Bergamot lowers cholesterol

In randomized trials, bergamot extracts taken for 4 to 16 weeks lowered LDL cholesterol and total cholesterol compared with placebo. The most recent review pooled nine small trials in 615 adults and found LDL about 40 mg/dL lower on average, but the trials disagreed so widely on the size of the effect that the reviewers rated their confidence in that figure as very low, and they rated six of the nine trials as poor quality.

The two newest placebo-controlled trials, which tested one extract and were paid for by its maker, found smaller changes: LDL fell 11.5 percent over four months in 60 Italian adults and 7 percent in 108 East Asian adults, while it held level or drifted up on placebo. Those results come from extracts; a 2024 trial of a drink made with up to 25 percent bergamot juice found no effect on blood lipids in 45 healthy adults over 12 weeks. For comparison, the UK clinical guideline for people taking a statin to prevent heart disease sets a target of more than a 40 percent fall in non-HDL cholesterol (total cholesterol minus HDL). No trial here measured heart attacks, strokes or deaths, and the same guideline advises that people taking a statin be told some supplements may interfere with it.

The review (Chambari 2026) searched to January 2025 and included trials published from 2011 to 2024, eight in Italy and one in China, each with 15 to 48 people per group. The preparations differed: juice extracts, polyphenolic fractions, a phytosome form and a powder, at 200 to 1,300 mg a day. One of the nine trials gave a tablet that held 200 mg of bergamot juice extract together with plant sterols, artichoke leaf extract and vitamin C. It ran for 24 weeks in 80 overweight adults on a low-calorie diet, against the diet alone, with no placebo. The review counts it as a bergamot trial, and leaving out any one trial did not significantly change its pooled lipid results. Participants had raised cholesterol or metabolic syndrome. Against control, LDL was 39.5 mg/dL lower, total cholesterol 44.7 mg/dL lower and triglycerides 52.5 mg/dL lower, and HDL was 5.6 mg/dL higher. Heterogeneity for LDL was 99.6 percent, meaning the trials varied in the size of the effect far more than chance would explain. One of the nine trials gave bergamot alongside the statin rosuvastatin, and no source here measured whether bergamot changes statin levels in the blood. In the four trials that measured liver enzymes, they did not differ from control.

The two most recent trials (Spina 2024, which the review includes, and Yu 2026) come from one registered study of the same juice extract, standardized to 150 mg of flavonoids a day, and enrolled people not taking statins. In the Italian trial LDL fell from about 172 to 152 mg/dL; in the East Asian trial, whose participants started lower, it fell from about 134 to 125 mg/dL. Weight, blood pressure and liver and kidney blood tests did not change in either. The extract's maker funded both and employed one author of each.

One randomized trial tested bergamot as a drink instead of an extract (Maggiolo 2024). Forty-five healthy adults in Italy were assigned either to drink 400 mL a day of a beverage containing up to 25 percent bergamot juice or to a control group, for 12 weeks. Total cholesterol fell over time in both groups with no significant difference between them, and the authors concluded the drink did not affect blood lipids. Urine tests picked up the drink's polyphenols in the drink group, but the bergamot flavanones that carry the chemical group behind the statin comparison (brutieridin and melitidin are two of them), and their breakdown products, were not detectable. The trial was not blinded, its registration describes the control as free diet with no drink, and it was registered eight months after it began. The review does not include it. The trial enrolled healthy adults, and no source here tested bergamot juice in people taking a statin; the UK guideline's example of a food that may interfere with statins is grapefruit juice, a different citrus fruit.

Two compounds in bergamot, brutieridin and melitidin, resemble statins in structure, which led to the proposal that bergamot works the way statins do. In human liver and gut cells grown in a lab, neither these compounds nor the whole extract directly blocked HMG-CoA reductase, the enzyme statins block. The extract instead lowered the amount of that enzyme and activated AMP-kinase, and brutieridin reduced cholesterol uptake by gut cells, which the authors describe as an action distinct from statins. None of this has been measured in people. A US government summary for health professionals mentions bergamot once, reporting a 2022 comparison of supplements in which bergamot and red yeast rice appeared the most effective at lowering LDL, and gives no bergamot safety information.