This page shows what was measured, who it was measured in, and what that does not settle.
What Berberine does in the body
What reaches the liver mildly slows the cell's power plants, and the cell reads that as being short of energy.
Berberine barely gets into your bloodstream at all. It responds by switching on a master energy sensor called AMPK, which tells the liver to stop manufacturing sugar and to keep more cholesterol catchers on its surface. Separately, most of the dose never leaves the gut, where bacteria convert it into a more absorbable form and where it changes the microbial population directly.
Why people take it. Sold for blood sugar, cholesterol and weight loss, but not approved for these uses.
What happened in people
A small study found three months of berberine lowered long-term blood sugar about as much as metformin.
✓ Reviewed first-read answer
Where this came from
A person wrote this and a reviewer approved it against this exact record. It carries no effect size.
A reviewer approved this against this record. The reviewed-claim record carrying the exact population and effect size does not exist yet.
No source is stored against this line.
The limit that matters most
Across weight studies, the average difference was less than one kilogram.
Where it acts
Intestinal lumen and hepatocyte mitochondria (liver)
Kind of result
A number that stands in for health
Supervision
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · 0I8Y3P32UF · read 2026-08-29
The supplement label database classes it as botanical, under the name Berberine.
A person wrote this explanation into the record, with the studies named in the path below.
A reviewer approved this sentence against this exact record and its sources.
The limit a reviewer approved as the one that matters most here.
The four opening statements run to 113 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Stand-in result
A stand-in result is a number measured because the real result takes too long.
A picture of it, and where the picture fails
It is like judging a journey by the speedometer rather than by arriving.
Where that stops being true. Speed does predict arrival. Many stand-in results do not predict the real one.
What people get wrong. A stand-in result is often reported as the result itself.
A surrogate endpoint substituted for a clinical endpoint, valid only where the substitution has been shown to hold.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Receptor
A receptor is a part of a cell that a signal fits into.
A picture of it, and where the picture fails
A receptor is like a lock waiting for one key.
Where that stops being true. A lock either opens or does not. A receptor can be half-triggered, or worn out.
What people get wrong. Fitting a receptor is read as causing a benefit. It causes a step, and nothing more.
A protein that binds a specific ligand and converts that binding into a cellular response.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 40 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Blood sugar
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
△Only a number moved11 registered test measure.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Cholesterol
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
△Only a number moved5 registered test measure.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Fertility and sexual health
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Body weight
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
△Only a number moved1 registered test measure.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Blood sugar
hba1c at 13 weeks; fasting glucose levels; hba1c; insulin/glucose after overnight fast; insuline/glucose after an oralglucose tolerance test; hba1c from baseline to week 12; glucose; insulin
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
∅ Nothing in the sources checked
No registered study lists a life outcome for this goal.
△ Only a number moved
11 registered test measure.
— Not recorded
Harms were not a registered measure for this goal.
… Waiting for a reviewer
Who was studied is listed further down the page.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Change in HbA1c and fasting plasma glucose at three months
✓ The study showed what it set out to show
Who was studied
Yin 2008 study A (berberine versus metformin, newly diagnosed type 2 diabetes)
How many people
36
Study design
Investigator-initiated randomised pilot
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
P < 0.01 for HbA1c and fasting glucose within the berberine arm
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Transient gastrointestinal adverse effects in 20 of 58 patients across both study arms, 34.5%. The trial was not blinded and had no placebo group.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral capsule or tablet, usually berberine hydrochloride
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Pooled effect on glucose and lipid parameters in type 2 diabetes, hyperlipidaemia and hypertension
✓ The study showed what it set out to show
Who was studied
Lan 2015 pooled analysis (27 randomised trials)
How many people
2569
Study design
Systematic review and meta-analysis
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Significant for glucose and lipid parameters; see paper for per-outcome values
Repeated elsewhere
Partially Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. The authors flagged that included trials were small, largely Chinese, and of limited methodological quality. No included trial reported a clinical event endpoint.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral capsule or tablet, usually berberine hydrochloride
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
P = 0.0003 for body weight; waist-to-hip ratio not significant
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Sample size is recorded as 0 because the paper reports the number of trials rather than a single pooled participant total. The effect on weight was -0.88 kg.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral capsule or tablet, usually berberine hydrochloride
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 3 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
■Living longer, or avoiding a major eventEvidence recorded. Death, a heart attack, a stroke, a hospital stay.1 registered measure of this kind. No reviewed result.
□What a body can do day to dayNo evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
□Measured performanceNo evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
■Symptoms and quality of lifeEvidence recorded. Pain, tiredness, mood, sleep, as the person rated it.1 registered measure of this kind.
■A number that stands in for healthEvidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.23 registered measures of this kind.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in C. elegans (roundworm), Drosophila (fruit fly), Mouse, Rat. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Berberine
What a person takes: Oral capsule or tablet, usually berberine hydrochloride.
The measurement behind this step
Sold in the United States as a dietary supplement under DSHEA, which means no premarket efficacy or safety review. Content and purity vary by manufacturer, and the 2026 meta-analysis specifically noted poor reporting of purity and potency in the trial literature itself.
Getting in
Swallowed, and then mostly not absorbed
The capsule dissolves and the alkaloid enters the gut, where the overwhelming majority of it stays. Very little crosses into the bloodstream.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Berberine is a permanently charged quaternary protoberberine cation, which limits passive membrane transit, and it is a P-glycoprotein substrate actively pumped back into the intestinal lumen. Liu et al. attributed the low plasma level to extensive intestinal first-pass elimination followed by predominant hepatic distribution of what does get through.
Gut bacteria convert it into a form that can be absorbed
Bacteria in the intestine chemically alter berberine into a related molecule that crosses the gut wall far more easily, then the body turns it back.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Bacterial nitroreductase reduces berberine to dihydroberberine, which Feng et al. measured as roughly five-fold more absorbable, and which is reoxidised to berberine in intestinal tissue. Absorption is therefore a microbial function and varies between people.
Inside the liver cell it collects in the mitochondria
What reaches the liver piles up inside the cell's power plants, because their electrical charge pulls the positively charged molecule in.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The delocalised cationic charge drives accumulation in the mitochondrial matrix down the inner-membrane potential gradient, where berberine mildly inhibits complex I of the respiratory chain and raises the cellular AMP to ATP ratio.
The energy sensor switches on and liver sugar production slows
The cell reads the drop in energy as a shortage and flips on its master energy switch, which tells the liver to stop making new sugar.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The raised AMP to ATP ratio promotes LKB1-dependent phosphorylation of AMPK alpha at Thr172. Active AMPK suppresses transcription of the gluconeogenic enzymes PEPCK and G6Pase and shifts hepatic metabolism from synthesis toward oxidation.
Blood glucose and LDL fall, on a separate route each
Less sugar leaves the liver, and separately the liver keeps more of its cholesterol catchers, so both readings come down.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Glucose lowering follows from AMPK-mediated suppression of gluconeogenesis. LDL lowering is a distinct mechanism: Kong et al. showed berberine stabilises LDL receptor mRNA through its 3' untranslated region, raising receptor density without engaging the SREBP pathway statins work through.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
appetite suppression
Measured
Things only a test, a scale or a device shows.
hba1c at 13 weeks
fasting glucose levels
hba1c
serum triglycerides
serum total cholesterol
hdl c
ldl c
insulin/glucose after overnight fast
insuline/glucose after an oralglucose tolerance test
hba1c from baseline to week 12
and 13 more.
Meaningful
Things that change how a life goes, not only a number.
progression free survival
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (15)
improved metabolic parameters
live birth rate
cardiovascular risk
helicobacter pylori eradication
contrast induced nephropathy
lipid profile
il 1
il 6
p2y12 reaction
testosterone
alanine aminotransferase
aspartate aminotransferase
alkaline phosphatase
gut microbiome
brachial ankle pulse wave velocity
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Adults with prediabetes, type 2 diabetes, high cholesterol or polycystic ovary syndrome, usually buying it themselves rather than being prescribed it.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
Where the result stopped carrying
Oral bioavailability below 1%, which invalidated the first generation of blood-concentration-based mechanistic explanations
Trial reporting quality: the 2026 meta-analysis had to ask its own included studies for basic purity, potency and gram amounts
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
The product may not be what it says
Contents of a sold product are not always what the label states.
On this record: This is sold as a supplement, so no agency checked what is in a given tub before it was sold.
Other reasons RNAWiki checked and found nothing for (9)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Withdrawn
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Oral capsule or tablet, usually berberine hydrochloride
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Suppression classes recorded: S8.
No source is stored against this line.
What is in the pack
Sold in the United States as a dietary supplement under DSHEA, which means no premarket efficacy or safety review. Content and purity vary by manufacturer, and the 2026 meta-analysis specifically noted poor reporting of purity and potency in the trial literature itself.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Gastrointestinal effects — constipation, diarrhoea, cramping — were reported in about a third of participants in the Yin trial. Berberine inhibits CYP3A4 and CYP2D6 and can raise concentrations of co-administered drugs cleared by those enzymes. It is contraindicated in neonates because of its potential to displace bilirubin from albumin, and it is not recommended in pregnancy.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Oral capsule or tablet, usually berberine hydrochloride
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
Content and purity vary by manufacturer, and the 2026 meta-analysis specifically noted poor reporting of purity and potency in the trial literature itself.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
431 marketed supplement labels list this ingredient, classed as botanical with nutrients, non-nutrient/non-botanical and other combinations.
Those labels carry all other, nutrient and structure/function claims. A claim of that kind is written by the manufacturer and is not assessed by any regulator, so its presence says nothing about whether it is true.
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
Self-experiment planning is not offered for a prescription or clinician-supervised medicine, withdrawn medicine. The questions below are for a clinician or pharmacist.
Questions worth asking
Which of the trials of Berberine studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That berberine is a natural equivalent of a GLP-1 receptor agonist — the measured weight difference is under one kilogram
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That a berberine-driven fall in HbA1c or LDL-C carries the clinical benefit that the same fall carries for metformin or a statin
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the trial evidence generalises freely, when the pooled base is small, mostly unblinded and geographically concentrated
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
How fast does the body clear it?
The sources RNAWiki checked hold nothing for this field.
Why it matters. Without this, nothing on this page can say how long anything lasts.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Berberine are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
Yin 2008: HbA1c fell from 9.5% to 7.5% in newly diagnosed type 2 diabetes
In plain words
In a small Chinese pilot trial, three months of berberine moved long-term blood sugar about as much as metformin did.
What was measured
HbA1c, fasting and postprandial plasma glucose over three months
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Study A randomised 36 adults with newly diagnosed type 2 diabetes to berberine or metformin for three months. HbA1c fell from 9.5 +/- 0.5% to 7.5 +/- 0.4% (P < 0.01), fasting glucose from 10.6 +/- 0.9 to 6.9 +/- 0.5 mmol/L (P < 0.01) and postprandial glucose from 19.8 +/- 1.7 to 11.1 +/- 0.9 mmol/L (P < 0.01). Study B added berberine to existing therapy in 48 poorly controlled patients, with HbA1c falling from 8.1 +/- 0.2% to 7.3 +/- 0.3% (P < 0.001). Twenty of 58 patients, 34.5%, had transient gastrointestinal adverse effects.
Written into the record, not signed off as a reviewed claim
Kong 2004: a cholesterol mechanism genuinely distinct from statins
In plain words
Berberine lowers cholesterol by making liver cells hold on to the instructions for their LDL catchers for longer, which is not how statins work.
What was measured
Hepatic LDL receptor mRNA stability and serum lipid concentrations
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Nature Medicine 2004. Berberine was identified from a screen of Chinese medicinal herbs as an upregulator of LDL receptor expression acting through stabilisation of LDL receptor mRNA, rather than through the SREBP-dependent transcriptional route that statins engage. The paper reported reductions in serum cholesterol, triglycerides and LDL-C in hyperlipidaemic hamsters and in a small human cohort. The mechanistic claim, not the clinical one, is what has replicated.
Written into the record, not signed off as a reviewed claim
Oral bioavailability is under 1%: almost none of a dose reaches the blood
In plain words
Ninety-nine percent of swallowed berberine never gets into the bloodstream, which means most explanations of how it works cannot be about the blood level.
What was measured
Plasma and tissue berberine concentration after oral dosing in rats
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Liu et al. showed in rats that oral berberine undergoes extensive intestinal first-pass elimination and is then concentrated in the liver, leaving plasma levels far too low to explain the systemic effects reported in trials. The paper is the standard reference for berberine bioavailability in the low single-digit percentage range or below. This is not a minor pharmacokinetic footnote: it means any mechanism proposed from a cell-culture concentration achievable only by direct dosing is unlikely to be what happens in a person.
Written into the record, not signed off as a reviewed claim
The field moved the mechanism into the gut after the absorption problem surfaced
In plain words
Once it was clear berberine barely reaches the blood, researchers stopped explaining it as a blood-borne drug and started explaining it as something that acts in the intestine.
What was measured
That a fixed oral amount produces a comparable systemic exposure across people, when the conversion step is microbial and therefore individual
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Feng et al. (Sci Rep 2015) showed that gut bacterial nitroreductase converts berberine into dihydroberberine, which is absorbed roughly five times more efficiently and is then oxidised back to berberine in intestinal tissue. That reframes the pharmacology: the gut microbiota is not a nuisance in the absorption path, it is part of the activation step, and it also means the effect size should vary with a person's microbiome. Almost no clinical trial in this literature stratifies for that.
Written into the record, not signed off as a reviewed claim
The weight-loss claim rests on a 0.88 kg mean difference
In plain words
The full pooled evidence for berberine and body weight is a difference of under a kilogram — a real effect, and not remotely what the marketing implies.
What was measured
That berberine is a natural equivalent of a GLP-1 receptor agonist for weight loss
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
A 2026 systematic review and meta-analysis of 23 randomised controlled trials found berberine reduced body weight by a mean difference of -0.88 kg (95% CI -1.36 to -0.39, P = 0.0003), BMI by -0.48 kg/m2 (95% CI -0.89 to -0.07) and waist circumference by -1.32 cm (95% CI -2.24 to -0.41), with no significant change in waist-to-hip ratio. The authors explicitly called for better reporting of purity, potency and gram amounts, and flagged lack of blinding and randomisation as common biases. The comparison implied by calling berberine a natural GLP-1 agonist is with agents that produce double-digit percentage weight loss in trials designed to measure it.
Written into the record, not signed off as a reviewed claim
No trial has measured a clinical event, and the trial base is geographically narrow
In plain words
Every positive berberine result is a number from a blood test. Nobody has run a trial long enough or large enough to see whether anything happens to patients.
What was measured
That a berberine-induced fall in HbA1c or LDL-C carries the same clinical benefit as the same fall produced by a drug with outcome trials behind it
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The 2015 meta-analysis by Lan et al. pooled 27 randomised trials in type 2 diabetes, hyperlipidaemia and hypertension and found effects on glucose and lipid parameters comparable to oral hypoglycaemics and lipid-lowering drugs, with the important qualifier that the included trials were small, largely conducted in China, and of limited methodological quality. No cardiovascular outcome trial, no renal outcome trial and no mortality trial has been conducted for berberine in any indication.
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The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A plant alkaloid with a real, replicated effect on glucose and lipid blood chemistry, almost no oral absorption, and a 23-trial meta-analysis showing a 0.88 kg weight difference — which is not what "nature's Ozempic" means to anyone who says it.
Recorded evidence blocks (11)
Q2
What did Berberine's largest trial (5200 people) and its longest (7.8 years) measure?
5200 people in Berberine's largest registered study, 7.8 years in its longest registered window, measuring AUC:the area under the concentration-time curve. ClinicalTrials.gov · 2026-09-01
26 na, 19 phase4, 12 phase2, 12 phase3, 4 phase1, 2 early phase1, 2 na or unstated; NCT03378934; 2026-08; no ageing endpoint recorded. Last human test completed 2026, NCT07480018.
Interpretation These counts include studies where Berberine was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
na
26
phase4
19
phase2
12
phase3
12
phase1
4
early phase1
2
2 more recorded rows
na or unstated
2
Last recorded human testNCT07480018
2026-06-01
recorded 2026-09-01 · last checked 2026-09-04
Q3
From C. elegans to human: where has Berberine shown lifespan?
Hormetic in human: "These results introduce the concept of hormesis to study the biphasic effects of berberine on damaged pancreatic β-cells, while also exploring the relationship between the hormetic mechanism of BBR and the p53-mediated apoptosis pathway." Europe PMC · dose-response search · 2026-07-01
6 recorded sentences naming Berberine; hormesis, hormetic, biphasic
Show the evidence
hormesisPMID 40488312
"These results introduce the concept of hormesis to study the biphasic effects of berberine on damaged pancreatic β-cells, while also exploring the relationship between the hormetic mechanism of BBR and the p53-mediated apoptosis pathway."
hormetic
PMID 26421434
"This study aims to investigate the hormetic effect of berberine and its influence on the anticancer activities of chemotherapeutic agents."
PMID 26421434
"The hormetic effect and thereby the attenuated anticancer activity of chemotherapeutic drugs by berberine may attributable to the activated protective stress response in cancer cells triggered by berberine, as evidenced by up-regulated MAPK/ERK1/2 and PI3K/AKT signaling pathways."
biphasic
PMID 42378001
"Current management strategies include nonsystemic antibiotics such as rifaximin, dietary interventions (low-FODMAP and biphasic diets), and nutraceuticals including berberine, oregano oil, peppermint oil, garlic derivatives, vitamins, and magnesium."
PMID 40858186
"In vitro release studies showed that liposomes with a lower content of DPPG exhibited a slow, sustained biphasic release profile, while liposomes with a higher content of DPPG released Berberine rapidly, consistent with dominant surface localization."
PMID 32155852
"The majority of data on biphasic dose-response have been found for phytoestrogens; other reports described these types of effects for resveratrol, sulforaphane, and natural compounds from various chemical classes such as isoquinoline alkaloid berberine, polyacetylenes falcarinol and falcarindiol, prenylated pterocarpan glyceollin1, naphthoquinones plumbagin and naphazarin, and panaxatriol…"
recorded 2026-07-01 · last checked 2026-09-04
Q7
Which of alanine aminotransferase, alkaline phosphatase and appetite suppression did Berberine's trials measure?
alanine aminotransferase, alkaline phosphatase and appetite suppression lead 40 outcome terms across Berberine's trials. ClinicalTrials.gov · 2026-09-01
Interpretation serum triglycerides, serum total cholesterol, hdl c, ldl c, improved metabolic parameters and insulin/glucose after overnight fast follow.
Show the evidence
hba1c at 13 weeks
1
fasting glucose levels
1
hba1c
1
serum triglycerides
1
serum total cholesterol
1
hdl c
1
14 more recorded rows
ldl c
1
improved metabolic parameters
1
insulin/glucose after overnight fast
1
insuline/glucose after an oralglucose tolerance test
1
live birth rate
1
cardiovascular risk
1
appetite suppression
1
hba1c from baseline to week 12
1
helicobacter pylori eradication
1
contrast induced nephropathy
1
glucose
1
insulin
1
lipid profile
1
il 1
1
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which of Berberine's 12 ongoing trials reports first?
P2Y12 reaction unit (PRU); Change in HbA1c; latest 2029-01-01
Show the evidence
Trial
NCT03378934
"Anti-platelet Effect of Berberine in Patients After Percutaneous Coronary Intervention"; n 64; "P2Y12 reaction unit (PRU)"; 2026-08
NCT04698330
"Effects Of Berberine Plus Inulin On Diabetes Care in Patients With LADA"; n 240; "Change in HbA1c"; 2026-12
NCT04918667
"Effect of Gamma-cyclodextrin on the Bioavailability of Berberine"; n 16; "The area under the plasma concentration versus time curve (AUC, expressed in ng x h/mL) of berberine incorporated in gamma-cyclodextrin"; 2026-12
NCT05105321
"Cardiovascular Diseases and Diabetes Prevention Programme in Metabolic Syndrome (CDPP)"; n 5200; "Rate of composite cardiometabolic endpoints"; 2028-12
NCT06629051
"6-year Follow-up Data After the Berberine Intervention Trial"; n 891; "The recurrence rates of traditional colorectal adenomas within the follow-up period of 6 years"; 2024-12-31
NCT06782646
"Study on the Sex-specific, Lipid- and Lipoprotein-lowering Effects of Berberine"; n 100; "Total cholesterol in mmol/L"; 2026-03
6 further recorded trials
NCT06911983
"Comparative Efficacy of Metformin and Berberine Among TCF7L2 (rs7903146) TT vs. CC Genotype Carriers With Type 2 Diabetes"; n 60; "Change in HbA1c"; 2026-03-01
NCT07129460
"Efficacy and Safety of Berberine for Gastric Intestinal Metaplasia"; n 204; "The regression rate of gastric intestinal metaplasia based on OLGIM stage in different groups."; 2027-05-01
NCT07356765
"Berberine in Treating Negative Symptoms of Schizophrenia: Clinical Efficacy and Mechanisms"; n 120; "Change in the total score of the Scale for Assessment of Negative Symptoms (SANS)"; 2026-04-30
NCT07420231
"Evaluation of the Synergistic Effect of Combining a Prebiotic and a Postbiotic on Intestinal Discomfort"; n 140; "Change from baseline in the intensity and frequency of intestinal symptoms"; 2026-12-24
NCT07519681
"Effects of Berberine on the Human Gut Microbiome"; n 20; "Relative abundance of Akkermansia in fecal samples as measured by quantitative PCR (qPCR)"; 2026-10-15
NCT07541898
"Effects of Berberine on Cardiometabolic Outcomes"; n 40; "Blood triglycerides"; 2029-01-01
recorded 2026-09-01 · last checked 2026-09-04
Q9
Which 31 trials of Berberine posted no result?
Posted no result
31 of 31 completed trials
Registrations
NCT00425009, NCT00462046, NCT01087632, NCT00633282, NCT01696448 and NCT01293162, and 25 more
Completion dates
oldest 2004-12; newest 2023-12-31
Show the evidence
Trial
NCT00425009
2004-12
NCT00462046
2006-09
NCT01087632
2010-07
NCT00633282
2011-08
NCT01696448
2013-04
NCT01293162
2014-10
14 further recorded trials
NCT02296021
2015-09
NCT02936414
2015-12
NCT02633930
2016-08
NCT06426966
2017-02-01
NCT03548155
2017-05-08
NCT03251716
2017-12-30
NCT02226185
2018-12-29
NCT04049396
2019-06-15
NCT03609892
2019-08-20
NCT03972215
2020-02-17
NCT04479202
2020-04-23
NCT03438292
2020-09-11
NCT03770325
2020-11-01
NCT05021341
2020-11-04
Q10
At the median, Berberine's trials enrolled 76 people — anything larger?
Median enrolment
76
Largest enrolment
5200
Registered trials counted
67
Q11
Was Berberine studied with fasting?
fasting is named in Berberine's label sentences: "At the end of study, fasting blood sugar (FBS) (P = 0.031) and hemoglobin A1C (HbA1c) (P = 0.013) were significantly lower in participants taking berberine plus cinnamon than those taking the placebo capsules." openfda-label+europepmc · 2025-02-25
1 recorded statement; fasting
Show the evidence
fasting
At the end of study, fasting blood sugar (FBS) (P = 0.031) and hemoglobin A1C (HbA1c) (P = 0.013) were significantly lower in participants taking berberine plus cinnamon than those taking the placebo capsules.
recorded 2025-02-25 · last checked 2026-09-04
Q12
What is recorded about Berberine and mTOR?
"Immunosenescence represents an age-associated remodeling of the innate and adaptive immune systems, closely linked to impaired immunometabolism, chronic inflammation, and shifts in the AMPK/mTOR, NF-κB, autophagy, and inflammasome pathways; therefore, berberine is a logical candidate for the role of a multi-target regulator of these…" — where Berberine and mTOR appear together. Europe PMC · pathway abstract search · 2026-09-01
"Immunosenescence represents an age-associated remodeling of the innate and adaptive immune systems, closely linked to impaired immunometabolism, chronic inflammation, and shifts in the AMPK/mTOR, NF-κB, autophagy, and inflammasome pathways; therefore, berberine is a logical candidate for the role of a multi-target regulator of these processes."
AMPKPMID 42678634
"Immunosenescence represents an age-associated remodeling of the innate and adaptive immune systems, closely linked to impaired immunometabolism, chronic inflammation, and shifts in the AMPK/mTOR, NF-κB, autophagy, and inflammasome pathways; therefore, berberine is a logical candidate for the role of a multi-target regulator of these processes."
autophagyPMID 42678634
"Immunosenescence represents an age-associated remodeling of the innate and adaptive immune systems, closely linked to impaired immunometabolism, chronic inflammation, and shifts in the AMPK/mTOR, NF-κB, autophagy, and inflammasome pathways; therefore, berberine is a logical candidate for the role of a multi-target regulator of these processes."
AMPKPMID 42588134
"Berberine, an isoquinoline alkaloid from Berberis species, modulates metabolic dysfunction via AMP-activated protein kinase (AMPK) activation and reshapes gut microbiota composition through direct high intraluminal exposure, with the most extensive clinical dataset of the four compounds."
mTORPMID 42607934
"Experimental and clinical evidence indicates that phytochemicals engage conserved ageing hubs spanning insulin-IGF signaling, AMPK-mTOR nutrient sensing, redox regulation, and mitochondrial quality control - exemplified by berberine via AMPK, curcumin via NF-κB, and resveratrol via SIRT1."
AMPKPMID 42607934
"Experimental and clinical evidence indicates that phytochemicals engage conserved ageing hubs spanning insulin-IGF signaling, AMPK-mTOR nutrient sensing, redox regulation, and mitochondrial quality control - exemplified by berberine via AMPK, curcumin via NF-κB, and resveratrol via SIRT1."
9 more recorded rows
sirtuinPMID 42607934
"Experimental and clinical evidence indicates that phytochemicals engage conserved ageing hubs spanning insulin-IGF signaling, AMPK-mTOR nutrient sensing, redox regulation, and mitochondrial quality control - exemplified by berberine via AMPK, curcumin via NF-κB, and resveratrol via SIRT1."
NAD+PMID 41745094
"Nicotinamide riboside (NR), a potent NAD<sup>+</sup> precursor, and berberine (BBR), an AMPK activator derived from Berberis aristata, have recently emerged as synergistic modulators of mitochondrial metabolism and oxidative stress resistance."
sirtuinPMID 42126802
"Berberine activates AMPK/SIRT1/PGC-1α pathway, thereby improving fatty acid metabolism, and ultimately exerts therapeutic effects on NAFLD accompanied by T2DM."
IGF-1PMID 40328339
"Berberine chloride hydrate also effectively ameliorated GC-induced growth retardation by restoring Ghr expression via KMT1A inhibition, thereby enhancing the circulating IGF-1 levels."
autophagyPMID 42259199
"Major phytochemicals including curcumin, resveratrol, quercetin, berberine, epigallocatechin gallate, apigenin, and ginsenosides suppress NF-κB, PI3K/Akt, MAPK, and JAK/STAT signaling while activating Nrf2-mediated antioxidant defense, AMPK signaling, autophagy, and apoptosis."
mTORPMID 41595746
"Curcumin, resveratrol, quercetin, berberine, and epigallocatechin gallate are known to have the ability to restore apoptotic signaling, block pro-survival autophagy, and sensitize ovarian cancer cells to chemotherapy through the regulation of key pathways including PI3K/AKT/mTOR, AMPK, MAPK, p53, and Bcl-2 family proteins."
autophagyPMID 41595746
"Curcumin, resveratrol, quercetin, berberine, and epigallocatechin gallate are known to have the ability to restore apoptotic signaling, block pro-survival autophagy, and sensitize ovarian cancer cells to chemotherapy through the regulation of key pathways including PI3K/AKT/mTOR, AMPK, MAPK, p53, and Bcl-2 family proteins."
sirtuinPMID 42329291
"This review addresses the dual promise of berberine therapy, a biologically active plant alkaloid that enhances mitochondrial production via AMPK/PGC-1α and SIRT1, restores membrane potential, promotes mitophagy, and inhibits NF-κB and NLRP3-mediated inflammation."
NAD+PMID 41516357
"Nicotinamide riboside (NR), a vitamin B<sub>3</sub> derivative and efficient precursor of NAD<sup>+</sup> (nicotinamide adenine dinucleotide), and berberine (BBR), an isoquinoline alkaloid widely investigated in metabolic regulation, have independently emerged as promising mitochondrial modulators."
recorded 2026-09-01 · last checked 2026-09-04
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