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.

Want the outcome before the arithmetic? The reason check opens any registry entry on this page with its trial result first, then compares your daily intake with the studied amount.

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 · how we grade this) · 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 · how we grade this) · 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.

Terms: MASLD — the current formal name for the condition usually called non-alcoholic fatty liver disease (NAFLD); CYP3A4 — a liver enzyme that clears many drugs.

Safety red flags

  • On insulin or a sulfonylurea: do not start berberine without your prescriber — the combination adds glucose-lowering pressure.
  • Dizziness, sweating, unusual weakness, nausea, or a racing pulse can be low blood sugar — report it promptly.
  • Not for pregnancy, breastfeeding, or under 18; ask a clinician first with gallbladder disease, gallstones, or a flare of a chronic GI condition (for example, an ulcer, colitis, or IBS).

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.