Educational dose math only — not medical advice, not a product recommendation, and not a pass/fail on whether a supplement will work for you.
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Diabetes-free adults with obesity and MASLD. 1 g/day berberine vs placebo for 6 months. Pre-specified primary endpoints (visceral adipose tissue, liver fat) did not differ from placebo. Excellent safety profile. Not GLP-1-level adiposity reduction.

Educational only — not medical advice. Disclaimer.

NIH DSLD market slice

Median400 mg
Products730
Below85%

Bulk CSV dump 16 January 2026 · label entries through 2025. Disclosed amounts only — proprietary blends without gram weights excluded.

Trial floors

Primary

Adiposity RCT (Lei 2026, MASLD) · 1,000 mg over 6 months (medium evidence) · Primary endpoint missed — Diabetes-free adults with obesity and MASLD. 1 g/day berberine vs placebo for 6 months. Pre-specified primary endpoints (visceral adipose tissue, liver fat) did not differ from placebo. Excellent safety profile. Not GLP-1-level adiposity reduction.

Secondary

Weight meta-analyses (1 g/day and up) · 1,000 mg over 8-12 weeks (medium evidence) · Secondary outcomes only — Pooled body-weight estimates unstable across meta-analyses (−0.11 kg to −2.07 kg). Dose-response suggests ≥1 g/day. Indirect evidence; not mirtazapine-specific.

Label reading notes

  • Trials used berberine hydrochloride at gram/day doses; a label claiming 500 mg berberine may be a different salt or an underdose.
  • Lei 2026 missed primary adiposity endpoints; shelf math against weight meta is a label check, not proof berberine substitutes semaglutide.
  • Inhibits CYP3A4 in vitro; disclose to prescriber if on other medications.
  • Retail often stacks 500 mg × 2-3/day; the meta floor is ≥1 g/day.