Cholera

Overview

Berberine, Saccharomyces boulardii, and Vitamin B3 (Niacin) have limited cholera evidence in this review. A single berberine dose may slightly reduce diarrhea volume, but daily berberine combined with tetracycline added no benefit over antibiotic treatment alone.

Saccharomyces boulardii 250 mg did not reduce cholera symptoms versus anti-diarrheal medicine or placebo in one small trial that may have been underpowered. Niacin 1–2 g reduced stool fluid loss by roughly one-third to one-half in one severe-cholera study, with higher doses performing better. See the heatmap and evidence reviews below.

Effect graph

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Relevant supplements

Relevant supplements sorted by DEX Score.


Berberine	★★★★★	Low
Vitamin B3 (Niacin)	★★★★★	Low
Saccharomyces boulardii	★★★★★	Very Low / None

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Studies

Find individual evidence reviews for supplements sorted by DEX Score.

3 supplements for and rated at least stars. All purchase bands. No minimum star filter.

BerberineView supplement →

Reconsider purchase★★★★★

How we scored this

Effect SizeLowEvidenceMediumTrustMedium

Evidence Review

Taking a single dose of berberine may slightly decrease diarrhea volume in cholera.
But taking berberine daily with the antibiotic tetracycline does not add benefit for cholera diarrhea treatment.

Browse 3 studies

Clinical trialClinical trial of high-dose berberine and tetracycline in cholera1987

A clinical trial of high-dose berberine plus tetracycline in cholera was conducted, but available abstract text provides no quantitative outcome data.

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RCTRandomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae1987n=165

An RCT of 165 adults with acute diarrhea found 400 mg berberine sulfate reduced stool volume in ETEC diarrhea and stopped diarrhea in 42% by 24 hours versus 20% on placebo; cholera effects were slight.

Effect: Benefit
Dose: 400 mg/day
Population: Adults
Participants: 165

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RCTClinical trial of berberine in acute watery diarrhoea1985n=215

An RCT of 400 adults with acute watery diarrhea found tetracycline reduced cholera stool output, while berberine alone lacked antisecretory benefit in cholera and non-cholera diarrhea.

Effect: No Benefit
Population: Adults
Participants: 215

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Vitamin B3 (Niacin)View supplement →

Reconsider purchase★★★★★

How we scored this

Effect SizeLowEvidenceLowTrustMedium

Evidence Review

It is not clear if taking niacin helps with cholera.
One small study in adults with severe cholera showed that taking 1 to 2 grams of niacin by mouth reduced the amount of stool fluid loss by about one-third to nearly half in the first 16 hours.
The higher dose worked better than the lower dose, but more studies are needed to confirm these findings.

Browse 1 study

RCTReduction of fluid-loss in cholera by nicotinic acid: a randomised controlled trial1983n=62

A randomized trial of 62 adults found that 1–2 g/day nicotinic acid during the third and fourth 8 h periods, the rates were lower in the treatment groups, but not significantly so.

Effect: Benefit
Dose: 2 g/day
Population: Adults
Participants: 62

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Saccharomyces boulardiiView supplement →

Do not purchase★★★★★

How we scored this

Effect SizeVery Low / NoneEvidenceLowTrustMedium

Evidence Review

It is uncertain if taking Saccharomyces boulardii helps with cholera.
In a small study, taking 250 mg of this probiotic, alone or with a common anti-diarrheal medicine, did not reduce cholera symptoms compared to medicine alone or placebo.
The study might not have been large enough to show a difference.

Browse 1 study