The History of Citrus Bergamot: From Calabrian Perfume Fruit to Heart-Health Supplement

Few supplements have a back story as unusual as citrus bergamot. For roughly three centuries this bitter, pear-shaped fruit was prized almost exclusively for the oil in its rind, the signature note of classic eau de cologne and Earl Grey tea. Only in the last two decades has its juice attracted cardiologists and lipid researchers. Our editorial team traces that path and looks at what the science actually supports.

A fruit with a narrow homeland

Bergamot (Citrus bergamia) is a citrus tree whose exact botanical origin is still debated. Genetic analyses suggest it is a hybrid, most likely involving bitter orange and a lemon-type ancestor, rather than a wild species. What is not in dispute is where it thrives: a thin coastal strip of the province of Reggio Calabria at the toe of the Italian peninsula.

That stretch of land, squeezed between the Ionian Sea and the Aspromonte mountains, offers mild winters, sea breezes and particular soils. Attempts to grow bergamot commercially elsewhere, from West Africa to South America, have produced fruit, but the Calabrian crop has long dominated world supply of the essential oil. Italy protects the oil from this area with a designation of origin.

The name itself is uncertain. Popular accounts link it to the Italian city of Bergamo, to the Turkish phrase for "lord's pear," or to the Spanish town of Berga. None of these stories has been settled by historians, and our editors treat them as legend rather than fact.

Unlike oranges or lemons, bergamot is almost never eaten fresh. The pulp is sour and noticeably bitter, which is one reason the juice was long treated as a by-product. That bitterness, as it turns out, comes partly from the very flavonoids that would later interest scientists.

Perfume, tea and folk medicine

Bergamot entered European commerce through perfumery. In the early 1700s, Italian perfumers working in Cologne created the light citrus-and-herb water that became known as eau de cologne, and bergamot oil was among its defining notes. Demand from the fragrance trade drove the first systematic plantations in Calabria during the eighteenth century.

For generations the oil was extracted by hand, by pressing the rind against sponges, before mechanical extraction machines took over in the nineteenth and twentieth centuries. The oil also found its way into tea: Earl Grey blends are flavored with bergamot, and the association is now so strong that many consumers know the word only from the tea box.

In southern Italy, bergamot also had a place in folk practice. The oil was applied to the skin as an antiseptic, and the juice was reportedly used in household remedies for fever, sore throat and digestion. These traditional uses were never formally tested, and they are best understood as cultural history rather than medical evidence.

One early lesson about bergamot was a safety lesson. The essential oil contains bergapten, a furocoumarin that makes skin dramatically more sensitive to sunlight. Perfumes with untreated oil could cause blotchy burns and pigmentation in the sun, which led the fragrance industry to use bergapten-free grades and led to limits under international fragrance standards.

• Rind oil: perfumery, flavoring of tea and confectionery, aromatherapy.
• Juice: historically discarded or used locally; now the main source of supplement extracts.
• Albedo and peel residues: sources of pectin and flavonoids explored by food scientists.

The shift to cardiometabolic research

The turning point came from analytical chemistry. In the 2000s, Italian researchers characterizing the juice found unusually high levels of flavanone glycosides, including naringin, neohesperidin and neoeriocitrin. They also identified a family of compounds bearing a 3-hydroxy-3-methylglutaryl (HMG) group, notably brutieridin and melitidin, described by Di Donna and colleagues in 2009.

That HMG moiety caught attention because it resembles part of the substrate of HMG-CoA reductase, the liver enzyme that statin drugs inhibit. A computational study by Leopoldini and co-workers in 2010 modeled how these bergamot flavonoids might bind the enzyme. The resemblance gave rise to the popular, and somewhat overstated, label of a "natural statin."

From there, a group led by Vincenzo Mollace at the University of Catanzaro developed a standardized bergamot polyphenolic fraction (often abbreviated BPF) and published a combined animal and human study in 2011 reporting lower total and LDL cholesterol and improved blood glucose markers. Commercial products based on such extracts reached the US market in the following years.

The timing mattered. Statin intolerance, especially muscle complaints, was a widely discussed problem, and many people with borderline cholesterol were looking for non-prescription options. Bergamot arrived with a plausible mechanism, a Mediterranean origin story and a few encouraging studies, which made it attractive to supplement marketers.

What the human studies show

The clinical evidence is real but limited. Several trials, most of them conducted in Italy and many involving researchers connected to the original extract, have reported reductions in LDL cholesterol and triglycerides and modest increases in HDL over periods of one to several months. A 2013 study by Gliozzi and colleagues reported that a bergamot fraction added to low-dose rosuvastatin enhanced the LDL-lowering effect.

Independent reviewers have urged caution. A systematic review by Lamiquiz-Moneo and co-authors published in 2020 concluded that bergamot appeared to improve lipid profiles but noted small sample sizes, heterogeneous products, short follow-up and a high risk of bias in several trials. No study has shown that bergamot reduces heart attacks, strokes or deaths.

The "organ protection" interest among gym-goers comes from a specific concern: certain anabolic agents and oral steroids are known to lower HDL cholesterol and raise LDL. Bergamot is sometimes promoted as a way to offset this. Our editors stress that no trial has studied bergamot in that setting, and a supplement cannot be assumed to neutralize the cardiovascular risks of drugs that harm lipid profiles.

The fair summary is that bergamot is one of the more interesting botanical lipid candidates, with a coherent chemical rationale, but its evidence base remains early-stage and partly dependent on a single research network.

Safety, quality and regulation in the US

In the United States, bergamot extracts are sold as dietary supplements under the Dietary Supplement Health and Education Act of 1994. That means they do not need FDA approval for safety or effectiveness before sale, and labels may not claim to treat or prevent disease. Quality depends heavily on the manufacturer.

Studies have used standardized extracts, typically in the range of 500 to 1,000 mg per day of polyphenolic fraction, but products on shelves vary in polyphenol content and some do not disclose standardization at all. Third-party testing seals, such as those from USP or NSF, offer some reassurance about identity and contaminants.

Reported side effects in trials have mostly been mild, such as stomach upset or heartburn. Because bergamot may act on cholesterol pathways and may interact with medications metabolized by liver enzymes, anyone already taking a statin, other lipid drugs or blood thinners should discuss it with a physician first. The essential oil, which is not the same product, remains a phototoxicity risk on the skin.

Pregnant and breastfeeding women, people with liver disease and children were generally excluded from studies, so there is no basis for recommending bergamot to these groups.

Conclusions of the editorial team

Citrus bergamot's history is a story of a crop repurposed. For most of its existence it was a fragrance fruit, and its medical reputation is a twenty-first-century development built on the discovery of HMG-bearing flavonoids in its juice.

The lipid data are promising enough to justify further, larger and more independent trials, but they do not make bergamot a replacement for evidence-based therapy or a shield against drugs that damage cardiovascular health.

If you are considering it, choose a standardized, independently tested extract, keep your doctor informed and measure your lipid panel before and after rather than assuming it works.

Readers interested in this area may also want our editorial pieces on how to read a lipid panel, on the evidence behind red yeast rice, and on how anabolic agents affect HDL cholesterol.

References

1. Di Donna L, De Luca G, Mazzotti F, et al. Statin-like principles of bergamot fruit (Citrus bergamia): isolation of 3-hydroxymethylglutaryl flavonoid glycosides. J Nat Prod. 2009;72(7):1352–1354.
2. Leopoldini M, Malaj N, Toscano M, Sindona G, Russo N. On the inhibitor effects of bergamot juice flavonoids binding to the 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) enzyme. J Agric Food Chem. 2010;58(19):10768–10773.
3. Mollace V, Sacco I, Janda E, et al. Hypolipemic and hypoglycaemic activity of bergamot polyphenols: from animal models to human studies. Fitoterapia. 2011;82(3):309–316.
4. Gliozzi M, Walker R, Muscoli S, et al. 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):140–145.
5. Navarra M, Mannucci C, Delbò M, Calapai G. Citrus bergamia essential oil: from basic research to clinical application. Front Pharmacol. 2015;6:36.
6. Lamiquiz-Moneo I, Giné-González J, Alisente S, et al. Effect of bergamot on lipid profile in humans: a systematic review. Crit Rev Food Sci Nutr. 2020;60(18):3133–3143.