Forty-three hypercholesterolemic patients were randomly assigned to receive 500 mg of berberine twice a day (n = 32) or placebo (n = 11) for 3 months. In the berberine group, compared with baseline, the mean serum cholesterol level fell by 29% (p < 0.0001), LDL-cholesterol fell by 25% (p < 0.0001), and triglycerides fell by 35% (p < 0.0001), whereas the mean HDL-cholesterol level did not change. Changes in the placebo group were small and not statistically significant. No side effects were reported, except for mild constipation in one patient.

Comment: Berberine is an alkaloid present in several medicinal plants, including goldenseal and Oregon grape. Although best known for its antimicrobial activity, Berberine is also used in Asia to treat congestive heart failure. In a recent study it was found to decrease ventricular premature complexes and mortality in patients with heart failure (Am J Cardiol 2003;92:173-176). The current study extends the apparent cardioprotective effects of this compound. In human hepatoma cells, berberine was shown to up-regulate LDL-receptor expression; therefore, the mechanism of its cholesterol-lowering action differs from that of statin drugs.

Kong W, et al. Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins. Nat Med 2004;10:1344-1351.