Berberine is an herbal supplement with a history that’s thousands of years long.
It’s been used and researched to treat everything from joint pain to weight loss to controlling diabetes in people with insulin insensitivity.
Berberine’s mechanism of action is complex, but it appears to alter the way your body’s mitochondria generate energy, which might indicate why it’s helpful for such a wide variety of ailments.
If you’re looking for a quality weight loss supplement sourced from an herbal remedy, berberine is worth a look.
We’ve examined what’s available on the market right now and come up with the top ten, ranked according to efficacy.
Research
Rankings
1. Nuzena Berberine Pure +
If you want to leverage the benefits of berberine for better heart health, blood sugar control, and gastrointestinal function, look no further than Nuzena Berberine Pure +.
Each veggie capsule boasts 600 mg of highly pure and highly concentrated berberine, putting it at the top of our list thanks both to its high dosage and to its high purity. On top of that, its purity is independently verified by third-party lab testing, and it’s certified non-GMO, gluten-free, and vegan-friendly.
For all of these reasons, Berberine Pure + by Nuzena is our number one pick for 2021.
2. Thorne Research Berberine
Thorne Research is a well-known name in the rarer, less common herbal extracts because they almost always make a quality, pure product with a minimal amount of extraneous ingredients.
That’s certainly the case here, as this is one of the best berberine supplements out there that comes in a vegetarian capsule. At 500 mg per capsule, it doesn’t skimp on the dosage either.
3. aSquared Nutrition Berberine
aSquared Nutrition makes a highly pure berberine supplement in a gelatin capsule that provides a very solid 500 mg of berberine per capsule at a 60% concentration.
With the only other ingredients being rice flour and gelatin, it’s a pure and reliable source of berberine. aSquared also has an excellent reputation for purity and quality in its supplements, making it hard to go wrong with this product.
4. Integrative Therapeutics Berberine Complex
Unlike many other companies, Integrative Therapeutics is doing something innovative with its berberine supplement. It uses three different plant species as sources of berberine, and one of them is combined with several of the other related compounds in the plant that are bioactive.
This means that this berberine supplement could be more likely to work if others have failed you, though if all you want is 100% pure berberine, there are better options on the market.
5. We Like Vitamins Berberine
The dosage of berberine in this supplement is middle-of-the-road, but its simplistic design and its allergen-free certification make it a very solid choice.
The only other ingredients are gelatin (for the capsule–sorry, vegetarians) and rice flour, and the fact that it’s gluten, dairy, egg, and soy free are all to its benefit.
6. Divine Bounty Berberine
For those looking for a high dosage berberine supplement, Divine Bounty is a good choice. With 600 mg per capsule, it provides 20% more berberine per serving than most of its other competitors.
Add to that the fact that it comes in a vegetarian capsule and doesn’t have much in the way of extra fillers and stabilizers, and you’ve got a winning formula for those who need a higher than usual dose of berberine.
7. Naturebell Berberine Plus
Naturebell provides a solid berberine supplement with a high dose of 600 mg per capsule, which is nice for more aggressive supplementation routines shooting for 1200 mg per day in two separate doses. Aside from this, the purity and supplement design is good but not the absolute best.
8. Dr. Whitaker’s Clinical Grade Berberine
Though it’s branded as clinical grade, this berberine supplement doesn’t appear to be of higher dosage or quality than anything else on the market.
It has the usual 500 mg of berberine per capsule, and the capsules are made of gelatin along with a few extra fillers and stabilizers not found in the competitors, making it hard to justify ranking this supplement any higher.
9. EzyAbsorb Berberine
While this supplement claims to offer superior absorption properties to other berberine supplements, it’s not clear how it intends to accomplish this. Its ingredients are pretty much standard fare: it has 500 mg of berberine per capsule, along with a brown rice concentrate filler in the vegetarian capsule.
Without any obvious bonus ingredients or a different manufacturing process, it’s hard to see how this supplement could be better than any others when it comes to absorption.
10. Sunergetic Berberine
Sunergentic has a high-dose 600 mg berberine supplement that is delivered in a vegetarian capsule.
It’s also certified free of many common allergens like gluten and soy, though the main downside of the berberine supplement from this lesser-known supplement manufacturer is its reliance on silica as a filler for its capsules. Higher-quality brands will opt for something more natural, like rice flour.
Category winners
Best berberine overall: Nuzena Berberine Pure +
With 600 mg of berberine per capsule, independent lab verification for purity, and no extraneous ingredients, Nuzena is a great choice. High dose, super-pure, and easy to use.
Best berberine for gut health: Thorne Research Berberine
If you are using berberine for gut problems, like the bacterial overgrowth linked to SIBO, you want a berberine supplement that’s free of any extraneous ingredients. That’s why we recommend Thorne Research Berberine for gut health—its ultra-simple supplement design makes it well-suited for this application.
Best berberine for weight loss: Integrative Therapeutics Berberine
Integrative Therapeutics provides berberine alongside two other herbal extracts for digestive and metabolic health: goldenseal and Oregon grape extracts. These could be useful for preventing some of the troublesome gastrointestinal side effects that can come along with starting a weight loss diet.
Best berberine for women: aSquared Nutrition Berberine
Women benefit from the slightly lower dose of berberine found in aSquared Nutrition, while still benefiting from a well-standardized extract from berberis aristata—since the berberine concentration is explicitly measured, you know you’ll be getting a consistent dose from one batch to another.
Best berberine for heart health: Thorne Research Berberine
Berberine has been used in a few scientific studies to reduce blood lipids and blood pressure, which can help decrease your risk of heart disease. To follow the protocols from these studies as closely as possible, go for a pure and concentrated berberine supplement like Thorne Research Berberine, which boasts 500 mg of 85% berberine extract.
Best berberine for blood sugar control: Nuzena Berberine Pure +
One of berberine’s most popular applications is helping to control blood sugar, and the high-dose formulation of Nuzena Berberine Pure + is perfectly suited for this use case: its 600 mg of concentrated berberine extract per capsule leads the industry in dosage.
Who should buy berberine?
The supplemental benefits of berberine are best taken advantage of by people who are concerned about their metabolic health, want to reverse the negative health effects of obesity, or who want a chance at improving their blood glucose regulation and fight back against metabolic dysfunction.
It’s been studied most intently as a way to help treat insulin insensitivity in people who have type two diabetes or who have metabolic syndrome. However, berberine also finds applications in helping with other health issues commonly associated with an unhealthy diet and excessive body weight, such as high cholesterol and high blood lipids.
While berberine is not, on its own, a fantastic weight loss supplement, it does do a fairly good job helping to ameliorate the negative health effects associated with being overweight. It might help lower your body fat percentage, but it’s far stronger at improving health than just reducing the number that you see on the scale.
Some research suggests that berberine works for weight loss, but not as well as some of the more high-powered compounds for weight loss like green tea extract. Its real strength lies in changes to your body’s metabolic health. So taking berberine might be helpful as you are trying to lose weight, so you can move your body closer to a metabolically healthy state.
Interestingly, berberine also has a dedicated core of advocates among people who have irritable bowel syndrome. While the mechanism of action here is not entirely clear, clinical research does support the use of berberine to reduce some of the symptoms of irritable bowel syndrome, so if you have gastrointestinal problems attributable to IBS, you may have success using berberine as well.
How we ranked
Because berberine is specifically geared towards certain health conditions, and because most of the evidence for it comes from clinical trials that used pure berberine extracts in their experiments, we required all of the berberine supplements in our rankings to deliver only berberine as their active ingredient, not any other vitamins, minerals, or supplements.
While it’s not necessarily true that berberine must be taken to the exclusion of all other supplements, this is how it is usually prescribed in clinical research. No products that included non-berberine active ingredients made it into our rankings.
Next, after focusing on berberine-specific supplements, we looked at the dosage.
Since the research on berberine typically uses 900-1500 mg daily doses divided up into several smaller tablets, we required that the berberine supplements in our rankings deliver a dose that was easily parsed out into two or three tablets or capsules per day to reach this clinically effective dosage range.
Anything with less than 450 or more than 600 mg per capsule was dropped from consideration.
Beyond just the dosage, we also looked at the purity of the berberine supplements. Did they take advantage of independent laboratory testing for purity, like Amazing Formulas? Did the capsules have a clean, simple ingredient design, or were they bloated with silica and other binders or coloring agents?
These were the kinds of things we considered when evaluating the remaining berberine supplements. While a cellulose-based capsule as opposed to a gelatin-based capsule was a nice perk (for strict vegetarians and vegans), it wasn’t a core evaluation criteria.
Those that did well on these criteria scored near the top of the rankings, and those that did poorly scored lower, or didn’t even make the final list.
Benefits
Berberine is a powerful natural plant compound that improves cardiovascular health, lowers blood sugar, and may assist in weight loss. Altering body processes on a molecular level, this supplement rivals the effects of pharmaceutical drugs for controlling blood sugar.
Bioactive substances are present in the berberis shrub and other plants from which berberine is extracted. (1) An alkaloid imbued with bright yellow coloring, the compound has been used in the past as a dye, as well as in traditional Chinese medicine.
Berberine has been shown to drop total cholesterol levels in clinical trials; it can improve LDL cholesterol profiles (the bad kind), and aid in the management of type 2 diabetes. (2)
Recent evidence indicates berberine may even act as an anti-cancer agent. (3)
Let’s take a look at how berberine supplements work to normalize body processes and contribute to better overall health.
Berberine Exerts Powerful Effects on Metabolism. When berberine is ingested, it reaches cells via the bloodstream; on a cellular level, berberine seeks “molecular targets” and then binds to these, altering function. It may also play a role in determining gene expression through affecting the switching process. (4)
This is the same way pharmaceutical drugs affect the system.
Next comes the activation of the cellular enzyme AMP-activated protein kinase (AMPK) (5), which has been called the master switch for metabolism. (6)
This substance is found in organs like the heart, kidneys, muscles, brain and liver, and is necessary for the regulation of metabolism. (7, 8)
Berberine has shown great promise in treating symptoms of type 2 diabetes, a metabolic disorder that has become disturbingly common in the modern world.
Globally, nearly 10% of adults suffered from diabetes in 2012, and fatalities directly attributed to the disease in the same year were estimated at a staggering million and a half. (9)
Diabetic patients experience high blood glucose (blood sugar) levels that result from one of these physical disorders: not enough insulin produced in the body; or cell resistance to insulin. Both circumstances can inflict physical damage on organs and tissues over long periods of time.
Berberine is effective in reducing blood sugar levels for patients diagnosed with type 2 diabetes. (10) Over a three-month clinical trial, the natural substance performed comparably to metformin, a pharmaceutical drug used to treat hypoglycemia. (11)
This natural substance appears to affect blood sugar through several different mechanisms. (12)
The following process occurs: Decreases the speed at which carbohydrates are broken down in the gut, drops the production of sugar in the liver, bumps up glycolysis, which helps the body break down cell sugars more effectively, amps up the effectiveness of insulin, which lowers blood sugar, and increases friendly bacteria in the gut, functioning like a probiotic.
Berberine can also affect other aspects of bodily processes integral to the regulation of blood sugar, including gene expression and the function of molecules and enzymes.
Diabetic patients taking a gram of berberine daily dropped blood sugar levels into normal ranges during a three-month study. Triglycerides and cholesterol also improved, as well as measurements of hemoglobin A1c, which is a long-term indicator of high blood sugar levels. (13)
When analysts reviewed data from 14 studies, they found berberine as effective in lowering blood sugar levels as three separate oral medications used to treat diabetes: glipizide, rosiglitizone, and as mentioned above, metformin. (14)
Berberine could help with weight loss. Two separate studies recently examined the impact of berberine supplements on weight loss in humans.
In a 12-week trial with obese participants, average weight loss amounted to about 5 pounds, with a 3.6% loss of body fat. Berberine was administered at 500 mg three times daily. (15)
Another 3-month study focused on the effects of berberine with 37 subjects diagnosed with metabolic syndrome. This group took even less berberine: 900 mg split into three daily doses. (16)
The average body mass index (BMI) measurements of test participants dropped from 31.5 to 27.4 during the trial, shifting them from obese to overweight. Belly fat decreased significantly, and other health markers also improved.
Changes appear to result from alterations to hormones that regulate fat storage, including insulin, leptin and adiponectin. Berberine is believed to suppress the formation of fat cells at the molecular level. (17, 18)
The cholesterol-lowering properties of berberine could improve heart health. The most common cause of premature death worldwide is heart disease, and berberine has a positive effect on several blood markers associated with a greater risk of developing this deadly disorder.
A meta-analysis reviewing 11 studies of how berberine affected risk factors presented these conclusions: (19) Total cholesterol drops of up to 0.061 mmol/L, increase in HDL cholesterol (the good kind) by as much as 0.05 mmol/L, decrease in LDL cholesterol (the bad kind) by 0.65 mmol/L and blood triglyceride levels decreased by 0.50 mmol/L.
Drops in apolipoprotein B levels by as much as 15% were also noted in some studies. This is a major marker for developing heart disease. (20, 21)
Researchers believe berberine works to alter cholesterol levels by inhibiting the production of an enzyme called PCSK9, which results in the removal of more LDL cholesterol from the blood. (22, 23)
Diabetics and others with high blood sugar levels are more likely to develop heart disease, so the positive effects of berberine on these factors should also reduce risks.
Berberine may exert other health benefits too. Lab studies show berberine helps rats fight depression, and may prove to be beneficial for humans as well. (24)
The effects of berberine on reducing cancerous tumor growths, as well as preventing the spread of cancer, are being explored with animal ad laboratory studies, and results look promising. (25, 26)
Antioxidant and anti-inflammatory properties of berberine may also prove to be effective in delivering valuable health benefits. (27)
Berberine has been shown to kill viruses, fungi, bacteria, parasites and other pathogens. (28)
For patients with heart failure, berberine can improve symptoms and decrease mortality rates. (29)
Berberine may help people with irritable bowel syndrome. The effects of berberine on fat metabolism and cellular energy processing is fairly well-studied, but an emerging body of scientific literature suggests that berberine could also be helpful for gastrointestinal problems that can be traced to irritable bowel syndrome.
A randomized controlled trial published in 2015 in the journal Phytotherapy Research split 132 people into two groups. One received a placebo, while the other took a berberine supplement that delivered 800 mg per day split into two equal doses (30).
The subjects were followed for eight weeks. After analyzing the results, the researchers found that the people receiving the berberine supplement had decreased abdominal pain, decreased diarrhea, and improvements in other gastrointestinal symptoms compared to the placebo group.
As for why these effects emerged, the research doesn’t provide many clues. Changes in metabolic function inside the gastrointestinal tract could be one potential explanation; alterations to the immune system (which is implicated in irritable bowel syndrome) could be a different explanation.
Regardless, berberine shows promise as a natural remedy for more than just obesity-related health problems.
Side effects
Berberine is considered very safe, although some experience digestive distress, including diarrhea, flatulence, stomach pain or cramping, and constipation. (31)
One study of 84 people with type two diabetes reported that five of the subjects who were randomly assigned to take berberine experienced mild constipation, which is in line with some other research suggesting that berberine could alter the functioning of the gastrointestinal tract.
While some research indicates that these effects are helpful in people with irritable bowel syndrome, the study mentioned above suggests that others who are healthy could experience constipation as a side effect of berberine.
Since this powerful substance is fairly new to the supplement scene, you may not find it in health food stores, but it’s available online. Talk to your doctor before taking berberine, especially if you’re currently on medications to lower blood sugar.
Berberine’s ability to interact with other medications is not well understood, and many people who have trouble with blood sugar take medications like metformin to keep their blood sugar controlled.
While at least one clinical trial has tested berberine in combination with metformin without any negative side effects, more research needs to be done to confirm the safety of berberine and drug combinations in the long term (X).
Recommended dosage
Because berberine’s half-life is several hours, spreading dosages over the day is most effective; amounts used in clinical studies in humans ranged from a total of 900 to 1500 mg daily, usually taken 30 minutes before meals.
When making our rankings, we only included berberine supplements that had doses that were convenient to parse out into multiple daily servings. For example, with 450 mg of berberine per capsule, it’s quite easy to get 900 or 1350 mg in two or three equally-spaced doses.
It’s not clear to what extent berberine’s absorption is positively or negatively affected by the presence of other compounds, so we can’t yet say whether you should take it on an empty stomach or after a meal.
FAQ
Q: What does berberine do for the body?
A: Berberine primarily acts on your body’s metabolic environment, helping to prevent the stresses of a poor diet and the stresses of being overweight or obese from causing increases in your blood lipids and blood cholesterol.
It also exerts a potent level of control over poorly regulated blood sugar, which is characteristically seen in type two diabetes and metabolic syndrome.
These mechanisms are fairly well-researched, but berberine also appears to exert some direct benefits on weight loss, and may have benefits for controlling irritable bowel syndrome as well—the reasoning behind why it works in these applications are less well-understood.
Q: Is berberine safe to take long term?
A: The long-term safety of berberine (beyond studies lasting a few months or so) has not yet been established. That’s because research on berberine in humans is fairly new, and we don’t know how berberine’s effects play out over the long term.
However, berberine appears to be both safe and effective when taken for periods of at least eight to twelve weeks, with only mild gastrointestinal side effects like constipation and stomach pain reported in a few people in these studies, so there’s a decent chance future research will find that berberine is safe over the long run.
Q: Can I take berberine and metformin at the same time?
A: Berberine has been studied in combination with metformin in one study (32), and no negative drug interactions were reported.
However, it’s risky to take a prescription medication and a supplement that are supposed to do the same thing (i.e. lower blood sugar) at the same time, since whether these drugs interact, or inhibit each others’ mechanism of action is unknown.
You should talk to your doctor first if you take metformin (or any other prescription drug) and would also like to try berberine alongside it to better control your blood sugar.
Q: Does berberine kill good bacteria?
A: Actually, quite the contrary—scientific evidence may suggest that berberine might actually alter your body’s probiotic bacteria populations in a beneficial way.
A paper published in the Medical Science Monitor in 2011 argues that the benefits of berberine on metabolic symptoms can be attributed to alterations in probiotic bacteria levels (33).
However, at the time of writing, there were no direct experiments confirming this hypothesis. Surprisingly, little research has followed up on this line of thought, but at least there is no evidence suggesting that berberine has a negative effect on the gut microbiome in your body.
Q: Can berberine affect testosterone levels?
A: Some basic biological research conducted in cells on Petri dishes suggests that certain kinds of cells (mostly tumor cells, or ovary cells) may reduce their expression of testosterone and other androgens, but in terms of effects on your body overall, there’s no evidence that berberine will either lower or boost your testosterone levels.
Q: Is there berberine in turmeric?
A: No, berberine comes from a different plant species than the plant that produces turmeric and its primary active ingredient, curcumin.
They do, however, have some crossover on the possible health benefits of their active ingredients. Both berberine and turmeric are thought to help lower blood lipids, though they likely do so through different mechanisms.
Some very preliminary research has explored using both of these herbal extracts in combination to potentially treat type two diabetes, but this research hasn’t even been tested in humans yet.
Q: How long should you take berberine?
A: Clinical research suggests that getting the benefits of berberine may take six to eight weeks to achieve its effects, and several studies have found benefits at twelve weeks as well.
Beyond the timeframe of a few months, it’s not clear if you should take berberine indefinitely, and any potential long-term health effects have not been explored in detail.
Q: Does berberine help with weight loss?
A: Some research suggests that berberine may help with short-term weight loss, which is great given that we already know berberine can be helpful at controlling health issues associated with being overweight or obese.
While it’s not as potent of a weight loss supplement as ingredients like green tea extract or green coffee bean extract, the benefits are nevertheless welcome if you are overweight and are taking berberine for metabolic health. Just don’t rely on it to do all of the proverbial heavy lifting for you when it comes to losing weight.
Q: How long does it take for berberine to lower blood sugar?
A: Most studies on berberine for lowering blood sugar have examined their results at six or eight weeks. That’s not to say that significant differences wouldn’t have emerged if these studies were concluded either, but it does suggest that you may want to be patient when waiting for results from berberine. It’s not necessarily going to be a quick overnight fix, even if it does work.
Q: What foods contain berberine?
A: You can’t get berberine in any common foods, unless you can find barberries, goldenseal, or goldenthread at your local grocery store. It’s a compound that’s only found in a small number of plants, most of which are native to China.
To get berberine in any significant amount, you’ll need to take a berberine supplement.
Related articles
Recap
Berberine has been studied as a natural supplement for controlling blood sugar in people with metabolic syndrome and type two diabetes.
Moreover, it has applications in controlling some of the other negative effects of obesity, such as high blood cholesterol and high blood lipids. While berberine shows some promise as a weight loss product as well, its true strength is in controlling the metabolic environment in your body, especially when it’s stressed by an unhealthy diet or carrying around extra weight.
Some emerging evidence even suggests that berberine could be helpful for irritable bowel syndrome, but the causal pathways behind this are not yet clear.
Berberine is fairly safe, with mild gastrointestinal side effects like constipation and stomach pain occasionally reported. Berberine appears to be most effective when taken at dosage levels of 900 to 1500 mg per day, split into two to three equal doses.
Berberine’s potential for controlling blood sugar, blood lipids, and other indicators of your body’s metabolic health is quite strong, making it one of the most exciting herbal supplements on the market right now.
For BodyNutrition‘s #1 berberine recommendation, click here.