Does the popular berberine supplement reverse heart disease risk? According to a study that published last year, it seems so [1]. The researchers gave berberine to a group of individuals with some noticeable plaque buildup in their arteries and found that berberine supplementation did, indeed, reduce their plaque burden. However, there are some things to keep in mind.
While the evidence clearly showed reduces plaque in the areas measured, the effects were tiny. So, it isn’t as if the plaque burden was reduced 40% or anything to that effect - more so, 2-3%. Still, as I always say, considering the cost (consuming a supplement) and the reward (reversing plaque), that isn’t anything to scoff at. Additionally, it should be pointed out that it may also be possible berberine offers additional help by preventing plaque formation in the first place (something not measured, but is conceivable considering the reversing effect). Also, keep in mind that these individuals consumed berberine for only 12 weeks, so would the effect compound after 2-3 years? We don’t know, but it is certainly possible.
Okay - now the bad news. Unfortunately, this study was more comprehensive than looking at human data - I say ‘unfortunately’, because if they had focused more on creating a rigorous study design for the human section of the study, they might have had more convincing results. The reason is that the study was not blinded (as in, the researchers knew each person on the berberine supplement) and did not have an adequate control group (there was no comparison group offered a placebo, a fake treatment). So, this lends itself well to strong risk of bias in the assessments. So, does that mean this study is useless?
Not necessarily. It does weaken the interpretation significantly - it really becomes a toss up on whether you believe the results or not. However, fortunately, there have been other studies looking at berberine and cardiovascular disease, and these studies seem to corroborate the overall end result (improved cardiovascular disease risk) [2]. So, while the specifics of plaque reversal are in question, it still seems likely berberine supplementation is a cardiovascular disease benefit.
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References [1] Ma SR, Tong Q, Lin Y, et al. Berberine treats atherosclerosis via a vitamine-like effect down-regulating Choline-TMA-TMAO production pathway in gut microbiota. Signal Transduct Target Ther. 2022;7(1):207. Published 2022 Jul 7. doi:10.1038/s41392-022-01027-6 [2] Yang L, Zhu W, Zhang X, Zhou X, Wu W, Shen T. Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials. Phytomedicine. 2023;112:154716. doi:10.1016/j.phymed.2023.154716