Barberry

Berberis vulgaris L. was named by Linnaeus in 1753 and belongs to Berberidaceae, the barberry family (Kew’s Plants of the World Online). Rahimi-Madiseh and colleagues put the genus at about 500 species worldwide. Kew gives the native range of common barberry as much of continental Europe, from Spain, France, Italy, and Greece north to Germany, Poland, and the Baltic states and east through Ukraine and European Russia, together with Morocco and Algeria, Türkiye, the Caucasus, Iran, and Uzbekistan. It is listed as introduced in Great Britain, Ireland, Portugal, Scandinavia, and New Zealand, and across much of the northern United States and southern Canada. Sources differ on its origin, and the Minnesota Department of Agriculture describes it as native to Asia and naturalized in Europe. Several relatives matter for this page. Indian barberry or tree turmeric, Berberis aristata DC., is native to the Himalaya, India, Nepal, Tibet, Assam, and Myanmar (Kew) and is known in Ayurveda as daruharidra, daruhaldi, and darvi (Potdar and colleagues, Fitoterapia 2012). Oregon grape, Berberis aquifolium, still widely sold under its older name Mahonia aquifolium, is a North American member of the family. Goldenseal (Hydrastis canadensis) and Chinese goldthread (Coptis chinensis) also contain berberine but belong to a different family, Ranunculaceae.

Common barberry is an upright, deciduous shrub. King’s American Dispensatory (1898) describes it as 3 to 8 feet tall, with long, bending branches dotted with triple spines; the Minnesota Department of Agriculture gives 8 to 10 feet. The spines are modified leaves: King’s notes that the first leaves on a shoot are three-parted and spiny, and Rahimi-Madiseh and colleagues describe the leaves of long branches in Berberis as transformed into single, double, or triple spines. The true leaves grow in clusters at the nodes on short side shoots. They are oval, narrowing at the base to a very short stalk, about 2 inches long, and finely and bristly toothed. Small yellow flowers hang in drooping clusters in May and June, and King’s records that the stamens are “irritable,” springing against the stigma when touched. The fruits are bright red, oblong, intensely sour berries, each holding one to three small black seeds. Birds spread the seeds, and the plant also sprouts from creeping underground stems. The Minnesota Department of Agriculture distinguishes it from the ornamental Japanese barberry (Berberis thunbergii) by its sharply toothed leaf margins, three-pronged spines, and taller, looser branches.

Cut into a stem or root and the color explains the plant’s history. King’s describes the root bark as orange-yellow on its inner surface and vivid yellow inside, staining the saliva yellow when chewed, with the color running through the wood; the bark was once a source of yellow dye (US Department of Agriculture Agricultural Research Service, ARS). Imanshahidi and Hosseinzadeh (Phytotherapy Research 2008) name berberine, berbamine, and palmatine as the plant’s most important alkaloids, King’s adds oxyacanthine, and Rahimi-Madiseh and colleagues count more than 30 alkaloids, with the highest alkaloid content in the root bark. Berberine (PubChem CID 2353) has the formula C20H18NO4+; LiverTox describes it as a quaternary ammonium compound, meaning it carries a permanent positive charge. The berries are a different product. Rahimi-Madiseh and colleagues report vitamin C, anthocyanin pigments, more than 10 phenolic compounds, and a fruit that is about 80% water, and King’s attributes part of the sourness to malic acid. Iran is the world’s biggest producer of the fruit, with about 11,000 hectares under cultivation and more than 10,000 tons of dried berries a year, about 95% of it from Ghaenat County in South Khorasan province.

Barberry’s medical history is long, though some of the oldest claims are hard to check. Rahimi-Madiseh and colleagues write that barberry fruit was recorded as a blood purifier on clay tablets in the library of the Assyrian king Ashurbanipal around 650 BC, that the Persian physician Rhazes was the first in Iran to describe its medicinal properties, and that medicinal use of Berberis in Chinese medicine goes back more than 3,000 years. King’s American Dispensatory, quoting the pharmacists C. G. and J. U. Lloyd, credits the twelfth-century Arabic medical writer Averroes with first applying the name berberys to the fruit. NCCIH notes that berberine-containing plants have been used in Ayurvedic and traditional Chinese medicine for thousands of years. A review by Neag and colleagues (Frontiers in Pharmacology 2018) describes Ayurvedic use of Berberis root and bark for infections of the eye, ear, and mouth, wounds, hemorrhoids, indigestion, and dysentery, and Chinese use of goldthread rhizome to lower fevers and treat diarrhea and dysentery. Chan (Biology of the Neonate 1993) gives that Chinese herb its name, huang lian. In South Asia, rasanjana, a concentrated extract of Indian barberry, is used in eye preparations; in a small 2011 study in the journal AYU, 35 people with mucopurulent conjunctivitis received rasanjana-and-honey or honey-and-rosewater eye drops, without a placebo group.

In Europe barberry was a garden and hedge plant as much as a medicine. ARS records that it was widely grown for medicinal purposes and planted in monastery gardens throughout southern Europe, that its long, straight wood made good tool handles, and that its dense, spiny growth kept livestock and poultry out. Early European settlers brought it to North America, where the fruit became a favorite for sauces, jellies, wines, and preserves and the bark was used as a yellow dye. The French name épine-vinette, King’s explains, means “acid thorn.” American domestic medicine used it widely. King’s quotes the Lloyds’ description of barberry bark tea taken in spring as a “blood purifier” and a strong decoction applied to sores on children’s lips, and calls the plant a tonic and laxative once used extensively by New England practitioners for jaundice, chronic diarrhea, and dysentery. The berries made a sour drink for fevers, and a decoction of bark or berries served as a wash for mouth ulcers and chronic eye inflammation. King’s warns that a teaspoonful of powdered root bark acts as a purgative, and the Lloyds judged a fluid extract of the bark more satisfactory than the isolated alkaloid berberine.

The plant’s biggest historical impact was on farming. Common barberry is the alternate host of the stem rust fungus, Puccinia graminis: the rust found on barberry in spring is the same fungus that attacks wheat, oats, and other small grains in summer and fall (ARS). Farmers suspected the link early. ARS notes a 1660 law against barberry in Rouen, France, nearly 200 years before the German scientist A. de Bary proved the connection, and colonial laws in Connecticut (1726), Massachusetts (1754), and Rhode Island (1766). The 1916 epidemic was the worst stem rust outbreak on record, destroying about 61% of Minnesota’s wheat and an estimated 200 million bushels, about 40% of the US crop (Peterson, Annual Review of Phytopathology 2018). Grain states passed barberry laws from 1917, and in 1918 a cooperative federal and state eradication program began under the plant pathologist E. C. Stakman, backed from 1919 by Federal Quarantine No. 38 on moving susceptible barberries between states. Government staff, farmers, and schoolchildren joined the search. By the late 1970s, when the federal program wound down, 18 states had taken part, about 800,000 square miles had been searched, and about 500 million bushes had been destroyed (Peterson). Minnesota still lists common barberry as a prohibited noxious weed.

Berberine’s defining trait is that very little of a swallowed dose reaches the blood. In rats, Chen and colleagues (AAPS PharmSciTech 2011) measured an absolute oral bioavailability of 0.68% and suggested that a transporter, P-glycoprotein, pumps absorbed berberine back into the gut. In the fatty liver trial by Yan and colleagues (PLoS One 2015), people taking 500 mg three times a day had average blood levels of only about 7 ng/ml, although in animals the same team found berberine concentrated in the liver. Much of each dose therefore stays in the intestine, and that may be part of how it works. Berberine has long been used as an antibiotic drug, and Zhang and colleagues (Journal of Clinical Endocrinology and Metabolism 2008) note that its glucose-lowering effect was first noticed when it was given for diarrhea to people with diabetes. In the PREMOTE trial (Zhang and colleagues, Nature Communications 2020), which described berberine as bacteriostatic, analyses of gut microbes and metabolites linked its effect on blood sugar to changes in gut bacteria, in particular reduced conversion of bile acids into deoxycholic acid by the bacterium Ruminococcus bromii. Memorial Sloan Kettering Cancer Center (MSKCC) notes that poor absorption has prompted a continuing search for better-absorbed berberine combinations, which also means trial results for one product may not transfer to another.

Two laboratory discoveries shaped the modern berberine story. Kong and colleagues (Nature Medicine 2004) reported that berberine increases LDL receptors, the docking sites liver cells use to pull LDL cholesterol out of the blood, by stabilizing the messenger RNA that codes for them. In hamsters with high blood lipids it lowered LDL cholesterol by 42% while LDL receptor messenger RNA in the liver rose 3.5-fold, and in human liver cancer cells the effect worked independently of the sterol-sensing pathway that statins rely on, which the authors called a mechanism distinct from statins. MSKCC adds preclinical evidence that berberine lowers PCSK9, a protein that breaks down LDL receptors, and improves the function of blood vessel linings. Two years later, Lee and colleagues (Diabetes 2006) showed that berberine activates AMP-activated protein kinase (AMPK), an energy sensor inside cells. In obese, diabetic db/db mice it reduced body weight and improved glucose tolerance without changing food intake, and in fat and muscle cells it increased AMPK activity, while in muscle cells it moved glucose transporters to the cell surface. These are animal and cell findings. They explain why berberine is often compared with metformin, and why UCLA Health (2025) stresses that it works differently from GLP-1 drugs such as semaglutide, which mimic a gut hormone that regulates appetite and digestion.

Barberry contains more than berberine, and the extra chemistry matters when reading fruit trials. Rahimi-Madiseh and colleagues describe berbamine as a calcium channel blocker and list vitamin C, anthocyanins, and other phenolic compounds in the berries; because alkaloids are concentrated in the root bark, berries and juice deliver a different mix from root extracts or purified berberine, and the effects seen in fruit trials cannot be credited to berberine alone. Berbamine has not been tested on its own in the human trials described on this page. Two other actions of berberine matter for safety, and both have been measured. In healthy men, two weeks of berberine slowed the breakdown of probe drugs handled by CYP3A4, CYP2D6, and CYP2C9 (Guo and colleagues, European Journal of Clinical Pharmacology 2012), which is the basis for its drug interactions. And berberine displaces bilirubin, the yellow pigment made when old red blood cells are broken down, from albumin, the blood protein that carries it. Chan (Biology of the Neonate 1993) found berberine about ten times more potent at this than phenylbutazone, a drug known for the effect, and about a hundred times more potent than papaverine, a related alkaloid; daily injections for a week also raised free and total bilirubin in adult rats.

Type 2 diabetes is where berberine has the most trials. In a pilot study, Yin and colleagues (Metabolism 2008) randomized 36 adults with newly diagnosed type 2 diabetes to berberine or metformin, 0.5 g three times a day for three months; the glucose-lowering effects were similar, and HbA1c in the berberine group fell from 9.5% to 7.5%. In a second, uncontrolled group of 48 poorly controlled patients, adding berberine lowered HbA1c from 8.1% to 7.3%. Zhang and colleagues (Journal of Clinical Endocrinology and Metabolism 2008) gave 116 people with type 2 diabetes and abnormal blood lipids 1 g of berberine a day or placebo for three months, and HbA1c fell from 7.5% to 6.6% with berberine. The PREMOTE trial randomized 409 people with newly diagnosed diabetes at 20 Chinese centers; after 12 weeks HbA1c had fallen by about 1.0 percentage point with berberine versus 0.6 with placebo. Meta-analyses agree on direction. Dong and colleagues (2012) found 14 trials with 1,068 people, of generally low methodological quality, in which berberine showed no significant difference from metformin, glipizide, or rosiglitazone and improved control when added to them, and Xie and colleagues (Frontiers in Pharmacology 2022) pooled 37 trials, finding fasting glucose about 15 mg/dL and HbA1c 0.63 points lower. Most participants were Chinese and most trials were small and short, which is why NCCIH calls the evidence weak.

Cholesterol is berberine’s second major use. In the 2004 Nature Medicine paper, 32 people with high cholesterol who took berberine for three months saw total cholesterol fall 29%, triglycerides 35%, and LDL cholesterol 25%. Ju and colleagues (Phytomedicine 2018) pooled 16 randomized trials with 2,147 participants and found LDL cholesterol about 15 mg/dL (0.38 mmol/L) lower, with lower total cholesterol and triglycerides as well, but judged the trials highly variable, mostly of low methodological quality, and open to several kinds of bias. MSKCC summarizes the picture as several studies suggesting benefit with an effect that may be small, and cites an international lipid expert panel suggesting berberine may be most useful for people with mildly raised cholesterol who cannot tolerate statins or who have metabolic syndrome. Several European trials tested combination products that pair berberine with red yeast rice, policosanol, and other ingredients, and MSKCC notes that the monacolin K in red yeast rice has statin-like side effects, so results from those blends cannot be credited to berberine. None of the trials described here measured heart attacks or strokes, the outcomes that statins have been shown to reduce, so berberine is at most an adjunct for people whose clinicians agree.

Fatty liver disease and PCOS have smaller evidence bases. Yan and colleagues randomized 184 adults with non-alcoholic fatty liver disease at three Chinese centers to lifestyle advice alone, lifestyle advice plus 15 mg of the diabetes drug pioglitazone, or lifestyle advice plus berberine 0.5 g three times a day for 16 weeks. Liver fat fell by 52.7% with berberine versus 36.4% with lifestyle advice alone, with greater improvements in weight, insulin resistance, and blood lipids, but the trial was open-label, so patients and doctors knew who was taking what. A 2024 meta-analysis of 10 trials with 811 patients (Nie and colleagues, Journal of Translational Medicine) found improvements in liver enzymes, lipids, and insulin resistance, whereas an earlier analysis of 12 trials found no significant effect on the liver enzymes ALT and AST (Asbaghi and colleagues 2020). These studies tracked liver fat and enzymes rather than scarring. In PCOS, Wei and colleagues (European Journal of Endocrinology 2012) randomized 89 Chinese women with insulin resistance, all also taking a compound cyproterone acetate hormone pill, to berberine, metformin, or placebo for three months; berberine improved waist-to-hip ratio, lipids, and insulin resistance. A 2019 review of 12 trials found no solid evidence that berberine improves live birth rates, which were lower with berberine than with the fertility drug letrozole.

Weight loss is the use that made berberine famous online. UCLA Health (2025) describes it as a supplement commonly called “nature’s Ozempic,” but notes that it works differently from GLP-1 drugs and that there is no conclusive evidence yet for similar effects. The numbers bear that out. Asbaghi and colleagues (Clinical Nutrition ESPEN 2020) pooled 12 trials and found body weight about 2.1 kg (4.6 pounds) lower with berberine. A larger 2026 meta-analysis in the International Journal of Obesity (Elahi Vahed and colleagues) included 23 trials and found an average loss of only 0.88 kg (under 2 pounds), with body mass index (BMI) about 0.5 points lower and no change in waist-to-hip ratio, and the authors called for better blinding and clearer reporting of product purity and dose. By contrast, in the STEP 1 trial of 1,961 adults, weekly semaglutide injections reduced body weight by 14.9% over 68 weeks, against 2.4% with placebo (Wilding and colleagues, New England Journal of Medicine 2021). One of the largest berberine trials addressed a different question entirely. In 1,108 Chinese adults who had colorectal adenomas, precancerous polyps, removed, 0.3 g of berberine twice a day lowered the rate of new adenomas over up to two years of follow-up to 36%, compared with 47% on placebo, and no cancers were found in either group (Chen and colleagues, Lancet Gastroenterology and Hepatology 2020).

Barberry itself has a smaller and separate evidence base, almost entirely from Iran. In a double-blind trial in people with type 2 diabetes, 3 g a day of Berberis vulgaris fruit extract for three months lowered triglycerides, total and LDL cholesterol, glucose, and insulin compared with placebo, but did not change HbA1c (Shidfar and colleagues, Iranian Journal of Pharmaceutical Research 2012). Pooled analyses of these small trials differ in the details. Hadi and colleagues (2019) found LDL cholesterol about 14 mg/dL lower across 5 trials with 339 people; Safari and colleagues (2020) found lower insulin but no significant change in fasting glucose, HbA1c, or insulin resistance across 7 studies with 452 people; and a 2024 analysis of 9 trials in type 2 diabetes found fasting glucose about 15 mg/dL and HbA1c 0.3 points lower. The most recent, by Zhang and colleagues (Journal of Health, Population and Nutrition 2025), included 11 trials with 718 people, all conducted in Iran, lasting 3 to 12 weeks and using anything from 75 mg to 10 g of fruit a day or 200 to 480 ml of juice. It found modest falls in weight, blood pressure, cholesterol, triglycerides, and fasting glucose, but no significant change in HbA1c. The traditional uses of the root bark, for jaundice, diarrhea, and as a bitter tonic, rest on folk practice; the trials above tested berberine, fruit, or juice.

As food, barberries are eaten dried, cooked, or juiced. Rahimi-Madiseh and colleagues describe common barberry as mainly a food plant in Iran, where the dried fruit is cooked with rice and made into sauces, jelly, juice, jam, marmalade, and carbonated drinks, and is used to season and garnish dishes; the related black barberry, Berberis integerrima, is used mainly for juice and as medicine. In Iran the dried berries are called zereshk. ARS records sauces, jellies, wines, and preserves in early America. The berries are intensely sour, and King’s attributes part of that taste to malic acid. In the Iranian trials, fruit products ranged from 75 mg to 10 g a day and juice from 200 to 480 ml a day, typically for 3 to 12 weeks. Because alkaloids are concentrated in the root bark rather than the fruit, a spoonful of dried barberries in a rice dish should not be assumed to act like a berberine capsule, and the fruit trials, with their mix of pigments, acids, and alkaloids, should not be read as berberine trials either. If you enjoy barberries as food, that is a culinary choice rather than a dose.

Berberine supplements are usually sold as capsules or tablets of berberine hydrochloride; MSKCC lists berberine HCl among its common names. NCCIH considers berberine safe at the doses used in clinical situations, 200 to 1,000 mg two to three times a day. Trials used similar amounts split through the day: 0.5 g three times daily in Yin’s diabetes study and Yan’s fatty liver trial, 1 g a day in Zhang’s placebo-controlled trial, and 0.3 g twice daily in the polyp trial, for periods from 12 weeks to two years. The drug interaction study used 300 mg three times a day for two weeks, a common supplement dose, so interactions should be expected at ordinary intakes. Product quality varies. LactMed notes that dietary supplements may contain multiple ingredients, that differences are often found between labeled and actual ingredients or amounts, and that test results for one product may not apply to another. Enhanced-absorption formulas and multi-ingredient “metabolic” or “glucose support” blends add further uncertainty, and products pairing berberine with red yeast rice add monacolin K, which MSKCC notes has statin-like side effects.

Traditional preparations used the root bark. King’s describes thin pieces of bark, vivid yellow inside, given as a tea or fluid extract, with a strong decoction used as a wash, and warns that a teaspoonful of the powdered root bark acts as a purgative. In Ayurveda, rasanjana is a concentrated extract of Indian barberry used in eye preparations. These preparations deliver unknown amounts of alkaloids, and their safety has not been established. Practical points: if you want to try berberine, talk first with a pharmacist or prescriber, especially if you take any regular medicine; choose a single-ingredient product that states the amount of berberine per capsule; check your blood sugar more often if you have diabetes; and stop it if you might be pregnant or are breastfeeding. Do not make root bark teas or eye washes at home, and see a doctor about a red or painful eye. Gardeners should know that common barberry is a prohibited noxious weed in Minnesota, where it may not be sold, moved, or propagated, and that the Minnesota Department of Agriculture advises gloves, long sleeves, and long pants when digging it out because of its spines.