Berberine
Berberine featured article
Background
Berberine is an alkaloid compound present in the roots, stems, rhizomes, and bark of a variety of plants, including Californian poppy, goldenseal, cork tree, Chinese goldthread, Oregon grape, and several plants in the Berberis genus. It is also widely available as a dietary supplement. Berberine has a long history of use in the ancient and traditional medicine systems of India, China, and Persia. Research demonstrates that berberine may exert pharmacological effects against certain chronic health conditions such as cardiovascular disease, gastrointestinal disorders, neurodegenerative disease, depression, and metabolic dysfunction. Some of berberine's effects mirror those associated with metformin, an antihyperglycemic agent commonly used to treat type 2 diabetes. Preliminary research in animals also suggests that berberine may exert anti-aging...
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Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
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People who have had colon polyps removed remain at risk of new growths, and preventive drugs either cause side effects or lack long-term evidence. Researchers in China revisited a randomized controlled trial of the compound berberine to test whether a two year course could provide durable protection.
The original CBAR trial, which tested whether berberine could prevent the return of adenomas (a non-cancerous growth that can develop into colorectal cancer) in the colon or rectum enrolled adults who had undergone endoscopic removal of these lesions and randomly assigned them to berberine tablets (0.3 grams twice daily) or a matching placebo for two years. In the new follow-up analysis, 648 of the 895 people who completed the trial later had at least one surveillance colonoscopy over a median of six years.
Here's what the researchers observed:
- Participants who had taken berberine experienced a 42% lower rate of adenoma recurrence, and by the end of follow-up, about 35% of them had a recurrence compared with about 52% in the placebo group.
- When all types of abnormal growths (adenomas, serrated lesions and cancer) were considered together, berberine was linked to a 25% lower rate over time, and by the end of follow-up, about 63% of the berberine group had at least one such growth compared with 71% in the placebo group.
- This difference is explained by the observation that more serious adenomas and colorectal cancer remained rare in both groups and did not differ in a meaningful way. The clearest benefit appeared in low-risk adenomas, which developed 44% less often over the follow-up period in those who had taken berberine.
These clinical patterns mirror experimental work in which berberine modifies gut microbial communities and the tumor microenvironment, dampening bacteria and pathways that favor tumor formation and improving metabolic disturbances. Although the study did not collect microbiome or mechanistic measurements, durable shifts in gut bacteria after a finite berberine course could underlie the sustained protection, while evidence for preventing advanced lesions or cancer remains limited.
Future studies could test different dosing schedules, include more diverse populations and directly track microbiome, metabolic and genetic markers to clarify how berberine works and who benefits most. If replicated, a low-cost berberine regimen combined with quality colonoscopy surveillance could become a practical strategy to reduce long-term colorectal neoplasia risk. You can learn more about berberine in our detailed topic article.