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Can You Lower Your Cholesterol with Bergamot?

Some research suggests that an extract of the citrus fruit bergamot can lower cholesterol much as red yeast rice does. Is it right for you?

How do you control your cholesterol? Many people take a statin medication such as atorvastatin  or simvastatin to keep their blood fats within normal range. On the other hand, you might prefer a more natural approach. Some readers have wondered whether to try taking a bergamot extract to lower high cholesterol.

Will Citrus Bergamot Help Lower Cholesterol?

Q. My LDL cholesterol is a bit high, but I’d rather not take a statin. I’ve heard that bergamot extract could help. Can you tell me how effective bergamot is for lowering LDL cholesterol and triglycerides?

A. Bergamot is a citrus fruit (Citrus bergamia) popular in Italy. Tea connoisseurs appreciate its flavor in Earl Grey tea. Although it is used in food preparation, the fruit is too sour to eat out of hand.

A systematic review of 14 randomized controlled trials found that bergamot extract lowered total cholesterol, triglycerides and LDL cholesterol (Phytotherapy Research, Dec. 2022). Not all the studies were of high quality, however. Moreover, the effects of products containing bergamot with other ingredients were inconsistent.

Animal experiments demonstrate that bergamot leaf extract lowers cholesterol and inflammation and can counteract metabolic syndrome (International Journal of Food Science and Nutrition, Dec. 15, 2022).  In a different experiment, scientists compared red yeast rice to bergamot extract in rats (Nutrients, Jan. 22, 2022). Both natural products lowered cholesterol, but the citrus extract also reduced triglycerides and raised beneficial HDL cholesterol levels.

Side Effects of Bergamot:

Q. I’d like to know about citrus bergamot to lower cholesterol. It seems to work. Are there side effects?

A. The citrus fruit Citrus bergamia is native to southern Italy. Over the past decade or so, scientists have published numerous studies indicating that polyphenol-rich bergamot extract can lower total and LDL cholesterol levels (Critical Reviews in Food Science and Nutrition, 2020). Some trials also show benefits in lowering triglycerides and raising HDL cholesterol.

Bergamot compounds act on lipids through different pathways than statins (Nutrients, Sep. 10, 2021).  Consequently, this natural product may be an option for people who don’t do well on statins. In a randomized controlled trial, a combination of bergamot and artichoke extract lowered blood lipids significantly better than placebo (Nutrients, Dec. 27, 2021).

There are few reports of side effects, although in one study some volunteers experienced heartburn (Integrative Food, Nutrition and Metabolism, March 2019). Some people have reported muscle cramps and visual problems as a result of drinking Earl Grey tea.

In laboratory research, scientists found that bergamot oil might be phototoxic (Central European Journal of Public Health, Sep. 2016).  That is, tissues exposed to bergamot might be especially susceptible to damage from UV light. You can learn more about lowering blood lipids with and without statins in our eGuide to Cholesterol Control and Heart Health.

Citrus Bergamot Against High Cholesterol:

Q. I have had success taking red yeast rice to lower my cholesterol. However, it’s not quite as effective now as in the beginning. My nutritionist suggested trying citrus bergamot. Is there research to back this up?

A. We were surprised to learn that Citrus bergamia acts on the same enzyme as red yeast rice and statins to lower cholesterol, although the exact mechanism is unclear (Fitoterapia, April 2011). Presumably we ought not to have been surprised: an Israeli study showed that a different citrus fruit, red grapefruit, can improve blood lipids  (Journal of Agricultural and Food Chemistry, March 2006).

Clinical Trials:

Scientists have conducted a handful of studies to determine if C. bergamia or its extract would be effective for treating high cholesterol. One study of 80 individuals found that such an extract (Bergavit R®) lowered cholesterol significantly during the six-month study (Frontiers in Pharmacology, Jan. 6, 2016).  This trial was not placebo-controlled, however. In addition, a very small clinical trial using a blend of bergamot fruit extract and other plant extracts (Cardiox-LDL®) demonstrated drops in cholesterol and LDL cholesterol (Canadian Journal of Physiology and Pharmacology, Dec. 2016). Disappointingly, this study had no placebo arm, either.

Some other studies have not confirmed the lipid-lowering benefits of bergamot. On the other hand, a review found that overall, this unusual fruit contains flavanone compounds that may act as natural statins (Mini Reviews in Medicinal Chemistry, 2016).

Possible Side Effect:

Some people complain that drinking Earl Grey tea can trigger muscle cramps. Since C. bergamia provides the distinctive flavoring for this tea, you should be alert for this complication.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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Citations
  • Sadeghi-Dehsahraei H et al, "The effect of bergamot (KoksalGarry) supplementation on lipid profiles: A systematic review and meta-analysis of randomized controlled trials." Phytotherapy Research, Dec. 2022. DOI: 10.1002/ptr.7647
  • Palacio TLN et al, "Bergamot (Citrus bergamia) leaf extract improves metabolic, antioxidant and anti-inflammatory activity in skeletal muscles in a metabolic syndrome experimental model." International Journal of Food Science and Nutrition, Dec. 15, 2022. DOI: 10.1080/09637486.2022.2154328
  • Mollace R et al, "Comparative effect of bergamot polyphenolic fraction and red yeast rice extract in rats fed a hyperlipidemic diet: Role of antioxidant properties and PCSK9 expression." Nutrients, Jan. 22, 2022. DOI: 10.3390/nu14030477
  • Lamiquez-Moneo I et al, "Effect of bergamot on lipid profile in humans: A systematic review." Critical Reviews in Food Science and Nutrition, 2020. DOI: 10.1080/10408398.2019.1677554
  • Huang Y et al, "Defining the cholesterol lowering mechanism of bergamot ( Citrus bergamia) extract in HepG2 and Caco-2 cells." Nutrients, Sep. 10, 2021. DOI: 10.3390/nu13093156
  • Riva A et al, "Artichoke and bergamot phytosome alliance: A randomized double blind clinical trial in mild hypercholesterolemia." Nutrients, Dec. 27, 2021. DOI: 10.3390/nu14010108
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  • Mollace, V et al, "Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies." Fitoterapia, April 2011. DOI: 10.1016/j.fitote.2010.10.014
  • Gorenstein S et al, "Red grapefruit positively influences serum triglyceride level in patients suffering from coronary atherosclerosis: studies in vitro and in humans." Journal of Agricultural and Food Chemistry, March 2006. DOI: 10.1021/jf058171g
  • Toth PP et al, "Bergamot reduces plasma lipids, atherogenic small dense LDL, and subclinical atherosclerosis in subjects with moderate hypercholesterolemia: A 6 months prospective study." Frontiers in Pharmacology, Jan. 6, 2016. DOI: 10.3389/fphar.2015.00299
  • Babish JG et al, "Synergistic in vitro antioxidant activity and observational clinical trial of F105, a phytochemical formulation including Citrus bergamia, in subjects with moderate cardiometabolic risk factors." Synergistic in vitro antioxidant activity and observational clinical trial of F105, a phytochemical formulation including Citrus bergamia, in subjects with moderate cardiometabolic risk factors. DOI: 10.1139/cjpp-2016-0062
  • Cappello AR et al, "Bergamot (Citrus bergamia Risso) flavonoids and their potential benefits in human hyperlipidemia and atherosclerosis: an overview." Mini Reviews in Medicinal Chemistry, 2016. DOI: 10.2174/1389557515666150709110222
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