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Research summary

Berberine Side Effects

Key takeaway

Berberine is a substance found in plants including goldenseal, barberry and Oregon grape. Human trials commonly report gastrointestinal side effects. NCCIH cautions about medication interactions, including cyclosporine, and possible harm during pregnancy or breastfeeding; it considers berberine likely unsafe for infants.[1], [2]

Limitations

The umbrella review concluded that the methodological quality of the evidence needs improvement. The liver-enzyme finding is a pooled group average and does not establish individual outcomes.[2], [3]

Gastrointestinal symptoms are the most commonly reported side effects

An umbrella review of meta-analyses of randomized controlled trials reported that the most commonly reported side effects of oral berberine were gastrointestinal symptoms, including constipation and diarrhea.[2]

Liver-enzyme findings in pooled trials

A meta-analysis of 12 randomized controlled trials found that berberine supplementation did not significantly change alanine aminotransferase or aspartate aminotransferase compared with control. This is a pooled group-average result and does not establish individual safety.[3]

Limits of the current evidence

The umbrella review concluded that the methodological quality of pooled berberine meta-analyses needs improvement and that clinical effects should be confirmed in high-quality randomized controlled trials. This is an evidence-quality limitation, not a finding about a specific adverse effect or dose.[2]

Medication and vulnerable-population cautions

Berberine may interact with medicines, including cyclosporine. NCCIH advises people taking medicine to speak with their health care provider before considering berberine supplements. This is a medication-interaction caution, not advice to stop, replace or change a prescribed medicine.[1]

NCCIH cautions that berberine is likely unsafe for infants and may also be unsafe during pregnancy or breastfeeding because of possible effects on the fetus or infant. This caution concerns infants, pregnancy and breastfeeding; the cited guidance links berberine exposure to harmful bilirubin buildup in infants.[1]

References

  1. Berberine and Weight Loss: What You Need To Know. NIH National Center for Complementary and Integrative Health. Retrieved 2026-09-09. Government health fact sheet View source →
  2. Berberine and health outcomes: An umbrella review.. Phytotherapy research : PTR. 2023. Systematic review View source →
  3. The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials.. Clinical nutrition ESPEN. 2020. Systematic review and meta-analysis View source →

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