What to Know About Black Pepper and Piperine Supplements

Medically reviewed by Melissa Nieves, LND, RD

Black pepper is a common spice used in cooking to enhance flavor. Pepper comes from the peppercorn, a dried unripe fruit. Peppercorns are picked when almost ripe and then allowed to dry until they turn black.

Pepper contains piperine, an alkaloid that functions as an antioxidant. One teaspoon of black pepper provides 6 calories and 1 gram (g) of fiber. Piperine is also available in supplement form.

This article discusses black pepper, including piperine supplements, its possible uses in health, and more.

Supplement Facts

• Active ingredient(s): Piperine

• Alternate name(s): Piper nigrum, Piperine, Piperaceae

• Suggested dose: No standard dose; the most common supplement dose in studies was curcumin with 5 mg of piperine.

• Safety considerations: Safe when added to foods; as a supplement, piperine should be used with caution in people with diabetes, bleeding disorders, and gastrointestinal disorders. Piperine may interact with some medications.
  

Uses of Black Pepper

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.

Black pepper is marketed for its anti-inflammatory properties. It is suggested to help with cognitive brain function and gastrointestinal function. It also has antimicrobial and antidepressant properties.

Yet, very few human clinical trials have assessed the outcomes of black pepper as a supplement.

Below are some possible health benefits of black pepper. It should be noted that the studies reviewed mostly use a curcumin supplement combined with piperine. Curcumin is the active compound found in the spice turmeric. Therefore, it is not certain whether the results are due to one or both compounds.

Additionally, most of the study outcomes focus on laboratory findings and not clinically significant findings like reduced risk of heart attack or secondary complications associated with diabetes.

Therefore, the research is preliminary and not enough to recommend black pepper or piperine supplementation routinely.

May Lower Cholesterol Levels

Studies have looked at whether combining curcumin with piperine may have a role in improving lipid profiles which could prevent heart disease.

A meta-analysis concluded that curcumin and piperine combined significantly reduced total and low-density lipoprotein (LDL) cholesterol (considered "bad" cholesterol) in people with metabolic syndrome.

Another randomized, double-blinded, placebo-controlled trial evaluated the effects of 500 mg of curcumin capsules with piperine supplement in people with a previous heart attack.

After eight weeks, the supplement significantly reduced hemoglobin A1C, LDL cholesterol, and liver enzymes. It also significantly improved levels of high-density lipoprotein (HDL) cholesterol (considered "good" cholesterol).

Although the results seem promising, the study populations were small, requiring future larger-scale trials to confirm the findings.

May lmprove Glucose Control

Combining curcumin and piperine may help lower glucose (blood sugar) levels in people with diabetes. Blood glucose control is important with diabetes to avoid further complications.

Hemoglobin A1c (HbA1c or A1c) levels are measured over a three-month period in people with diabetes to assess the average glucose levels over the previous three months.

In a small study of 71 participants, people were randomized to take either a placebo (an ineffective substance) or a supplement containing 5 mg of piperine and 500 mg of curcumin. After 120 days, those who took the supplement had significantly lower glucose levels, hemoglobin A1C levels, and levels of triglycerides (a fat in the blood).

In people with type 2 diabetes, a daily dose of 500 mg of curcumin and 5 mg of piperine (compared to placebo) significantly reduced blood glucose, C-peptide, and A1c levels.

The supplement also significantly lowered liver enzymes but did not affect C-reactive protein levels.

May Improve Liver Health

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), is a group of conditions with a fatty buildup in the liver. Common causes include obesity, insulin resistance, and diabetes.

A few studies suggest that piperine combined with curcumin as a supplement can improve liver function in people diagnosed with MASLD

In one study, short-term treatment with curcumin and piperine seemed to reduce the severity of MASLD.

Another study randomized 70 people with MASLD to receive a supplement of 500 mg curcuminoids with 5 mg piperine daily or a placebo for 12 weeks. At the end of the study, those who received the supplement had significantly lower concentrations of liver enzyme blood levels and less severe MASLD.

Another study with a similar regimen in participants diagnosed with hepatic steatosis found that the supplement improved liver function enzymes and lipid profiles. However, it did not improve fibroscan measurements, which are used to assess the improvement of MASLD.

What Are the Side Effects of Black Pepper?

Not many side effects are reported with the use of black pepper.

Higher doses of black pepper may cause a burning sensation in the throat or stomach. It could also contribute to reflux or heartburn.

Precautions

Black pepper in amounts usually found in food is safe.

Although safe in normal amounts, high doses of black pepper have not been studied for safety in pregnant people, breastfeeding people, or children.

Lab studies have suggested that piperine, the chemical found in pepper, may slow blood-clotting. High doses could lead to bleeding. For this reason, you should discontinue piperine supplements for two weeks before any scheduled surgeries.

People with diabetes should monitor their glucose levels closely, as piperine can lower blood glucose levels. Adding piperine could reduce how much medication is needed. People with diabetes should discuss adding supplements to their regimen with their primary care provider to determine if medication dosage adjustments are needed.

People with gastrointestinal (GI) conditions, such as inflammatory bowel disease (IBD), may not tolerate pepper, but this can vary by person.

Dosage: How Much Black Pepper Should I Take?

There is no standard recommended dose for black pepper.

Studies have shown that doses of piperine often range from 5 mg to 20 mg per day. Five mg is usually the most common dose used in research studies.

Explainer

Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs. 

Interactions

It's possible for piperine to interact with medications.

Some studies have shown that piperine can reduce blood glucose levels.

Combining medications to lower glucose levels with piperine could theoretically lead to hypoglycemia. People with diabetes should always discuss supplements with their primary care provider or other treating provider before starting them. You may need to monitor your blood glucose levels closely.

Piperine may also slow blood clotting. Combining piperine with anticoagulant medications, such as Jantoven (warfarin), could increase your chances of bruising or bleeding as they have similar effects.

Piperine can slow the breakdown of other medications in the liver, increasing the drug's effects. This may include:

• Nonsteroidal inflammatory drugs (NSAIDs), such as Advil or Motring (ibuprofen)

• Lipid-lowering drugs, such as Zocor (simvastatin)

• Fexofenadine, such as Allegra or Mucinex Allergy

However, studies on these interactions were done in animals and used higher-than-normal piperine doses.

Piperine could increase how the body absorbs some medications, including:

• Phenytoin

• Propranolol

• Rifampin

• Theophylline

• Amoxicillin

• Carbamazepine

Theoretically, this could increase the effects and possible side effects of these medications.

It is essential to carefully read the ingredients list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included. Please review the supplement label with your healthcare provider to discuss any potential interactions with foods, other supplements, and medications.

Frequently Asked Questions

What is the active ingredient in black pepper?

Black pepper contains piperine, an alkaloid that has antioxidant properties.

Where does black pepper come from?

Pepper comes from the vine Piper nigrum. The small dried berries are peppercorns. They are picked when almost ripe and allowed to dry further until they turn black.

Is black pepper helpful for people with COVID-19?

There is not enough evidence to support the use of curcumin with piperine supplementation for COVID-19.

One study found that the supplement did improve some markers of inflammation but had no effect on mortality.

Another study found that curcumin-piperine supplementation did not affect inflammatory and other blood indexes but improved weakness. However, the study was limited to the number of participants (only 46 patients).

Sources of Black Pepper & What to Look For

Black pepper is available as a spice and is easy to add to foods or use in cooking.

Many different types of pepper are available such as white peppercorns and red pepper flakes. However, the information contained in this article is specific to black pepper.

If you are looking for supplements, you could find piperine alone, but it is often found as a combination of curcumin and piperine. It may also be added to supplements marketed for inflammation that contain several different ingredients.

Always look for supplements that have been third-party tested. This means that the product has been evaluated to ensure that it contains what the label claims and is free of contaminants.

Summary

Black pepper is a common spice added to foods. Piperine, a compound found in pepper, has been studied for health benefits. Preliminary results show that piperine (combined with curcumin) may improve lipid profiles, glucose control, and liver function enzymes.

Further research is needed to determine whether piperine supplementation could lead to a reduced risk of disease.

Discuss your supplement use with a healthcare provider, as many supplements are not recommended in certain conditions and can interact with prescribed medications.