Berberine: benefits, side effects and dosage

A compound named berberine is one of the most effective natural supplements available.

It has awe-inspiring health benefits and impacts your body at the molecular level. Berberine has been shown to influence weight loss, lower blood sugar, and enhance heart health. It is one of the few supplements indicated to be as effective as a pharmaceutical drug [1].

What is Berberine?

Berberine is a bioactive compound from several plants, including a group of shrubs called Berberis [2]. Technically, it is classified into compounds called alkaloids. It is yellow and is often applied as pigment.

Berberine has a running history of use in conventional Chinese medicine to treat various ailments. Modern science has confirmed its impressive benefits for several health problems [3].

How does Berberine work?

Berberine has been tested in hundreds of various analyses. It was presented to have powerful effects on many biological systems.

After ingesting berberine, it gets carried in by the body and transported into the bloodstream. Then it travels into the body’s cells. It binds to several different “molecular targets” inside the cells and changes their function, similar to how pharmaceutical drugs work [4].

Without getting into much detail, as the biological mechanisms are complicated and diverse – one of the primary actions of berberine is to activate an enzyme inside cells called AMPK (AMP-activated protein kinase) [5]. 

Berberine has been tested in hundreds of various analyses.

This enzyme, sometimes referred to as a “metabolic master switch, ” is found in the cells of various organs, including the brain, heart, muscle, kidney and liver. It also plays a significant role in controlling metabolism. Berberine also affects multiple other molecules inside cells and may influence which genes turn on or off.

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Berberine causes a notable reduction in blood sugar levels: type 2 diabetes is a severe disease that has become extremely common in recent decades, generating millions of deaths yearly.

Represented by raised blood sugar (glucose) levels, either induced by insulin resistance or deficiency of insulin. Through time, elevated blood sugar levels can hurt the body’s organs and tissues, leading to various health problems and a shortened lifespan.

Many studies show that berberine can remarkably reduce blood sugar levels in individuals with type 2 diabetes. Its effectiveness is similar to the prevalent diabetes drug metformin (Glucophage) and seems to work via multiple different mechanisms [6]:

  • Augments glycolysis, enabling the body to break down sugars inside cells
  • Increases the figure of beneficial bacteria in the gut
  • Lessens sugar production in the liver
  • Lowers insulin resistance, driving the blood sugar decreasing hormone insulin more effective
  • Slows the disintegration of carbohydrates in the gut

In one study of 116 diabetic patients, a gram of berberine a day reduced fasting blood sugar by 20%, from 7.0 to 5.6 mmol/L (126 to 101 mg/dL), indicating a shift from from diabetic to normal levels [7]. It also lowered hemoglobin A1c by 12% (a marker for long-term blood sugar levels) and improved blood lipids like cholesterol and triglycerides.

A collective review of 14 studies reveals that berberine is as productive as oral diabetes drugs, including glipizide, metformin and rosiglitazone [8].

It fares very well with lifestyle modifications and has additive effects when dispensed with other blood sugar lowering drugs.

Per online discussions, you often see people with sky-high blood sugars standardising them just by taking this supplement.

Berberine may help you drop the pounds: berberine may also be useful a supplement to take for weight loss. So far, there ar two studies have examined the effects on body weight [9].

In a 12-week study on obese individuals, 500 mg taken three times per day caused an average of around 5 pounds of weight loss. The participating individuals also lost 3.6% of their body fat [10].

Another impressive study conducted was on 37 men and women with metabolic syndrome. This study lasted three months, and the participants took 300 mg daily.

The participants only dropped their body mass index (BMI) levels from 31.5 to 27.4, or from obese to overweight. They also lost belly fat and improved various health markers [11].

The researchers consider that the weight loss is caused by the improved function of fat-regulating hormones, like adiponectin, insulin and leptin.

Berberine also seems to deter the growth of fat cells at the molecular level. Although, more analysis is needed on the weight loss effects of berberine.

Lowers cholesterol and may scale down risk of heart disease: heart disease is presently the world’s most typical cause behind untimely death.

Several factors that can be gaguged in the blood are associated with an increased risk of heart disease. It turns out that berberine has shown to improve a lot of these aspects.

According to an analysis of 11 studies, it can:

  • Reduced overall cholesterol by 0.61 mmol/L (24 mg/dL).
  • Lower LDL (low-density lipoprotein or “bad fat”) by 0.65 mmol/L (25 mg/dL).
  • Lessened blood triglycerides by 0.50 mmol/L (44 mg/dL).
  • Higher HDL (high-density lipoprotein or “good cholesterol”) by 0.05 mmol/L (2 mg/dL).

It has also been documented to lower apolipoprotein B by 13-15%, a critical risk factor. Per some studies, berberine works by inhibiting an enzyme called PCSK9, leading to more LDL being removed from the bloodstream.

It is also good to note that diabetes, obesity and high blood sugar levels are primary heart disease risk factors, all of which appear to improve with taking berberine.

Health benefits of berberine

Berberine may also have considerable other health benefits:

  •  Anti-inflammatory and antioxidant: it has been shown to have powerful antioxidant and anti-inflammatory effects in some studies [12].
  • Cancer: animal and test tube studies have shown that it can lessen the growth and spread of different types of cancer [13].
  • Depression: rat studies show it may help combat depression [14].
  • Fatty liver: it can lower fat build-up in the liver, which should help safeguard against non-alcoholic fatty liver disease (NAFLD) [15].
  • Heart failure: a study yielded that it drastically improved symptoms and reduced the risk of death in heart failure patients [16].
  • Infections: it has been shown to resist harmful microorganisms, including bacteria, fungi, parasites and viruses [17].

Many benefits need more research before making firm recommendations, but current evidence is promising.

Berberine and its effect on blood sugar levels

Raised blood sugar levels indicate conditions like diabetes and prediabetes due to reduced insulin production or decreased sensitivity to insulin.

Although it’s standard for your blood sugar levels to fluctuate throughout the day, prolonged high blood sugar levels can cause diverse health problems, including organ damage.

A decent amount of animal research implies berberine may help lower blood sugar levels through various pathways, including the following:

  • Augmenting glycolysis, or the breakdown of glucose
  • Controlling metabolism
  • Delaying carbohydrate absorption from the gut
  • Improving insulin sensitivity
  • Lowering glucose production in the liver
  • Raising nitric oxide (NO) production, which helps widen arteries
  • Stimulating insulin production
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Several studies on individuals with type 2 diabetes show that consuming 600–2,700 mg of berberine may diminish fasting and long-term blood sugar levels by up to 20% and 12%, subsequently, specifically when taken alongside blood sugar medication [18].

Similarly, research suggests berberine may aid in supporting the blood-sugar-lowering effects of other diabetes medications when taken with them. Accordingly, berberine seems to be a promising blood-sugar-lowering treatment. This may be particularly helpful to those who cannot take diabetes medications because of heart, kidney or liver disease.

Insufficient evidence to rate berberine’s effectiveness

Here are several conditions which berberine may have been used for but does not carry enough evidence of efficacy:

  • Burns: early research suggests that using an ointment containing beta-sitosterol and berberine and can medicate second-degree burns as adequately as conventional treatment with silver sulfadiazine.
  • Congestive heart failure (CHF): early research implies that berberine can reduce some symptoms and lessen the death rate in some individuals with congestive heart failure.
  • Diarrhea: some early research tells that berberine sulfate can decrease diarrhea in people with certain bacterial infections. In addition, berberine hydrochloride seems to hasten recovery time for people with diarrhea when added to some standard treatments. Although, berberine does not seem to enhance the effects of tetracycline in treating diarrhea related to cholera infection.
  • Glaucoma: eearly research says that using eye drops containing berberine and tetrahydrozoline for three days does not lessen eye pressure in individuals with glaucoma better than eye drops containing tetrahydrozoline alone.
  • Hepatitis: early research says that taking berberine daily for two months lowers triglycerides, blood sugar and markers of liver damage in individuals with diabetes and hepatitis B or C.
  • Injuries caused by radiation: some early research reports that taking berberine during radiation therapy can recede the occurrence and severity of some damages provoked by radiation in patients receiving treatment for cancer.
  • Liver disease: early research says that taking berberine for 12 weeks lowers fat in the blood and markers of liver damage in individuals suffering from liver disease and diabetes.
  • Sparse blood platelet counts (thrombocytopenia): blood platelets are essential for the process of blood clotting. According to early research, taking berberine for 15 days – either by itself or along with prednisolone, can raise the count of blood platelets in individuals with low blood platelet counts.
  • Menopausal symptoms: early research mentions that taking berberine and soy isoflavones can lessen menopausal indications.
  • Metabolic syndrome: taking an aggregate product (Armolipid Plus) with berberine, red yeast rice and policosanol might improve blood flow and blood pressure in individuals suffering from metabolic syndrome.
  • Obesity: early research maintains that taking berberine for 12 weeks can lower weight in obese people by around five pounds.
  • Osteoporosis: early research suggests that taking berberine with vitamin D3, vitamin K and a chemical found in hops for 14 weeks can lower bone loss in postmenopausal women with osteoporosis.
  • Ovary disorder also known as polycystic ovary syndrome (PCOS): early research adds that berberine can lower cholesterol, blood sugar, , triglycerides, testosterone and waist-to-hip ratio in women with PCOS.
  • Stomach ulcers from by Helicobacter pylori (H pylori) infection: early research suggests that taking berberine three times daily for six weeks is more effective than the drug ranitidine at eliminating H. pylori infection, but lacking efficacy at healing ulcers in people with stomach ulcers due to H. pylori.
  • Trachoma: there is some data that eye drops with berberine might help treat trachoma, a common reason of blindness in developing countries.

Is Berberine safe?

Individuals should consult their doctor before using berberine products [19]. Here are some potential risks, according to the National Center for Complementary and Integrative Health (NCCIH):

  • Berberine may inhibit other medications, such as metformin.
  • It is not always evident how much of an active ingredient is included in a supplement, which could lead to taking the wrong dosage.
  • Unfavourable effects can occur if people take too much or if a person is susceptible.
  • There is insufficient scientific information to prove that goldenseal and other berberine products are safe for long-term use.
  • Taking berberine while pregnant or while breastfeeding could harm the fetus or newborn.

Berberine dosage and side effects

Many studies mentioned used dosages ranging from 900 to 1500 mg daily. It is usual to take 500 mg, three times daily before meals (1500 mg/daily).

Berberine has a half-life of a few hours, so it is critical to spread your dosage several times daily to attain steady blood levels. If suffering from a medical condition or are currently on any medications, then it is suggested that you first communicate with your doctor before taking it. This is especially critical if you are currently taking blood sugar-lowering medications.

In general, berberine has an excellent safety profile. The main side effects link to digestion and some reports of constipation, cramping, diarrhea, flatulence and stomach pain [20].

Drug interactions that need attention

It’s always best to discuss with your health practitioner prior to starting any supplements, especially if you’re currently taking other drugs [21]:

Cyclosporine (Neoral, Sandimmune): Do not take this combination. The body breaks down cyclosporine (Neoral, Sandimmune) to get rid of it. Berberine might reduce how fast the body breaks down cyclosporine (Neoral, Sandimmune). Cyclosporine (Neoral, Sandimmune) might build up in the body and could cause side effects.

Medications for diabetes (Antidiabetes drugs): Do not take this combination. Berberine might lower blood sugar and diabetes medications are used to lower blood sugar as well. Berberine and diabetes medications might cause your blood sugar to go too low. Observe and striclty monitor your blood sugar and the dosage of diabetes medication might need to be adjusted. Some drugs used for diabetes include glyburide (Diabeta, Glynase PresTab, Micronase), glimepiride (Amaryl), insulin, pioglitazone (Actos), rosiglitazone (Avandia), among others.

Dextromethorphan (Robitussin DM, and others): Be cautious with this combination. The body breaks down dextromethorphan (Robitussin DM, others) to eliminate it. Berberine might decrease how quickly the body breaks down dextromethorphan (Robitussin DM, others). Taking berberine while taking dextromethorphan (Robitussin DM, others) might increase the effects and side effects of dextromethorphan (Robitussin DM, others).

Losartan (Cozaar): Be careful with this combination. The liver triggers losartan (Cozaar) to make it function. Berberine could decrease how fast the body breaks down losartan (Cozaar). Taking berberine while taking losartan (Cozaar) might reduce the effects of losartan.

Berberine is one of the several supplements that are as effective as a drug. It strongly affects various aspects of health, especially blood sugar control.

The individuals who benefit the most are those with type 2 diabetes and metabolic syndrome. Nevertheless, it may also be helpful as a general defence against chronic disease, as well as an antiaging supplement. If you use supplements, berberine may be one of the top ones to include in your arsenal.

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[1] https://www.healthline.com/nutrition/berberine-diabetes#berberine-blood-sugar
[2] http://www.naturalmedicinejournal.com/journal/2012-12/clinical-applications-berberine
[3] https://www.ncbi.nlm.nih.gov/pubmed/25498346
[4] https://www.ncbi.nlm.nih.gov/pubmed/24174332
[5] http://diabetes.diabetesjournals.org/content/55/8/2256.full
[6] https://www.ncbi.nlm.nih.gov/pubmed/25861268
[7] https://www.ncbi.nlm.nih.gov/pubmed/18397984
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3478874/
[9] https://www.ncbi.nlm.nih.gov/pubmed/23118793
[10] https://www.ncbi.nlm.nih.gov/pubmed/23118793
[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310165/
[12] http://www.hindawi.com/journals/ecam/2014/289264/
[13] http://journals.lww.com/anti-cancerdrugs/Abstract/2009/10000/A_systematic_review_of_the_anticancer_properties.1.aspx
[14] https://www.ncbi.nlm.nih.gov/pubmed/18585703
[15] http://translational-medicine.biomedcentral.com/articles/10.1186/s12967-015-0383-6
[16] https://www.ncbi.nlm.nih.gov/pubmed/12860219
[17] https://www.ncbi.nlm.nih.gov/pubmed/12422513
[18] https://pubmed.ncbi.nlm.nih.gov/18397984
[19] https://www.medicalnewstoday.com/articles/325798
[20] https://www.ncbi.nlm.nih.gov/pubmed/18442638
[21] https://www.rxlist.com/berberine/supplements.htm

The information included in this article is for informational purposes only. The purpose of this webpage is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.