Berberine

Berberine HCl

Snapshot

Indications	Contraindications
Glucose lowering^{1, 2} Lipid lowering^{1, 3} Metabolic syndrome components^4–7 Fatty liver disease⁸ Waist circumference^{9, 10} Colorectal adenoma recurrence^{11, 12}	Pregnancy or breastfeeding¹³ Tacrolimus or cyclosporin¹³ Bosutinib¹³ Sulfonylureas¹³

Berberine is an alkaloid from barberry, goldenseal, and Chinese goldthread, long used in traditional Chinese medicine and Ayurveda¹³. It supports glucose and lipid metabolism largely by activating adenosine monophosphate-activated protein kinase¹⁴. An international expert panel sees the most use in mild hypercholesterolemia with statin intolerance or metabolic syndrome¹³. It is also used after polypectomy to reduce colorectal adenoma recurrence^{11, 12}.

A 2025 network meta-analysis in small intestinal bacterial overgrowth ranked berberine highest among compared regimens, though its authors call for direct-comparison trials¹⁵. Of 821 products listing berberine, sampled products are nearly all capsules; poor oral bioavailability has driven modified formulations (see Form comparison)¹³.

Pregnancy and breastfeeding are the most consequential exclusions, because berberine may worsen jaundice in infants and risk kernicterus¹³. Two of 30 United States supplement labels ask for practitioner consultation before use with insulin¹⁶.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

71 sources, 56 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Articles

Berberine vs metformin: the trials side by sideOct 8, 2026Berberine lowers HbA1c by about a third as much as metformin in placebo trials and has no long-term outcome data. What it adds to metformin, and what to check first.

Snapshot

In the full monograph

Articles

Sources