Berberine

What Is Berberine?

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Berberine is a natural yellow-colored compound found in certain plants. It has been used in traditional Chinese and Ayurvedic medicine for many years. Berberine is extracted from the roots, bark, and stems of plants like goldenseal, barberry, and Oregon grape. People often take berberine for health benefits such as improving digestion, fighting infections, and controlling blood sugar levels. It is available as a dietary supplement in the form of capsules or tablets. Always talk to a healthcare professional before taking any new supplement, including berberine.

What are the Benefits of Berberine?

• Helps Control Blood Sugar: Berberine is particularly beneficial for people with diabetes. It enhances the body’s insulin sensitivity, improving the way insulin is used to lower blood sugar levels. This mechanism can be crucial in managing type 2 diabetes, as it helps regulate glucose metabolism, thereby maintaining healthy blood sugar levels.
  • Aids in Managing Metabolic Syndrome: Metabolic syndrome, a cluster of conditions including high blood pressure [PMID: 25498346], high blood sugar, excess body fat around the waist, and abnormal cholesterol levels, may be positively impacted by berberine. It helps address several of these factors, thereby reducing the risk of developing related diseases like type 2 diabetes and heart disease.
• Supports Heart Health: Berberine plays a significant role in cardiovascular health. Studies have shown that it can help reduce high blood pressure and cholesterol levels, two major risk factors for heart disease. By improving lipid profiles and promoting better blood vessel function, berberine contributes to a healthier heart and circulatory system. [PMID: 36805484]
  • Reduces Cholesterol Levels: While its role in heart health includes lowering cholesterol, it’s worth noting specifically that berberine can help regulate LDL (bad) cholesterol and increase HDL (good) cholesterol, contributing to better cardiovascular health. [PMID: 36941490]
  • Reduces TMAO: Gut bacteria produce TMA from choline and carnitine from foods such as red meat, egg yolks, and dairy. TMA is then converted to TMAO in the liver. High levels have been associated with heart disease risk. In a small human trial, researchers found that 21 patients with atherosclerosis showed an average decrease of plaque score by 3.2% after 4 months taking berberine at a dose of 500 mg twice per day.  [PMC9259588]
• Reduces Inflammation: The anti-inflammatory effects of berberine are significant, especially for individuals suffering from conditions like arthritis. It can help reduce pain and swelling associated with inflammatory conditions. This effect is not just limited to joint health but also extends to reducing systemic inflammation, which is a contributor to many chronic diseases.
• Boosts Digestion: The impact of berberine on digestive health is multifaceted. It promotes the growth of beneficial gut bacteria, which is essential for a healthy gut microbiome. Additionally, berberine helps reduce inflammation in the digestive tract, which can improve overall digestive function and may alleviate symptoms associated with gastrointestinal disorders.
• Fights Infections: Berberine possesses notable antibacterial properties. It can help the body combat harmful bacteria, potentially reducing the risk of infections. This property makes berberine a valuable supplement in boosting the body’s natural defense mechanisms against various bacterial infections.
• Supports Weight Loss: There is growing evidence that berberine may aid in weight loss. It appears to improve the body’s energy usage efficiency, which can lead to a reduction in body fat. This effect is particularly beneficial for individuals trying to manage their weight or combat obesity, as it can enhance metabolic rate and support healthier weight management.
• Improves Liver Function: Berberine may have a positive effect on liver health. It’s thought to enhance liver function by aiding in the detoxification process and improving liver enzyme levels. This can be particularly beneficial for people with fatty liver disease.
• Antioxidant Properties: Berberine also acts as an antioxidant. It helps combat oxidative stress, a factor in aging and many chronic diseases, by neutralizing harmful free radicals in the body.
• Enhances Immune Function: Beyond its antibacterial properties, berberine may strengthen the overall immune system. It may enhance the body’s ability to fend off various pathogens, including viruses and fungi, not just bacteria.
• Supports Mental Health: Emerging research suggests that berberine may have a beneficial impact on mental health. It might help alleviate symptoms of depression and anxiety, potentially due to its effects on neurotransmitters and neuroprotective properties.
• Helps with Polycystic Ovary Syndrome (PCOS): Women with PCOS may benefit from berberine. It’s been found to help regulate menstrual cycles, improve insulin resistance, and reduce hyperandrogenism (excess male hormones), which are all key concerns in PCOS.
• Anti-Cancer Potential: Preliminary studies suggest that berberine may have anti-cancer properties. It’s thought to induce cell cycle arrest and apoptosis (programmed cell death) in various cancer cell types, though more research is needed to fully understand this potential.

Berberine Stimulates Insulin Production

Berberine promotes the secretion of insulin. In a recent review of the literature involving over 3,000 patients, it was found to help lower blood sugar levels in people with type 2 diabetes. Unlike other diabetes medicines that increase insulin secretion and put users at risk for low blood glucose, berberine only causes insulin secretion when blood sugars are high.

It was found that berberine could lower fasting blood sugar levels by an average of about 14.8 mg/dL. The effect on hemoglobin A1c, a measure of long-term blood sugar control, was a decrease of 0.63%, which is significant. After-meal blood sugar levels were also lowered by an average of about 20.9 mg/dL. These effects were particularly pronounced in individuals who started with higher baseline blood sugar and HbA1c levels.

Berberine was found to be safe to use, as it did not significantly increase the incidence of adverse events or the risk of hypoglycemia, whether used alone or in combination with other oral diabetes medications. This suggests that berberine could potentially offer a safer alternative to traditional diabetes treatments that carry a risk of hypoglycemia. [PMC9709280]

Berberine Increases Insulin Receptors

In other studies, berberine was found to increase insulin receptors on the surface of cells and improve the way sugar is used in animal models. The research team then investigated the impact of berberine on individuals with type 2 diabetes. They showed that those who took berberine had lower levels of fasting blood sugar, hemoglobin A1c (a measure of long-term blood sugar control), triglycerides (a type of fat in the blood), and insulin. The improvements were comparable to standard diabetes medications, such as metformin and rosiglitazone.

Notably, berberine was also successful in reducing fasting blood sugar in patients with chronic hepatitis B or C who also had type 2 diabetes or prediabetes. For these people, liver function also seemed to improve, as indicated by decreased levels of liver enzymes. Given these findings and their earlier research, the researchers are confident that berberine could be a very promising treatment for type 2 diabetes, working differently from drugs like metformin and rosiglitazone. [PMID: 19800084]

Berberine Reduces Blood Glucose Production In the Liver

Researchers found that berberine can directly reduce fasting blood glucose levels by inhibiting the production of glucose in the liver, even without relying on insulin. This is important because it suggests that berberine may offer a potential natural approach to managing blood sugar levels in people with type 2 diabetes.

Also, berberine was found to reduce liver fat accumulation and inhibit the production of fatty acids, which are beneficial for overall metabolic health. These findings provide insight into the mechanisms by which berberine acts and support its potential as an alternative treatment for improving glucose metabolism in people with type 2 diabetes. Be sure to consult with a healthcare professional before starting any new treatment or supplement regimen. [PMC3033390]

Berberine Reduces Fatty Liver

Berberine can protect the liver and may potentially be used in non-alcoholic fatty liver disease (NAFLD) treatment. It improves NAFLD by inhibiting the production of fat and glucose, enhancing insulin sensitivity, improving lipid profile, and modulating gut microbiota. Although the exact mechanisms are not fully understood, there is increasing evidence supporting the positive impact of berberine on multiple metabolic pathways, such as lipid and glucose metabolism, energy balance, and gut microbiota. This suggests that it could be an important natural substance for the treatment of NAFLD. [PMC9459907]

Berberine Affects the Microbiome And That Affects Everything

Here’s a graphic from a recent review of studies on berberine and the microbiome. [PMC7933196]

An Even Deeper Dive Into Berberine

If you are a professional interested in developing an even deeper understanding of the physiological effects of berberine, check out this Youtube Video: Berberine: Liver and Metabolic Health or Berberine Treats Atherosclerosis in Humans (Small Study) by Mobeen Syed, MD, MS.

When you purchase linked products presented on this page, Supplement Sciences, LLC receives affiliate fees so that our dietitians can continue to create great content.

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Is Berberine Safe?

Extensive research and clinical studies have shown that berberine has a favorable safety profile with minimal adverse effects. Commonly reported side effects include mild gastrointestinal discomfort, which is generally transient and resolves on its own. Individuals taking prescription drugs should consult with a healthcare professional before starting berberine supplementation to ensure there are no potential interactions. Additionally, pregnant or breastfeeding women, as well as individuals with medical conditions, should seek medical advice before using berberine.

Medication Interactions with Berberine

Here is a list of some medications that may interact with berberine, along with the severity of each interaction:

• Blood thinners (e.g., warfarin): Severity: Moderate to severe. Berberine may increase the risk of bleeding when taken with blood thinners.
• Blood pressure medications (e.g., beta-blockers, calcium channel blockers): Severity: Moderate. Berberine may lower blood pressure, which could cause your blood pressure to drop too low when taken with these medications.
• Diabetes medications (e.g., insulin, metformin): Severity: Moderate. Berberine can lower blood sugar levels, so combining it with diabetes medications may lead to low blood sugar (hypoglycemia).
• Immunosuppressants (e.g., cyclosporine): Severity: Moderate. Berberine may interfere with the effectiveness of these medications, which could increase the risk of infections or other side effects.
• Antidepressants (e.g., selective serotonin reuptake inhibitors or SSRIs): Mild to moderate. Berberine may interact with these medications, potentially increasing the risk of side effects or reducing their effectiveness.
• CYP3A4 and CYP2D6 enzyme inhibitors: These include Fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox), duloxetine (Cymbalta), bupropion (Wellbutrin), quinidine, amiodarone (Cordarone), chloroquine (Aralen), ritonavir (Norvir), ketoconazole (Nizoral), itraconazole (Sporanox), voriconazole (Vfend), clarithromycin (Biaxin), telithromycin (Ketek), and grapefruit juice are medications or substances that are known inhibitors of both CYP3A4 and CYP2D6 enzymes. Berberine is broken down by these enzymes, so taking it with any of these medications may increase the amount of berberine in the body, leading to an increased risk of side effects.

Supplement Interactions with Berberine

• St. John’s wort: This supplement may decrease the effectiveness of berberine by speeding up how quickly it is broken down in the body.
• High-dose vitamin C: Large amounts of vitamin C may reduce the absorption of berberine, making it less effective.
• Milk thistle: Milk thistle can affect liver enzymes that break down berberine, which may lead to increased levels of berberine in the body and a higher risk of side effects.
• Goldenseal: Goldenseal contains berberine, so taking it with a berberine supplement may result in too much berberine and increase the risk of side effects.
• Echinacea: Echinacea can affect how the body processes berberine, potentially altering its effectiveness.

Summary

Berberine is a bioactive compound that can be extracted from several different plants, including a group of shrubs called Berberis. Historically, it has been used in various forms of traditional medicine around the world, primarily for its antimicrobial, anti-inflammatory, and antidiabetic properties. Recent research has found that berberine has potentially broad-spectrum health benefits, such as reducing blood sugar levels, decreasing cholesterol levels, and having potential anti-cancer properties. However, these claims are primarily based on laboratory and animal studies, and more clinical trials in humans are needed to fully confirm these benefits. As a supplement, berberine is generally considered safe but can have side effects, especially at high doses. These side effects include digestive problems like diarrhea, constipation, and stomach cramps.

Food First

Although overall diet was beyond the scope of this article, it should be top of mind. Not only will your overall food intake provide nutrients, it will have a profound effect on your gut microbiome. The tiny bacteria in your intestine are the modulators of your immune system. They can create molecules that are capable of turning genes on or off. They synthesize neurotransmitters. To avoid toxins, choose organic foods and avoid plastic packaging (even BPA-free) whenever possible.

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The Supplement Sciences website seeks to provide comprehensive access to the most relevant supplement information along with convenient online ordering. We do not provide medical advice and cannot guarantee that every product suggested is completely without risk. Since each person is unique in their health history and medication use, it is important to discuss supplements with your personal physician.

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