Meta-analysis supports berberine-silymarin combination for cardiometabolic health

By Stephen Daniells contact

- Last updated on GMT

Berberine is found naturally in medicinal plants such as Goldenseal (above), while silymarin is found in Milk Thistle. Image © Getty Images / bkkm
Berberine is found naturally in medicinal plants such as Goldenseal (above), while silymarin is found in Milk Thistle. Image © Getty Images / bkkm
Supplements formulated with berberine and silymarin may improve blood lipid levels and fasting blood sugar levels, says a meta-analysis of five randomized, double‐blind, placebo‐controlled clinical trials (RCTs).

Co-consumption of berberine and silymarin was associated with significant improvements in triglycerides, total cholesterol, HDL and LDL cholesterol, according to data published in Phytotherapy Research​.

In addition, significant reductions in blood glucose levels were observed, with average decreases of 7.5 mg/dl reported by scientists from the universities of Bologna, L'Aquila, and Palermo in Italy.

“[Berberine] lipid‐lowering efficacy in humans is well‐known and definitely confirmed by a meta‐analysis of 27 clinical studies with overall 2,569 participants​,”​ they wrote. “In comparison with that meta‐analysis, our findings show that the addition of silymarin to [berberine] is able to improve its positive effect on lipid and glucose metabolism in humans, allowing for the administration of lower doses of [berberine] and accordingly reducing the associated risk of gastrointestinal discomfort which is demonstrably dose related.

“As a matter of fact, considerations on tolerability of low doses of [berberine] may also have important clinical implications, because it is well known that hypercholesterolemia is an asymptomatic clinical condition in which adherence and persistence on prescribed lipid‐lowering medications are relatively low, and discontinuation rates are even higher in presence of adverse events or drug reactions.”

Meta-analysis details

The Italy-based scientists performed a systematic review of literature and found five eligible RCTs to include in their meta‐analysis. These provided data from 497 individuals. Study durations ranged from three to 12 months and doses of berberine 500 or 1,000 mg/day while silymarin doses were either 105 or 210 mg/day.

Results showed that the combination was associated with reductions in total cholesterol of 25 mg/dl, of triglycerides of 28 mg/dl, and of LDL cholesterol of 29 mg/dl, while HDL cholesterol levels were increased by 6 mg/dl.

“The present findings suggest that the coadministration of berberine and silymarin is associated with an advantageous improvement in lipid and glucose profile, suggesting the possible use of this nutraceutical combination in order to promote the cardiometabolic health,” ​wrote the researchers.

Source: Phytotherapy Research
Published online ahead of print, doi: 10.1002/ptr.6282
“Metabolic effect of berberine-silymarin association: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials”
Authors: F. Fogacci et al.

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