Barberry

What Is Barberry?

Barberry is a spiny shrub whose bright yellow root and bark are bitter with berberine, and it is used as a digestive and liver tonic and for diarrhoea and infections of the gut. The name covers the genus Berberis, about 500 species, of which European barberry (Berberis vulgaris) is the one most used ^{11,28Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →Reference 28WhittemoreWhittemore, A. T. (n.d.). Berberis Linnaeus — genus treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=103816View study →}.

European barberry is native to central and southern Europe and east to Iran, and it was carried to North America, where it went wild ^{29,32Reference 29WhittemoreWhittemore, A. T. (n.d.). Berberis vulgaris Linnaeus — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500244View study →Reference 32North Carolina Extension Gardener Plant Berberis vulgaris (European barberry) — reference databaseView study →}. Its tart red berries are eaten across Iran, where the plant is called zereshk ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}.

The root and bark carry berberine and related alkaloids such as berbamine and palmatine ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}. Human trials of barberry fruit extract and of isolated berberine have looked at blood lipids, blood sugar and fatty liver ^{1,2,3,4,5,6,7,8,9Reference 1Hadi et al. · 2019Meta-analysisBarberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters — systematic review and meta-analysis of randomized controlled trialsView study →Reference 2Shidfar et al. · 2012RCTThe effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients — randomised controlled trialView study →Reference 3Safari et al. · 2020Meta-analysisThe effect of barberry (Berberis vulgaris L.) on glycemic indices — systematic review and meta-analysis of randomized controlled trialsView study →Reference 4Guo et al. · 2021Meta-analysisThe effect of berberine on metabolic profiles in type 2 diabetic patients — systematic review and meta-analysis of randomized controlled trialsView study →Reference 5Liu et al. · 2025Meta-analysisEfficacy and safety of berberine on the components of metabolic syndrome — systematic review and meta-analysis of randomized placebo-controlled trialsView study →Reference 6Lan et al. · 2015Meta-analysisMeta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipidaemia and hypertensionView study →Reference 7Dong et al. · 2012Meta-analysisBerberine in the treatment of type 2 diabetes mellitus — systematic review and meta-analysisView study →Reference 8Chen et al. · 2020RCTBerberine versus placebo for the prevention of recurrence of colorectal adenoma — multicentre, double-blinded, randomised controlled studyView study →Reference 9Iloon Kashkooli et al. · 2015Clinical trialThe effect of Berberis vulgaris extract on transaminase activities in non-alcoholic fatty liver disease — clinical trialView study →}.

Oregon grape (Berberis aquifolium), long placed in a separate genus as Mahonia aquifolium, is now usually treated as a barberry too ^{28,30Reference 28WhittemoreWhittemore, A. T. (n.d.). Berberis Linnaeus — genus treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=103816View study →Reference 30WhittemoreWhittemore, A. T. (n.d.). Berberis aquifolium Pursh — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500223View study →}. It is an evergreen shrub with holly-like leaves, and its root is used in the same way.

How Is Barberry Used?

• Root and root bark — the most active parts ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}, taken as a decoction, tincture or liquid extract for digestion, the liver and the gut.
• Bark tea — traditionally drunk in spring as a blood purifier ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.
• Wash — a decoction of the bark or berries, used for a sore mouth and sore eyes ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.
• Berries — eaten as food, pressed into juice and used in rice dishes in Iran ^{11,16Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →Reference 16Aliakbarlu et al. · 2018In vitroEffect of extraction conditions on antioxidant activity of barberry (Berberis vulgaris) fruit — in vitroView study →}. They were made into a sour drink for fevers ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.
• Extracts — standardised fruit extracts and isolated berberine, used in the modern trials ^{1,2,3,4,5,6,7,8,9Reference 1Hadi et al. · 2019Meta-analysisBarberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters — systematic review and meta-analysis of randomized controlled trialsView study →Reference 2Shidfar et al. · 2012RCTThe effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients — randomised controlled trialView study →Reference 3Safari et al. · 2020Meta-analysisThe effect of barberry (Berberis vulgaris L.) on glycemic indices — systematic review and meta-analysis of randomized controlled trialsView study →Reference 4Guo et al. · 2021Meta-analysisThe effect of berberine on metabolic profiles in type 2 diabetic patients — systematic review and meta-analysis of randomized controlled trialsView study →Reference 5Liu et al. · 2025Meta-analysisEfficacy and safety of berberine on the components of metabolic syndrome — systematic review and meta-analysis of randomized placebo-controlled trialsView study →Reference 6Lan et al. · 2015Meta-analysisMeta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipidaemia and hypertensionView study →Reference 7Dong et al. · 2012Meta-analysisBerberine in the treatment of type 2 diabetes mellitus — systematic review and meta-analysisView study →Reference 8Chen et al. · 2020RCTBerberine versus placebo for the prevention of recurrence of colorectal adenoma — multicentre, double-blinded, randomised controlled studyView study →Reference 9Iloon Kashkooli et al. · 2015Clinical trialThe effect of Berberis vulgaris extract on transaminase activities in non-alcoholic fatty liver disease — clinical trialView study →}.

Traditional Uses

Eclectic and American Domestic Medicine

European barberry had long been in domestic use in North America by the 1890s. A tea of the bark was taken in spring as a blood purifier, and a strong decoction was applied to sores on children’s lips ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.

The Eclectic physicians used it as a tonic and laxative. Practitioners in New England gave it wherever a tonic was indicated, and for jaundice, chronic diarrhoea and dysentery ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}. It was valued in jaundice when the bile ducts were not obstructed, and in small doses for intestinal indigestion ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.

The root bark was considered the most active part; a teaspoon of the powder acts as a purgative ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}. A decoction of bark or berries was used as a wash for mouth ulcers and chronic eye inflammation ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.

The berries made a sour, cooling drink for fevers, and were given for dysentery and diarrhoea ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}. Small doses were also given for kidney stones and for burning in the urinary tract ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.

Persian Medicine (Zereshk)

In Iran, barberry is called zereshk. Its fruits are cooked with rice and made into juice, and a tea is sometimes made from the bark ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}.

The roots, bark, leaves and fruits have long been used in folk medicine there. The stem and root bark are used as a purgative, diuretic, fever remedy and antiseptic, and to clear bile. A decoction of the leaves is used for dysentery, scurvy and sore throat ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}.

Barberry is also used for diarrhoea, fever, poor appetite and an upset stomach, and species of the genus have been used for jaundice, gallstones, malaria and leishmaniasis ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}.

Native North American Medicine (Oregon Grape)

Native Americans used root preparations of Oregon grape for stomach trouble, bleeding and tuberculosis. It was taken as a tonic and a cure-all, used as a gargle and an eyewash, and taken to purify the blood ^{30Reference 30WhittemoreWhittemore, A. T. (n.d.). Berberis aquifolium Pursh — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500223View study →}.

The leaves and roots were used in steam baths for yellow fever, and the stem tips for stomach ache ^{30Reference 30WhittemoreWhittemore, A. T. (n.d.). Berberis aquifolium Pursh — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500223View study →}.

Indications

• Poor appetite and weak digestion [root bark; Eclectic and Persian use]
• Jaundice and sluggish bile flow [root bark; Eclectic and Persian use]
• Diarrhoea and dysentery [root bark, berries; Eclectic and Persian use]
• Fever [berries, bark; Eclectic and Persian use]
• Sore mouth, sore throat and sore eyes, as a wash or gargle [bark or berry decoction, leaf decoction; Eclectic and Persian use]
• Malaria and parasitic infections [Persian use] ⚠Caution: Berberine and related alkaloids were as potent as quinine against malaria parasites in the test tube, but inactive in infected mice ¹⁹.
• High cholesterol and triglycerides [fruit extract]
• High blood sugar and insulin resistance [fruit extract] ⚠Caution: A meta-analysis of seven trials found that barberry lowered insulin but did not significantly change fasting blood sugar, HbA1c or insulin resistance ³.
• Fatty liver [B. vulgaris extract]
• Psoriasis [Oregon grape bark cream, on the skin]

Botany

Barberry is the common name of Berberis, a genus of evergreen or deciduous shrubs in the family Berberidaceae. The genus has about 500 species and grows almost worldwide ^{28Reference 28WhittemoreWhittemore, A. T. (n.d.). Berberis Linnaeus — genus treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=103816View study →}.

Barberries have yellow wood and yellow flowers ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}. The flowers have six sepals and six petals, and the fruits are berries, usually juicy ^{28Reference 28WhittemoreWhittemore, A. T. (n.d.). Berberis Linnaeus — genus treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=103816View study →}.

European barberry (B. vulgaris) is a deciduous shrub 1–3 m tall. Its stems carry simple or three-forked spines, and its leaves grow in clusters on short side shoots ^{29Reference 29WhittemoreWhittemore, A. T. (n.d.). Berberis vulgaris Linnaeus — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500244View study →}. The leaves are obovate to oblanceolate, 2–6 cm long, with 16–30 fine, bristle-tipped teeth along each edge ^{29Reference 29WhittemoreWhittemore, A. T. (n.d.). Berberis vulgaris Linnaeus — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500244View study →}.

Its flowers hang in loose clusters of 10–20, and its berries are red or purple, oval and 10–11 mm long ^{29Reference 29WhittemoreWhittemore, A. T. (n.d.). Berberis vulgaris Linnaeus — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500244View study →}. The bark has a vivid yellow inner surface ^{31Reference 31Felter et al. · 1898Berberis.—Barberry — materia medica entryView study →}.

Oregon grape (B. aquifolium) is an evergreen shrub 0.3–3 m tall with no spines on its stems. Its leaves are divided into five to nine glossy, spiny-toothed leaflets, and its berries are blue with a whitish bloom ^{30Reference 30WhittemoreWhittemore, A. T. (n.d.). Berberis aquifolium Pursh — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500223View study →}.

Some botanists have kept the spineless, compound-leaved species in a separate genus, Mahonia. Species in other parts of the world combine the features of both groups, so Flora of North America treats them as one genus ^{28Reference 28WhittemoreWhittemore, A. T. (n.d.). Berberis Linnaeus — genus treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=103816View study →}.

Distribution

European barberry grows wild from central and southern Europe to Iran ^{32Reference 32North Carolina Extension Gardener Plant Berberis vulgaris (European barberry) — reference databaseView study →}. It was widely planted in North America in the eighteenth and nineteenth centuries for thorn hedges, jam and yellow dye. It escaped and became naturalised across much of eastern North America ^{29Reference 29WhittemoreWhittemore, A. T. (n.d.). Berberis vulgaris Linnaeus — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500244View study →}.

European barberry is the main alternate host of wheat stem rust (Puccinia graminis), the fungus that completes part of its life cycle on the shrub. It was the target of vigorous eradication programmes, and is now scarce or absent in many areas where it was once common ^{29Reference 29WhittemoreWhittemore, A. T. (n.d.). Berberis vulgaris Linnaeus — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500244View study →}. In the United States and Canada, selling or moving barberry species susceptible to the rust is illegal ^{28Reference 28WhittemoreWhittemore, A. T. (n.d.). Berberis Linnaeus — genus treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=103816View study →}.

Oregon grape is native to western North America, from British Columbia to California and east to Idaho and Montana, in open woods and shrubland up to 2,100 m ^{30Reference 30WhittemoreWhittemore, A. T. (n.d.). Berberis aquifolium Pursh — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500223View study →}. It resists wheat rust, is widely planted as an ornamental and is the state flower of Oregon ^{30Reference 30WhittemoreWhittemore, A. T. (n.d.). Berberis aquifolium Pursh — species treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=233500223View study →}.

Growing Conditions

Cultivation snapshot for Barberry

ZoneEuropean barberry, USDA zones 3–7; Oregon grape, zones 5–8 ^{32,33Reference 32North Carolina Extension Gardener Plant Berberis vulgaris (European barberry) — reference databaseView study →Reference 33North Carolina Extension Gardener Plant Berberis aquifolium (Oregon grape holly) — reference databaseView study →}.

Sunfull sun to partial shade ^{32,33Reference 32North Carolina Extension Gardener Plant Berberis vulgaris (European barberry) — reference databaseView study →Reference 33North Carolina Extension Gardener Plant Berberis aquifolium (Oregon grape holly) — reference databaseView study →}.

SoilEuropean barberry prefers moist loam but tolerates heavy clay and poor soils, and needs moist soil in shade ^{32Reference 32North Carolina Extension Gardener Plant Berberis vulgaris (European barberry) — reference databaseView study →}.

HabitEuropean barberry takes pruning well and can become weedy; birds and small mammals spread its seeds ^{32Reference 32North Carolina Extension Gardener Plant Berberis vulgaris (European barberry) — reference databaseView study →}.

Regulationbecause European barberry hosts wheat stem rust, planting or moving it is restricted in parts of North America ^{28Reference 28WhittemoreWhittemore, A. T. (n.d.). Berberis Linnaeus — genus treatment. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 3. eFloras. http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=103816View study →}.

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Pharmacology & Research

Barberry’s pharmacology is largely that of berberine, the main alkaloid of the root and bark. Berberine from other plants, such as coptis and goldenseal, has been tested in dozens of human trials and several meta-analyses for blood lipids, blood sugar and fatty liver ^{4,5,6,7,14Reference 4Guo et al. · 2021Meta-analysisThe effect of berberine on metabolic profiles in type 2 diabetic patients — systematic review and meta-analysis of randomized controlled trialsView study →Reference 5Liu et al. · 2025Meta-analysisEfficacy and safety of berberine on the components of metabolic syndrome — systematic review and meta-analysis of randomized placebo-controlled trialsView study →Reference 6Lan et al. · 2015Meta-analysisMeta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipidaemia and hypertensionView study →Reference 7Dong et al. · 2012Meta-analysisBerberine in the treatment of type 2 diabetes mellitus — systematic review and meta-analysisView study →Reference 14Li et al. · 2023ReviewBerberine and health outcomes: an umbrella reviewView study →}.

Barberry itself has been tested mainly as a fruit extract. A meta-analysis of five trials found it lowered cholesterol and triglycerides, and a separate trial of B. vulgaris extract found it lowered liver enzymes in fatty liver disease ^{1,9Reference 1Hadi et al. · 2019Meta-analysisBarberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters — systematic review and meta-analysis of randomized controlled trialsView study →Reference 9Iloon Kashkooli et al. · 2015Clinical trialThe effect of Berberis vulgaris extract on transaminase activities in non-alcoholic fatty liver disease — clinical trialView study →}.

The antimicrobial and antiparasitic work is almost all in the test tube ^{17,18,19,20,21Reference 17Kaneda et al. · 1991In vitroIn vitro effects of berberine sulphate on the growth and structure of Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis — in vitroView study →Reference 18De Sarkar et al. · 2019In vitroBerberine chloride mediates its antileishmanial activity by inhibiting Leishmania mitochondria — in vitroView study →Reference 19Vennerstrom et al. · 1988In vitroProtoberberine alkaloids as antimalarials — in vitro and animal modelView study →Reference 20Da Silva et al. · 2016In vitroBerberine antifungal activity in fluconazole-resistant pathogenic yeasts: action mechanism evaluated by flow cytometry and biofilm growth inhibition in Candida spp. — in vitroView study →Reference 21Mahmoudvand et al. · 2014In vitroAntifungal, antileishmanial and cytotoxicity activities of various extracts of Berberis vulgaris (Berberidaceae) and its active principle berberine — in vitroView study →}. The one human trial found berberine reduced diarrhoea caused by toxin-producing E. coli ^{12Reference 12Rabbani et al. · 1987RCTRandomized controlled trial of berberine sulfate therapy for diarrhoea due to enterotoxigenic Escherichia coli and Vibrio choleraeView study →}.

1. Hypolipidemic

A meta-analysis of five randomised trials (339 participants) found that barberry lowered total cholesterol by about 23.6 mg/dL, triglycerides by 29.2 mg/dL and LDL by 13.8 mg/dL. The rise in HDL was not significant ^{1Reference 1Hadi et al. · 2019Meta-analysisBarberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters — systematic review and meta-analysis of randomized controlled trialsView study →}.

In a double-blind trial, 31 people with type 2 diabetes took 3 g a day of Berberis vulgaris fruit extract or placebo for three months. The extract lowered triglycerides, total cholesterol, LDL and apoB ^{2Reference 2Shidfar et al. · 2012RCTThe effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients — randomised controlled trialView study →}.

Meta-analyses of isolated berberine also show lower triglycerides and total cholesterol in people with metabolic syndrome and diabetes ^{5,6Reference 5Liu et al. · 2025Meta-analysisEfficacy and safety of berberine on the components of metabolic syndrome — systematic review and meta-analysis of randomized placebo-controlled trialsView study →Reference 6Lan et al. · 2015Meta-analysisMeta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipidaemia and hypertensionView study →}.

Gap: most trials use standardised fruit extracts or isolated berberine, not the traditional root or bark tincture, and the barberry trials are small and largely from one country.

2. Antidiabetic

A meta-analysis of seven trials (452 participants) found that barberry lowered fasting insulin. It did not significantly change fasting blood sugar, HbA1c or HOMA-IR ^{3Reference 3Safari et al. · 2020Meta-analysisThe effect of barberry (Berberis vulgaris L.) on glycemic indices — systematic review and meta-analysis of randomized controlled trialsView study →}.

In the fruit-extract trial, blood sugar, insulin and insulin resistance fell against placebo, while HbA1c did not change ^{2Reference 2Shidfar et al. · 2012RCTThe effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients — randomised controlled trialView study →}.

Isolated berberine has a much larger evidence base. A meta-analysis of 46 trials, with berberine alone or added to standard treatment, found lower HbA1c (by 0.73%), fasting glucose, HOMA-IR and BMI ^{4Reference 4Guo et al. · 2021Meta-analysisThe effect of berberine on metabolic profiles in type 2 diabetic patients — systematic review and meta-analysis of randomized controlled trialsView study →}. Earlier meta-analyses found no significant difference between berberine and oral diabetes drugs for blood sugar, with a mild added effect on lipids ^{6,7Reference 6Lan et al. · 2015Meta-analysisMeta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipidaemia and hypertensionView study →Reference 7Dong et al. · 2012Meta-analysisBerberine in the treatment of type 2 diabetes mellitus — systematic review and meta-analysisView study →}.

Gap: whole-barberry data show lower insulin but not clear falls in glucose or HbA1c; the stronger glucose results belong to concentrated berberine.

3. Hepatoprotective

In a trial of 80 people with non-alcoholic fatty liver disease, two capsules of Berberis vulgaris extract (750 mg) a day for three months lowered ALT from 49 to 27 U/L and AST from 48 to 30 U/L, against no significant change on placebo ^{9Reference 9Iloon Kashkooli et al. · 2015Clinical trialThe effect of Berberis vulgaris extract on transaminase activities in non-alcoholic fatty liver disease — clinical trialView study →}. Weight, triglycerides and cholesterol also fell ^{9Reference 9Iloon Kashkooli et al. · 2015Clinical trialThe effect of Berberis vulgaris extract on transaminase activities in non-alcoholic fatty liver disease — clinical trialView study →}.

In rats on a high-fat diet, berberine reversed fatty liver, partly by reducing methylation of the MTTP gene promoter and increasing the liver’s export of triglycerides ^{22Reference 22Chang et al. · 2010AnimalBerberine reduces methylation of the MTTP promoter and alleviates fatty liver induced by a high-fat diet in rats — animal modelView study →}.

Gap: this is one small trial from one country, with no biopsy endpoint and nothing beyond three months.

4. Antibacterial

Berberine is a cationic antimicrobial, and bacteria pump it out through multidrug-resistance pumps. Several Berberis species also make 5′-methoxyhydnocarpin, which blocks the NorA pump of Staphylococcus aureus and strongly increases berberine’s activity against it ^{13Reference 13Stermitz et al. · 2000In vitroSynergy in a medicinal plant: antimicrobial action of berberine potentiated by 5′-methoxyhydnocarpin, a multidrug pump inhibitor — in vitroView study →}.

In a trial of 165 adults with acute diarrhoea, a single 400 mg dose of berberine sulfate reduced stool volume in diarrhoea from enterotoxigenic E. coli. At 24 hours, 42% of treated patients had stopped having diarrhoea, against 20% of controls ^{12Reference 12Rabbani et al. · 1987RCTRandomized controlled trial of berberine sulfate therapy for diarrhoea due to enterotoxigenic Escherichia coli and Vibrio choleraeView study →}. Its effect on cholera was slight and added nothing to tetracycline ^{12Reference 12Rabbani et al. · 1987RCTRandomized controlled trial of berberine sulfate therapy for diarrhoea due to enterotoxigenic Escherichia coli and Vibrio choleraeView study →}.

Gap: no trial shows barberry clearing an established infection, and the human result is antisecretory rather than antibacterial.

5. Colorectal Chemoprevention

A multicentre, double-blind trial in China randomised 1,108 people who had had colorectal adenomas removed to berberine 0.3 g twice daily or placebo. Adenomas recurred in 36% of the berberine group and 47% of the placebo group (relative risk 0.77). Constipation was the most common side effect, and there were no serious adverse events ^{8Reference 8Chen et al. · 2020RCTBerberine versus placebo for the prevention of recurrence of colorectal adenoma — multicentre, double-blinded, randomised controlled studyView study →}.

An umbrella review of berberine meta-analyses also found an effect on colorectal adenomas ^{14Reference 14Li et al. · 2023ReviewBerberine and health outcomes: an umbrella reviewView study →}.

Gap: this is isolated berberine, not barberry, and the finding needs replication outside China.

6. Antipsoriatic (Topical)

Three open-label studies of a 10% Oregon grape (Mahonia aquifolium) cream in plaque psoriasis were reported together ^{10Reference 10Gulliver et al. · 2005Clinical trialA report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasisView study →}. In 39 patients treated for 12 weeks, PASI scores and quality of life improved significantly. In a second study, 84% of 32 patients rated the treated side good to excellent, and 63% rated it equal to or better than standard treatment on the other side ^{10Reference 10Gulliver et al. · 2005Clinical trialA report on three recent clinical trials using Mahonia aquifolium 10% topical cream and a review of the worldwide clinical experience with Mahonia aquifolium for the treatment of plaque psoriasisView study →}.

In keratinocyte cultures, the bark extract and berberine inhibited growth equally, while berbamine and oxyacanthine were three times more potent ^{27Reference 27Müller et al. · 1995In vitroThe antipsoriatic Mahonia aquifolium and its active constituents; IIView study →}.

Gap: the trials are small and open-label, and they test a cream on the skin, not oral barberry.

7. Antioxidant

Extracts of Berberis vulgaris leaves, fruits and stems scavenge free radicals in vitro, with the leaves richest in polyphenols. Their phenolic acids and flavonoids were profiled in the same study ^{15Reference 15Och et al. · 2023In vitroEvaluation of the antioxidant and anti-lipoxygenase activity of Berberis vulgaris L. leaves, fruits and stem and their LC-MS/MS polyphenolic profile — in vitroView study →}. Fruit decoctions were more antioxidant than infusions ^{16Reference 16Aliakbarlu et al. · 2018In vitroEffect of extraction conditions on antioxidant activity of barberry (Berberis vulgaris) fruit — in vitroView study →}.

In the fruit-extract trial, serum total antioxidant capacity rose significantly ^{2Reference 2Shidfar et al. · 2012RCTThe effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients — randomised controlled trialView study →}.

8. Antiparasitic

Berberine inhibits Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis in vitro, causing chromatin clumping and vacuoles in the parasites ^{17Reference 17Kaneda et al. · 1991In vitroIn vitro effects of berberine sulphate on the growth and structure of Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis — in vitroView study →}.

Against Leishmania, berberine chloride disrupts the parasite’s mitochondria and depletes its ATP ^{18Reference 18De Sarkar et al. · 2019In vitroBerberine chloride mediates its antileishmanial activity by inhibiting Leishmania mitochondria — in vitroView study →}. B. vulgaris extracts and berberine inhibited Leishmania major and L. tropica in vitro ^{21Reference 21Mahmoudvand et al. · 2014In vitroAntifungal, antileishmanial and cytotoxicity activities of various extracts of Berberis vulgaris (Berberidaceae) and its active principle berberine — in vitroView study →}.

In the test tube, berberine, palmatine and jatrorrhizine were as potent as quinine against Plasmodium falciparum. ⚠ None was active against P. berghei in infected mice ^{19Reference 19Vennerstrom et al. · 1988In vitroProtoberberine alkaloids as antimalarials — in vitro and animal modelView study →}.

Gap: no controlled human antiparasitic trial of barberry or berberine exists.

9. Antifungal

Berberine inhibits fluconazole-resistant Candida strains in vitro, damaging their cell and mitochondrial membranes and reducing biofilm activity ^{20Reference 20Da Silva et al. · 2016In vitroBerberine antifungal activity in fluconazole-resistant pathogenic yeasts: action mechanism evaluated by flow cytometry and biofilm growth inhibition in Candida spp. — in vitroView study →}. Extracts of B. vulgaris, and berberine especially, were active against the dermatophyte fungi Trichophyton and Microsporum ^{21Reference 21Mahmoudvand et al. · 2014In vitroAntifungal, antileishmanial and cytotoxicity activities of various extracts of Berberis vulgaris (Berberidaceae) and its active principle berberine — in vitroView study →}.

Mechanisms

Berberine is poorly absorbed from the gut, but what is absorbed concentrates in the liver ^{34Reference 34Liu et al. · 2010AnimalExtensive intestinal first-pass elimination and predominant hepatic distribution of berberine explain its low plasma levels in rats — animal pharmacokineticsView study →}. It has been studied for activating the energy sensor AMPK and for reducing fat production in the liver, and for reducing fluid secretion in the gut.

The alkaloids have also been studied against microbes and parasites in the test tube. A separate fraction of phenolic acids and flavonoids carries the antioxidant activity of the leaves and fruit ^{15Reference 15Och et al. · 2023In vitroEvaluation of the antioxidant and anti-lipoxygenase activity of Berberis vulgaris L. leaves, fruits and stem and their LC-MS/MS polyphenolic profile — in vitroView study →}.

Clinical Trials

The human trials almost all test isolated berberine or standardised fruit extracts rather than the traditional root or bark preparation. The largest is the 1,108-patient colorectal-adenoma trial ^{8Reference 8Chen et al. · 2020RCTBerberine versus placebo for the prevention of recurrence of colorectal adenoma — multicentre, double-blinded, randomised controlled studyView study →}.

Last checked: July 2026.

Phytochemistry

Barberry’s chemistry is defined by its isoquinoline alkaloids, led by berberine and berbamine ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}. They give the wood its yellow colour ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}.

In B. vulgaris these are joined by palmatine, columbamine, lambertine, magnoflorine and the bisbenzylisoquinoline oxyacanthine ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}. Jatrorrhizine has been isolated from other Berberis species ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}.

The plant also contains triterpenes such as lupeol and oleanolic acid, sterols, tannins and phenolic compounds ^{11Reference 11Mokhber-Dezfuli et al. · 2014ReviewPhytochemistry and pharmacology of Berberis species — reviewView study →}. The leaves, fruits and stems carry phenolic acids, including chlorogenic acid, and flavonoids such as rutin and quercetin, with the leaves the richest ^{15Reference 15Och et al. · 2023In vitroEvaluation of the antioxidant and anti-lipoxygenase activity of Berberis vulgaris L. leaves, fruits and stem and their LC-MS/MS polyphenolic profile — in vitroView study →}.

The bark of Oregon grape carries berberine, berbamine and oxyacanthine ^{27Reference 27Müller et al. · 1995In vitroThe antipsoriatic Mahonia aquifolium and its active constituents; IIView study →}. Several Berberis species also make 5′-methoxyhydnocarpin, which strengthens berberine’s antibacterial action ^{13Reference 13Stermitz et al. · 2000In vitroSynergy in a medicinal plant: antimicrobial action of berberine potentiated by 5′-methoxyhydnocarpin, a multidrug pump inhibitor — in vitroView study →}.

Berberine is poorly absorbed by mouth. In rats its absolute oral bioavailability was 0.36%, with most of the loss in the small intestine ^{34Reference 34Liu et al. · 2010AnimalExtensive intestinal first-pass elimination and predominant hepatic distribution of berberine explain its low plasma levels in rats — animal pharmacokineticsView study →}.

Constituent Summary

The main alkaloids of barberry root and bark.

Dosage

The trial doses below are for fruit extracts and isolated berberine, not for the traditional root or bark preparation.

Traditional Dosage

Safety & Pregnancy

Barberry and berberine are generally well tolerated. The main cautions are drug interactions and pregnancy.

Full Safety & Interactions Detail

Side effects. In trials, berberine’s most common side effects are digestive, mainly constipation and diarrhoea ^{8,14Reference 8Chen et al. · 2020RCTBerberine versus placebo for the prevention of recurrence of colorectal adenoma — multicentre, double-blinded, randomised controlled studyView study →Reference 14Li et al. · 2023ReviewBerberine and health outcomes: an umbrella reviewView study →}. The meta-analyses report no serious adverse effects ^{6,7Reference 6Lan et al. · 2015Meta-analysisMeta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipidaemia and hypertensionView study →Reference 7Dong et al. · 2012Meta-analysisBerberine in the treatment of type 2 diabetes mellitus — systematic review and meta-analysisView study →}.

Cyclosporine and CYP3A4. In kidney-transplant patients taking cyclosporine, berberine 0.2 g three times daily raised cyclosporine trough levels by about 29% more than in patients not taking it, most likely by inhibiting the liver enzyme CYP3A4 ^{23Reference 23Wu et al. · 2005Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients — clinical and pharmacokinetic studyView study →}.

In healthy volunteers, berberine 300 mg three times daily for two weeks also slowed CYP2D6, CYP2C9 and CYP3A4 activity, raising midazolam levels by about 40%, while CYP1A2 and CYP2C19 were unaffected ^{35Reference 35Guo et al. · 2012Repeated administration of berberine inhibits cytochromes P450 in humans — healthy-volunteer studyView study →}. Barberry is best avoided with cyclosporine and other narrow-therapeutic-index drugs cleared by these enzymes.

Bilirubin. In vitro, berberine displaced bilirubin from albumin about ten times more strongly than phenylbutazone, and in rats it raised unbound bilirubin. Berberine-rich herbs are best avoided in jaundiced newborns and in pregnancy ^{24Reference 24Chan · 1993In vitroDisplacement of bilirubin from albumin by berberine — in vitro / animalView study →}.

Gallstones. Barberry is traditionally avoided when gallstones are present, because it promotes bile flow.

References

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