Bergamot (Citrus bergamia)
“The Lipid Whisperer.” A multi-target citrus polyphenol for improving atherogenic lipids, metabolic resilience, and vascular tone.
The Naturopathic Perspective
“The Lipid Whisperer.”
From a naturopathic lens, bergamot extract (Citrus bergamia) is less about “treating cholesterol” and more about restoring metabolic signaling—especially in people whose physiology is being pushed toward insulin resistance, fatty liver tendency, and chronic low-grade inflammation. Modern patients are often living in a “metabolic mismatch”: highly processed diets, disrupted circadian rhythms, stress hormones, and sedentary time all funnel into hepatic lipid dysregulation (overproduction of atherogenic lipoproteins) and endothelial dysfunction. Bergamot is used as a mechanism-forward nutraceutical because its flavonoids and related phytochemicals can influence cholesterol handling at multiple checkpoints (synthesis, absorption/transport, oxidation), rather than acting as a single blunt instrument.
Clinically, we often position bergamot as the “bridge” between lifestyle work and pharmacology: it’s most useful when a patient is doing “enough” (diet upgrades, movement, weight loss attempts) but their biomarkers still show atherogenic lipid patterning (LDL-C, TG, non-HDL, small dense LDL) and/or rising oxidative stress. In studies, standardized bergamot extracts have shown improvements in lipid parameters and related surrogate markers (including lipoprotein subfractions and inflammatory/metabolic indices), which matches how naturopaths tend to deploy it: cardiometabolic risk reduction, not hypey detox.
💡 Clinical Insight: The Depletion Gap
Why not just get this from food?
1. Unrealistic Exposure: Bergamot is mainly used for aroma/flavour (e.g., Earl Grey), not eaten like oranges; achieving clinically studied polyphenol intakes from food is impractical.
2. Therapeutic Standardisation: Clinical trials typically use extracts with defined flavonoid profiles/doses (e.g., naringin/neohesperidin), whereas food sources vary wildly by cultivar and processing.
“We prescribe this to bridge the gap between biological necessity and modern depletion.”
Naturopathic Use Cases
How we use this in clinical practice, validated by evidence.
1. Dyslipidemia (LDL-C & TG)
Clinical Goal: Lipid Quality
The Clinical Logic:
We use bergamot when we want to downshift hepatic lipid output and improve lipid quality, not just chase a single number. Mechanistically, bergamot contains flavonoids and related compounds that appear to influence cholesterol handling through multiple pathways (e.g., effects on cholesterol synthesis/handling and lipoprotein patterns). Clinically, this often shows up as improvements not only in LDL-C/TG but also in **lipoprotein subfractions** (small dense LDL), which is a more “root-cause” atherogenic driver.
Mod-High
Grade B+
Verdict: Human studies and a systematic review report that bergamot preparations—especially standardized extracts—can reduce total cholesterol and LDL-C, with variable but often favorable effects on triglycerides. Better-standardized interventions show the most reliable results.
2. Metabolic Syndrome Patterning
Clinical Goal: Insulin & Inflammation
The Clinical Logic:
When lipids are tied to insulin resistance, we want an intervention that targets multi-system metabolic traffic: glucose handling, hepatic stress signals, inflammation, and endothelial reactivity. In a metabolic syndrome phenotype, bergamot extracts have been associated with improvements in atherogenic dyslipidemia + insulin sensitivity indices + inflammatory markers.
Moderate
Grade B
Verdict: Controlled trials in metabolically at-risk adults show bergamot preparations can improve lipids and insulin sensitivity markers, with some studies also reporting improvements in inflammation and liver-risk indices.
3. Biological Function: Cholesterol Modulation
Clinical Goal: Synthesis Regulation
The Clinical Logic:
Bergamot contains unique statin-like phytochemicals (notably **brutieridin and melitidin**, HMG-conjugates) and other flavonoids that have documented interactions with cholesterol biology in mechanistic studies. Think of this as the “biochemical chassis” beneath the clinical outcomes: **cholesterol synthesis/uptake/transport machinery is being influenced**, even though the magnitude will be smaller than prescription statins.
Incontestable
Grade A
Verdict: Established biological fact. Presence and biochemical activity of key compounds is well established.
Form Matters: Quality Comparison
Why we prescribe Standardized BPF over other forms.
The “Hero” Form
We prioritize Standardized Bergamot Polyphenolic Fraction (BPF) or standardized flavonoid extracts. This ensures consistent polyphenol delivery and dose reproducibility aligned with human trials, ideally with attention to furocoumarin control.
Food Sources (Approximate)
Bergamot is not a common table fruit, but here are the sources.
Bergamot Juice (250 mL)
~25–100 mg Naringin
(Variable Composition)
Bergamot Zest (5 g)
Tens of mg
(Flavedo Abundance)
Marmalade (1 Tbsp)
Culinary Dose
(Not Therapeutic)
Earl Grey Tea (1 Cup)
Trace Exposure
(Aroma/Flavour Only)
📚 Clinical References & Evidence
-
Systematic Review on Lipids:
Effect of bergamot on lipid profile in humans: A systematic review. Taylor & Francis Online.
[Read Source] -
RCT (Standardized Flavonoids):
Citrus bergamia Extract, a Natural Approach for Cholesterol… MDPI.
[Read Source] -
Metabolic Syndrome Trial:
Metabolic and vascular effect of a new standardized bergamot phytocomplex. Archives of Medical Science.
[Read Source] -
Prospective Study (Lipoproteins):
Bergamot Reduces Plasma Lipids, Atherogenic Small Dense LDL… Frontiers.
[Read Source] -
Statin-Like Principles:
Statin-like Principles of Bergamot Fruit (Citrus bergamia). ACS Publications.
[Read Source] -
Phototoxicity Risk:
Accidental bullous phototoxic reactions to bergamot. PubMed.
[Read Source] -
CYP3A Interaction Basis:
Inactivation of cytochrome P450 3A4 by bergamottin. PubMed.
[Read Source]
*Disclaimer: Links connect to third-party scientific repositories. Access may require institutional login for some journals.
📋 Dosage & Safety Guidelines
500-1000 mg
Standardized BPF per day.
- Plant Sterols: Reduced absorption.
- Soluble Fiber: Bile acid binding.
- Note: Monitor for drug interactions.
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