Barberry Uses and Plant Monograph
Barberry first made an appearance in my life in the form of the bright red fruits of this shrub, a delectable tart berry with a bit of sweetness served atop a Persian dish of basmati rice, called Zereshk Polo. The largest cultivator of barberry fruit in the world is Iran, where as of 2010, 9200000 kg of dried seedless barberry fruit was produced yearly. Apart from being used as a food additive, it is planted as a landscape ornamental plant; the anthocyanin compounds in barberry are employed as a food coloring in food industries, and there is significant use of the stem and root bark as well as the berries for medicinal purposes. It is a wonderful herb that has been used medicinally with records since 650 BCE in Babylonia.1
Barberry Uses & Plant Profile Summary
- Botanical Name: Berberis vulgaris
- Other Common Names: European barberry, common barberry, berberis, Pipperidge Bush, Holy Thorn
- Family: Berberidaceae
- Parts Used: Stem and root bark, fruit
- Energetics: Cooling, drying
- Taste: Bitter, astringent, sour (fruit)
- Plant Properties: Bitter, cholagogue, anti-inflammatory, antimicrobial, antifungal, antiparasitic, immunomodulant, alterative, hypoglycemic, hypotensive, hypolipidemic
- Plant Uses: Infections, MRSA, diabetes mellitus, diarrhea, hyperlipidemia, NAFLD, kidney health, uterine fibroids, PCOS, cardiovascular health, acne
- Plant Preparations: Infusion, tincture, glycerite, topical, capsules, food
After the introduction of the common barberry plant to North America in the 17th century, it was found to be a host plant for cereal stem rust (Puccinia graminis). This proved to be devastating as with proximity to wheat crops, it resulted in this fungus adapting its genotype and infecting crops that were rust-resistant, contributing to the epidemic stem rust outbreak. Due to this, from the 18th century onwards, widespread eradication of barberry was conducted, and there have been restrictions on the planting and sale of barberry.2
The main active constituent of barberry is berberine, which is an isoquinoline alkaloid that exerts its therapeutic activities on several systems of the body. Berberine can be found in the stem and root bark and fruits of the plant.3 Berberine is also contained in the medicinal herbs oregon grape root (Mahonia aquifolium or Berberis aquifolium), coptis (Coptis trifolia), and goldenseal (Hydrastis canadensis). Barberry may be a great substitute for goldenseal, which is classified as a threatened species under the International Union for Conservation of Nature (IUCN).4 As an antioxidant, barberry also regulates the formation of free radical damage by acting as a scavenger and this is due to its phenolic and flavonol compounds.5,6
Immune Function
Historically, barberry has been used to fight a wide range of infections in the body, such as viral, bacterial, and fungal infections. These would include digestive infections causing cholera, diarrhea, and dysentery, as well as respiratory and urinary tract infections.
In modern research, barberry, or more specifically berberine extract, exerts a broad-spectrum effect on infections and the immune system. The extracts of barberry root and leaf were found to be antibacterial against different strains of Staphylococcus and Escherichia coli as well as have an antifungal effect on Penicillium verrucosum and Aspergillus species.
Barberry is useful for targeting bacteria and fungi with known resistance to conventional drugs typically used for treatment. In terms of resistant fungi, berberine extract was able to display antifungal action against Cryptococcus neoformans and Fluconazole-resistant candida through apoptosis.7
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that has developed resistance to a number of antibiotics due to biofilm and exotoxin formation and can result in serious conditions such as pneumonia, meningitis, and multiple-organ dysfunction syndrome.8 Berberine extract was determined to exert excellent antibacterial activity against MRSA, significantly reducing the bacterial count and biofilm formation in a concentration-dependent manner.9
The immunomodulatory role of berberine is due to its impact on the antigen-presenting cells of the immune system whereby it regulates the immune response to not become either too strong or too weak. The alkaloids in barberry may also contribute to improved immunity through the action of the T cells.10
A clinical trial on 336 patients with Helicobacter pylori comparing a standard regimen to a berberine-based therapy. The berberine treatment group took 300 mg of berberine 3 times a day and was compared to the groups taking the antibiotics omeprazole (20 mg) and amoxicillin (100 mg) each taken twice daily over a period of 14 days. It was found that the rate of eradication of the bacteria species was 80.4% for the berberine-based therapy compared to 67% for the standard therapy.11
Both berberine alone and berberine in combination with pyrimethamine (an antiparasitic drug) were found to effectively treat chloroquine-resistant malaria compared to drugs such as tetracycline and co-trimoxazole.12
A short 7-day study was conducted on 120 women with bacterial vaginosis with one group being treated with a vaginal gel containing 5% of Berberis vulgaris fruit extract in a metronidazole (an antibiotic) base and a treatment group with a vaginal gel containing only metronidazole. The treatment vaginal gel containing B. vulgaris had a better response to symptoms, including itching, redness, burning, and dysuria, compared to the metronidazole vaginal gel alone.13
Participants in a treatment group using a gel containing B. vulgaris in a study revealed that compared to a group using a placebo antiplaque toothpaste, it was more effective in reducing plaque index, which measures the amount of plaque present on the teeth formed by bacteria in the mouth.14
Antidiabetic Activity
Barberry and its extract berberine are becoming increasingly popular for their use to support blood sugar regulation, and just this past week I had come across a person at my local health food store who was currently taking this herb for this very reason. In China, it has been used as an antidiabetic agent for over 1500 years and may be relevant as an alternative therapeutic.15
The purported mechanisms that underlie the actions of barberry in balancing blood sugar include increased expression of glucose transporter 1, allowing for glucose to be taken up into cells without being dependent on insulin. It also may have a role in increasing the insulin signal transduction pathway, which may increase insulin sensitivity. This in turn may help regulate blood sugar levels.16
A parallel-controlled study of 300 patients with diabetes mellitus and pre-diabetes was conducted on the use of berberine and bifidobacteria over a period between the years 2015–2018. The patients on the berberine treatment had their fasting plasma glucose reduced from baseline compared to the placebo after a period of 16 weeks.17
An RCT of 116 patients with type 2 diabetes and dyslipidemia was conducted over 3 months and found that 1g of daily berberine treatment compared to placebo resulted in significant decreases in the treatment group of levels of fasting glucose, LDL-c, total cholesterol, and blood HbA1c levels.18 In another similar RCT on 31 patients with diabetes, but using the 3 g a day of barberry fruit extract, the treatment group had a significant decrease in the abovementioned trial’s health markers but with the addition of insulin.19
In a meta-analysis examining the use of berberine in patients with type 2 diabetes mellitus, a statistical difference was determined for berberine extract being able to increase levels of HDL-C and reduce levels of triglycerides compared to oral hypoglycemics.20
Digestive Complaints
Barberry has a number of actions that can provide relief to digestive complaints, such as being an antispasmodic, which can reduce stomach cramping and increase stool transit time.21 A study conducted on 196 patients with diarrhea-predominant irritable bowel syndrome over a period of 8 weeks found that the treatment group consisting of taking 400 mg of berberine twice a day was able to reduce the frequency of diarrhea and abdominal pain.22
Barberry has traditionally been used in cases of diarrhea and abdominal pain, where it can tonify and astringe the bowels. An in-vitro assessment of human colon monolayers showed evidence that berberine has a role as an anti-diarrheal agent through the mechanism of preventing tight junction defects and barrier breakdown that contributed to inflammation of the intestine.23 Furthermore, it is a strong antimicrobial that is able to reduce infection-related diarrhea and inhibits colonic secretion without impacting nutrient absorption.24
While it is common for certain pharmaceuticals and treatments to have digestive side effects, barberry may be able to help eliminate these unwanted effects. In patients undergoing abdominal radiation for cervical cancer treatment, 300 mg berberine extract taken 3 times daily, was found to reduce radiation-induced acute intestinal symptoms (RIAISs) compared to the control group with only radiation.25
Liver Health Promotion
One of the specific uses for barberry is for liver health as a bitter cholagogue and alterative herb, promoting bile flow out of the gallbladder and strengthening the functioning of the liver to relieve congestion and aid in the removal of metabolic wastes. One understanding of barberry’s affinity for the liver is that berberine has a longer half-life and concentration in the tissue of the liver compared to other organ tissues.26
In a meta-analysis of 6 RCT that totals 501 patients with nonalcoholic fatty liver disease (NAFLD), berberine treatment of 0.3-0.5 g taken 3 times a day over 3–4 months was found to be effective in reducing blood lipids (triglycerides and LDL), blood glucose (HbA1c and fasting plasma glucose), and improving fatty liver condition (significant lower liver lipid content). In addition, the improved liver function shown through the reduction of alanine transaminase (ALT) and aspartate transaminase (AST) liver enzymes was observed.27 The results of the impact on ALT and AST levels are especially significant as these liver enzymes are present in higher amounts when there is damage to the liver and the return to lower levels is indicative of restoration to the normal functioning of the liver.
Kidney and Bladder Health
Barberry has been used traditionally as a anti-urolithic for kidney stones, preventing and reducing the formation of stone-forming constituents in the body, and this mechanism may be through diuretic, hypocalciuric, and urine alkalinizing actions of berberine.28
In a study on patients with renal atherosclerosis, berberine at a dose of 500 mg taken 3 times daily over a period of 4 weeks was found to reduce blood urea nitrogen and creatinine in the serum and improve the function of the kidneys.29
Reproductive Health
Herbalist Aviva Romm lists barberry as a specific for uterine fibroids since barberry is a bitter with an affinity for the reproductive system. This may be due to the cholagogue action of barberry, supporting the elimination of excess estrogen in the body, which is a risk factor for uterine fibroids.30
In a study on women with anovulatory polycystic ovarian syndrome (PCOS), berberine taken 0.4 g 3 times a day over 4 months was found to improve the rate of ovulation, menstrual pattern (the duration and frequency of a menstrual cycle) and reduce insulin resistance, which is related to its pathogenicity.31
Its impact on lowering insulin resistance has also been determined to improve pregnancy rate and reduce severe ovarian hyperstimulation syndrome (enlargement of the ovaries due to hormones overstimulation used to stimulate ovulation) in a study on 150 infertile in vitro fertilization (IVF) PCOS patients.32
Cardiovascular Support
Berberine has anti-atherosclerotic actions through its effects as an anti-inflammatory. Inflammation has a main role in the pathogenesis of atherosclerosis and in the instability of coronary atherosclerotic plaque that results in the formation of a vascular thrombus that stops the flow of blood in the artery, leading to a heart attack. Berberine has been found to reduce inflammatory factors and inhibit proinflammatory cytokine expression in vivo studies on human pulmonary cells.33 It is important to note that if you have any cardiovascular health issues and are on pharmaceutical medications, it is advised that you consult with your doctor and/or healthcare professional before taking berberine for cardiovascular support.
In a study of 131 patients with acute coronary syndrome (atherosclerotic plaque rupture due to the formation of a thrombus and coronary vessel obstruction), a treatment group using berberine extract was compared to a control group. After one month, the berberine treatment group had a significant reduction in inflammatory and endothelial dysfunction biomarkers compared to the control.34
There was a systematic review that totaled 2,569 participants with hypertension over 27 studies and it was found that berberine extract significantly lowered blood pressure, and 3 of these studies compared berberine to a control, with the former able to reduce systolic blood pressure more than the control by 5.97 mmHg.35
A randomized trial on 158 patients with congestive heart failure found that treatment with berberine contributed to improved cardiac function, and exercise capacity, as well as reduced mortality.36
Lipid-Lowering Effects
The mechanisms by which berberine act as a hypolipidemic are by downregulating the expression of the protein PCSK9, which in turn leads to higher uptake and clearance of LDL cholesterol (LDL-C) in the body due to less degradation of LDL receptors. This LD cholesterol can then be incorporated into bile, which is responsible for its breakdown and clearance from the body.37
It may also limit the synthesis of fatty acids, and in turn triglycerides, through the activation of AMP-activated protein kinase. In addition, berberine may also have a role in promoting bile acid formation, reducing the absorption of cholesterol in the small intestine, and increasing the fecal excretion of cholesterol.38
Conventionally, statins are a drug used in patients with hypercholesterolemia and hyperlipidemia, and in a study on patients with these conditions that are unable to take statins, it was found that 500 mg of berberine treatment over 6 months was able to reduce LDL-C levels by 31.7%.39
In a meta-analysis of 27 clinical trials on patients with hyperlipidemia, it was found that berberine extract had evidence of decreasing levels of TG and increase HDL-C more than the oral medicine treatment group, and in combination with the lipid-lowering drugs was able to reduce total cholesterol and LDL-C more than the control.40
Skin Support
The fruits of barberry contain vitamin C, phenolic compounds, malic acid, citric acid, dextrose, and tartaric acid and contains 5.22–7.7% berberine.41,42A study on 49 adolescents with acne taking a 400 mg oral aqueous extract of the dried fruit of barberry fruit demonstrated that the adolescents taking the barberry fruit extract had a reduced acne severity score compared to placebo. This included inflamed and non-inflamed lesions of acne reduction by between 43.25% and 44.53% respectively, and this effect may be due to the berberine as it is anti-inflammatory, antibacterial, and anti-lipogenic, which is the prevention of glycerol and fatty acid conversion into fats.43
Botanically speaking
Barberry is a cold hardy, drought tolerant plant native to Europe, Western Asia, and Northwest Africa, and it has been naturalized in North America.44 It can be found growing in woodlands, forests, prairies, and grasslands. It is an erect, deciduous shrub with drooping stems surrounded by triple-branched thorns and can grow to a height of 3 meters.
The leaves of the shrub are 2 inches long, glossy, simple, alternate, petioled, lance-shaped, finely serrated, and clustered on the stem. The leaf color changes from green in the spring to orange, red, or purple in the fall.
The flowers are yellow in color and consist of 6 petals that bloom from April until June in North America. The stamens, when touched, are known to spring forcefully and release pollen from the anthers. The fruits are a bright red and oblong-shaped in clusters, measuring 0.5 inches long and remaining on the plant throughout the winter.
Large lateral roots extend from the root crown and can extend from 9.8-15.1 feet and barberry forms rhizomes from the root crown to promote vegetative regeneration.45 The bark of the root is made up of thin sections, and the inner surface is smooth and orange-yellow in color. The periderm is the outer layer that is yellow-gray brown and soft.
Harvesting Tips
The bark of the stem and root can be either peeled or shaved off either in the spring or autumn and allowed to dry for storage in pieces that are up to a couple of inches in length. When harvesting from barberry, it is important to do so sustainably by peeling one side of the shrub’s bark in order for the plant to properly heal and from a portion of the horizontal rhizomes of the plant in order for the plant to stay alive. It is also ideal to harvest barberry from an area that has no known pesticide or herbicide use and where the soil is not contaminated with heavy metals and harmful compounds.
The fruit is ready to be harvested in September or October depending on the region and is harvested by picking the clusters of berries by hand. When harvesting the bark or the berries, one should be mindful to watch out for the thorny spikes on the stems. Due to barberry plants, especially Berberis vulgaris, acting as hosts to the black stem rust disease, uccinia graminis, Canada and the U.S. have placed restrictions on the import, sale and propagation of these plants and seeds.46
Preparation
- Tea decoction: 1 tsp of dried barberry bark or berries in 1 cup of water, boiled then simmered for 10–15 minutes. Taken 3 times a day.47
- Tincture: 1–2 ml of dried root bark (1:5, 60%) taken 3 times a day.48
- Glycerite: 1–5 ml of dried root bark (1:5) taken 3-4 times a day.49
- Topical: A liniment or compress of the decocted barberry root can be used topically on skin infections.
- Capsule: 500–1500 mg capsule taken up to 3 times a day (or following supplement instructions).50
- Food: The berries can be eaten fresh or dried as a food and have a more gentle medicinal action on the body in comparison to the bark, which is more potent.
- Herbalist Margaret Grieve has suggested using the berries of barberry as a jelly, which could relieve a sore throat and be helpful in reducing inflammatory fevers.51
Special Considerations
Barberry and berberine extract are contraindicated in pregnancy and lactation due to potential uterine stimulant activity and neonatal jaundice. Caution should be exerted when taking the drug cyclosporine as berberine has been observed to increase its bioavailability.52 Berberine has also been found in a study to potentially decrease the effects of the antibiotic tetracycline (used for cholera), but due to conflicting information found in another study, simultaneous use of the two should be cautioned against.53 Barberry is also not recommended for use in people with jaundice, biliary disease, and liver disease.54
Summary
Barberry remains an effective herb used for centuries with modern research further backing its support for different systems of the body. These include a reduction in infections, regulation of blood sugar and lipid levels, tonifying gastrointestinal issues, modulating liver health, and supporting conditions of the cardiovascular system, among others. Most of this action is exerted through the alkaloid berberine, acting as an anti-inflammatory, antimicrobial, bitter cholagogue, and alterative to impact mechanisms at different levels.
Footnotes
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