A clinical study involving 23 heart disease patients found that berberine supplementation was associated with changes in gut bacteria, cholesterol levels and inflammation, suggesting a potential connection between intestinal health and cardiovascular function.
By yourNEWS Media Newsroom
A plant-derived supplement commonly used to support metabolic health may influence bacteria in the digestive tract while improving certain markers associated with cardiovascular disease, according to a small clinical trial published Oct. 20 in the journal Frontiers in Nutrition.
Researchers at Peking Union Medical College Hospital in Beijing studied 23 patients with stable coronary artery disease who had previously undergone procedures to open narrowed heart arteries. The 12-week clinical trial examined whether berberine could influence cholesterol, inflammation, blood vessel function and the composition of intestinal bacteria.
The findings showed that patients receiving berberine experienced changes in their gut microbiome alongside reductions in several inflammatory markers. Researchers also reported improvements in certain cholesterol measurements, although the study was too small to establish whether the supplement provides lasting cardiovascular protection.
Berberine is a naturally occurring yellow alkaloid found in plants such as barberry, goldenseal, goldthread, Oregon grape and tree turmeric. The compound has been used in traditional Chinese medicine for centuries and has attracted scientific interest for its potential effects on blood sugar regulation, cholesterol metabolism and inflammation.
For the trial, researchers randomly assigned 12 patients to receive berberine in addition to their prescribed cardiovascular medications, while 11 continued standard medical treatment without the supplement.
Participants in the berberine group began with 100 milligrams three times daily during the first four weeks. The dose increased to 200 milligrams three times daily during weeks five through eight and reached 300 milligrams three times daily during the final four weeks.
Researchers collected blood and stool samples while monitoring cholesterol, inflammatory proteins, gastrointestinal symptoms and blood vessel function.
One of the principal findings involved changes in bacteria responsible for producing short-chain fatty acids, substances generated when intestinal microorganisms ferment dietary fiber.
After berberine supplementation, researchers observed increases in several bacterial groups associated with short-chain fatty acid production, including Ruminococcus, Roseburia and Anaerostipes hadrus.
These bacteria are of particular interest because short-chain fatty acids, including butyrate, help maintain intestinal barrier function and participate in metabolic and inflammatory processes.
The investigators also found that increases in certain bacteria were associated with lower levels of inflammatory substances in the bloodstream.
Among the markers that declined were interleukin-1 alpha, interleukin-17, monocyte chemoattractant protein-1, macrophage inflammatory protein-1 beta and vascular endothelial growth factor.
These molecules participate in inflammatory signaling and other biological processes potentially relevant to coronary artery disease.
The researchers reported reductions in LDL cholesterol among patients receiving berberine, although the small study and differences between the treatment groups limit conclusions about its additional benefit over standard medications.
Blood vessel function also showed a favorable trend, but the improvement was not statistically significant, meaning chance could not be ruled out as an explanation.
Beyond changes in bacterial populations, berberine influenced the metabolic pathways through which intestinal microorganisms process aromatic amino acids.
Researchers identified changes involving compounds such as L-dopa, 3-hydroxyphenylacetic acid and phenylpropionic acid, suggesting that berberine may affect the chemical substances produced by the gut microbiome.
These findings support further investigation into the relationship between intestinal microorganisms and cardiovascular health, but they do not establish that microbiome changes caused the observed improvements in blood markers.
Previous research has also examined berberine’s potential metabolic benefits.
A 2022 study examining berberine and gut bacteria found evidence that the microbiome may contribute to the compound’s cholesterol-lowering effects. Animal experiments conducted as part of that research suggested that certain bacterial populations could influence the effectiveness of berberine treatment.
More recently, a 2026 systematic review of randomized clinical trials examined berberine’s effects on intestinal bacteria and cardiometabolic markers, finding promising but variable results across different patient populations.
Researchers have also studied the compound in patients with type 2 diabetes, elevated cholesterol and other metabolic disorders.
However, the latest coronary artery disease trial has important limitations. Only 23 patients participated, treatment lasted 12 weeks and the comparison group did not receive a placebo. The groups also differed in some baseline characteristics.
The research did not determine whether berberine prevents heart attacks, strokes or other major cardiovascular events.
Berberine can also cause digestive side effects and interact with medications, making medical supervision particularly important for individuals already receiving treatment for heart disease or diabetes.
The investigators emphasized the need for larger, longer clinical trials to determine whether the observed bacterial and metabolic changes translate into meaningful cardiovascular benefits.
Meanwhile, established dietary approaches that support a healthy gut microbiome include regularly consuming fiber-rich foods such as beans, lentils, oats, whole grains, vegetables and fruits.
The findings add to a growing body of research examining how substances produced by intestinal microorganisms may influence inflammation, cholesterol metabolism and blood vessel health.
Although berberine’s effects remain under investigation, the study suggests that targeting the gut microbiome could eventually become an additional approach to managing cardiovascular disease alongside established medical treatments.
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