Drug & supplement interaction

Berberine + Levothyroxine

Levothyroxine brand names: Euthyrox, Levothroid, Unithroid, Synthroid, Levoxyl, and others.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Berberine and Levothyroxine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Levothyroxine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Berberine and Levothyroxine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Levothyroxine and Berberine in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Berberine safety at a glance

Berberine overall Use caution Generally tolerated short-term but can cause digestive side effects and interacts with many medicines.
Pregnancy Likely Unsafe When used orally. Berberine is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine.... Read the full pregnancy detail
Breastfeeding Likely Unsafe When used orally. Berberine can be transferred to the infant through breast milk. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Levothyroxine and Berberine? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Levothyroxine

Interactions in our licensed database are recorded against drug classes, not just single drug names. Levothyroxine is filed under 3 classifications — including thyroid hormone, oral drugs. Berberine has documented interactions with 15 drug classes — the most serious being cyclosporine (neoral, sandimmune) (major), anticoagulant/antiplatelet drugs (moderate) and antidiabetes drugs (moderate) — and none of Levothyroxine’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Berberine Does Interact With Other Medications

Berberine has 1 major, 1,159 moderate known drug interactions in our database — Levothyroxine isn’t one of them. If you take anything else, check it against the full list below.

Major 1 Moderate 1,159 No known interaction 1,670 (incl. Levothyroxine)
Taking anything else?

Check Another of Your Medications Against Berberine

Covers the 2,830 medications we’ve checked against Berberine. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Berberine and Levothyroxine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Muscle weakness Worth acting on Additional detail

    Berberine

    “Reports of mild muscle pain and muscle weakness have been reported following the use of a combination product containing berberine, policosanol, red yeast rice, folic acid, coenzyme Q10, and astaxanthin. It is unclear if these effects are due to berberine or other constituents.”

    Berberine · Natural Medicines adverse-effect record, reported in pain.

    1 source cited
    1. 34283. Marazzi, G., Cacciotti, L., Pelliccia, F., Iaia, L., Volterrani, M., Caminiti, G., Sposato, B., Massaro, R., Grieco, F., and Rosano, G. Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Heart failure Worth acting on Additional detail

    Berberine

    “In four of 12 patients with refractory congestive heart failure, intravenous infusion of berberine at a rate of 0.2 mg/kg per minute caused ventricular tachycardia consistent with torsades de pointes.”

    Berberine · Natural Medicines adverse-effect record, reported in congestive heart failure (chf).

    1 source cited
    1. 33642. Marin-Neto, J. A., Maciel, B. C., Secches, A. L., and Gallo, Junior L. Cardiovascular effects of berberine in patients with severe congestive heart failure. Clin.Cardiol. 1988;11(4):253-260. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Flushing Additional detail

    Berberine

    “When administered intravenously, berberine can cause painful swelling at the injection site or facial flushing. In three of 12 people injected subcutaneously with berberine, permanent hyperpigmentation at the injection site occurred.

    Orally, berberine may cause rash, but this event appears to be rare.”

    Berberine · Natural Medicines adverse-effect record, reported in niacin-induced flushing.

    4 sources cited
    1. 34330. Saksena HC, Tomar VN, and Soangra MR. Efficacy of a new salt of Berberine Uni-Berberine in oriental sore. Current Medical Practice 1970;14:247-252.
    2. 33698. Seery TM and Bieter RN. A contribution to the pharmacology of berberine. J Pharmacol Exp Ther 1940;69:64-67. DOI
    3. 34285. Meng, S., Wang, L. S., Huang, Z. Q., Zhou, Q., Sun, Y. G., Cao, J. T., Li, Y. G., and Wang, C. Q. Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention. Clin Exp.Pharmacol Physiol 2012;39 PubMed
    4. 110106. Zhang J, Wang Y, Jiang H, et al. Preventive effect of berberine on postoperative atrial fibrillation. Circ Arrhythm Electrophysiol 2022;15(10):e011160. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • A fast or pounding heartbeat Additional detail

    Berberine

    Recorded for Berberine in the same Natural Medicines adverse-effect record shown under Flushing above.

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Stomach pain / Diarrhea / Vomiting Additional detail

    Berberine

    “Orally, berberine may cause diarrhea, constipation, flatulence, nausea, vomiting, abdominal pain, abdominal distention, gastroesophageal reflux, and bitter taste.”

    Berberine · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 33648. Choudhry, V. P., Sabir, M., and Bhide, V. N. Berberine in giardiasis. Indian Pediatr. 1972;9(3):143-146.
    2. 33689. Sharda DC. Berberine in the treatment of diarrhoea of infancy and childhood. J Indian M A 1970;54(1):22-24.
    3. 34245. Zhang, Y., Li, X., Zou, D., Liu, W., Yang, J., Zhu, N., Huo, L., Wang, M., Hong, J., Wu, P., Ren, G., and Ning, G. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol.Metab 2008;93(7):2559-2565. PubMed
    4. 34247. Yin, J., Xing, H., and Ye, J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008;57(5):712-717. PubMed
    5. 34285. Meng, S., Wang, L. S., Huang, Z. Q., Zhou, Q., Sun, Y. G., Cao, J. T., Li, Y. G., and Wang, C. Q. Berberine ameliorates inflammation in patients with acute coronary syndrome following percutaneous coronary intervention. Clin Exp.Pharmacol Physiol 2012;39 PubMed
    6. 91953. Dong H, Zhao Y, Zhao L, Lu F. The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials. Planta Med 2013;79(6):437-46. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Tiredness / Headache Additional detail

    Berberine

    “Orally, berberine may cause dizziness, drowsiness, fatigue, and headache.”

    Berberine · Natural Medicines adverse-effect record, reported in cluster headache.

    3 sources cited
    1. 33648. Choudhry, V. P., Sabir, M., and Bhide, V. N. Berberine in giardiasis. Indian Pediatr. 1972;9(3):143-146.
    2. 99921. Ju J, Li J, Lin Q, Xu H. Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials. Phytomedicine. 2018;50:25-34. PubMed
    3. 113462. Nie Q, Li M, Huang C, et al. The clinical efficacy and safety of berberine in the treatment of non-alcoholic fatty liver disease: a meta-analysis and systematic review. J Transl Med 2024;22(1):225. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • A skin rash Additional detail

    Berberine

    Recorded for Berberine in the same Natural Medicines adverse-effect record shown under Flushing above.

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

Showing the 10 most notable of 11 shared effects — ranked by how unusual each one is, not just whether both lists mention it.

Reported for Berberine but not commonly for Levothyroxine: heartburn, an irregular heartbeat, constipation and a change in taste.

Effects for Levothyroxine come from the ADVERSE REACTIONS section of its FDA label; effects for Berberine come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Berberine in Pregnancy & Breastfeeding

Pregnancy Likely Unsafe

When used orally. Berberine is thought to cross the placenta and may cause harm to the fetus. Kernicterus has developed in newborn infants exposed to berberine. Also, berberine may stimulate uterine contractions.

Lactation Likely Unsafe

When used orally. Berberine can be transferred to the infant through breast milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Levothyroxine Products Have a Food Rule — Berberine Should Not Break It

At least one FDA label for a product containing Levothyroxine says to take it on an empty stomach. Most supplements — Berberine included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Levothyroxine on its own and move Berberine to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Levothyroxine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Berberine or Levothyroxine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Berberine or Levothyroxine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Levothyroxine

This page covers Berberine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levothyroxine page lists 50 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Tiratricol (major), Acetyl-l-carnitine (moderate), Alpha-lipoic Acid (moderate) and Ascophyllum Nodosum (moderate).

By severity: 2 major · 39 moderate · 9 minor.

From our pharmacist’s overview on the Levothyroxine page

“Levothyroxine replaces a hormone your body measures in tiny amounts, so small shifts in its blood level show up in how you feel, and I treat this list with genuine care. Nearly everything on it does one of two things: blocks the pill from being absorbed in the gut, the way everyday minerals like calcium do by binding it into complexes,…”

Reviewed by 2 · Jul 18, 2026

Open the Levothyroxine interaction page

One more smart check

Taking Berberine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 908 real supplement products containing Berberine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Berberine. Even though Berberine itself has no known interaction with Levothyroxine, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Berberine and Levothyroxine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Berberine
Top 10%

#115 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Levothyroxine
Top 10

#2 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Berberine reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Berberine and Levothyroxine records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Berberine

What is Berberine?

Berberine
  • Blood sugar control
  • High cholesterol
  • Heart and metabolic health
  • Digestive upset
  • Antimicrobial support
  • Weight management

Berberine is a yellow plant compound that has shown promise for lowering blood sugar and cholesterol in some studies, but the quality of research varies and it is not a replacement for prescribed medicine. It can cause stomach upset and should be avoided during pregnancy and breastfeeding. Always check with your pharmacist or doctor before starting it, especially if you take other medications.

Roots, bark, and stems of berberine-containing plants (such as goldenseal, barberry, goldthread, and Oregon grape) · Capsules, tablets, powders, and tinctures

An interaction check asks whether these two react with each other — it does not ask whether Berberine is a good idea for someone in your situation. Here is what our Berberine record says about it on its own.

Berberine: dosing

There is no official, standardized dose of berberine, and the right amount can depend on the product and the reason it is being used. They can help you decide whether berberine is appropriate for you and review it against your other medicines and health conditions.

From our Berberine monograph — the full record covers uses, side effects and every documented interaction.

Read the full Berberine monograph & all interactions
Medication

About Levothyroxine

What Is Levothyroxine Used For?

Brand names: Euthyrox, Levothroid, Unithroid, Synthroid, Levoxyl, Levo-T, Eltroxin, Estre, Levothyroxine, Novothyrox, Levolet

Levothyroxine replaces or supplements the thyroid hormone your body isn't making enough of. It's used for hypothyroidism — an underactive thyroid — in adults, children, and even newborns, whether the cause is the thyroid gland itself, the pituitary gland, or the hypothalamus in the brain.

It's also used alongside surgery and radioiodine treatment in people with certain types of thyroid cancer, to help suppress the hormone that can stimulate cancer growth. It is not meant for weight loss, treating benign thyroid nodules in people who have enough iodine, or for hypothyroidism during recovery from a temporary condition called subacute thyroiditis.

See full Levothyroxine drug information
Keep checking

Other Drugs & Berberine

Browse every other medication we’ve checked against Berberine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

1Major
1,159Moderate
0Minor
1,669No known interaction
1 Major 1,159 Moderate 1,669 No interaction
Major

1 interaction

Moderate

1,159 interactions

Showing 60 of 1,159 moderate interactions — see all 1,159 on the Berberine page.

No interaction 1,669 drugs checked — show the list

We also checked Berberine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,669 medications checked with no known interaction — see the full Berberine list.

See the full Berberine interactions page
See every supplement checked against Levothyroxine, ranked by severity
Evidence & sources

Berberine References

The 41 references that drive our Berberine monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonate 1993;63:201-8. PubMed
  2. Janbaz KH, Gilani AH. Studies on preventive and curative effects of berberine on chemical-induced hepatotoxicity in rodents. Fitoterapia 2000;71:25-33.. PubMed
  3. Wu X, Li Q, Xin H, Yu A, Zhong M. Effects of berberine on the blood concentration of cyclosporin A in renal transplanted recipients: clinical and pharmacokinetic study. Eur J Clin Pharmacol 2005;61:567-72. PubMed
  4. Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008;93:2559-65. PubMed
  5. Huang XS, Yang GF, Pan YC. Effect of berberin hydrochloride on blood concentration of cyclosporine A in cardiac transplanted patients. Zhongguo Zhong Xi Yi Jie He Za Zhi 2008;28:702-4.
  6. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 2000;7:273-82. PubMed
  7. Chatterjee P, Franklin MR. Human cytochrome p450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components. Drug Metab Dispos 2003;31:1391-7. PubMed
  8. Marin-Neto, J. A., Maciel, B. C., Secches, A. L., and Gallo, Junior L. Cardiovascular effects of berberine in patients with severe congestive heart failure. Clin.Cardiol. 1988;11(4):253-260. PubMed
  9. Choudhry, V. P., Sabir, M., and Bhide, V. N. Berberine in giardiasis. Indian Pediatr. 1972;9(3):143-146.
  10. Shanbhag, S. M., Kulkarni, H. J., and Gaitonde, B. B. Pharmacological actions of berberine on the central nervous system. Jpn.J Pharmacol 1970;20(4):482-487. PubMed
  11. Wu, J. F. and Liu, T. P. [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6-keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion]. Yao Xue.Xue.Bao. 1995;30(2):98-102.
  12. Peng, W. H., Hsieh, M. T., and Wu, C. R. Effect of long-term administration of berberine on scopolamine-induced amnesia in rats. Jpn J Pharmacol 1997;74(3):261-266. DOI
  13. Sharda DC. Berberine in the treatment of diarrhoea of infancy and childhood. J Indian M A 1970;54(1):22-24.
  14. Sabir M and Bhide NK. Study of some pharmacological actions of berberine. Ind J Physiol & Pharmac 1971;15(3):111-132.
  15. Tripathi YB and Shukla SD. Berberis artistata inhibits PAF induced aggregation of rabbit platelets. Phytotherapy Research 1996;10:628-630.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Berberine and Levothyroxine Together: Common Questions

Is it safe to take Berberine with Levothyroxine?
We do not list a known interaction between Berberine and Levothyroxine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Berberine and Levothyroxine have any of the same side effects?
Yes — our sources link each of them separately to 10 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Berberine and Levothyroxine at the same time of day?
At least one FDA label for a product containing Levothyroxine says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Levothyroxine on its own and move Berberine to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
How was the Berberine and Levothyroxine combination checked?
Interactions in our licensed database are recorded against drug classes. Levothyroxine is filed under 3 classifications, and Berberine has documented interactions with 15 drug classes — none of Levothyroxine's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Berberine interact with any other medications?
Yes. Berberine has 1,160 documented drug interactions in our database — Levothyroxine is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Levothyroxine interact with any supplements?
Yes. Levothyroxine has documented interactions with 50 supplements in our database — Berberine is not one of them. The Levothyroxine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Berberine monograph Uses, safety profile, and every drug interaction in one place Levothyroxine drug information The full plain-English guide to this medication Levothyroxine supplement interactions Every supplement checked against Levothyroxine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 41 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Levothyroxine and Berberine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.