral adipose tissue in the absence of weight loss, promote insulin sensitivity, and support healthy lipid patterns. The review also demonstrated improvements in the ovulation rate per cycle and insulin sensitivity in ovarian theca cells, potentially being a safe compound for supporting fertility in women with PCOS; however, more robust clinical trials are needed to determine the proper dosage for long-term therapy before clinical conclusions can be made.

Lastly, studies with rodent models suggest that berberine may also promote a healthy gastrointestinal (GI) microbial environment. A healthy GI microbial environment may further promote healthy inflammatory responses and support healthy lipid status and blood sugar metabolism. 

Berberine is a botanical extract that may help support heart health, healthy blood sugar metabolism, insulin function, and a healthy weight. Consequently, berberine may be clinically beneficial to the aging population or those seeking ways to promote their cardiometabolic health and improve body composition.

By Danielle Moyer, MS, CNS, LDN and Caitlin Higgins, MS, CNS