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Bergamot is a citrus fruit native to southern Italy. Traditional medicine found it to improve immune response and cardiovascular function. Clinical trials¹ have shown that orally administered bergamot has been found to reduce both the total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the bloodstream.
Bergamot extract has been used in several studies² to determine if the benefits noticed in traditional medicine can be replicated in clinical trials.
Statins are often prescribed when cholesterol levels are too high in people with cardiovascular disease. Statins are a commonly-prescribed medication designed to lower blood cholesterol levels and help avoid forming plaques (atherosclerosis).
This all combines with the aim of reducing the risk of a cardiovascular event such as a heart attack.
Statins work by inhibiting a key part of the formation of cholesterol in the liver. Although statins are excellent at lowering cholesterol, they can also have several side effects, which is important to bear in mind.
These unpleasant side effects can include muscle aches or spasms and liver complications. Side effects make it less likely that the person will actually take their medication and can also lower the efficacy of the treatment.
Bergamot has the potential to work alongside statins as a prescribed treatment after (or in people at risk of) cardiovascular events. Statins competitively inhibit hydroxymethylglutaryl (HMG) CoA reductase, the rate-limiting step in cholesterol biosynthesis, thereby increasing low-density lipoprotein (LDL) receptor turnover that results from an enhanced rate of hepatic LDL receptor cycling.
A critical enzyme, HMG CoA reductase, has to function along the pathway to form cholesterol.
The enzyme has one specific site where it can interact with the coenzyme, but this site is also able to interact with statins. So, when a statin occupies the site, the coenzyme isn’t able to do its job—the statin blocks the access of this substrate to the active site on the enzyme.
Additionally, it’s been suggested that the bergamot’s mechanism is much more complex. For example, a study using two different cell lines demonstrated that it’s also involved in cholesterol biosynthesis in the HepG2 cells and cholesterol cellular transport in Caco-2 cells. Therefore, it can lower cholesterol by interacting with these pathways too.
These compounds belong to a group of chemicals known as flavonoids. Some flavonoids, such as neoeriocitrin, nargingin, neohesperidin, melitidin, and brutierdin, are much more present in bergamot than in normal citrus fruit.
Bergamot extract has already been used in some clinical trials. In a review³ of 31 studies (including 20 human studies), bergamot extract was successfully used orally to help people lose weight and regulate their cholesterol levels.
This helps people lower their risk of cardiovascular disease and has other health and psychological benefits.
Current medications, such as statins, do have side effects. Some of those side effects are severe, meaning statins may not be appropriate for all people with high cholesterol levels.
The fact that bergamot has been shown to be effective may mean that it could be appropriate for people who cannot have statins or help to lower their dose of the statins to a more tolerable level.
Although there are no immediate health risks to bergamot extract, the supplement should not be used in the absence of statins or medicine provided by your doctor. If the supplement becomes proven to work more effectively with fewer side effects than current medicine, it will be adopted by the healthcare industry.
Although bergamot isn't currently prescribed, that doesn't mean it doesn't work. It simply hasn't been shown to be more effective or produce fewer side effects. The clinical trials described above are the first step for bergamot to be adopted by the pharmaceutical industry. Furthermore, the available studies are of low quality, and high-quality data on the effects of bergamot are lacking. Thus, further studies are needed.
It has yet to be fully studied, so all possible side effects are yet to be determined. You must always consult a doctor before starting a new supplement or going off your current medication.
Bergamot oil has substances that can increase sensitivity to the sun and thus cause phototoxic reactions.
Bergamot may not be the only food with a high flavonoid level. Foods that can have medical benefits are known as nutraceuticals.⁴
Some possible nutraceuticals for cholesterol include red yeast rice, soluble fibers, and green tea. Some foods, like red yeast rice, have been made into other extracts like armolipid.⁵
Supplements and medications often start as food or treatments found by indigenous populations and are used as traditional medicine.
These traditional medicines are then refined, tested, and then often carried through to becoming approved for use as a pharmaceutical. Bergamot could be next on the way through this process.
Bergamot is a citrus fruit used for some time as a traditional medicine in Italy. A supplement from the extract has been shown in some studies to lower the level of lipids in the blood and could help to prevent cardiovascular disease.