| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Body Mass Index (BMI) No effect | 1 study | 641 people | ||||
Studies that measured body mass index (bmi) | ||||||
| Waist circumference No effect | 1 study | |||||
Studies that measured waist circumference | ||||||
| Waist-Hip Ratio Improvement | Improves (the measure goes up) | 1 study | ||||
Studies that measured waist-hip ratio | ||||||
| Weight No effect | 1 study | |||||
Supplement
Berberine is a yellow plant compound found in several herbs, and it switches on AMPK, an enzyme that helps cells manage energy and blood sugar. Most people look at it for type 2 diabetes, where the evidence is strong overall, and trials found blood glucose improved in people with fatty liver and apolipoprotein B, a cholesterol-carrying protein, improved in people with diabetes. Those individual findings are only moderate, though, and the apolipoprotein B study was small.
Sources: PMID 18442638
- Updated
- How we grade
- 18 studies cited
- Best evidence
- Grade B
- Conditions studied
- 20
- Outcomes
- 148
- Graded outcomes
- 0982
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Apolipoprotein B Small Improvement | Improves (the measure goes down) | Small effect | 127 people | |||
| Blood glucose Large Improvement | Improves (the measure goes down) | Large effect | 912 people | |||
| HbA1c | Improves (the measure goes down) | 5 studies | 786 people | |||
Studies that measured hba1c
| ||||||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 2,227 people | |||
Studies that measured total cholesterol
| ||||||
| Glycemic Control | Improves (the measure goes up) | 2 studies | 116 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 1,729 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 2,291 people | |||
| Blood Pressure | Improves (the measure goes down) | 1,426 people | ||||
| C-Reactive Protein (CRP) | Improves (the measure goes down) | 870 people | ||||
| Insulin | Changes; see studies | 1,138 people | ||||
| Insulin Resistance | Improves (the measure goes down) | 1,347 people | ||||
| Interleukin 6 | Improves (the measure goes down) | 536 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 1,860 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 466 people | ||||
Polycystic Ovary Syndrome (PCOS)
- Apolipoprotein B: improves
- HbA1c: improves
- Total cholesterol: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Apolipoprotein B Small Improvement | Improves (the measure goes down) | Small effect | 127 people | |||
| HbA1c | Improves (the measure goes down) | 5 studies | 1,156 people | |||
Studies that measured hba1c
| ||||||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 2,804 people | |||
Studies that measured total cholesterol
| ||||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 2,784 people | |||
| Body Mass Index (BMI) | Improves (the measure goes down) | 1 study | 487 people | |||
Studies that measured body mass index (bmi) | ||||||
| Triglycerides | Improves (the measure goes down) | 1 study | 3,004 people | |||
| Blood glucose | Improves (the measure goes down) | 4,257 people | ||||
| Blood Pressure | Improves (the measure goes down) | 1,426 people | ||||
| Fertility | Improves (the measure goes up) | 501 people | ||||
| Follicle-Stimulating Hormone | Improves (the measure goes up) | 497 people | ||||
| Insulin | Changes; see studies | 1,138 people | ||||
| Insulin Resistance | Improves (the measure goes down) | 1,119 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 2,824 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 577 people | ||||
| Sex Hormone Binding Globulin | Improves (the measure goes up) | 228 people | ||||
| Testosterone | Improves (the measure goes up) | 577 people | ||||
| Waist-Hip Ratio | Improves (the measure goes up) | 402 people | ||||
Dyslipidemia
- Apolipoprotein B: improves
- HbA1c: improves
- Total cholesterol: improves
Nonalcoholic Fatty Liver Disease (NAFLD)
- Blood glucose: improves
- HbA1c: improves
- Total cholesterol: improves
Metabolic Syndrome
- Blood glucose: improves
- HbA1c: improves
- Total cholesterol: improves
Prediabetes
- Blood glucose: improves
- HbA1c: improves
- Total cholesterol: improves
Schizophrenia
- Apolipoprotein B: improves
- Total cholesterol: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Apolipoprotein B Small Improvement | Improves (the measure goes down) | Small effect | 127 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 1,397 people | |||
Studies that measured total cholesterol
| ||||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 1,248 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 1,224 people | |||
Studies that measured triglycerides | ||||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 1,224 people | ||||
General Cardiovascular Health
- Blood glucose: improves
- HbA1c: improves
- Total cholesterol: improves
High Cholesterol
- Blood glucose: improves
- HbA1c: improves
- Total cholesterol: improves
Atherosclerosis
- C-Reactive Protein (CRP): improves
- Total cholesterol: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Small Decrease | Improves (the measure goes down) | Small effect | 120 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 689 people | |||
Studies that measured total cholesterol
| ||||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 589 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 689 people | |||
Studies that measured triglycerides | ||||||
| Interleukin 6 | Improves (the measure goes down) | 240 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 689 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 240 people | ||||
Coronary Artery Disease (CAD)
- C-Reactive Protein (CRP): improves
- Total cholesterol: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Small Decrease | Improves (the measure goes down) | Small effect | 120 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 689 people | |||
Studies that measured total cholesterol
| ||||||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 589 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 689 people | |||
Studies that measured triglycerides | ||||||
| Interleukin 6 | Improves (the measure goes down) | 240 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 689 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 240 people | ||||
Infertility
- Blood glucose: improves
- Total cholesterol: improves
- Body Mass Index (BMI): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose Large Improvement | Improves (the measure goes down) | Large effect | 1,544 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 457 people | |||
| Body Mass Index (BMI) | Improves (the measure goes down) | 1 study | 487 people | |||
| Fertility | Improves (the measure goes up) | 501 people | ||||
| Follicle-Stimulating Hormone | Improves (the measure goes up) | 497 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 577 people | ||||
| Sex Hormone Binding Globulin | Improves (the measure goes up) | 228 people | ||||
| Testosterone | Improves (the measure goes up) | 577 people | ||||
| Waist-Hip Ratio | Improves (the measure goes up) | 402 people |
Cardiovascular Disease
- C-Reactive Protein (CRP): improves
- Total cholesterol: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Small Decrease | Improves (the measure goes down) | Small effect | 120 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 689 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 589 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 689 people | |||
| Interleukin 6 | Improves (the measure goes down) | 240 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 689 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 240 people |
Ischemic Heart Disease
- C-Reactive Protein (CRP): improves
- Total cholesterol: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| C-Reactive Protein (CRP) Small Decrease | Improves (the measure goes down) | Small effect | 120 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 689 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 589 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 689 people | |||
| Interleukin 6 | Improves (the measure goes down) | 240 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 689 people | ||||
| TNF-Alpha | Improves (the measure goes down) | 240 people |
Metabolic Health
- Blood glucose: improves
- Total cholesterol: improves
- High-density lipoprotein (HDL): improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood glucose Large Improvement | Improves (the measure goes down) | Large effect | 1,449 people | |||
| Total cholesterol | Improves (the measure goes down) | 3 studies | 1,297 people | |||
| High-density lipoprotein (HDL) | Improves (the measure goes up) | 2 studies | 1,133 people | |||
| Triglycerides | Improves (the measure goes down) | 1 study | 1,231 people | |||
| Insulin Resistance | Improves (the measure goes down) | 471 people | ||||
| Low-density lipoprotein (LDL) | Improves (the measure goes down) | 1,233 people |
Cardiomyopathy
- Exercise Tolerance
- Quality of Life: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Exercise Tolerance No effect | NoneNo effect | 1 study | 156 people | |||
| Quality of Life | Improves (the measure goes up) | 156 people |
Heart Failure
- Exercise Tolerance
- Quality of Life: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Exercise Tolerance No effect | NoneNo effect | 1 study | 156 people | |||
| Quality of Life | Improves (the measure goes up) | 156 people |
Canker Sores
- Canker Sores Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Canker Sores Symptoms | Improves (the measure goes down) | 1 study | 84 people |
Colorectal Polyps
- Colorectal Polyp Incidence: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Colorectal Polyp Incidence | Changes; see studies | 1 study | 1,076 people |
What the published studies found
3 automated readings
LDL cholesterol
The studies disagree. The best available review (2026, 3 studies, 233 people) found little or no difference in LDL cholesterol, while 5 of the 7 studies read found an improvement. The evidence is very weak.
7 studies counted of 10 read: 6 reviews and 1 trial (144 people in the trials).
- Systematic review, 2026; 3 studies, 233 people; schizophrenia patients with metabolic syndrome: no clear difference (the review the verdict rests on).
No significant differences existed in low density lipoprotein cholesterol
Adjunctive berberine for schizophrenia with metabolic syndrome: a systematic review and meta-analysis - Systematic review, 2025; people with metabolic syndrome: improves. Efficacy and safety of berberine on the components of metabolic syndrome: a systematic review and meta-analysis of randomized placebo-controlled trials
- Meta-analysis, 2024; 41 studies, 4,838 people; patients with hyperlipidemia: improves. 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
- Systematic review, 2024: improves.
significantly reduce plasma total and low-density lipoprotein (LDL) cholesterol levels by 3-25%
Dietary supplements: clinical cholesterol-lowering efficacy and potential mechanisms of action - Meta-analysis, 2023; 44 studies, 4,606 people; patients with cardiovascular diseases: no clear difference.
Berberine plus statins significantly reduced TC, TG, LDL-C
Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials - Meta-analysis, 2019; 11 studies, 1,386 people; patients with hyperlipidemia: improves.
significantly reduce the total cholesterol and low-density lipoprotein levels
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 - Crossover trial, 2013; 144 people: improves.
Berberine reduced total cholesterol, triglycerides and LDL cholesterol
Effects of berberine on lipid profile in subjects with low cardiovascular risk
- Systematic review, 2026; 3 studies, 233 people; schizophrenia patients with metabolic syndrome: no clear difference (the review the verdict rests on).
Blood pressure
The best available review (2026, 21 studies, 1,426 people) found an improvement in blood pressure. That review studied adults with schizophrenia spectrum disorders on antipsychotics. 5 of the 9 studies read agree; 4 found no clear difference. The evidence is moderate.
9 studies counted of 10 read: 6 reviews and 3 trials (239 people in the trials).
- Meta-analysis, 2026; 21 studies, 1,426 people; adults with schizophrenia spectrum disorders on antipsychotics: improves (the review the verdict rests on). Efficacy and tolerability of nutraceuticals and phytotherapics for antipsychotic-induced weight gain in schizophrenia spectrum disorders: Systematic review and meta-analysis
- Systematic review, 2026; 3 studies, 233 people; schizophrenia patients with metabolic syndrome: no clear difference. Adjunctive berberine for schizophrenia with metabolic syndrome: a systematic review and meta-analysis
- Systematic review, 2025; 17 studies, 1,337 people; patients with type 2 diabetes mellitus: improves. 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
- Systematic review, 2025; people with metabolic syndrome: no clear difference. Efficacy and safety of berberine on the components of metabolic syndrome: a systematic review and meta-analysis of randomized placebo-controlled trials
- Systematic review, 2022: improves. The effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis
- Meta-analysis, 2015; 27 studies, 2,569 people; patients with type 2 diabetes, hyperlipidemia, hypertension: improves.
tended to lower the level of blood pressure more than the lifestyle intervention alone
Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension - Randomised trial, 2021; 84 people; chinese men with hyperlipidemia: no clear difference.
blood pressure, body mass index and waist-hip ratio after the intervention did not differ
Effect of Berberine on Cardiovascular Disease Risk Factors: A Mechanistic Randomized Controlled Trial - Randomised trial, 2019; 131 people: no clear difference.
BP and BMI levels remained unchanged
The Effects of a New Generation of Nutraceutical Compounds on Lipid Profile and Glycaemia in Subjects with Pre-hypertension - Randomised trial, 2013; 24 people; patients with metabolic syndrome: improves. Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion
Body weight
The studies disagree. The best available review (2026, 23 studies) found an improvement in body weight, while 3 of the 7 studies read found no clear difference. The evidence is very weak.
Possible harm: 1 study read reported a worse result for body weight with Berberine. One abstract says: "Berberine significantly: increased body weight (n = 7; SMD = 1.67; 95% CI: 0.57 to 2.76; P < 0.00001)" Check the studies below, and ask a doctor or pharmacist if this applies to you.
7 studies counted of 8 read: 6 reviews and 1 trial (113 people in the trials).
- Meta-analysis, 2026; 23 studies; adults with obesity indices: improves (the review the verdict rests on).
Berberine significantly reduced body weight (MD of -0.88 kg
The effect of berberine on obesity indices: a systematic review and meta-analysis - Meta-analysis, 2025; 7 studies; preclinical models: worsens.
increased body weight (n = 7; SMD = 1.67
The potential value of the use of berberine in depression: a systematic review and meta-analysis of preclinical studies - Systematic review, 2021; women with polycystic ovary syndrome: no clear difference. The effect and safety of Berberine on polycystic ovary syndrome: a systematic review
- Meta-analysis, 2020; 12 studies, 849 people: no clear difference. Effects of berberine and barberry on anthropometric measures: A systematic review and meta-analysis of randomized controlled trials
- Meta-analysis, 2020; 10 studies: no clear difference.
no significant decline in body weight
The effect of berberine supplementation on obesity indices: A dose- response meta-analysis and systematic review of randomized controlled trials - Meta-analysis, 2020; 12 studies: improves.
significantly decreased body weight (WMD = -2.07 kg
The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials - Randomised trial, 2022; 113 people; schizophrenia patients with metabolic syndrome: improves.
significantly greater reduction in weight gain
Adjunctive berberine reduces antipsychotic-associated weight gain and metabolic syndrome in patients with schizophrenia: a randomized controlled trial
- Meta-analysis, 2026; 23 studies; adults with obesity indices: improves (the review the verdict rests on).
Key findings
- Body Mass Index (BMI)
- Apolipoprotein BImproves (the measure goes down)
- Blood glucoseImproves (the measure goes down)
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- Grade B
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Studies cited
18 studies from PubMed
- Efficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
- Effects of berberine on lipid profile in subjects with low cardiovascular risk
- A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults.
- The effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis.
- The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis
- Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine
- Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis.
- Effects of administering berberine alone or in combination on type 2 diabetes mellitus: a systematic review and meta-analysis.
- 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.
- Efficacy of Berberine in Patients with Non-Alcoholic Fatty Liver Disease
- Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion
- Efficacy and safety of berberine for congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy
- Effects of berberine gelatin on recurrent aphthous stomatitis: a randomized, placebo-controlled, double-blind trial in a Chinese cohort
- Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials.
- Efficacy and safety of berberine in preventing recurrence of colorectal adenomas: A systematic review and meta-analysis.
- Effects of berberine and barberry on anthropometric measures: A systematic review and meta-analysis of randomized controlled trials
- The Effect of Berberine on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Control Trials.