Berberine, a bioactive alkaloid extracted from various plants, has been used in Chinese and Ayurvedic medicine for thousands of years. It is found in plants such as European barberry, goldenseal, goldthread, Oregon grape, phellodendron, and tree turmeric. Known for its vibrant yellow color and bitter taste, berberine has historically been used in herbal remedies to treat infections and support digestive health. Today, researchers are investigating its potential to treat diabetes, high cholesterol, and even polycystic ovary syndrome (PCOS). As a supplement, berberine is typically taken in capsule or tablet form, sometimes combined with other ingredients to enhance absorption and effectiveness.
How Berberine Works
Berberine affects the body at a cellular level, primarily by activating an enzyme often referred to as a “metabolic master switch.” This enzyme plays a key role in regulating how the body uses energy. By stimulating this enzyme, berberine may help improve various metabolic functions, including glucose uptake, fat oxidation, and insulin sensitivity. Berberine binds to enzymes and parts of cells and changes how they work, seeming to affect several enzymes and even DNA and RNA.
Potential Health Benefits of Berberine
Research suggests berberine may benefit several conditions, including metabolic health conditions, such as diabetes, obesity, and heart problems. It may also improve gut health.
Blood Sugar Management
Several studies suggest that berberine may help lower blood sugar levels in people with type 2 diabetes. A 2019 literature review indicated that berberine was better than a placebo at lowering blood sugar. The same analysis suggests that a combination of berberine and blood-sugar-lowering drugs is more effective than the drugs alone. Berberine appears to activate SIRT1 proteins, which are involved in cellular processes such as metabolism and inflammation, and AMP-activated protein kinase, which can help regulate how the body uses blood sugar. Berberine may help to improve insulin resistance by lowering body mass index (BMI) scores and fasting blood insulin levels.
Cholesterol and Heart Health
Berberine may support cardiovascular health by helping to lower LDL (bad) cholesterol and triglyceride levels while raising HDL (good) cholesterol. A 2021 systematic review highlights research suggesting that berberine may help lower LDL cholesterol and triglyceride levels and may also help to increase high-density lipoprotein (HDL), or “good” cholesterol. A 2021 study involving 84 Chinese men gave participants either 500 milligrams (mg) of berberine or a placebo for 12 weeks. Those who took berberine had more significant reductions in total and LDL cholesterol than those taking the placebo. The researchers also highlighted a slight reduction in HDL cholesterol but suggest this may be a chance occurrence. Studies show that taking a berberine supplement combined with standard heart disease treatments eases fatigue and irregular heartbeats, lowering the chance of death without apparent side effects.
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High Blood Pressure
Some research suggests that berberine may help to reduce blood pressure. Taking 0.9 grams of berberine by mouth daily along with the blood pressure-lowering drug amlodipine reduces blood pressure better than taking amlodipine alone in people with high blood pressure. However, a 2021 systematic review highlights that evidence is mixed and low quality and that other substances in the studies may have contributed to these results. A 2021 study outlines previous research suggesting berberine may have a positive effect on blood pressure. However, the study authors found no differences in blood pressure levels between the berberine and placebo groups.
Weight Management
By improving metabolic efficiency and supporting insulin function, berberine may aid in modest weight loss. A 2021 review suggests that berberine may have antiobesity effects. Another 2020 review suggests that berberine supplementation may contribute to reductions in the following weight markers: BMI, body weight, waist circumference, and C-reactive protein concentrations. A 2020 animal study suggests that berberine may help to act as an appetite suppressant, since it led to a lower food intake in mice and rats. Some studies suggest that berberine can reduce body mass index (BMI) and help with weight loss. However, many of these studies are of low quality and have a high risk of bias. This means that there is currently no medical agreement on how well berberine can help people lose weight and that new, high-quality research on the topic is needed.
Polycystic Ovary Syndrome (PCOS)
In some studies, berberine helped women with PCOS control their cholesterol, lower their waist-to-hip ratio, and increase their insulin response. Taking berberine by mouth might lower blood sugar, improve cholesterol and triglyceride levels, reduce testosterone levels, and lower waist-to-hip ratio in people with PCOS. A 2022 study compared the effects of berberine with the medications metformin (Glucophage) and myoinositol (Inofolic alpha) on people with PCOS. Berberine caused greater reductions in clinical, hormonal, and lipid parameters than metformin and myoinositol. The authors suggest berberine may be better than metformin at reducing the risk of cardiovascular disease in people with PCOS.
Cancer
A 2019 review found that berberine has “clear inhibitory effects” on colorectal cancer, lung cancer, ovarian cancer, prostate cancer, liver cancer, and cervical cancer. Another 2021 review suggests that berberine may prevent the spread of cancer cells by controlling the cell cycle and causing cell death. If berberine can help treat cancer, inflammation, diabetes, and other conditions, it may be due to a beneficial effect on gut microbiota, according to research from 2020.
Gut Health and Inflammation
Berberine has natural antimicrobial and anti-inflammatory properties and may help balance gut bacteria and reduce gastrointestinal discomfort. 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. Berberine has an antibacterial action that seems to remove the harmful bacteria in the gut and thus enhance the growth of healthy bacteria. Animal research highlights berberine’s anti-inflammatory properties, suggesting it may have therapeutic potential for inflammation-related health conditions. Berberine lowers inflammation in many ways. For example, it reduces oxidative stress, lowers production of inflammatory proteins, and promotes immune regulation. Its anti-inflammatory activity may mean it can treat inflammatory conditions like arthritis.
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Bacterial Infections
Berberine could be an effective antimicrobial agent. A 2022 study found that berberine helped inhibit the growth of Staphylococcus aureus. S. aureus can cause many health problems, including sepsis, pneumonia, meningitis, and certain skin conditions.
Brain Benefits
Research shows that berberine might help prevent dementia by protecting against brain damage and improving mental skills. Early studies also suggest that it may one day be able to treat conditions like cognitive dysfunction and Alzheimer’s disease.
Kidney Problems
According to a 2023 study, berberine has a positive effect on people with kidney problems. It does this by changing the types of friendly bacteria in the gut and stopping the production of bad substances in the gut that can make kidney disease worse.
Safety and Side Effects
Berberine is generally considered safe for most people when used short term and at recommended doses. Common side effects include diarrhea, constipation, gas, and upset stomach. To reduce gastrointestinal side effects, it may help to start with a lower dose and gradually increase it. It is also important to take berberine with meals. 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. 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.
In animal studies, scientists have noticed the following effects, depending on the type of animal, how much they consumed, and for how long: diarrhea, vomiting, nausea, muscle tremor, gastric ulcers, liver and kidney enlargement, and a reduction in white blood cells.
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Precautions to Take
It is essential to speak with a doctor before taking berberine or other supplements, as they may not be safe or suitable for everyone. Anyone who develops an allergic reaction to any herbal product should stop using it at once. Some herbal supplements may contain ingredients that are not on their label, so people should monitor their reaction after first taking them. The NCCIH advises people not to use goldenseal, which contains berberine, during pregnancy or while breastfeeding and cautions against giving it to infants. There may also be a potential for hypoglycemia from taking goldenseal, depending on whether someone is taking other hypoglycemic prescription medications. Goldenseal may also interact with prescription medications. It’s generally recommended to stop taking herbal supplements like berberine 2 to 3 weeks before surgery to avoid negative reactions to anesthesia and side effects like excessive bleeding. Berberine’s effects on blood clotting and blood sugar levels in particular may impact the success of surgery and make recovery take longer.
Who Should Avoid Berberine?
Berberine may not be safe for everyone. Pregnant and breastfeeding women should avoid it, as it can cross the placenta and may affect newborns. It may also interact with medications, particularly those for diabetes, high blood pressure, and blood thinners. Always talk with your healthcare provider before starting berberine or any new supplement.
Berberine vs. Other Medications
Berberine is a natural remedy that shares properties with some prescription drugs. Berberine and metformin share certain features, and both could be useful for treating metabolic disorders, such as type 2 diabetes. However, if a doctor prescribes metformin, people should not take berberine as an alternative without first speaking with their doctor. A doctor will prescribe the correct amount of metformin for someone based on clinical research. It is not possible to know how a supplement will match that amount. Berberine may interact with metformin and affect blood sugar levels, making them harder to manage. In one study, taking goldenseal, an extract containing berberine, and metformin together led to a 25% drop in the impact of metformin. One day, berberine may become a suitable alternative to metformin for managing blood sugar levels, but more research is necessary.
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. 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.
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.
Berberine Dosage
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.
Berberine-Rich Foods
You'll find berberine in high concentrations in plants, including:
- Hydrastis canadensis (goldenseal)
- Coptis chinensis (coptis or goldenthread)
- Berberis aquifolium (Oregon grape)
- Berberis vulgaris (barberry)
- Berberis aristata (tree turmeric)
Drug Interactions
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. Also, as berberine lowers blood sugar, taking berberine alongside antidiabetic drugs may cause blood sugar levels to drop too low. Berberine might decrease how quickly the body breaks down cyclosporine. This might increase the effects and side effects of cyclosporine. Taking berberine with pentobarbital might cause too much sleepiness. Berberine might slow down the body's ability to remove tacrolimus, which might increase the effects and side effects of tacrolimus.