Berberine is a yellow alkaloid from barberry and several other plants, sold in the EU as a food supplement, most often as berberine HCl in capsules. The EU has authorised no health claim for berberine, so a label can tell you the form, the amount and the warnings, but not what it does. The warnings matter here more than with most supplements, because berberine can interact with medicines.
Below: where berberine comes from, how berberine HCl, standardised extracts and dihydroberberine differ, how labels split the dose across meals, and who should not take it.
What berberine is and where it comes from
Berberine belongs to a group of plant compounds called isoquinoline alkaloids. It gives the roots and bark of some plants their bright yellow colour. The main sources are plants of the genus Berberis: common barberry (Berberis vulgaris) and Indian barberry (Berberis aristata). It is also found in goldenseal (Hydrastis canadensis), Chinese goldthread (Coptis chinensis) and Oregon grape (Mahonia aquifolium).
All products in our berberine collection use Indian barberry, taken from the root or the bark. Berberis aristata is the species you will see most often on European labels.
Berberine benefits: why there is no EU claim
People often search for the benefits of berberine. For the EU market the answer is short: Regulation (EU) No 432/2012, the list of health claims food supplements may use, contains no claim for berberine or barberry. Claims for plants and plant substances (botanicals) were put on hold by the European Commission in 2010 and have not been assessed since.
What that means for you as a buyer:
- no shop or manufacturer may say that berberine improves, supports or regulates any body function;
- "research shows" wording is a health claim too and is not allowed;
- the lack of a claim is a legal status, not a verdict on the substance in either direction.
What can be stated is what is on the label: the source plant, the form, the milligrams, the dose and the warnings. Plenty of useful information fits into that.
Berberine HCl, extract or dihydroberberine
Labels use several forms, and the milligrams in front of you mean different things depending on the form.
| Form | What the label states | Example in our range |
|---|---|---|
| Berberine HCl | milligrams of berberine hydrochloride, the salt form | NOW Foods 500 mg per capsule, Swanson 400 mg per capsule |
| Extract standardised to a high % | extract weight and berberine content | Aura Herbals: 500 mg extract with 490 mg berberine in 2 capsules |
| Extract standardised to a low % | extract weight and a small berberine share | OstroVit VEGE: 500 mg extract, 2 %, 10 mg berberine |
| Berberine with lecithin (Berbevis) | extract weight | Swanson Berberine Advanced: 550 mg Berbevis |
| Dihydroberberine (DHB) | milligrams of dihydroberberine | not in our range |
Berberine HCl is the most common form. The figure on the label is the salt, which is mostly berberine.
Standardised extracts are where labels get confusing. An extract at 98 % and one at 2 % can both print "500 mg" on the front, yet the amount of berberine differs about fiftyfold. Multiply the extract weight by the percentage before you compare.
Berbevis is a trademark of the Italian company Indena. The extract is combined with sunflower lecithin, a format Indena calls Phytosome. The label states the extract amount, not pure berberine.
Dihydroberberine is a reduced form of berberine. In the body it turns back into berberine. Makers of DHB say it is absorbed better and therefore list lower milligram doses. Compare DHB only with other DHB products, never milligram for milligram with berberine HCl.
Berberine dose and why it is split across meals
There is no EU reference value or upper level for berberine, so the dose to follow is the one on the pack. In our range it looks like this:
- NOW Foods: 1 capsule (500 mg HCl) a day with a meal;
- Swanson Berberine HCl: 1 capsule (400 mg) a day with a meal;
- Kenay Rebersa: 1 capsule twice a day, 500 mg HCl in the daily dose;
- Aura Herbals: 1 capsule twice a day, 490 mg berberine in the daily dose;
- OstroVit VEGE: 1 tablet a day with a meal;
- Swanson Berberine Advanced: 1 capsule a day before a meal.
Two habits repeat across labels: take berberine with food, and split larger amounts into two or three portions. Berberine is poorly absorbed from the gut and leaves the blood fairly quickly, which is one reason manufacturers spread it over the day. The other reason is the stomach.
Berberine can upset the digestive tract. The NOW Foods label warns of mild gastrointestinal discomfort, and constipation, diarrhoea, cramps or bloating are the complaints reported most often. Taking each capsule with a main meal, and not exceeding the label dose, is the simplest way to keep it comfortable. If the discomfort continues, stop.
Berberine and medicines: interactions
This is the main safety question with berberine, and the reason several labels ask you to see a doctor first.
Many medicines are broken down in the liver by enzymes from the cytochrome P450 (CYP) family. Studies in people have found that berberine can slow down some of these enzymes, including CYP2D6, CYP2C9 and CYP3A4. When that happens, a medicine can stay in the blood longer or at a higher level than intended. Reports from kidney transplant patients, for example, describe higher blood levels of the immunosuppressant ciclosporin after berberine was added.
The second group is diabetes medicines. The NOW Foods label names antidiabetic medicines and carbohydrate metabolism disorders, and the Swanson complex names medicines that affect blood sugar levels, hypoglycaemia and diabetes. If this applies to you, do not start berberine without your doctor, who may want to review your medicines and monitoring.
If you take any prescription medicine, ask your doctor or pharmacist before you start berberine. This matters most for diabetes medicines, blood thinners, immunosuppressants, heart medicines and anything with a narrow safe dose range. Bring the pack with you so they can see the form and the milligrams.
Who should not take berberine
- Pregnant and breastfeeding women. Most berberine labels in our range exclude them. NCCIH explains that berberine can cause or worsen jaundice in newborns and may lead to a rare type of brain damage, kernicterus, so it is avoided in pregnancy and while breastfeeding.
- Children and teenagers. Several labels say adults only, and Kenay names everyone under 18.
- People with a medical condition, especially a carbohydrate metabolism disorder, liver disease or low blood sugar episodes, without asking a doctor first.
- Anyone allergic to an ingredient of the product.
How long to take it and how to store it
None of the labels in our range sets a time limit, and none promises a result after a given number of weeks. If you plan to take berberine for longer than one pack, or alongside medicines, agree on it with your doctor, and mention it before blood tests or surgery.
Store the pack at room temperature in a dry place. Aura Herbals notes that a sediment from the natural ingredients may form, and NOW Foods notes that the capsule colour may change without affecting quality.
How to choose a berberine supplement
- Find the line that gives berberine or berberine HCl in milligrams, not just the extract weight.
- If it is an extract, multiply the weight by the percentage.
- Check the daily dose: one capsule or two, with or before a meal.
- Check what else is inside: lecithin, grape seed extract, cinnamon, other plants.
- Read the warnings against your own situation, especially medicines and pregnancy.
- Divide the pack price by the number of days it lasts. 90 capsules at one a day last 90 days, 60 capsules at two a day last 30.
The full list of forms and pack sizes is in the berberine collection, with the amount per daily dose on each card.
FAQ
What are the benefits of berberine?
The EU has authorised no health claim for berberine, so shops and manufacturers may not describe its effects. A label can tell you the source plant, the form, the milligrams, the dose and the warnings.
Is berberine HCl the same as berberine?
Berberine HCl is berberine as a hydrochloride salt. Labels state either the salt or pure berberine, so compare like with like.
Should I take berberine with food?
Most labels in our range say with a meal, one says before a meal. When the daily dose is two capsules, they are taken at two separate times.
Can I take berberine with metformin or other medicines?
Only after talking to your doctor. Labels name antidiabetic medicines specifically, and berberine can affect liver enzymes that break down many other medicines.
Is dihydroberberine better than berberine HCl?
It is a different form with different milligram doses. Makers say it is absorbed better. A label cannot tell you which is better for you, so compare within the same form.
Sources
- Commission Regulation (EU) No 432/2012, list of permitted health claims (EUR-Lex)
- EU Register of nutrition and health claims
- NCCIH: Goldenseal (berberine and newborns)
- The metabolism of berberine and its contribution to the pharmacological effects (PubMed)
- Physicochemical and pharmacokinetic properties of berberine (PubMed)
Content reviewed by Inese Kalniņa, dietitian.
