Berberine, a yellow compound found in the roots, stems, leaves, and bark of several plants, has garnered increasing attention as a natural alternative to prescription medications like Ozempic and Wegovy for weight loss. Known for its powerful effects on various aspects of health, especially blood sugar control†, berberine has a long history of use in traditional Chinese medicine. Modern science has recently discovered and confirmed its impressive benefits†. This article delves into the science-backed benefits of berberine, particularly regarding weight loss, and explores its potential risks and side effects.
What is Berberine?
Berberine is one of many nitrogen-containing alkaloids, a group of naturally occurring compounds that include substances such as morphine, nicotine, and caffeine. It is a bioactive compound that can be extracted from several plants, including shrubs from around the world belonging to the Berberis family, such as barberry, goldenseal, golden thread, Oregon grape, and tree turmeric. In traditional Chinese medicine, berberine-containing herbs such as Chinese goldthread (Coptis chinensis) and Amur cork tree (Phellodendron amurense) have been used to treat gastrointestinal disorders, diarrhea, infections, and inflammation.
How Does Berberine Work?
When taken by mouth, berberine is ingested and then transported into the bloodstream before entering the body’s cells. Berberine has a variety of functions inside cells. One of the main functions is activating an important enzyme called AMP-activated protein kinase (AMPK), which regulates metabolism. AMPK exists in every cell. Its primary job is to regulate metabolism, helping manage how your body breaks down and uses energy. But AMPK can also influence body fat composition, and it plays a critical role in regulating your appetite. It binds to several “molecular targets” (also known as cellular or tissue structures) inside the cells and changes their function†. Instead of producing a single change, berberine interacts with multiple targets, impacting more than one disease at a time. Berberine works at a cellular level and changes how cells work by turning signals off and on. Its basic interactions involve so many different processes in the body.
Berberine also affects other molecules inside cells and may even affect which genes are turned on or off. This could help protect against many chronic health conditions (7).
Berberine and Weight Loss: Is There a Connection?
The clinical research on the effects of berberine indicate that it may help reduce body fat. There’s been curiosity around berberine supplements, leading some to even name it “nature’s Ozempic.” Early research indicates that berberine may help reduce body fat. In one small clinical trial that looked at treating nonalcoholic fatty liver disease, participants who took berberine every day for three months experienced significant weight loss.
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In one older 12-week study in people with obesity, taking 500 milligrams (mg) of berberine three times per day caused about 5 pounds of weight loss, on average. The participants also lost 3.6% of their body fat (14).
Additionally, a review of 12 studies found that supplementing with berberine led to significant reductions in body weight, body mass index, and belly fat. It also decreased levels of C-reactive protein, a marker of inflammation (15).
Berberine also appears to inhibit the growth of fat cells at the molecular level, which could help promote weight loss (16).
However, more research is needed on the potential weight loss effects of berberine.
How Berberine May Aid Weight Loss:
- Regulation of metabolism: Berberine may activate an enzyme called adenosine monophosphate-activated protein kinase (AMPK). Known as a “metabolic master switch” AMPK regulates energy metabolism and promotes fat oxidation.
- Decreased fat storage: Berberine may inhibit the activity of certain enzymes involved in fat production and storage, such as fatty acid synthase and acetyl-CoA carboxylase.
- Improved insulin sensitivity: Berberine has demonstrated the ability to improve insulin sensitivity, which is crucial for maintaining stable blood sugar levels and preventing excessive fat storage. If you have insulin resistance, the cells are inefficient in removing sugar from the blood despite normal or high levels of insulin,” explains Dr. Tumah. Chronic exposure to high insulin levels - which is an anabolic hormone - can affect weight and metabolic syndrome.
- Appetite regulation: Some studies suggest that berberine may have an impact on appetite control and food intake. It has been found to influence the release of leptin and ghrelin, two hormones involved in hunger and satiety.
Berberine vs. Ozempic
Although some call berberine “nature’s Ozempic,” the comparison may be exaggerated. The two also work in different ways. While Ozempic slows down digestion, berberine helps control how the body breaks down and uses energy.
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Unlike Ozempic, berberine is a dietary supplement that has not gone through the FDA approval processes for weight loss. This means that there is less evidence that berberine can help people lose weight than there is for Ozempic.
Berberine vs. Metformin
Doctors commonly prescribe metformin to lower blood sugar levels in people with type 2 diabetes. As berberine can also reduce blood sugar levels, some ask if it can be used instead of metformin. Compared to metformin, research is limited on how well berberine can lower blood sugar levels. The dietary supplement hasn’t been approved by the FDA for type 2 diabetes, whereas metformin has.
We need more studies to understand the effects of berberine on lowering blood sugar levels. Early research suggests that metformin may help manage diabetes better than berberine. A study on mice found that while berberine was better at reducing high cholesterol and obesity, metformin was better at controlling blood sugar levels.
Other Potential Health Benefits of Berberine
Today, it is recognized for its wide range of potential benefits, from supporting healthy blood sugar† and cholesterol levels†, to aiding digestion† and promoting weight management†. Berberine has garnered increasing attention for its potential to support blood sugar regulation, heart health, digestive balance, weight management, and concerns related to PCOS†. While research continues to expand, current studies suggest this natural compound may be a valuable tool for maintaining overall wellness†.
Blood Sugar Control: Numerous studies have shown that berberine can significantly reduce blood sugar levels in individuals with type 2 diabetes. A bonus benefit is its affordability. Berberine may also lower glucose levels in people with diabetes. Studies show that it helps your body respond better to insulin and prevents your liver from creating more glucose. As a result, people with diabetes may find that berberine helps lower their blood sugar levels. It seems to work via multiple mechanisms and may help (9, 10):
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- decrease insulin resistance, making the blood sugar-lowering hormone insulin more effective
- increase glycolysis, helping your body break down sugars inside cells
- decrease sugar production in your liver
- slow the breakdown of carbohydrates in your gut
- increase the number of beneficial bacteria in your gut
Heart Health: A leading cause of death in the United States is heart disease, and high cholesterol is a major culprit. Berberine has a cholesterol-lowering effect†, which may improve heart health†. It also has the potential to help lower blood sugar†, prevent type 2 diabetes†, fight bacteria†, aid digestion†, and may even support weight loss†. Berberine shares some issues with all other supplements, Schmidt says. Because of this, medical professionals may shy away from taking a stand on a supplement, citing lack of research, Schmidt says. “We just have to wait sometimes for research to catch up. But research requires money.
- LDL Cholesterol: LDL is the “bad” cholesterol that attaches to blood vessels and increases the chance of health problems. Berberine is thought to reduce LDL cholesterol†. According to some research, berberine works by inhibiting an enzyme called PCSK9. This leads to more LDL cholesterol being removed from your bloodstream (21).
- HDL Cholesterol: Berberine may help with Hyperlipidemia†, lowering cholesterol† and triglyceride levels† while raising the HDL (“good” or “hero”) cholesterol†. Studies suggest that berberine reduces cholesterol and triglyceride levels while raising HDL (good) cholesterol levels. While more research is needed, it may lower the risk of heart disease in the long term.
Gut Health: Known for its anti-bacterial† and anti-inflammatory properties†, Berberine may support the gut microbiome† and keep it in balance†. H. pylori (Helicobacter pylori) is a bacterium that can cause an infection in the stomach or duodenum (first part of the small intestine). It’s the most common cause of peptic ulcer disease and can also inflame and irritate the stomach lining. A recent study revealed that berberine can effectively inhibit and kill H. Berberine has been shown to protect the gut barrier from inflammation. It also kills harmful gut bacteria and encourages the growth of healthy bacteria, which may help treat conditions like diabetes and high cholesterol.
PCOS Support: Although more research is needed, the compound is thought to offer benefits, including improved fertility† and a reduced risk of metabolic complications† associated with this condition†. Many women with PCOS have insulin resistance†, which means their cells don’t respond well to insulin, resulting in elevated insulin and blood sugar levels. In some studies, berberine helped women with PCOS control their cholesterol, lower their waist-to-hip ratio, and increase their insulin response.
Other potential benefits:
- Depression: Animal studies suggest that it may help reduce symptoms of depression (22, 23).
- Cancer: Test-tube and animal studies suggest that it can reduce the growth and spread of various types of cancer (24).
- Oxidative stress and inflammation: It has been shown to have potent antioxidant and anti-inflammatory effects in some test-tube and animal studies (25, 26, 27).
- Infections: Test-tube studies suggest that it can reduce the growth of harmful microorganisms, including certain types of bacteria, viruses, and fungi (28, 29, 30).
- Fatty liver: It may reduce fat buildup in the liver, which could theoretically help protect against NAFLD (31).
- Heart failure: One older study showed that it improved symptoms and reduced the risk of death in people with heart failure (32).
Risks and Side Effects
While berberine has been shown to have several health benefits†, it’s essential to note that the evidence is still limited. As with any supplement, it’s best not to take any berberine until you’ve talked with a member of your health care team, especially as berberine may interact with other medications or supplements.
- Digestive Issues: The most common side effects of berberine include nausea, abdominal discomfort, constipation, and diarrhea. Some people may not experience any side effects. But for those who do, consider reducing your dose, which will help ease and reduce any side effects. One study done with berberine found that it can lead to digestion problems, such as constipation, diarrhea, and flatulence, in some people. But these symptoms typically clear up within 4 weeks.
- Drug Interactions: Berberine may interact with several medications. One known interaction is with cyclosporine, which suppresses the immune system. Berberine can alter how quickly the liver breaks down medications - including anti-clotting drugs and immunosuppressants - and change their effectiveness. Also, as berberine lowers blood sugar, taking berberine alongside antidiabetic drugs may cause blood sugar levels to drop too low. Berberine has many drug interactions, so it’s best to check with your doctor before using it. For example, as berberine may slow blood clotting, taking it alongside blood-clotting medications may increase the risk of bruising and bleeding.
- Not Recommended for Certain Groups: If you’re pregnant or breastfeeding, you shouldn’t take berberine. Berberine isn’t recommended for children or babies either. Berberine may cause adverse effects in these groups, such as jaundice in infants. Berberine also has links to bilirubin buildup in infants. This can lead to a serious and possibly fatal condition known as kernicterus, which may cause damage to the brain.
- Changes in Gut Flora: Berberine is antimicrobial and can alter microbes in the gut, reducing diversity. A diverse microbiome that is abundant in “good” bacteria is important for health.
- Low blood pressure: Berberine’s blood pressure-lowering effects are helpful if you have high blood pressure. But for some people, this effect could cause blood pressure to drop too low, which can be dangerous.
Dosage and How to Take Berberine
Berberine is not typically found in foods we eat, but is taken as a supplement. Berberine supplements come in pills, powder, gummies and drops. Food and Drug Administration (FDA). And berberine can interact with certain medications, so it’s important to speak to your healthcare provider before starting berberine.
Dr. Tumah recommends that you start slowly and at a low dosage. Once you know how you react to berberine, the goal is to take 500 milligrams up to three times a day. Berberine supplements aren’t meant to be taken with food, so opt to take your three doses before or in between meals.
The suggested dose of berberine is 250 milligrams or 500 milligrams two or three times a day. Talk to your doctor before starting a new supplement program to make sure it's suitable for your specific needs and health status.
It is common to take 500 mg three times per day before meals, for a total of 1,500 mg per day.
Cooper Complete offers Berberine Complex for glucose metabolism support† and cardiometabolic balance†. This custom formulation contains berberine along with alpha lipoic acid to sustain proper insulin function† and vitamin C for additional antioxidant support†.