Cholesterol is a fundamental molecule in the functioning of our bodies. It’s an essential component of cell membranes, acts as a precursor for numerous hormones, and plays a vital role in the formation of bile acids, and these are just few examples that highlight the significance of this molecule.
Furthermore, cholesterol in our bodies can originate from two distinct sources: the food we consume or through the synthesis that occurs in the liver. These two sources are in equilibrium, ensuring the body’s needs are met without causing an excessive presence of cholesterol in the bloodstream.
This “equilibrium process” is crucial because, as with many other molecules, it’s the dosage that makes all the difference. While cholesterol is essential for our body in “normal” or physiological concentrations, excessive level is a major risk factor for cardiovascular diseases and events like stroke or heart attack.
Numerous natural molecules have been studied to evaluate their ability to reduce cholesterol levels when it’s excessively elevated. One of these exhibits synergistic effects that significantly enhance its effectiveness, making it highly intriguing for this purpose. We are talking about Berberine, a molecule derived from the plant named Berberis, commonly known as barberry.
Kong and colleagues conducted a study to investigate the effects of Berberine on 32 patients which presented hypercholesterolemia. They measured the lipid parameters of these patients before and after treatment with Berberine (500 mg per day) for three months. 
Figure 1: A group of patients received Berberine (500 mg per day for three months). Different lipid parameters in the blood were measured before and after treatment. (Asterisks indicate statistically significant differences.)
At the conclusion of this treatment, as depicted in the graph, “total cholesterol,” “triglycerides,” and “LDL cholesterol” significantly decreased (*), resulting in normal physiological values at the end of the treatment, in contrast to the initial evaluation. “HDL cholesterol” remained unchanged after the treatment, which is positive as it represents a group of lipoproteins responsible for recovering excess cholesterol [Fig. 1]. This demonstrates that Berberine is able to reduce the lipids content when it’s too elevated and also has a selective ability concerning cholesterol, with a more pronounced effect on LDL and a less pronounced effect on HDL.
In another study, also conducted by Kong and colleagues in 2008, the ability of Berberine to reduce cholesterol and triglyceride concentrations was evaluated in comparison to simvastatin, a commonly used medication to treat these conditions. Furthermore, the effects of the combination of these two molecules was assessed too. 
Figure 2: Patients were treated with Berberine, simvastatin, or the combination of both for two months. The numbers above the columns represent the percentage difference between the starting and final situations (the higher the number, the greater the difference, and the more effective the treatment).
In Figure 2, we can observe the percentage reduction in various parameters at the end of treatment compared to the initial evaluation. Berberine demonstrates a comparable, if not superior, effect to Simvastatin. Moreover, the combination of these two molecules proves to be much more effective in inducing reductions for all parameters.
These studies affirm the capacity of Berberine to reduce the “lipid profile” in patients who suffer of conditions like hypercholesterolemia or, more generally hyperlipidemia, whether administered as a monotherapy or in combination with common medications. Furthermore, it is well-tolerated by the body and exhibits no side effects when used at recommended dosages.
- Kong W, Wei J, Abidi P, Lin M, Inaba S, Li C, Wang Y, Wang Z, Si S, Pan H, Wang S, Wu J, Wang Y, Li Z, Liu J, Jiang JD. Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins. Nat Med. 2004 Dec;10(12):1344-51. doi: 10.1038/nm1135. Epub 2004 Nov 7. PMID: 15531889.
- Kong WJ, Wei J, Zuo ZY, Wang YM, Song DQ, You XF, Zhao LX, Pan HN, Jiang JD. Combination of simvastatin with berberine improves the lipid-lowering efficacy. Metabolism. 2008 Aug;57(8):1029-37. doi: 10.1016/j.metabol.2008.01.037. PMID: 18640378.