Barberry is a wonderful diverse medicine that has many beneficial effects on our health. It is a highly nutritive plant medicine that is rich in vitamin C and trace minerals such as copper, zinc, and manganese, as well as antioxidant compounds.

A mouthwash made with barberry infusion may be used to promote good dental hygiene by reducing plaque and gingivitis. It has specific antibacterial properties that fight against bacteria associated with caries.

It is both bitter and cooling. It is specific for heat and stagnation of fluids in the body. Its bitter action on the liver helps to eliminate toxins in the body. This mechanism is one way in which barberry may be helpful for skin conditions such as acne (16).

Herbalists often address the liver for skin inflammations- this is because the liver is the primary organ of blood detoxification. Where there is inflammation or heat coming out through the skin- it is often indicative of poor elimination or congestion in the liver which brings toxins or heat out through the surface (skin which is also an organ of elimination – sweat).

Barberry is a blood purifier that enables detoxification and promotes elimination. This action makes this plant cooling due to the reduction of toxins and inflammatory by-products in the circulation of the body.

Barberry has played a prominent role in herbal medicine for more than 2,500 years. In European folk medicine it was used for nearly every gastrointestinal ailment, urinary tract and respiratory infection. It has been used as a bitter tonic and antipyretic to support the liver and help remove cold from the body.

It is known for its anti-arrhythmic and sedative effects in Iranian traditional medicine. The traditional Iranian system of medicine understands barberry to have cold, dry energetics. It is traditionally used to check diarrhoea, strengthen the stomach, liver, and heart, eliminate excess bile, relieve thirst and cool stomach heat and internal inflammations (14).

Barberry has a number of actions that support systemic health. It reduces inflammation, moderating the immune function as well as supporting cardiovascular function, liver function and detoxification. This makes it an excellent herb for debility during convalescence. Although sometimes barberry fruit is used as medicine, the majority of uses discussed below relate to the use of the root and bark unless stated otherwise.

Digestive system

Barberry is used for many conditions in the gastrointestinal tract. Most specifically for infective conditions such as amoebic dysentery and diarrhoea, inflammation and liver problems (11).

Barberry is considered a hepatic and hepatoprotective and stimulant is used in a number of liver and gallbladder problems, congestion, stones and biliousness. It promotes the flow of bile and aids in problems associated with sluggish liver function. It may be used by herbalists to treat jaundice, hepatitis and cirrhosis of the liver. It both cleanses and regulates the liver function but its main action is as a liver tonic (8).

Barberry works especially for hepatic portal vein congestion which often correlates with a sluggish liver (12). This can sometimes correspond with varicosities in the body such as haemorrhoids due to the secondary effects of vascular congestion further up the digestive tract. Jaundice and constipation may be symptoms of such a picture.

Plants high in berberine are used as a stomachic and antimicrobial. Barberry may be used as part of a treatment for the active and recovery phases of gastric illness of either bacterial or viral nature.

The tart, red berries have been used for centuries to treat diarrhoea. Barberry fruit may also promote good dental hygiene by reducing plaque and gingivitis (8).

Immune system

Barberry has a number of uses for conditions of the immune system, particularly autoimmune and rheumatic conditions. It has been shown to reduce inflammation and increase anti-inflammatory cytokines in rheumatoid arthritis. It has also been shown to increase T- helper cell production (that play an important role in the adaptive immune system- the part of the immune system that eliminates pathogens or inhibits their growth) (4).

Barberry may be used in conjunction with immune moderating herbs and other nutritional interventions in fighting infections due to its antibacterial and anti-infective properties. Barberry has been shown to have anti-parasitic properties. It may be used alongside other vermifuges to fight intestinal parasites. This is likely due to the action of berberine (9). Usually, dietary changes are made during the treatment of parasites such as to reduce dietary sugars. This is because most parasites thrive on sugars.

Barberry is sometimes used for enlargement of the spleen and for spleen disorders. There are also a number of references for the traditional use of barberry in malaria and a protozoan infection called leishmaniasis (10, 12), including as a topical treatment for cutaneous infection (14). The combined actions of blood purification and improved liver and bile function will likely contribute to some of the actions of barberry in these types of infections.

Urinary system

Barberry’s antimicrobial and anti-inflammatory actions may be utilised in the recovery stages of a urinary tract infection (UTI). Barberry strengthens the urinary system and is useful in chronic reoccurring infections, which can be a sign of cystitis or weak tissues. Herbs and dietary changes are often required to fully address the problem of recurring UTI’s. A herbalist may use other herbs such as horsetail or cornsilk to address inflammation and tissue damage. High antioxidant herbs such as bilberry and barberry to protect against further tissue damage and infection.

It is important to note that barberry does not treat UTI’s alone. Urinary tract infections need to be addressed with care due to the potential for a secondary infection in the kidneys. Any lower back pain would usually indicate that the kidneys are affected. This should indicate the immediate need for medical attention.

A medical herbalist will be able to support through active stages of an infection as well as to improve recovery outcomes and lower the risks of reoccurrences. The holistic approach will usually address the root causes of reoccurring UTI’s with an integrated approach that may include dietary changes as well as herbs. It is always important to redress microfloral imbalances following UTI’s- particularly where there has been recurrent and chronic use of antibiotics.

Cardiovascular system

Barberry fruit is indicated in a number of cardiovascular conditions. It is a powerful blood purifier which works via its effects on the detox systems such as the liver (14). Berberine has shown many beneficial cardiovascular effects. It has a strong antioxidant and anti-inflammatory action that supports cellular health in the endothelium (lining of the blood vessel cavities) (8).

Barberry is used for the prevention of hypertension, tachyarrhythmia and to lower peripheral vascular resistance. It is also used in combination with other herbs and nutritional interventions to treat heart disease, including arrhythmia (8).

Cellular and metabolic

Barberry fruit helps to regulate blood sugar levels, as well as lower cholesterol levels, and reduce oxidative stress via its strong antioxidant action (8).

Barberry has also been shown to have a number of effects that make it a beneficial adjunct in the treatment of non-insulin dependent diabetes mellitus and to improve pancreatic tissue health (14).

There are many promising studies on barberry including some excellent clinical trials on opiate withdrawal, immune function and rheumatoid arthritis. A number of clinical reviews have also been included below.

Barberry root contains the bioactive alkaloid berberine and may provide anti-hyperglycemic, antioxidant, anti-inflammatory, anti-hypertensive, and lipid lowering effects.

Berberine is an active compound in barberry which is also bactericidal, amoebicidal and fungicidal. It has some antiepileptic, uterine stimulant and hypotensive effects and is slightly sedative, as are jatrorrhizine and palmatine (17).

Antibiotic resistance

Antibiotics have been overused and as a result, bacteria are evolving more rapidly than we can develop new medicines, leading to increased resistance and decreased efficacy. Berberine from barberry has been shown to support and enhance the efficacy of antibiotics against Methicillin-Resistant Staphylococcus aureus infections (MRSA), and therefore can offer support for the antibiotics crisis (12).

Clinical reviews of barberry

A clinical review was carried out to investigate the therapeutic effects of barberry and its constituents, particularly berberine- an alkaloid. The review analysed the results of 77 clinical studies on human subjects that suggested a wide range of therapeutic applications.

Lipid-lowering and insulin-resistance improving actions are the most studied properties of berberine in numerous randomised clinical trials as well as cardiovascular, anticancer, gastrointestinal, CNS and endocrine effects. Berberine has very low toxicity in usual doses and reveals clinical benefits without major side effects apart from rare incidence of mild gastrointestinal reactions in a small number of patients (1). It must be noted that in a herbalist’s extract of barberry it will contain both berberine as well as hundreds of other molecules that work in synergy, but this study was on berberine alone.

Another clinical review discusses further diversity of barberry’s pharmacological effects. Both pharmacological and clinical studies on Berberis vulgaris and berberine were assessed with over 1200 new articles studying the properties and clinical uses. Barberry has been studied for treating tumours, diabetes, cardiovascular disease, hyperlipidemia, inflammation, bacterial and viral infections, cerebral ischemia trauma, mental disease, Alzheimer’s disease and osteoporosis.

Further studies suggest that barberry has beneficial effects on both the cardiovascular and nervous systems suggesting a potential use for the treatment of hypertension, tachycardia and some neuronal disorders, such as epilepsy and convulsions (3).

Inflammation

A clinical trial was carried out to evaluate the effects of short-term barberry juice supplementation on the response of immunoglobulin A, G and M and cortisol in active female participants following exhaustive exercise activity. 20 healthy young women aged between 23- 25 years were randomly divided into two experimental groups. The first group received 250 ml barberry juice and did exhausting activity. The control group received 250 ml placebo and did exhausting activity.

After two weeks of supplementation, both groups carried out an exercise activity on the treadmill until they reached maximum exertion. Humoral immune variables were measured in similar conditions in three stages; pre-test, after two weeks of supplementation and after the exhaustive test.

The results showed that levels of immunoglobulin A and M after acute exhaustive activity were significantly higher than the control group in the experimental group, whereas in the experimental group cortisol values were significantly lower than the control group.
The study concludes that these positive results show that consumption of barberry juice for two weeks increases immune function reduces the effects of acute exhausting activity on the immune system in active women (6).

Opiate withdrawal

A double-blind clinical trial was carried out to ascertain the effect of dried barberry root on the symptoms of opiate withdrawal syndrome in patients undergoing methadone maintenance therapy. The aim of the study was to reduce the daily dose of methadone and thus reduce its side effects. Subjects included were clients referred to addiction treatment centres. 40 subjects were randomly assigned in two groups of 20.

The intervention group was treated with methadone syrup and barberry capsules and the control group received methadone and placebo syrup for a period of 2 months. The findings of the study showed that there was a significant difference between the effectiveness of barberry compared with placebo on pain, diarrhoea, temptation, nasal congestion caused by drug withdrawal. No significant difference was seen between the two groups on anorexia induced cracks. The study concludes that barberry extract can be complementary to methadone on helping to reduce the symptoms of a withdrawal syndrome (5).

Barberry grows invasively in many non-native countries. The fruit has a tart flavour and it is often made into jellies and jams. A popular dish in Iran is zereshk polow ba morgh, a rice dish with barberries and raisins.

Barberry is native to Europe and the British Isles. It was introduced to America during the 17th century where it is now naturalised.

According to the IUCN Red List of Threatened Plants Status barberry is classified as Least Concern in Europe due to its widespread distribution, presumed stable populations and no major threats (7).

Barberry is shade tolerant which allows it to easily invade woodlands. It is also an alternate host for wheat rust (Puccinia graminis) a fungal disease of cereal crops- which makes the control and removal of this invasive shrub of primary importance.

Barberry is a good substitute to the endangered species goldenseal. The two plants have similar actions and both contain berberine.

Habitat loss and over harvesting from the wild are two of the biggest threats faced by medicinal plant species. There are an increasing number of well known herbal medicines at risk of extinction. We must therefore ensure that we source our medicines with sustainability in mind. 

The herb supplement industry is growing at a rapid rate and until recent years a vast majority of medicinal plant products in global trade was of unknown origin. There are some very real and urgent issues surrounding sustainability in the herb industry. These include environmental factors that affect the medicinal viability of herbs, the safety of the habitats that they are taken from, as well as the welfare of workers in the trade.

The botanical supply chain efforts for improved visibility (transparency and traceability) into verifiably sustainable production sites around the world is now certificated through the emergence of credible international voluntary sustainability standards (VSS). Read our article on sustainable sourcing of herbs to learn more about what to look for and questions to ask suppliers about sustainability.

Herbal Medicines are often extremely safe to take, however it is important to buy herbal medicines from a reputed supplier. Sometimes herbs bought from unreputable sources are contaminated, adulterated or substituted with incorrect plant matter.

Some important markers for quality to look for would be to look for certified organic labelling, ensuring that the correct scientific/botanical name is used and that suppliers can provide information about the source of ingredients used in the product.

A supplier should be able to tell you where the herbs have come from. There is more space for contamination and adulteration when the supply chain is unknown.

Barberry is an attractive plant that provides a dense habit of abundant flowers making them invaluable as wildlife-friendly hedging and screening.  Barberry can become invasive so it is important to control its growth and ensure that it does not escape the garden into natural habitats where it crowds-out and displaces beneficial native plants.

• Barberry bushes are best planted in full sun or partial shade. The leaves are susceptible to scorching so the warmer the growing zone, the more shade you should provide your plants. These robust plants can tolerate a variety of soil types, but ideally, they enjoy loamy, well-draining soil with a pH of 6.0-7.5.
• Pot grown barberry can be sourced from many garden centres. They should be planted out between October and April whilst leafless and dormant, so long as the ground is not frozen or waterlogged at the time of planting.
• Water newly-planted barberry regularly and well- especially during summer and over the first year whilst the roots are establishing. After this you should only need to water during prolonged dry spells
• Barberry will not tolerate a very wet or waterlogged soil and may struggle in excessively dry conditions.

1. Imenshahidi, M. and Hosseinzadeh, H. (2019). Berberine and barberry (Berberis vulgaris ): A clinical review. Phytotherapy Research, 33(3), pp.504–523. doi:https://doi.org/10.1002/ptr.6252.
2. Imenshahidi, M. and Hosseinzadeh, H. (2016). Berberis Vulgarisand Berberine: An Update Review. Phytotherapy Research, 30(11), pp.1745–1764. doi:https://doi.org/10.1002/ptr.5693.
3. Fatehi, M., Saleh, T.M., Fatehi-Hassanabad, Z., Farrokhfal, K., Jafarzadeh, M. and Davodi, S. (2005). A pharmacological study on Berberis vulgaris fruit extract. Journal of Ethnopharmacology, 102(1), pp.46–52. doi:https://doi.org/10.1016/j.jep.2005.05.019.
4. Aryaeian, N., Hadidi, M., Mahmoudi, M., Asgari, M., Hezaveh, Z.S. and Sadehi, S.K. (2020). The effect of black barberry hydroalcoholic extract on immune mediators in patients with active rheumatoid arthritis: A randomized, double–blind, controlled clinical trial. Phytotherapy Research. doi:https://doi.org/10.1002/ptr.6874.
5. Nematshahi, Mohammad, Mirhamidi, Mahdi, Asadi and Atefeh (2020). The effect of dried barberry root on the symptoms of opiate withdrawal syndrome in patients undergoing methadone maintenance therapy-double-blind clinical trial. Journal of Medicinal Plants, 19(74), pp.335–342. doi:https://doi.org/10.29252/jmp.19.74.335.
6. Hooshmand Moghadam, B., Eskandari, M., Bijeh, N., Mohammadnia Ahmadi, M. and Norouzi, J. (2019). Evaluation of the Effect of short-term Barberry Juice Supplementation on humoral immune response in active girls following exhaustive exercise activity: A randomized double-blind clinical trial. Razi Journal of Medical Sciences, [online] 26(2), pp.39–49. Available at: https://rjms.iums.ac.ir/article-1-5579-en.html [Accessed 15 Jun. 2023].\
7. Unit), M.B. (Red L. (2012). IUCN Red List of Threatened Species: Berberis vulgaris. [online] IUCN Red List of Threatened Species. Available at: https://www.iucnredlist.org/species/202941/2758147.
8. herbalgram.org. (2023). Barberry04-15-2020 – American Botanical Council. [online] Available at: http://herbalgram.org/resources/herbclip/herbclip-news/2020/barberry/ [Accessed 15 Jun. 2023].
9. (No date) O monograph berberine – alternative medicine review. Available at: https://altmedrev.com/wp-content/uploads/2019/02/v5-2-175.pdf (Accessed: 15 June 2023). 
10. RxList. (n.d.). European Barberry: Health Benefits, Side Effects, Uses, Dose & Precautions. [online] Available at: https://www.rxlist.com/european_barberry/supplements.htm [Accessed 15 Jun. 2023].
11. Williamson, E., Driver, S., Baxter, K. and Al, E. (2009). Stockley’s herbal medicines interactions : a guide to the interactions of herbal medicines, dietary supplements and nutraceuticals with conventional medicines. London: Pharmaceutical Press.
12. Hoffmann, D. (2003). Medical Herbalism – principles and practices. Inner Traditions Bear And Comp.
13. (No date) Chemical constituents from Berberis vulgaris. A) Berlambine, B … Available at: https://www.researchgate.net/figure/Chemical-constituents-from-Berberis-vulgaris-a-Berlambine-b-Hydroxycanthine-c_fig3_281863569 (Accessed: 16 June 2023). 
14. Bone, K. and Mills, S. (2013). Principles and practice of Phytotherapy modern Herbal Medicine. 2nd ed. Edinburgh Churchill Livingstone, Elsevier.
15. Foundation, E.I. (n.d.). Welcome to Encyclopaedia Iranica. [online] iranicaonline.org. Available at: https://www.iranicaonline.org/articles/barberry-zeresk-berberis-spp [Accessed 16 Jun. 2023].
16. Wood. M. 2004. The Practice of Traditional Western Herbalism: Basic Organs and Systems. North Atlantic Books,U.S.
17. Zarei, A., Changizi-Ashtiyani, S., Taheri, S. and Ramezani, M. (2015). A quick overview on some aspects of endocrinological and therapeutic effects of Berberis vulgaris L. Avicenna Journal of Phytomedicine, [online] 5(6), pp.485–497. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678494/.
18. Chu MC, Zhang M, Liu Y, et al. Role of Berberine in the Treatment of Methicillin-Resistant Staphylococcus aureus Infections. Scientific Reports. 2016;6(1). doi:10.1038/srep24748