Berberine | Benefits, Supplements and Side Effects

Herbs and their associated bioactive compounds have been used in Eastern medicine for millennia. Now, they are becoming increasingly popular for managing various health conditions and supporting overall wellness in many parts of the world, especially the United States.

One particularly intriguing herbal compound is berberine, which comes from a number of plants. Berberine supplementation has been suggested to promote weight loss and improve blood sugar, among many other benefits.

However, you may wonder whether these claims are true and if berberine supplementation has any risks. This article discusses everything you need to know about berberine, including what it is, its health benefits, potential side effects, and dosing information.

What is Berberine?

Berberine is an isoquinolone alkaloid found in various plants, but the Berberis genus, commonly known as barberry, represents its main natural source. Around 500 species comprise the genus Berberis, which consists of spiny evergreen shrubs with yellow inner bark (1). Berberine is widely distributed throughout these plants, but the bark and roots tend to be richer in berberine compared with other plant parts.

Today, berberine is commonly used as a dietary supplement to lower blood sugar, promote weight loss, and improve components of metabolic syndrome, such as high blood pressure. It has strong anti-inflammatory, antioxidant, anti-diabetic, and immune-enhancing properties (1).

Owing to these properties, the compound has traditionally been used for thousands of years to treat inflammation, infectious diseases, indigestion, and constipation, among other conditions

Benefits of Berberine

There are dozens of studies to support berberine for its various purported health benefits.

Berberine Lowers Blood Glucose for People with Type 2 Diabetes

Berberine can lower blood glucose by increasing insulin receptor expression (2). Insulin, a hormone produced and secreted by the pancreas, binds to these receptors to shuttle blood sugar into cells, thereby lowering blood glucose.

Berberine may also inhibit the enzyme needed to digest and absorb blood glucose. Many diabetes medications also act through these pathways to lower blood sugar levels.

In a review of 37 randomized controlled trials, type-2-diabetes patients given a berberine supplement experienced a significant decrease in fasting blood sugar and in blood sugar two hours after a meal (2). These decreases significantly improved the patients' average blood sugar levels compared to the previous 2–3 months.

Another review of 46 randomized controlled trials found that berberine alone or combined with standard diabetes medications like metformin significantly lowered blood sugar and improved insulin resistance in patients with type 2 diabetes (3).

Berberine is unlikely to lower blood sugar levels in people without diabetes, but it may still be beneficial for people with insulin resistance, a hallmark of metabolic syndrome and nonalcoholic fatty liver disease.

Berberine May Lower High Blood Pressure and Aid Other Metabolic Issues

High blood pressure is a leading cause of chronic kidney disease and cardiovascular or heart disease. Berberine may lower blood pressure by enhancing acetylcholine levels and preventing its breakdown.

Acetylcholine is a neurotransmitter that, among other things, increases blood circulation by stimulating nitric oxide production. A review of three trials found that berberine was more effective for lowering high blood pressure when combined with blood pressure medication than blood pressure medication alone in patients with type 2 diabetes (4).

High cholesterol and triglyceride levels are other metabolic issues that increase your risk for heart disease and other chronic conditions. Berberine activates a protein called AMP-activated protein kinase (AMPK) that suppresses the production of these fats while promoting their breakdown (5). One review concluded that berberine can lower LDL "bad" cholesterol by 20 to 55 mg/dL, and triglyceride levels by 25 to 55 mg/dL (6).

Another trial involving 63 patients with an imbalance of blood lipids demonstrated that berberine was more effective than simvastatin — a common cholesterol medication — for lowering LDL cholesterol.

However, the combination of berberine with simvastatin was the most effective compared with either alone (7).

Berberine May Promote Weight Loss

Berberine's potential ability to promote weight loss has some people calling it "nature's Ozempic," in reference to a drug used to treat diabetes but is commonly prescribed for weight loss.

Berberine may promote modest weight loss by improving blood sugar control and supporting fat metabolism (8). A review of 12 studies demonstrated that participants given berberine experienced an average weight loss of about 4.6 pounds (2.07 kg) over an average of three months, resulting in a significant decrease in body mass index and waist circumference compared to placebo (8).

Those categorized as obese based on body mass index lost the most weight from berberine. The same review also found reduced concentrations of C-reactive protein (CRP)—a measure of inflammation—in those taking berberine.

Possible Effective For Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common hormonal condition in females.

The condition is associated with infertility, acne, elevated testosterone, and insulin resistance, among other health issues.

Berberine may be a potential treatment option for PCOS since it has been shown to improve hormonal balances and insulin sensitivity and promote modest weight loss (9).

It may also enhance the efficacy of drugs commonly prescribed to manage PCOS such as metformin and oral contraceptives (9).

Potential Side Effects of Berberine

Most of the data suggests that berberine is safe, well-tolerated, and has no negative effect on liver function enzymes (10). However, some studies have reported gastrointestinal symptoms, such as constipation, diarrhea, nausea, and bloating (11).

Even so, these symptoms tended to occur no more frequently with berberine than with the placebo. Despite being relatively safe and well-tolerated, it's still a good idea to talk with your doctor before taking berberine. This is especially true if you take any prescription drugs, since berberine can enhance the efficacy of various medications — especially those for diabetes, cholesterol, and blood pressure.

Berberine may also interfere with medications prescribed for blood clotting.

Avoid taking berberine if you are pregnant or breastfeeding.

Berberine Supplement Dose and Quality

Berberine is most commonly sold by itself in hydrochloride or sulfate forms (generally in capsules). Much of the research on berberine demonstrates benefits with a total dose of 1 to 1.5 grams daily, split into two or three 500-mg doses for three to four months.

Like other herbal supplements, berberine supplements may be adulterated. Adulteration can result from contamination, low-quality ingredients, or less expensive procurement and manufacturing processes to increase profits.

Adulteration — while not always deliberate — can cause significant harm, especially if it results in the product containing an unlabeled or banned ingredient.

You can prevent the risk of adulteration by choosing reputable manufacturers that have their products third-party tested for potency and purity. For example, Transparent Labs GDA contains patented GlucoVantage Dihydroberberine®, a highly bioavailable berberine derivative (making it efficacious in much lower doses than traditional berberine supplements).

Should You Try Berberine?

Berberine likely improves blood sugar and other markers of metabolic health like cholesterol, triglycerides, and high blood pressure.

Supplementation has also been shown to promote modest weight loss. However, most studies supporting the benefits of berberine also required positive lifestyle changes related to diet and exercise.

It's also unknown whether berberine's potential benefits would continue or diminish past three or six months or if there would be any regression after you stopped taking it.

Therefore, if you wish to try berberine to manage your blood sugar, promote weight loss, or for some other health goal, you'll get the greatest — and most sustainable — benefits by improving your diet, being physically active, managing stress, and sleeping well.

Frequently Asked Questions about Berberine Supplements

Is Berberine Safe?

Berberine has a relatively strong safety profile and is well-tolerated, but some people have reported diarrhea, constipation, nausea, and bloating with supplementation.

Is Berberine Good for Weight Loss?

Berberine has been shown to induce modest weight loss and decrease waist circumference when combined with a low-calorie diet, physical activity, or both.

Is Berberine a Blood Thinner?

Berberine has been shown to have anticoagulant or blood-thinning effects, so it can interfere with blood clotting medicines or enhance their side effects like bruising and bleeding (12).

Is Berberine Like Ozempic?

Berberine has been suggested to induce glucagon-like peptide 1 (GLP-1) secretion—in the same way as Ozempic—to stimulate insulin secretion, slow digestion, and decrease satiety (13). Unlike berberine, however, Ozempic can decrease hunger and cravings and, as a result, significantly promote weight loss.

Is Berberine Hard on the Kidneys?

Berberine hasn't been shown to harm the kidneys; contrarily, some animal studies suggest berberine may protect against kidney damage by protecting the cells from oxidative stress (14, 15).

Is Berberine an Appetite Suppressant?

Animal studies suggest that berberine may reduce food intake, but its effects on the hunger hormones, satiety signals, and food intake in humans are largely unknown (16).

Is Berberine Better Than Metformin?

Studies suggest that berberine has a similar blood sugar-lowering effect as the commonly prescribed diabetes drug metformin (17).

Like metformin, berberine can also improve cholesterol and triglyceride levels and promote weight loss.

Whether one is better than the other remains to be determined; given the nature of the drug-approval process, much more evidence supports metformin's uses and benefits.

The Bottom Line on Berberine Supplements

Berberine is an isoquinolone alkaloid derived from various plants, primarily barberry and goldenseal. Taking berberine can lower blood sugar in people with diabetes, lower high blood pressure, and improve other markers of metabolic health, including cholesterol, triglyceride levels, and body weight (however, its effects on weight loss are relatively modest).

Berberine may also serve as a potential treatment for managing PCOS (polycystic ovary syndrome) by modulating endocrine function.

The most effective dose of berberine is 1,000 to 1,500 mg per day, taken in two or three 500-mg doses for at least three months. It's generally best to take berberine before meals, but this is not required.

Berberine is relatively safe and well-tolerated, but it can interfere with or increase the effectiveness of certain drugs. If you take prescription medications, it's best to consult with your healthcare physician before taking berberine supplements.