Understanding: Are there any negative effects of berberine?

October 6, 2025 •

3 min read

While often marketed for its metabolic benefits, common side effects of berberine can include significant gastrointestinal issues such as diarrhea and bloating. It is a potent alkaloid with a long history of use, but its powerful effects mean it is not without risks.

Quick Summary

Common negative effects of berberine include digestive problems like stomach pain and diarrhea, as well as significant interactions with numerous medications, impacting their effectiveness. It is strongly contraindicated for pregnant and breastfeeding women and infants due to serious risks.

Key Points

Gastrointestinal Distress: Berberine's most common negative effects are digestive, including diarrhea, constipation, bloating, and nausea, especially at higher doses.
Significant Drug Interactions: Berberine can interact with numerous medications by altering liver enzymes, potentially causing dangerous fluctuations in drug levels.
Contraindicated for Pregnancy and Breastfeeding: It is unsafe for pregnant women (risk of miscarriage) and breastfeeding mothers (risk of kernicterus in infants).
Hypoglycemia and Hypotension Risks: Berberine can lower blood sugar and blood pressure, which poses risks for individuals already on medication for these conditions.
Need for Professional Consultation: Due to potential side effects and interactions, it is crucial to consult a healthcare provider before taking berberine, especially if you have pre-existing conditions or take other medicines.
Lack of Long-Term Safety Data: Most studies on berberine have been short-term, meaning its long-term safety profile and effects are not yet fully understood.

Common Side Effects of Berberine

Berberine is a bioactive compound found in several plants and is often taken as a dietary supplement for its purported health benefits, especially related to metabolic health. While generally well-tolerated, the most commonly reported negative effects are related to the gastrointestinal (GI) system.

Digestive Discomfort: Many users experience nausea, diarrhea, constipation, bloating, and abdominal pain. These symptoms often occur with higher doses, and starting with a lower dose and increasing it gradually may help mitigate this. Taking berberine with a meal can also help lessen digestive upset.
Low Blood Sugar (Hypoglycemia): Berberine can lower blood glucose levels, which can be a negative effect if blood sugar drops too low, especially with other diabetes medications. Symptoms include dizziness, fatigue, and headache.
Low Blood Pressure (Hypotension): Berberine can also lower blood pressure. This can be a risk for people who already have low blood pressure or are on medication for hypertension.
Allergic Reactions: Though rare, some individuals may have an allergic reaction to berberine or the plants it comes from. Symptoms can include hives, rash, or difficulty breathing.

Serious Contraindications and Special Populations

Berberine is not recommended for certain groups due to significant safety concerns.

Pregnancy and Breastfeeding

Berberine is likely unsafe for pregnant and breastfeeding women. It can cross the placental barrier, potentially harming the fetus, and may induce uterine contractions. It can also transfer to infants through breast milk and cause health issues.

Infants and Children

Berberine is unsafe for newborns and infants due to the risk of kernicterus. There is insufficient research to determine its safety in older children.

Individuals with Liver or Kidney Disease

While some research suggests benefits for liver health in conditions like NAFLD, preclinical studies suggest high doses can impair liver function. Berberine also affects liver enzymes that metabolize drugs. Those with pre-existing liver or kidney conditions should use with caution and under medical supervision.

Significant Drug Interactions

Berberine can interact with numerous medications by affecting liver enzymes (CYP450) responsible for drug metabolism. This can increase drug levels or decrease their effectiveness. Consult a healthcare provider before taking berberine if on any prescription medication.

Comparison of Berberine Use


Aspect	Healthy Adults	Pregnant/Breastfeeding Women	Individuals on Medication	Individuals with Liver/Kidney Issues
Suitability	Possibly safe for short-term use, especially when starting with a low dose.	Highly contraindicated due to risk of harm to fetus/infant.	Potentially dangerous due to multiple drug interactions. Requires strict medical supervision.	Requires caution and professional consultation due to effects on liver enzymes.
Common Risks	Mild GI upset (diarrhea, constipation, bloating).	Miscarriage, kernicterus in infants.	Over-potentiated or reduced effect of concurrent medications.	Potential for liver function impairment at high doses.
Important Consideration	Adhere to recommended dosages (up to 1.5g/day, split).	Absolutely avoid berberine during these periods.	Inform your doctor about all medications before starting berberine.	Requires regular monitoring of liver/kidney enzyme levels.

Lack of Long-Term Safety Data

Most clinical studies on berberine have been small and short (typically 3-6 months). This means there is not enough data to understand the effects of long-term use, and the full scope of potential risks is unknown.

Product Quality and Dosage Concerns

As a dietary supplement, berberine is not subject to the same strict regulations as drugs. Product purity and the amount of active ingredient can vary between brands. Choosing a high-quality, third-party tested product is crucial. A sudden, high dose can increase the risk of side effects.

Conclusion

While berberine offers potential health benefits, it is essential to be aware of its negative effects and safety considerations. Common side effects are gastrointestinal, but more serious risks include drug interactions and contraindications for pregnant women, breastfeeding mothers, and infants. The lack of long-term safety data also highlights the need for caution. Anyone considering berberine, especially those with pre-existing conditions or taking other medications, should consult with a healthcare professional.

For more information on supplements and safety, visit the National Center for Complementary and Integrative Health (NCCIH) website.

Frequently Asked Questions

The most common side effects are gastrointestinal, and include diarrhea, constipation, bloating, gas, and nausea. These symptoms often occur with higher doses and may subside over time or with a lower dosage.

Yes, berberine is known to interact with several medications, including those for diabetes, blood thinners, immunosuppressants (like cyclosporine), and statins. It is crucial to consult a doctor to review all potential interactions.

No, berberine is considered unsafe for both pregnant and breastfeeding women. It can cross the placenta and potentially cause harm to the fetus or be passed to the infant via breast milk, carrying a risk of kernicterus in newborns.

Berberine can lower blood sugar levels, and when taken with other diabetes medications, it can cause blood sugar to drop too low (hypoglycemia). Blood sugar levels should be monitored closely if combining treatments.

While berberine has shown benefits for liver health in some cases, high doses can elevate liver enzyme levels, and some studies indicate potential for liver damage. People with existing liver conditions should be cautious and monitored by a doctor.

The long-term safety of berberine is not well-established, as most studies have been of short duration (3-6 months). Therefore, potential long-term negative effects on organs like the liver or other systems are not fully understood.

To minimize side effects, start with a low dose and gradually increase it. Taking berberine with meals can also help reduce digestive discomfort. It is also essential to use a high-quality, third-party tested product.