Berberine modestly lowers LDL cholesterol and triglycerides in placebo-controlled trials. The best pooled estimate is a drop of about 0.46 mmol/L (roughly 18 mg/dL) in LDL and about 0.34 mmol/L (roughly 30 mg/dL) in triglycerides over 4–24 weeks. That is a real but small effect, measured on blood tests only. No berberine trial has shown fewer heart attacks or strokes, so it is not a substitute for a prescribed cholesterol medicine.
Evidence grade: C for lowering LDL and triglycerides (consistent short trials, mostly from one region). Grade D for preventing heart disease (not studied).
Key takeaways
As an Amazon Associate, Stacking Years earns from qualifying purchases.
Use only as directed on the current label
Thorne Berberine Dual Action combines berberine phytosome and berberine HCl; check the current label for serving details.
Best for: comparing a berberine label
View on Amazon · Affiliate link
Blais and colleagues pooled randomized trials that compared berberine with placebo in adults and measured blood lipids (Blais et al., 2023). Eighteen studies with 1,788 participants qualified, 15 of them from mainland China or Hong Kong. Compared with placebo, berberine changed:
| Marker | Average change vs placebo | Trials (people) |
|---|---|---|
| LDL cholesterol | −0.46 mmol/L (about −18 mg/dL) | 14 (1,447) |
| Total cholesterol | −0.48 mmol/L | 17 (1,637) |
| Triglycerides | −0.34 mmol/L (about −30 mg/dL) | 18 (1,661) |
| Apolipoprotein B | −0.25 g/L | 2 (127) |
| HDL cholesterol | +0.06 mmol/L | 15 (1,471) |
The HDL result differed by sex: about +0.11 mmol/L in women and no clear change in men. The authors call the LDL, triglyceride and apoB reductions "small" and say large trials measuring clinical outcomes are still needed.
An earlier meta-analysis by Bertuccioli and colleagues also found lower total and LDL cholesterol with berberine alone, with berberine plus silymarin, and with multi-ingredient mixtures (Bertuccioli et al., 2020). It mixed controlled and non-randomized studies, though, so it is weaker evidence than the placebo-only analysis above.
If your LDL or apoB is high enough that a clinician has recommended a statin or another prescription, do not replace it with berberine. See our statins page and the berberine and statins guide before combining them.
The placebo-controlled trials used 900–1,500 mg of berberine a day, usually split into two or three doses, for 4 to 24 weeks (Blais et al., 2023). NCCIH describes 200 to 1,000 mg two to three times daily as the dose range used in clinical settings (NCCIH). If you and your clinician decide to try it, recheck a lipid panel after about three months to see whether it is doing anything for you.
In the trials, gastrointestinal side effects were reported more often with berberine (2–23% of participants) than with placebo (2–15%). NCCIH lists nausea, diarrhea, bloating and constipation as the common side effects (NCCIH).
If you decide to try it, choose a product that states the amount of berberine per capsule and has third-party testing. The links below are for comparing labels. No head-to-head trial shows one brand lowers cholesterol more than another.
Use only as directed on the current label
Berberine phytosome capsules; no head-to-head trial shows one brand lowers cholesterol more than another.
Best for: comparing a second berberine label
View on Amazon · Affiliate link
For more on forms and dosing, see the berberine guide.