How can berberine help you? What the research says

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Clinical reviewer

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant

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Last update: July 1, 2026

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

To see more details, click the plus sign to the right of any section.

Our assessments of evidence for each medical benefit fall into one of these categories:

Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

Learn more about how we research and rate therapies and practices in How We Rate Therapies ›

Improving treatment outcomes

Is berberine linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies?

The only published evidence we have found regarding berberine’s use in improving treatment outcomes is preclinical—involving cells, tissues, or lab animals. Preclinical evidence is a first step toward finding whether a therapy has anticancer activity. Without any evidence of effects in living humans, we do not recommend concluding that berberine might have anticancer effects for you. The preclinical evidence is promising, but we consider it still only a weak indication of possible effects in people with cancer. Preclinical evidence is a bit like taking a poll several months before an election. Most of us would not be comfortable saying that the election results will be identical to the poll, and sometimes the election results are not at all what the poll predicted.

Preclinical evidence for improving treatment outcomes

All the evidence of berberine’s effects on treatment outcomes so far is preclinical. The strongest evidence to date shows improved survival in animals treated with berberine, which has been reported only in lung cancer and multiple myeloma.

Cancer as a whole

Bladder cancer

Brain and nervous system cancers

Breast cancer

Colorectal cancer

Gastrointestinal cancer

Gynecological cancer

Head, neck, and oral cancer

Leukemia

Lung cancer

Lymphoma

Melanoma

Mesothelioma

Multiple myeloma

Ovarian cancer

Pancreatic cancer

Prostate cancer

Sarcoma

Optimizing your body terrain

Does berberine promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

See Optimizing Your Body Terrain ›

Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›

Body weight

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower measures of body weight among people treated with berberine (not specific to cancer)

High blood sugar and insulin resistance

Good evidence of lower markers of blood sugar among people with type 2 diabetes treated with berberine, comparable to oral diabetes medicine

Good evidence of lower markers of blood sugar and insulin resistance among people with metabolic disorders besides type 2 diabetes treated with berberine

Hormone imbalance

Changes in hormone levels seen in the studies here may not be beneficial in every situation. Your oncology team needs to determine whether any changes would be favorable for your condition.

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of changes in leptina hormone that helps regulate energy balance by inhibiting hunger levels correlating with weight loss among people with schizophrenia treated with berberine

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better sex hormone balance among people with polycystic ovary syndrome treated with berberine

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of higher testosterone among men with hyperlipidemia treated with berberine

Appetite hormones: preliminary evidence of changes in leptina hormone that helps regulate energy balance by inhibiting hunger levels correlating with weight loss among people with schizophrenia treated with berberine

Changes in leptin levels correlating with weight loss among people with schizophrenia on stable dose of a single antipsychotic for at least one month treated with 900 mg berberine per day for 8 weeks compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁰²Qiu Y, Li M et al. Berberine treatment for weight gain in patients with schizophrenia by regulating leptin rather than adiponectin. Asian Journal of Psychiatry. 2022;67:102896.

Sex hormones

Modest evidence of better sex hormone balance among people with polycystic ovary syndrome treated with berberine

Weak evidence of higher testosterone among men with hyperlipidemia treated with berberine

Lower total testosterone among people with polycystic ovary syndrome treated with both berberine and metformin compared to metformin alone in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 2 RCTs¹⁰³Zhao H, Xing C, Zhang J, He B. Comparative efficacy of oral insulin sensitizers metformin, thiazolidinediones, inositol, and berberine in improving endocrine and metabolic profiles in women with PCOS: a network meta-analysis. Reproductive Health. 2021;18(1):171.
Comparable effects on follicle-stimulating hormone and luteinizing hormone among people with polycystic ovary syndrome with insulin resistance treated with either berberine or metformin in a meta-analysis of 3 RCTs¹⁰⁴Li MF, Zhou XM, Li XL. The effect of berberine on polycystic ovary syndrome patients with insulin resistance (PCOS-IR): a meta-analysis and systematic review. Evidence-based Complementary and Alternative Medicine. 2018 Nov 14;2018:2532935.
Greater reductions in total testosterone and free androgen index, decreases in total follicle-stimulating hormone requirement, lower incidence of severe ovarian hyperstimulation syndrome, and increases in sex hormone binding globulin and live birth rate during in vitro fertilization treatment among infertile women with polycystic ovary syndrome treated with berberine for 3 months before ovarian stimulation compared to placebo in a mid-sized RCT¹⁰⁵An Y, Sun Z et al. The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clinical Endocrinology (Oxford). 2014;80(3):425-431.
More favorable levels of total testosterone, free androgen index, androstenedione, sex hormone binding globulin, and progesterone, and better menses frequency among obese women with infrequent menses and polycystic ovary syndrome treated with 500 mg berberine twice a day for 6 months compared to controls in a mid-sized RCT¹⁰⁶Orio F, Muscogiuri G et al. Berberine improves reproductive features in obese Caucasian women with polycystic ovary syndrome independently of changes of insulin sensitivity. E-SPEN Journal. 2013 Oct;8(5):e200-e204.
Lower testosterone and higher sex hormone-binding globulin among normal-overweight women with polycystic ovary syndrome with normal menses treated with 110 mg bioavailable berberine phospholipid formulation for 60 days compared to baseline in a small uncontrolled studya study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design¹⁰⁷Rondanelli M, Riva A et al. Berberine phospholipid is an effective insulin sensitizer and improves metabolic and hormonal disorders in women with polycystic ovary syndrome: a one-group pretest-post-test explanatory study. Nutrients. 2021;13(10):3665.
Lower sex hormone binding globulin and better menstrual pattern and ovulation among normal weight Chinese women with polycystic ovary syndrome treated with 0.4 g berberine 3 times a day for 4 months compared to baseline in a small uncontrolled study¹⁰⁸Li L, Li C et al. A single arm pilot study of effects of berberine on the menstrual pattern, ovulation rate, hormonal and metabolic profiles in anovulatory Chinese women with polycystic ovary syndrome. PLoS One. 2015;10(12):e0144072.

Immune function

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on white blood cell counts among people with severe COVID-19 treated with berberine

Inflammation

Good evidence of lower markers of inflammation among people with a variety of health conditions other than cancer or after surgery

Your microbiome

Preliminary evidence of better composition of intestinal flora, especially fewer Firmicutes species, among people with metabolic disorders treated with berberine; a higher Firmicutes to Bacteroidetes ratio is associated with dysbiosismicrobial imbalance or maladaptation on or inside the body and obesity

Preliminary evidence of better markers of intestinal flora among people with Parkinson’s disease treated with berberine

Berberine combined with other therapies

Modest evidence of lower glucose levels among people treated with NComb, a mixture of red yeast rice, berberine, policosanol, astaxanthin, coenzyme Q10, and folic acid

Preliminary evidence of lower levels of insulin and insulin resistancea condition in which cells in your muscles, fat, and liver don’t respond well to insulin and can’t efficiently take up glucose from your blood for energy among adults with impaired fasting glucose treated with Lagerstroemia speciosa, Berberis aristata, Curcuma longa, alpha-lipoic acid, chromium picolinate, and folic acid

Preliminary evidence of more weight loss and better glycemic control among people with fatty liver disease and diabetes treated with HTD1801 (berberine ursodeoxycholate)

Preliminary evidence of better body mass index, waist circumference, waist to hip ratio, percent of abdominal fat, fasting blood glucose and insulin, and insulin resistance (HOMA-IR) among overweight or obese people with type 2 diabetes treated with berberine and silymarin

Weak evidence of lower body mass index after 3 months among women with estroprogestin-induced hypercholesterolemia treated with berberine and monacolins

Preliminary evidence of lower measures of blood sugar, insulin, and insulin resistance among people with high cholesterol treated with policosanol, red yeast rice containing monacolin K, berberine, and in one case other nutriceuticals

Preliminary evidence of lower fasting insulin and insulin resistance among overweight people with hyperlipidemia treated with berberine, chlorogenic acid, and tocotrienols

NComb: red yeast rice, berberine, policosanol, astaxanthin, coenzyme Q10, and folic acid: modest evidence of lower glucose levels among people treated with NComb

Lower glucose levels among people treated with red yeast rice, berberine, policosanol, astaxanthin, coenzyme Q10, and folic acid (NComb) compared to controls, with a higher effect seen among people with higher baseline glucose levels and longer duration of supplementation in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 10 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹²²Pirro M, Mannarino MR et al. The effects of a nutraceutical combination on plasma lipids and glucose: a systematic review and meta-analysis of randomized controlled trials. Pharmacological Research. 2016 Aug;110:76-88.

Lagerstroemia speciosa, Berberis aristata, turmeric, alpha-lipoic acid, chromium picolinate, and folic acid: preliminary evidence of lower levels of insulin and insulin resistance among adults with impaired fasting glucose treated with Lagerstroemia speciosa, Berberis aristata, Curcuma longa, alpha-lipoic acid, chromium picolinate, and folic acid

Lower levels of insulin and insulin resistance (HOMA-IR) among adults with impaired fasting glucose treated with Lagerstroemia speciosa, Berberis aristata, turmeric, alpha-lipoic acid, chromium picolinate, and folic acid in a small RCT¹²³Cicero AFG, Fogacci F et al. Nutraceutical effects on glucose and lipid metabolism in patients with impaired fasting glucose: a pilot, double-blind, placebo-controlled, randomized clinical trial on a combined product. High Blood Pressure & Cardiovascular Prevention. 2017 Sep;24(3):283-288.

Berberine ursodeoxycholate, an ionic salt of berberine and ursodeoxycholic acid: preliminary evidence of more weight loss and better glycemic control among people with fatty liver disease and diabetes treated with HTD1801 (berberine ursodeoxycholate)

More weight loss and better glycemic control among people with fatty liver disease and diabetes treated with 500 mg or 1000 mg HTD1801 (berberine ursodeoxycholate) twice a day for 18 weeks compared to placeboa pill, medicine, or procedure—thought to be both harmless and ineffective—prescribed for the psychological benefit to the patient or as a sham treatment in a study to allow a comparison to a therapy of interest in a small RCT¹²⁴Harrison SA, Gunn N et al. A phase 2, proof of concept, randomised controlled trial of berberine ursodeoxycholate in patients with presumed non-alcoholic steatohepatitis and type 2 diabetes. Nature Communications. 2021;12(1):5503.

Berberine and silymarin: preliminary evidence of better body mass index, waist circumference, waist to hip ratio, percent of abdominal fat, fasting blood glucose and insulin, and insulin resistance (HOMA-IR) among overweight or obese people with type 2 diabetes treated with berberine and silymarin

Better body mass index, waist circumference, waist to hip ratio, percent of abdominal fat, fasting blood glucose and insulin, and insulin resistance (HOMA-IR) among overweight or obese people with type 2 diabetes treated with 500 mg berberine and 105 mg silymarin twice a day for 52 weeks compared to placebo in a mid-sized RCT¹²⁵Guarino G, Strollo F et al. Bioimpedance analysis, metabolic effects and safety of the association Berberis aristata/Bilybum marianum: a 52-week double-blind, placebo-controlled study in obese patients with type 2 diabetes. Journal of Biological Regulators and Homeostatic Agents. 2017;31(2):495-502.

Berberine and monacolins: weak evidence of lower body mass index, fasting plasma glucose, insulin resistance, and inflammation after 3 months among women with estroprogestin-induced hypercholesterolemia treated with berberine and monacolins

Lower body mass index, fasting plasma glucose, insulin resistance (HOMA-IR), and inflammation (hsCRP) after 3 months among women with estroprogestin-induced hypercholesterolemia treated with 500 mg berberine and 3 mg monacolins compared to baseline in a small controlled studya study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹²⁶Cicero AF, Reggi A et al. Berberine and monacolin effects on the cardiovascular risk profile of women with oestroprogestin-induced hypercholesterolemia. High Blood Pressure & Cardiovascular Prevention. 2014;21(3):221-226.

Policosanol, red yeast rice containing monacolin K, berberine, and in one study also astaxantine, folic acid, and coenzyme Q10: preliminary evidence of lower measures of blood sugar, insulin, and insulin resistance among people with high cholesterol treated with policosanol, red yeast rice containing monacolin K, berberine, and in one case other nutriceuticals

Lower glycated hemoglobin, fasting glucose, insulin plasma levels, and insulin resistance (HOMA-IR) among people with high cholesterol not on statins treated with 10 mg policosanol, 200 mg red yeast rice containing 3 mg monacolin K, 500 mg berberine, 0.5 mg astaxantine, 200 mcg folic acid and 2 mg coenzyme Q10 compared to 531.25 mg berberine (), 220 mg red yeast rice powder containing 3.3 mg monacolin K) and 200 mg leaf extract of Morus alba for 4 weeks in a small RCT¹²⁷Trimarco V, Izzo R et al. Effects of a new combination of nutraceuticals with Morus alba on lipid profile, insulin sensitivity and endotelial function in dyslipidemic subjects. A cross-over, randomized, double-blind trial. High Blood Pressure & Cardiovascular Prevention. 2015;22(2):149-154.
Better insulin sensitivity (HOMA-IR) among people with high cholesterol and insulin resistance treated with 500 mg berberine, 200 mg red yeast rice, and 10 mg policosanol daily for 6 weeks and a subsequent extension of 4 weeks compared to placebo in a small RCT¹²⁸Affuso F, Ruvolo A, Micillo F, Saccà L, Fazio S. Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study. Nutrition, Metabolism and Cardiovascular Diseases. 2010;20(9):656-661.

Berberine, chlorogenic acid, and tocotrienols: preliminary evidence of lower fasting insulin and insulin resistance among overweight people with hyperlipidemia treated with berberine, chlorogenic acid, and tocotrienols

Lower fasting insulin and insulin resistance (HOMA-IR) among overweight people with hyperlipidemia treated with berberine, chlorogenic acid, and tocotrienols for 8 weeks compared to placebo in a small RCT¹²⁹Cicero AF, Rosticci M et al. Short-term effects of a combined nutraceutical of insulin-sensitivity, lipid level and indexes of liver steatosis: a double-blind, randomized, cross-over clinical trial. Nutrition Journal. 2015;14:30.

Managing side effects and promoting wellness

Is berberine linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Breathlessness and other lung symptoms

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower incidence of radiation-induced lung injury among people with non-small cell lung cancer treated with berberine during radiotherapy

Gastrointestinal symptoms

Weak evidence of lower incidence and severity of radiation-induced acute intestinal symptoms during abdominal or pelvic radiotherapy among people with seminoma, lymphomas, or cervical cancer treated with oral berberine

Reducing cancer risk

Is berberine linked to lower risks of developing cancer or of recurrence? We present the evidence.

Colorectal cancer

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower risk of recurrence of colorectal adenoma among people treated with berberine

Berberine combined with other therapies

Berberine with other treatments for H. pylori infections: modest evidence of comparable effects in eradicating Helicobacter pylori infections—a risk factor for stomach cancer—among people treated with berberine as part of a combination therapy compared to bismuth-containing combination therapies

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References[+]

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Berberine for Cancer