Bergamot

Bergamot’s traditional use is mainly as an aromatic. The peel oil was used in Calabrian folk practice, and later throughout European perfumery and flavouring, and in aromatherapy for mood and relaxation.

The first human report gave BPF by mouth for 30 days to 237 people with raised blood lipids, with or without raised blood sugar. It lowered total and LDL cholesterol and triglycerides, raised HDL, and inhibited HMG-CoA reductase; the same study also tested rats ^{1Reference 1Mollace et al. · 2011AnimalHypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studiesView study →}.

In a double-blind trial in 60 people with type 2 diabetes and mixed hyperlipidaemia, both standard BPF and a phytosome form (“BPF Phyto”) lowered LDL cholesterol and triglycerides, raised HDL and reduced small dense LDL particles compared with placebo. The two forms worked equally well, although the phytosome absorbed naringin at least 2.5 times better ^{3Reference 3Mollace et al. · 2019Hypoglycemic and hypolipemic effects of a new lecithin formulation of bergamot polyphenolic fractionView study →}.

In 60 overweight adults with mild hypercholesterolaemia who had responded poorly to bergamot alone, a bergamot phytosome combined with artichoke leaf extract lowered total and LDL cholesterol compared with placebo over two months ^{5Reference 5Riva et al. · 2021RCTArtichoke and bergamot phytosome alliance: a randomised double-blind clinical trial in mild hypercholesterolemiaView study →}.

A whole-fruit extract (Brumex, 400 mg a day for 12 weeks) in 50 people with moderately raised cholesterol lowered total cholesterol, triglycerides, LDL, non-HDL cholesterol, ApoB and liver enzymes compared with placebo ^{6Reference 6Pierdomenico et al. · 2023Clinical trialEffect of Citrus bergamia extract on lipid profile: a combined in vitro and human studyView study →}.

A 2022 meta-analysis of 14 trials pooled large falls in total cholesterol, triglycerides and LDL, while noting inconsistent results for combination products and the need for higher-quality studies ^{7Reference 7Sadeghi-Dehsahraei et al. · 2022Meta-analysisThe effect of bergamot supplementation on lipid profiles: a systematic review and meta-analysis of randomised controlled trialsView study →}. A network meta-analysis ranked bergamot the most effective LDL-lowering nutraceutical of those compared, but noted that the estimate rests on a small number of participants ^{9Reference 9Osadnik et al. · 2022Meta-analysisA network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adultsView study →}.

A systematic review of 12 studies reported falls of 12.3–31.3% in total cholesterol, 7.6–40.8% in LDL and 11.5–39.5% in triglycerides, with heterogeneous designs and limited quality ^{8Reference 8Lamiquiz-Moneo et al. · 2020Systematic reviewEffect of bergamot on lipid profile in humans: a systematic reviewView study →}.

A 2024 randomised trial gave 45 healthy adults 400 mL a day of a bergamot drink (up to 25% juice) or a control for 12 weeks. There was no difference between the groups in lipids, glucose or inflammatory markers, and bergamot’s HMG-containing flavanones could not be detected in the urine ^{10Reference 10Maggiolo et al. · 2024Chronic consumption of a bergamot-based beverage does not affect glucose, lipid and inflammatory biomarkers of cardiometabolic risk in healthy subjectsView study →}.

Gap: LDL falls range from about 8% to about 40%, the largest come from proprietary and combination products, and the one clear null trial was in healthy (not hyperlipidaemic) subjects. The true effect in people with high cholesterol is uncertain.

The BPF trial in type 2 diabetes reduced fasting plasma glucose as well as lipids ^{3Reference 3Mollace et al. · 2019Hypoglycemic and hypolipemic effects of a new lecithin formulation of bergamot polyphenolic fractionView study →}.

A double-blind trial of a pectin-enriched bergamot formulation (BPE-C, 650 or 1,300 mg a day for 90 days) enrolled 52 obese people with a high atherogenic index and mild hyperglycaemia, and 15 per group completed it. At the high dose, fasting glucose fell by 18.1%, triglycerides by 32% and body weight by 14.8%, with lower HOMA-IR and insulin ^{4Reference 4Capomolla et al. · 2019Atherogenic index reduction and weight loss in metabolic syndrome patients treated with a novel pectin-enriched formulation of bergamot polyphenolsView study →}.

The whole-fruit extract lowered fasting glucose compared with placebo ^{6Reference 6Pierdomenico et al. · 2023Clinical trialEffect of Citrus bergamia extract on lipid profile: a combined in vitro and human studyView study →}. A bergamot–artichoke combination lowered glucose compared with baseline after 12 weeks ^{15Reference 15Fogacci et al. · 2024Effect of a dietary supplement containing dry artichoke and bergamot extracts on metabolic and vascular risk factorsView study →}.

Gap: no adequately powered trial separates bergamot’s effect on blood sugar from weight loss or from co-formulated botanicals, and no trial has shown a lasting change in HbA1c.

In a double-blind trial in 102 people with fatty liver, a combination of bergamot polyphenols and wild cardoon (Cynara cardunculus) extract, 300 mg a day for 12 weeks, reduced liver fat measured by transient elastography more than placebo (−48 vs −27 dB/m, p = 0.02). After adjusting for weight change, the benefit was significant only in people over 50 ^{11Reference 11Ferro et al. · 2020RCTBergamot citrus and wild cardoon reduce liver steatosis and body weight in non-diabetic individuals aged over 50 years: a randomised, double-blind, placebo-controlled trialView study →}.

A secondary analysis of the same combination found lower serum uric acid after six weeks ^{13Reference 13Ferro et al. · 2022Citrus bergamia and Cynara cardunculus reduce serum uric acid in individuals with non-alcoholic fatty liver diseaseView study →}.

A multi-ingredient product (Livogen Plus) containing bergamot polyphenols with curcumin, artichoke, fish oil and other ingredients also reduced liver fat compared with placebo in 140 people ^{12Reference 12Ferro et al. · 2022A new nutraceutical (Livogen Plus) improves liver steatosis in adults with non-alcoholic fatty liver diseaseView study →}.

Bergamot–artichoke combinations lowered the fatty liver index compared with placebo in people with raised cholesterol ^{14,15Reference 14Fogacci et al. · 2022Effect of dietary supplementation with Eufortyn Colesterolo Plus on serum lipids, endothelial reactivity and NAFLD indices (ANEMONE study)View study →Reference 15Fogacci et al. · 2024Effect of a dietary supplement containing dry artichoke and bergamot extracts on metabolic and vascular risk factorsView study →}.

Gap: every positive fatty-liver trial used bergamot in a combination, so the benefit cannot be attributed to bergamot alone; there is no trial of BPF alone with a liver-fat endpoint.

The juice flavanones neoeriocitrin, neohesperidin and naringin have antioxidant activity, and the proposed vascular benefit is protection of LDL from oxidation.

In an open-label randomised study of 77 people with mixed hyperlipidaemia, BPF 1,000 mg a day, alone or with rosuvastatin, lowered cholesterol. Adding BPF to rosuvastatin enhanced the statin’s effect, and the lipid change came with lower malondialdehyde, LOX-1 (the oxidised-LDL receptor) and phospho-PKB in white blood cells ^{2Reference 2Gliozzi et al. · 2013Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylationView study →}.

In the ANEMONE trial of a bergamot–artichoke–Q10 product in 60 people, hs-CRP and endothelial reactivity improved compared with baseline; compared with placebo, the significant changes were in lipids, waist size and the fatty liver index ^{14Reference 14Fogacci et al. · 2022Effect of dietary supplementation with Eufortyn Colesterolo Plus on serum lipids, endothelial reactivity and NAFLD indices (ANEMONE study)View study →}. A second bergamot–artichoke product improved endothelial reactivity and hs-CRP compared with placebo ^{15Reference 15Fogacci et al. · 2024Effect of a dietary supplement containing dry artichoke and bergamot extracts on metabolic and vascular risk factorsView study →}.

In a pilot trial in 90 male cyclists, a combination of BPF Gold and L-citrulline raised nitric oxide, reactive hyperaemia index and VO₂max compared with placebo over three months ^{16Reference 16Mollace et al. · 2025The antioxidant power of bergamot polyphenolic fraction Gold potentiates the effects of L-citrulline in athlete performance and vasodilationView study →}.

Gap: these are biomarkers and surrogate endpoints in small samples, not clinical outcomes.

HDL rose in the first human series ^{1Reference 1Mollace et al. · 2011AnimalHypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studiesView study →} and in the BPF diabetes trial ^{3Reference 3Mollace et al. · 2019Hypoglycemic and hypolipemic effects of a new lecithin formulation of bergamot polyphenolic fractionView study →}. The 2022 meta-analysis pooled a small increase of about 5.8 mg/dL across 14 trials ^{7Reference 7Sadeghi-Dehsahraei et al. · 2022Meta-analysisThe effect of bergamot supplementation on lipid profiles: a systematic review and meta-analysis of randomised controlled trialsView study →}, and eight trials in the systematic review reported an HDL rise ^{8Reference 8Lamiquiz-Moneo et al. · 2020Systematic reviewEffect of bergamot on lipid profile in humans: a systematic reviewView study →}.

The change is inconsistent, and the trial in healthy adults found no lipid effect of any kind ^{10Reference 10Maggiolo et al. · 2024Chronic consumption of a bergamot-based beverage does not affect glucose, lipid and inflammatory biomarkers of cardiometabolic risk in healthy subjectsView study →}.

This indication uses a different preparation: the peel essential oil used in aromatherapy, not the juice-derived BPF taken for cholesterol.

In an open-label randomised crossover trial in 48 university students, a bergamot oil spray used before bed and on waking improved how rested they felt on rising and their sleep length, and lowered depression, anxiety and stress scores ^{17Reference 17Wakui et al. · 2023Relieving psychological stress and improving sleep quality by bergamot essential oil use before bedtime and upon awakeningView study →}.

A systematic review of C. bergamia clinical trials found that aromatherapy with the oil could be safe and useful for reducing stress, but that the studies were small and of low quality ^{18Reference 18Mannucci et al. · 2017Systematic reviewClinical pharmacology of Citrus bergamia: a systematic reviewView study →}.

Gap: the mood and sleep evidence is for inhaled peel oil, not the oral lipid supplement; trials are small, often use oil blends, and outcomes are subjective.

The juice fraction. No adverse events were recorded in the bergamot-drink trial, and no harmful effects in the BPF Gold trial ^{10,16Reference 10Maggiolo et al. · 2024Chronic consumption of a bergamot-based beverage does not affect glucose, lipid and inflammatory biomarkers of cardiometabolic risk in healthy subjectsView study →Reference 16Mollace et al. · 2025The antioxidant power of bergamot polyphenolic fraction Gold potentiates the effects of L-citrulline in athlete performance and vasodilationView study →}. None ran longer than about three months.

Sun sensitivity. Bergamot essential oil contains bergapten (5-methoxypsoralen), one of the most potent phototoxic furanocoumarins ^{19,21Reference 19Irizar et al. · 2025ReviewPhototoxicity and skin damage: a review of adverse effects of some furocoumarins found in natural extractsView study →Reference 21Fern · 2024Citrus bergamia — habit, range, hybrid origin, cultivation, uses and hazards — species databaseView study →}. With UVA light it can cause skin irritation and photosensitivity, and at higher doses and repeated exposure it can damage DNA ^{19Reference 19Irizar et al. · 2025ReviewPhototoxicity and skin damage: a review of adverse effects of some furocoumarins found in natural extractsView study →}. Cosmetic products are limited to 1 ppm total furanocoumarins where prolonged sun exposure is likely, and 5 ppm in other products ^{19Reference 19Irizar et al. · 2025ReviewPhototoxicity and skin damage: a review of adverse effects of some furocoumarins found in natural extractsView study →}. Furocoumarin-free grades of the oil are made for this reason ^{21Reference 21Fern · 2024Citrus bergamia — habit, range, hybrid origin, cultivation, uses and hazards — species databaseView study →}.

Drug interactions. Bergamottin, the furanocoumarin behind the grapefruit–drug interaction, irreversibly inactivates intestinal CYP3A4, which metabolises up to half of marketed drugs ^{20Reference 20Fuhr et al. · 2023Physiologically based pharmacokinetic modeling of bergamottin and 6,7-dihydroxybergamottin to describe CYP3A4-mediated grapefruit–drug interactionsView study →}. In healthy volunteers, bergamottin capsules of 2–12 mg raised blood levels of the CYP3A4 drug felodipine by about a third, with large differences between people ^{25Reference 25Goosen et al. · 2004Bergamottin contribution to the grapefruit juice-felodipine interaction and disposition in humans — clinical pharmacokinetic studyView study →}.

It also inactivates CYP2C9 in laboratory tests and inhibits CYP2D6 in mice ^{22,23Reference 22Liu et al. · 2021In vitroMechanistic study of bergamottin-induced inactivation of CYP2C9 — in vitroView study →Reference 23Pawar et al. · 2026In vitroCytochrome P450 2D6 (CYP2D6) inhibition by bergamottin and diosmetin as a strategy to enhance the pharmacokinetics and antidepressant efficacy of amoxapine — in vitro / animalView study →}. This applies to peel, whole-fruit and oil products that contain it; no study has tested bergamot itself, and furocoumarin-free oil lacks it.

With lipid drugs. One trial combined BPF with rosuvastatin ^{2Reference 2Gliozzi et al. · 2013Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylationView study →}. Anyone taking a statin or other cardiovascular medicine should use bergamot under medical supervision.