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Citrus Bergamot (Citrus bergamia)

Citrus bergamia
Evidence Level
Moderate
3 Clinical Trials
7 Documented Benefits
3/5 Evidence Score

Citrus bergamot (Citrus bergamia) is a sour orange variety grown almost exclusively in the Calabria region of southern Italy, containing a unique profile of polyphenols — particularly brutieridin and melitidin — not found in any other citrus fruit. In laboratory assays these compounds inhibit HMG-CoA reductase and activate AMPK. In human trials bergamot extract has lowered total and LDL cholesterol and triglycerides, but the reported reductions range widely across studies (roughly 8 to 41% for LDL and 12 to 40% for triglycerides); the largest figures come mainly from one Italian research group, and effects vary considerably between trials. The standardized polyphenolic extract (bergamot polyphenolic fraction or BPF) is distinct from bergamot essential oil used for flavoring. The lowering of total and LDL cholesterol is the most consistently reported finding. Effects on triglycerides, HDL, blood glucose and insulin are less consistent and were not statistically significant in the one placebo-controlled randomized trial that measured them. Standardized branded forms available include Bergamonte® (HP Ingredients, ≥38% flavonoids) and Bergamet®. Effects appear within 30 days of consistent use.

Studied Dose 500-1,500 mg/day standardized BPF; lipid: 500 mg twice daily (1,000 mg/day); blood sugar: 500 mg/day. Bergamonte® ~600 mg/day, Bergamet® ~1,000 mg/day.
Active Compound Bergamot polyphenolic fraction (BPF): brutieridin, melitidin, neoeriocitrin, neohesperidin, naringin. Bergamonte® (≥38% flavonoids), Bergamet®.

Benefits

LDL cholesterol reduction

Human trials report LDL cholesterol reductions with standardized bergamot extract ranging from about 8% to 41% across studies, with the largest figures coming mainly from one research group. The lowering of total and LDL cholesterol is the most consistently reproduced finding. Brutieridin and melitidin inhibit HMG-CoA reductase in laboratory assays; how much this contributes in people is not established.

Supported by Trial 1, Trial 2

Triglyceride and VLDL reduction

Bergamot extract has reduced triglycerides in several trials, with reported reductions ranging from about 12% to 40%. The effect is not uniform: in the one placebo-controlled randomized trial that measured triglycerides, the change was not statistically significant versus placebo.

Supported by Trial 1, Trial 2

HDL cholesterol (inconsistent effect)

Some trials report increases in HDL cholesterol with bergamot, but the size is inconsistent: one 6-month study raised HDL by roughly 8%, and the one placebo-controlled randomized trial found no significant HDL change versus placebo. An HDL benefit should not be assumed.

Supported by Trial 1, Trial 2

Blood glucose and insulin resistance (mixed results)

Some trials report reductions in fasting and post-meal glucose with bergamot, but findings are mixed: the one placebo-controlled randomized trial found no significant change in glucose, insulin or insulin resistance versus placebo. AMPK activation is a proposed mechanism from laboratory work, not a demonstrated clinical effect.

Supported by Trial 3, Trial 1

Studied alongside statins

In one small 30-day study (77 patients, about 15 per group), adding bergamot extract to low-dose rosuvastatin lowered LDL cholesterol more than the low statin dose alone. This is early research, not dosing advice. Do not change or reduce a prescribed statin except on the direction of the prescribing doctor.

Supported by Trial 2, Trial 1

Liver fat and liver enzyme markers

In people with type 2 diabetes and fatty liver, a bergamot polyphenol formulation combined with artichoke (Cynara cardunculus) improved liver ultrasound findings and blood markers including ALT and AST versus placebo. The human trial tested a bergamot plus artichoke combination, not bergamot alone, and this is not a treatment for fatty liver disease.

Supported by Trial 3

Distinct from bergamot essential oil

Important consumer education: bergamot essential oil (used in Earl Grey tea flavoring, perfumes) is the photosensitizing aromatic oil from peel — different from the polyphenolic fraction (BPF) used in supplements. BPF does not cause photosensitivity; only the essential oil does.

Supported by Trial 1, Trial 3

Mechanism of action

1

HMG-CoA reductase inhibition (statin-like mechanism)

Brutieridin and melitidin — polyphenols unique to Citrus bergamia — contain a hydroxymethylglutaric acid moiety that inhibits HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis, in laboratory assays. This is a proposed mechanism; bergamot is a food-derived extract, not a statin drug.

2

AMPK activation

BPF activates AMP-activated protein kinase (AMPK) via the LKB1 pathway, stimulating fatty acid oxidation, increasing LDL receptor expression, and reducing hepatic gluconeogenesis. Master metabolic regulator effect.

3

PCSK9 inhibition and LDL receptor upregulation

In laboratory studies, bergamot flavonoids inhibit PCSK9 (proprotein convertase subtilisin/kexin type 9) and increase LDL receptor density on liver cells.

4

Antioxidant activity

BPF flavonoids (neoeriocitrin, naringin, neohesperidin) are potent antioxidants — protect LDL particles from oxidation, reduce inflammatory markers. Complements the cholesterol-lowering effects with vascular protection.

5

Gut microbiome effects (emerging)

Emerging research: BPF polyphenols modulate gut microbiome composition, increase short-chain fatty acid producers — additional metabolic benefit pathway beyond direct enzyme inhibition.

Clinical trials

1
Bergamot Polyphenol Fraction in Hyperlipidemia and Metabolic Syndrome
PubMed

Foundational clinical trial establishing BPF as effective cholesterol agent.

Clinical population described in trial publication.

Foundational clinical trial establishing BPF as effective cholesterol agent. In this early 30-day study of 237 hyperlipidemic patients, higher bergamot doses reduced total and LDL cholesterol and triglycerides and modestly raised HDL and lowered glucose. These are among the largest effect sizes reported for bergamot and come from a single research group; independent trials have generally reported smaller changes.

2
Bergamot + Statin Combination
PubMed

In a small 30-day study, adding bergamot extract to low-dose rosuvastatin lowered LDL cholesterol more than low-dose rosuvastatin alone, with reductions in oxidative stress markers. The exact percentage figures often quoted for this comparison are not reported in the trial.

Clinical population described in trial publication.

In a small 30-day study, adding bergamot extract to low-dose rosuvastatin lowered LDL cholesterol more than low-dose rosuvastatin alone, with reductions in oxidative stress markers. The exact percentage figures often quoted for this comparison are not reported in the trial. This is early research, not a basis for changing a prescribed statin dose.

3
Bergamot Polyphenols for NAFLD — Clinical Trial
PubMed

Bergamot extract significantly reduced hepatic steatosis on ultrasound, decreased ALT and AST, and improved lipid profile and fasting glucose vs placebo.

Clinical population described in trial publication.

In 80 patients with type 2 diabetes and fatty liver, a combination of bergamot polyphenols and artichoke (Cynara cardunculus) improved liver ultrasound findings and blood markers versus placebo. This tested a bergamot plus artichoke combination, not bergamot alone, and does not establish bergamot as a treatment for fatty liver disease.

Side effects and drug interactions

Common Potential side effects

Generally very well tolerated; no myopathy, liver toxicity, or CoQ10 depletion unlike pharmaceutical statins.
Mild GI effects (nausea, heartburn) in small percentage — take with food.
Headache rare.
Photosensitivity — BPF (polyphenolic extract) does not cause photosensitivity; only bergamot essential oil (different product) does.
Bergamot juice/essential oil contains bergapten (a furanocoumarin) — standardized supplemental extracts have reduced bergapten levels; use caution with photosensitizing medications if combining with bergamot juice.

Important Drug interactions

Statins — synergistic; lower statin doses may be possible with BPF combination; consult cardiologist before adjusting prescription. Monitor lipid panel and for muscle side effects.
CYP3A4 substrates — bergamot may inhibit CYP3A4; may increase blood levels of statins, calcium channel blockers, immunosuppressants; separate dosing.
Anticoagulants (warfarin) — CYP2C9 inhibition may increase warfarin levels; monitor INR.
Antidiabetic medications — additive glucose-lowering; monitor blood sugar closely.
Antihypertensives — modest BP reduction; monitor.
CYP-metabolized drugs — bergamot polyphenols may modestly affect CYP enzymes; theoretical interactions.
Furocoumarins in bergamot oil (not BPF) — strong CYP3A4 inhibitors; bergamot essential oil and possibly low-quality BPF products may interact with statins, immunosuppressants, calcium channel blockers, and other CYP3A4 substrates.

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Frequently asked questions about Citrus Bergamot (Citrus bergamia)

What is citrus bergamot used for?

Citrus bergamot is an extract from bergamot oranges, rich in unique flavonoids, used mainly to support healthy cholesterol and triglycerides and overall metabolic and cardiovascular health.

Does citrus bergamot help cholesterol?

Bergamot's flavonoids have research suggesting they may support healthy LDL and triglyceride levels and raise HDL, partly through statin-like effects on cholesterol production. It is popular as a natural cardiovascular-support option.

How much citrus bergamot should I take?

Studies commonly use about 500 to 1,000 mg per day of a standardized bergamot extract (standardized to its flavonoids), often before meals. Follow product labeling and give it several weeks.

Is citrus bergamot safe?

It is generally well tolerated; mild digestive effects can occur. As a citrus extract it may interact with some medications, so check with your doctor if you take statins or other prescriptions. The oral extract differs from bergamot essential oil, which is phototoxic on skin.

What is Citrus Bergamot?

Citrus bergamot (Citrus bergamia) is a sour orange variety grown almost exclusively in the Calabria region of southern Italy, containing a unique profile of polyphenols — particularly brutieridin and melitidin — not found in any other citrus fruit.

What is the recommended dosage of Citrus Bergamot?

The clinically studied dose is 500-1,500 mg/day standardized BPF; lipid: 500 mg twice daily (1,000 mg/day); blood sugar: 500 mg/day. Bergamonte® ~600 mg/day, Bergamet® ~1,000 mg/day. Always follow the product label and check with a healthcare provider for personal advice.

Is Citrus Bergamot safe, and does it have side effects?

For most healthy adults, Citrus Bergamot is well tolerated at studied doses. Reported effects can include: Generally very well tolerated; no myopathy, liver toxicity, or CoQ10 depletion unlike pharmaceutical statins. Mild GI effects (nausea, heartburn) in small percentage — take with food. It may also interact with some medications. Citrus Bergamot is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Citrus Bergamot interact with any medications?

Possible interactions include: Statins — synergistic; lower statin doses may be possible with BPF combination; consult cardiologist before adjusting prescription. Monitor lipid panel and for muscle side effects. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Citrus Bergamot?

NutraSmarts rates the evidence for Citrus Bergamot as Moderate (3 out of 5). It is backed by 3 clinical trials and 6 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(6 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Mollace V, Sacco I, Janda E, Malara C, Ventrice D, Colica C, et al. Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies. Fitoterapia. 2011;82(3):309-16. doi: 10.1016/j.fitote.2010.10.014.PubMedUsed to support: Foundational human study: bergamot polyphenolic fraction reduced total and LDL cholesterol and triglycerides (and lowered glucose) in hyperlipidemic patients. Promising but early-stage, from the group that has driven most bergamot research.
  2. Toth PP, Patti AM, Nikolic D, Giglio RV, Castellino G, Biancucci T, 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. 2016;6:299. doi: 10.3389/fphar.2015.00299.PubMedUsed to support: 6-month study: bergamot extract reduced total cholesterol, LDL, triglycerides and small dense LDL while raising HDL, with reduced carotid intima-media thickness. Supports the lipid-lowering claim; small, non-randomized prospective design limits certainty.
  3. Rondanelli M, Peroni G, Riva A, Petrangolini G, Allegrini P, Faliva MA, 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. doi: 10.1002/ptr.6950.PubMedUsed to support: Randomized, placebo-controlled trial (64 subjects, 12 weeks): bergamot phytosome significantly reduced visceral fat and total and LDL cholesterol versus placebo, but showed no significant between-group change in triglycerides, HDL, glucose, insulin or insulin resistance. The clearest signal is for total and LDL cholesterol and visceral fat; the other metabolic outcomes were not confirmed here. Industry-funded (Indena employees among the authors) and uses a phytosome formulation.
  4. Lamiquiz-Moneo I, Gine-Gonzalez J, Alisente S, Bea AM, Perez-Calahorra S, Marco-Benedi V, et al. Effect of bergamot on lipid profile in humans: A systematic review. Crit Rev Food Sci Nutr. 2020;60(18):3133-3143. doi: 10.1080/10408398.2019.1677554.PubMedUsed to support: Systematic review of 12 studies: 75% showed significant reductions in total cholesterol, LDL and triglycerides with bergamot. Honest caveat: the authors stressed heterogeneous study designs and limited scientific quality, so evidence is promising but not definitive.
  5. Gliozzi M, Walker R, Muscoli S, Vitale C, Gratteri S, Carresi C, Musolino V, Russo V, Janda E, Ragusa S, Aloe A, Palma E, Muscoli C, Romeo F, Mollace V. 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):140-5. doi: 10.1016/j.ijcard.2013.08.125.PubMedUsed to support: Small open-label, placebo-controlled 30-day study in 77 patients with mixed hyperlipidemia (about 15 per group): adding bergamot polyphenolic fraction (1,000 mg/day) to low-dose rosuvastatin (10 mg) lowered LDL cholesterol more than the low statin dose alone and reduced oxidative-stress markers. Early research from the main Italian bergamot group, and not a basis for changing a prescribed statin dose.
  6. Musolino V, Gliozzi M, Bombardelli E, Nucera S, Carresi C, Maiuolo J, Mollace R, Paone S, Bosco F, Scarano F, Scicchitano M, Macrì R, Ruga S, Zito MC, Palma E, Gratteri S, Ragusa M, Volterrani M, Fini M, Mollace V. The synergistic effect of Citrus bergamia and Cynara cardunculus extracts on vascular inflammation and oxidative stress in non-alcoholic fatty liver disease. J Tradit Complement Med. 2020;10(3):268-274. doi: 10.1016/j.jtcme.2020.02.004.PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 80 patients with type 2 diabetes and fatty liver: a combination of bergamot polyphenols and artichoke (Cynara cardunculus), 300 mg/day, improved liver ultrasound and vascular and oxidative-stress markers versus placebo. It tested a bergamot plus artichoke combination rather than bergamot alone, so it does not establish bergamot on its own as a treatment for fatty liver.