Supplements

Citrus Bergamot

Updated · 25 sources

Citrus bergamot is a dietary supplement made from the juice and peel of the bergamot orange (Citrus bergamia), a citrus fruit grown mainly in Calabria, southern Italy. Its flavonoid-rich extracts, often sold as “bergamot polyphenol fraction” (BPF), are marketed to lower cholesterol and triglycerides. Small trials and meta-analyses report sizable drops in LDL cholesterol, but most of the studies are small, short, at high risk of bias and often run by the same research groups or ingredient makers, and none has tested bergamot in people using anabolic steroids.

People who use testosterone or other anabolic-androgenic steroids (AAS) often look at bergamot because these drugs can sharply lower HDL (“good”) cholesterol and raise LDL. Whether bergamot changes that picture has never been studied. No trial has measured heart attacks, strokes or deaths with bergamot in any population.

This page summarizes what the trials, meta-analyses and laboratory studies report. It is for education only and is not medical advice.

Property Detail
Source Juice and peel of Citrus bergamia (bergamot orange), a citrus hybrid native to Calabria, Italy
Main compounds Flavanone glycosides naringin, neohesperidin and neoeriocitrin; the HMG-flavanones brutieridin and melitidin
Common product names Bergamot polyphenol fraction (BPF), BPF phytosome (lecithin-bound), Bergavit R, Brumex; often combined with artichoke, plant sterols or other ingredients
Route Oral capsules or tablets; bergamot juice and drinks
Doses studied in trials 150 mg/day of flavonoids for 6 months; 1,000 mg/day of BPF for 30 days; 500 mg of bergamot phytosome given as two daily tablets for 12 weeks
Half-life Not established. Lecithin formulation raised absorption of naringin at least 2.5-fold in one trial
Best-supported effect Lower total cholesterol, LDL and triglycerides in small trials; low- to very-low-certainty evidence
Outcome data None. No trial has tested heart attacks, strokes or deaths
US status Sold as a dietary supplement; not an FDA-approved drug
WADA status Not named on the 2026 Prohibited List

What it is

The bergamot orange is best known for its essential oil, which is used in perfume, cosmetics, foods and Earl Grey tea. Clinical research on the essential oil has focused on aromatherapy for anxiety and stress (Navarra et al., Front Pharmacol 2015). Cholesterol supplements are a different product: they are extracts of the juice and the pith and peel left over after juicing, concentrated for flavonoids.

The “statin-like” flavonoids

Bergamot contains flavanones bound to a 3-hydroxy-3-methylglutaryl (HMG) group. That group is also part of the molecule HMG-CoA, the substrate of HMG-CoA reductase, the enzyme that statins block. In 2009, chemists isolated two such compounds from bergamot fruit and named them brutieridin and melitidin (Di Donna et al., J Nat Prod 2009). The structural resemblance is why bergamot is often described as a “natural statin.”

The lab evidence for that label is mixed:

  • In rats fed a high-fat diet, an early study from the main bergamot research group reported that BPF inhibited HMG-CoA reductase activity (Mollace et al., Fitoterapia 2011).
  • A later cell study tested bergamot fruit extract and its five main flavonoids directly. None of them directly inhibited HMG-CoA reductase. The extract and neohesperidin instead lowered the amount of the enzyme in liver cells, activated AMP-kinase (an energy-sensing enzyme), and brutieridin reduced cholesterol uptake in gut cells by lowering the transporter NPC1L1, the same transporter targeted by ezetimibe. The authors concluded that bergamot’s action “is distinct from statins” (Huang et al., Nutrients 2021).

These are cell and animal findings. How much of each compound reaches the bloodstream in people is not well defined. In a 2024 trial of a bergamot-based drink, the HMG-containing flavanones and their HMG-containing breakdown products could not be detected in participants’ urine (Maggiolo et al., Food Funct 2024).

Absorption

Polyphenols are poorly absorbed from the gut. To improve this, some products bind the extract to lecithin (a “phytosome”). In a randomized trial in 60 people with type 2 diabetes and mixed hyperlipidemia, standard BPF and BPF phytosome produced similar lipid and glucose changes, but absorption of naringin, the main BPF component, was at least 2.5-fold higher with the phytosome (Mollace et al., Endocr Metab Immune Disord Drug Targets 2019). No formal half-life has been published for bergamot flavonoids in humans.

Regulatory status

In the US, bergamot extracts are sold as dietary supplements. The FDA does not review supplements for effectiveness before sale, and products are not standardized to a common recipe. A 2024 review of cholesterol supplements noted lingering concerns about the lack of supervision and quality control for these products (von Känel-Cordoba et al., J Health Popul Nutr 2024).

An international expert panel listed bergamot among nutraceuticals that “might be considered” for people who cannot tolerate statins, while stating that evidence on long-term safety and on preventing cardiovascular disease is still insufficient (Banach et al., J Am Coll Cardiol 2018).

What the research shows

Individual trials

Most bergamot trials are small, short and used different products. Representative studies:

Study Design and participants Product and dose Main lipid findings
Mollace et al., Fitoterapia 2011 237 patients with high blood lipids, with or without high blood sugar; 30 days BPF Total and LDL cholesterol, triglycerides and glucose fell; HDL rose
Gliozzi et al., Int J Cardiol 2013 Open-label, 77 patients with high LDL and triglycerides; 30 days BPF 1,000 mg/day, alone or with rosuvastatin 10 mg BPF alone lowered total and LDL cholesterol vs control; adding BPF to rosuvastatin 10 mg improved lipids more than the statin alone
Toth et al., Front Pharmacol 2015 80 adults with LDL 160–190 mg/dL; 6 months; all took the extract (no placebo group described) Bergavit R, 150 mg flavonoids/day LDL 4.6 → 3.7 mmol/L (≈178 → 143 mg/dL); triglycerides 1.8 → 1.5 mmol/L; HDL 1.3 → 1.4 mmol/L; fewer small, dense LDL particles
Mollace et al., 2019 Double-blind RCT, 60 patients with type 2 diabetes and mixed hyperlipidemia Standard BPF or BPF phytosome vs placebo LDL, triglycerides and glucose fell; HDL rose; fewer small, dense LDL particles
Rondanelli et al., Phytother Res 2021 RCT, 64 adults with overweight and mild high cholesterol; 12 weeks Bergamot phytosome 500 mg, two tablets daily Total and LDL cholesterol and visceral fat fell vs placebo; HDL and triglycerides did not change significantly
Maggiolo et al., Food Funct 2024 RCT, 45 healthy adults; 12 weeks 400 mL/day of a drink containing up to 25% bergamot juice No difference from control in lipids, glucose or inflammation markers

Several other trials tested combination products, for example bergamot flavonoids (120 mg) combined with plant sterols, vitamin C and artichoke extract (Cicero et al., Phytother Res 2019), or two standardized bergamot extracts that lowered LDL by 17.7% vs baseline after 12 weeks at the higher dose (Fogacci et al., Arch Med Sci 2023). In combination products, the effect of bergamot cannot be separated from the other ingredients.

Meta-analyses

Review Studies included Pooled findings Quality notes
Lamiquiz-Moneo et al., Crit Rev Food Sci Nutr 2020 (systematic review, no pooling) 12 studies 75% of studies showed lower total cholesterol, triglycerides and LDL. Reductions ranged from 12.3–31.3% (total cholesterol), 7.6–40.8% (LDL) and 11.5–39.5% (triglycerides); 8 trials reported higher HDL “Heterogeneous designs and scientific quality of studies was quite limited”
Sadeghi-Dehsahraei et al., Phytother Res 2022 14 trials Total cholesterol −63.6 mg/dL; triglycerides −74.7 mg/dL; LDL −55.4 mg/dL; HDL +5.8 mg/dL Results for combination products were inconsistent; higher-quality studies needed
Osadnik et al., Pharmacol Res 2022 (network meta-analysis of 10 nutraceuticals) 131 trials, 13,062 participants overall Bergamot ranked first for LDL lowering (−1.21 mmol/L, ≈ −46.8 mg/dL), ahead of red yeast rice Bergamot evidence was based on a relatively small study group
Chambari et al., Food Sci Nutr 2026 9 RCTs, 615 participants LDL −39.5 mg/dL; total cholesterol −44.7 mg/dL; triglycerides −52.5 mg/dL; HDL +5.6 mg/dL; systolic blood pressure −2.1 mmHg; glucose −12.1 mg/dL Six of nine trials rated poor quality; certainty “low to very low” for all outcomes; authors warn the results do not establish clinical efficacy
Pujia et al., Obes Rev 2026 11 RCTs Small reductions in body weight, BMI and waist; no effect on other body composition measures Very high heterogeneity (I² = 90% for weight and BMI)

Pooled LDL drops of 40–55 mg/dL would rival a moderate-dose statin. Effects that large, from small and mostly unblinded or poorly reported trials, should be read with caution. The most recent and most critical meta-analysis rated every outcome as low or very low certainty.

What has not been studied

  • Cardiovascular events. No trial has tested whether bergamot prevents heart attacks, strokes or deaths. The lipid changes are surrogate markers.
  • Long-term use. Trials ran from 30 days to 6 months.
  • Head-to-head comparisons with statins at doses used in clinical practice. The one statin trial combined BPF with rosuvastatin 10 mg and was open-label (Gliozzi et al., 2013).
  • Athletes. A 2025 pilot study in 90 male cyclists tested BPF alone and with L-citrulline. The combination improved blood flow and VO2 max measures, but the authors called it a pilot needing confirmation (Mollace et al., Nutrients 2025). It did not measure lipids in steroid users.

Fatty liver

In a double-blind trial of 102 people with fatty liver, a combination of BPF and wild cardoon extract (300 mg/day for 12 weeks) reduced liver fat more than placebo. After adjusting for weight change, the benefit held only in participants over 50 (Ferro et al., Front Endocrinol 2020). The product contained two ingredients, so the effect of bergamot alone is unknown.

Quality and consistency problems

Several issues make the bergamot literature harder to trust than the headline numbers suggest:

  1. Many different products. Trials used BPF, BPF phytosome, Bergavit R, Brumex (standardized to 40% flavonoids and at least 5% HMG-flavanones) and others, at doses from 150 mg of flavonoids to 1,000 mg of extract (Fogacci et al., Arch Med Sci 2023). Results from one extract do not transfer to another.
  2. Concentrated authorship and industry links. A large share of trials come from a few Italian research groups. In both phytosome trials, several coauthors worked in the research and development department of Indena SpA, an Italian ingredient company (Mollace et al., 2019; Rondanelli et al., 2021).
  3. High risk of bias. The 2026 meta-analysis rated six of nine randomized trials as poor quality (Chambari et al., 2026).
  4. Null results with juice-based products. A 12-week trial of a bergamot juice drink found no lipid effect, and the HMG-flavanones were not detected in urine (Maggiolo et al., 2024).
  5. No independent label testing data. We found no published, independent analysis of how much flavonoid commercial bergamot supplements actually contain compared with their labels. Buyers cannot assume a product matches what was tested in a trial.

Relevance to anabolic steroid use

AAS cause some of the largest lipid changes seen outside genetic disorders:

  • In 19 strength athletes self-administering several AAS for 8 or 14 weeks, HDL fell from 1.08 to 0.43 mmol/L (≈42 to 17 mg/dL), apolipoprotein A1 halved and apolipoprotein B rose from 0.96 to 1.32 g/L. Six weeks after stopping, levels had still not returned to baseline (Hartgens et al., Br J Sports Med 2004).
  • In a prospective cohort of 100 men doing an AAS cycle, LDL rose by 0.45 mmol/L (≈17 mg/dL) and HDL fell by 0.40 mmol/L (≈15 mg/dL). Values returned to baseline 3 months after the cycle (Smit et al., Andrologia 2022).

Against that background, the pooled HDL increase with bergamot in dyslipidemic adults was about 5.6 mg/dL (Chambari et al., 2026), and the phytosome trial found no HDL change. No study has tested bergamot in people using AAS, so whether it blunts steroid-induced HDL suppression or LDL increase is unknown. The cause of the HDL drop during AAS use differs from ordinary dyslipidemia, so results from the general population may not apply.

Raising HDL by itself has also failed to prevent heart disease in drug trials (see niacin). LDL and apolipoprotein B remain the better-established targets. Drugs with outcome data for lowering them include atorvastatin, rosuvastatin, ezetimibe and evolocumab. The atorvastatin page covers AAS lipid data in more detail.

Side effects and risks

Tolerability in trials

Trials lasting 30 days to 12 weeks have consistently reported bergamot as well tolerated (Nauman and Johnson, Integr Food Nutr Metab 2019). The juice-drink trial recorded no adverse events (Maggiolo et al., 2024). These trials were small and short, so rare or long-term harms would not be detected.

Interactions and cautions

  • Statins. Bergamot has been studied with rosuvastatin in one open-label trial (Gliozzi et al., 2013). Formal drug interaction studies have not been published.
  • Combination products. Many bergamot supplements also contain red yeast rice, berberine or other active ingredients, each with its own side effects and interactions. Red yeast rice contains monacolin K, which is chemically identical to lovastatin.
  • Essential oil is a different product. Bergamot essential oil is made for fragrance and aromatherapy and is not the extract used in cholesterol trials (Navarra et al., 2015).
  • Pregnancy and breastfeeding. No safety data.

Bergamot extracts are legal dietary supplements in the US and are not named on the WADA 2026 Prohibited List. As with any supplement, contamination with prohibited substances is possible, and athletes are responsible for what they take.

Key takeaways

  • A citrus flavonoid supplement. Bergamot extracts contain naringin, neohesperidin, neoeriocitrin and the HMG-flavanones brutieridin and melitidin.
  • “Natural statin” is an overstatement. A cell study found no direct HMG-CoA reductase inhibition; proposed effects include lower enzyme levels and less cholesterol absorption.
  • Lipid results look large but are low quality. Meta-analyses report LDL drops of roughly 40–55 mg/dL, but most trials are small, short, inconsistent and at high risk of bias; one juice trial was null.
  • No outcome data. No trial has shown fewer heart attacks, strokes or deaths.
  • Untested in steroid users. AAS can cut HDL by more than half; bergamot’s pooled HDL effect is about +5.6 mg/dL in other populations, and no study has tested it during AAS use.
  • Product quality varies. Trials used different branded extracts, and there is no independent data on how closely commercial products match their labels.

Sources

  1. Di Donna L, De Luca G, Mazzotti F, et al. Statin-like principles of bergamot fruit (Citrus bergamia): isolation of 3-hydroxymethylglutaryl flavonoid glycosides. J Nat Prod. 2009;72(7):1352–1354. PubMed.
  2. Huang Y, Tocmo R, Nauman MC, et al. Defining the cholesterol lowering mechanism of bergamot (Citrus bergamia) extract in HepG2 and Caco-2 cells. Nutrients. 2021;13(9):3156. PubMed.
  3. Mollace V, Sacco I, Janda E, et al. Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies. Fitoterapia. 2011;82(3):309–316. PubMed.
  4. Mollace V, Scicchitano M, Paone S, et al. Hypoglycemic and hypolipemic effects of a new lecithin formulation of bergamot polyphenolic fraction: a double blind, randomized, placebo-controlled study. Endocr Metab Immune Disord Drug Targets. 2019;19(2):136–143. PubMed.
  5. Gliozzi M, Walker R, Muscoli S, et al. Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia. Int J Cardiol. 2013;170(2):140–145. PubMed.
  6. Toth PP, Patti AM, Nikolic D, et al. Bergamot reduces plasma lipids, atherogenic small dense LDL, and subclinical atherosclerosis in subjects with moderate hypercholesterolemia: a 6 months prospective study. Front Pharmacol. 2015;6:299. PubMed.
  7. Rondanelli M, Peroni G, Riva A, et al. Bergamot phytosome improved visceral fat and plasma lipid profiles in overweight and obese class I subject with mild hypercholesterolemia: a randomized placebo controlled trial. Phytother Res. 2021;35(4):2045–2056. PubMed.
  8. Maggiolo G, Aldigeri R, Savini C, et al. Chronic consumption of a bergamot-based beverage does not affect glucose, lipid and inflammatory biomarkers of cardiometabolic risk in healthy subjects: a randomised controlled intervention study. Food Funct. 2024;15(11):5842–5854. PubMed.
  9. Cicero AFG, Fogacci F, Bove M, et al. Three-arm, placebo-controlled, randomized clinical trial evaluating the metabolic effect of a combined nutraceutical containing a bergamot standardized flavonoid extract in dyslipidemic overweight subjects. Phytother Res. 2019;33(8):2094–2101. PubMed.
  10. Fogacci F, Giovannini M, Imbalzano E, et al. Metabolic and vascular effect of a new standardized bergamot phytocomplex: a three-arm, placebo-controlled, double-blind clinical trial. Arch Med Sci. 2023;19(5):1228–1235. PubMed.
  11. Fogacci F, Di Micoli V, Veronesi M, et al. Comparative effect of a nutraceutical compound based on a flavonoid complex from bergamot on plasma lipids, glucose metabolism, and liver enzymes: a 3-arm, double-blind, placebo-controlled, randomized clinical trial. Arch Med Sci. 2023;19(5):1180–1185. PubMed.
  12. Lamiquiz-Moneo I, Giné-González J, Alisente S, et al. Effect of bergamot on lipid profile in humans: a systematic review. Crit Rev Food Sci Nutr. 2020;60(18):3133–3143. PubMed.
  13. Sadeghi-Dehsahraei H, Esmaeili Gouvarchin Ghaleh H, Mirnejad R, et al. The effect of bergamot (KoksalGarry) supplementation on lipid profiles: a systematic review and meta-analysis of randomized controlled trials. Phytother Res. 2022;36(12):4409–4424. PubMed.
  14. Osadnik T, Goławski M, Lewandowski P, et al. A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults. Pharmacol Res. 2022;183:106402. PubMed.
  15. Chambari M, Mardani H, Roshandel M, et al. Bergamot (Citrus bergamia) supplementation and cardiovascular disease risk factors: a systematic review and meta-analysis. Food Sci Nutr. 2026;14(9):e72357. PubMed.
  16. Pujia C, Ferro Y, Castagna A, et al. Effect of Citrus bergamia supplementation on body composition in humans: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2026;27(7):e70094. PubMed.
  17. Ferro Y, Montalcini T, Mazza E, et al. Randomized clinical trial: bergamot citrus and wild cardoon reduce liver steatosis and body weight in non-diabetic individuals aged over 50 years. Front Endocrinol (Lausanne). 2020;11:494. PubMed.
  18. Mollace R, Macrì R, Serra M, et al. The antioxidant power of bergamot polyphenolic fraction gold potentiates the effects of L-citrulline in athlete performance and vasodilation in a pilot study. Nutrients. 2025;17(7):1106. PubMed.
  19. Banach M, Patti AM, Giglio RV, et al. The role of nutraceuticals in statin intolerant patients. J Am Coll Cardiol. 2018;72(1):96–118. PubMed.
  20. von Känel-Cordoba I, Wirnitzer K, Weiss K, et al. Efficacy, side effects, adherence, affordability, and procurement of dietary supplements for treating hypercholesterolemia: a narrative review. J Health Popul Nutr. 2024;43(1):189. PubMed.
  21. Nauman MC, Johnson JJ. Clinical application of bergamot (Citrus bergamia) for reducing high cholesterol and cardiovascular disease markers. Integr Food Nutr Metab. 2019;6(2). PubMed.
  22. Navarra M, Mannucci C, Delbò M, et al. Citrus bergamia essential oil: from basic research to clinical application. Front Pharmacol. 2015;6:36. PubMed.
  23. Hartgens F, Rietjens G, Keizer HA, et al. Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein (a). Br J Sports Med. 2004;38(3):253–259. PubMed.
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  25. World Anti-Doping Agency. The 2026 Prohibited List (in effect January 1, 2026). 2025. WADA.