Berberine: Uses, Benefits, Supplements And Side Effects

Berberine has a long history of use in traditional medicine systems, such as Ayurveda and East Asian medicine. It’s a bitter-tasting chemical compound derived from a variety of plants, such as hydrastis canadensis (goldenseal), coptis chinensis (coptis or goldenthread) and berberis vulgaris (barberry). Research suggests berberine may have antimicrobial and antibiotic properties, as well as a positive effect on metabolism, but further clinical trials are needed to confirm these benefits.

Berberine may also have numerous physiological benefits and pharmacological activities in the liver, kidney, heart and brain, potentially providing further metabolic support. For example, berberine activates the enzyme AMP-activated protein kinase, which research suggests helps regulate metabolism, cell function and energy levels.

Berberine is mainly used to potentially help lower blood sugar, improve cardiovascular health, reduce oxidative stress and lower cholesterol, as well for its anti-diarrheal, anti-inflammatory and anti-cancer effects, says Heather Zwickey, Ph.D, professor of immunology at the National University of Natural Medicine in Portland, Oregon.

Berberine is typically found in capsule form, but it’s also formulated as eye drops and gels for a variety of inflammatory conditions of the skin, eyes or joints.

Many plants and herbs containing berberine have been used medicinally for thousands of years, yet more research is needed to understand the compound’s mechanisms of action and long-term effects. With that said, research suggests it may benefit one’s health in several ways.

May Help Lower Blood Sugar and Prevent Insulin Resistance

A 2022 review in Molecules shows berberine can help lower blood glucose levels because it increases insulin production and improves insulin sensitivity, though more research is needed to fully understand these effects[1].

May Help Lower Cholesterol

Research indicates berberine may have a positive effect on LDL cholesterol and total cholesterol, though additional clinical trials are needed to understand this health claim completely.

May Improve Cardiovascular Health

Berberine may have a positive effect on cardiac tissue, especially in cases of ischemia (inadequate blood supply), by potentially improving cardiac muscle strength, decreasing inflammation, reducing oxidative stress, lowering blood pressure and increasing cardiac output.

May Have Anti-Inflammatory Effects

Berberine is a bitter alkaloid that provides systemic anti-inflammatory effects, says Alicia McCubbins, a naturopathic doctor based in Vancouver, Washington. These properties may benefit overall metabolic processes, such as potentially contributing to the prevention of atherosclerosis, type 2 diabetes, obesity and cardiovascular complications. Berberine’s anti-inflammatory properties have been studied at length, but its mechanism of action is not yet understood, highlighting a need for additional research.

May Have Antioxidant Properties

A 2018 review in Frontiers in Pharmacology concludes that berberine’s antioxidant effects are comparable to that of vitamin C, a highly potent antioxidant[2]. Substances like vitamin C and berberine act as antioxidants to help avoid the damage free radicals can cause to cells.

May Have Antibacterial and Antimicrobial Properties

”Berberine has astringent properties and is considered a natural antimicrobial with potential to oust bacteria, parasites and fungi/candida,” shares Dr. McCubbins. These antimicrobial properties may help improve certain conditions, such as acute diarrhea, dysentery, jaundice and vaginal infections, though more research is needed to support these claims. If an individual believes they have a bacterial infection of any kind, they should consult their health care provider for proper diagnosis and treatment before taking berberine or any other supplement.

May Improve Digestive Health

Berberine may benefit digestive concerns, such as constipation and heartburn, according to Dr. McCubbins. “These alkaloids may provide promising benefits to the gut-brain connection,” she adds, emphasizing the importance of the link between digestion, mood and overall health.

May Support Weight Loss and Weight Management

Berberine may help decrease fat and glucose storage by improving metabolic processes, such as the breakdown of lipids (fats) and sugars, research suggests. Berberines’ positive impact upon the gut microbiome may also be a key component in its support of weight management.

May Improve Symptoms of Polycystic Ovarian Syndrome (PCOS) and Ovulation

According to the review in Molecules, taking 1,500 milligrams of berberine a day for three months reduced high testosterone levels in women with PCOS[3]. This condition may involve abnormal reproductive hormone levels and result in a range of imbalances, leading to issues like small cysts on the ovaries or abnormal menstruation. Experts also believe berberine improves insulin resistance, which is a common feature of PCOS. However, researchers suggest further clinical trials are needed to confirm this effect of berberine, including treatment length and therapeutic dosing.

 

How to Take Berberine?

Berberine supplements are available in capsule, tablet or tincture form, allowing for precise dosing and easy consumption. Capsules may be preferable for most consumers given its very bitter taste, explains Dr. McCubbins. “Berberine is often taken as a digestive tonic 5 to 30 minutes prior to meals. Berberine is naturally bitter which stimulates gastric juices for more efficient functional digestion,” she continues.

Berberine Dosage

Individuals should consult a health care provider or herbalist to discuss accurate dosing (which isn’t standardized), and read the manufacturer’s instructions, says Dr. Zwickey. “It’s generally considered safe in [daily] doses of [no more than] 2 grams. To [achieve optimal results], an individual likely wants to use at least 1 gram (1000 milligrams) per day. Most supplements [contain] 500 milligrams per capsule, so someone would want to take [at least two] capsules per day,” she continues.

Berberine dosage may depend on an individual’s health goals. Regarding blood sugar, a 2019 systematic review and meta-analysis in the Endocrine Journal found taking under 2 grams of berberine a day for three months positively affected blood glucose levels of participants with type 2 diabetes[4].

Meanwhile, a review of available research in Complementary Therapies in Clinical Practice examined the dose response of berberine extract for people with obesity and looking for weight management, finding that doses of 500 milligrams taken three times a day led to a decrease in body mass index (BMI), waist circumference and body weight[5].

Berberine Side Effects

Berberine supplements can have some side effects, including diarrhea, stomach upset and headache, says Dr. McCubbins.

“Berberine is rising in popularity and heavily marketed to the weight loss community,” she continues. “Be cautious and consult a naturopathic doctor about [the] therapeutic use [of berberine before consuming it].”

While berberine is usually well tolerated, it may cause abdominal pain and distension, constipation, diarrhea, flatulence, nausea and vomiting, adds Dr. Zwickey.

Is Berberine Safe?

The main safety concern of berberine is that it may interact with several medications, says Dr. Zwickey. The most severe potential interaction is with cyclosporine, an immunosuppressive drug used after an organ transplant and to help manage autoimmune conditions like rheumatoid arthritis, as berberine increases the concentration of cyclosporine in the blood, she explains.

Regardless of whether a person takes berberine as a standalone extracted supplement or in a whole herbl format, it’s important to follow the recommended dose instructions provided by the product manufacturer or a health care professional. Berberine is contraindicated for children, as well as pregnant and lactating people, notes Dr. Zwickey.

What to Consider When Purchasing Berberine?

Because most manufacturers purify berberine from a plant, third-party laboratory testing for identity of berberine, strength, quality and purity is essential, says Dr. Zwickey. “One should be very particular about supplement sourcing from a physician-grade supplement company to ensure third-party testing from reputable companies and quality assurance for [the] best [dosing] regulation,” adds Dr. McCubbins.

It’s also important to ensure berberine is sourced sustainably, according to Dr. McCubbins. “Goldenseal, though an excellent source of berberine, is endangered. Reputable supplement companies are aware of this [issue],” she explains. Most supplement labels specify from what herbs the berberine is extracted.

As berberine is lacking long-term safety studies, one should consult with a health care provider before adding berberine to their supplement regimen to ensure it’s appropriate and safe for their unique health needs. To learn more about berberine’s potential health benefits, speak with a naturopathic doctor, certified herbalist or acupuncturist.