Berberine Research Analysis

Q: Does berberine help with weight loss?

In people with preexisting conditions that are related to metabolism (e.g., type II diabetes, PCOS, CVD, metabolic syndrome, NAFLD), berberine could potentially induce weight loss (as measured through BMI, body weight, waist circumference, and waist to hip ratio).[5][8][4][25] However, the few studies in otherwise healthy participants did not echo these findings.[26][25] Given the mechanisms by which berberine acts on metabolism, this might point to weight loss merely being a function of berberine’s regulation of metabolic factors, such as a decrease in the genes responsible for the body’s production of lipids and/or an increase in stored fatty tissue being used for energy.[18] If so, then berberine may not be useful for weight loss in those without the matching genetic predisposition, since, for example, not all people who want to lose weight will meaningfully underexpress genes for fatty acid metabolism. While preclinical evidence on berberine for weight loss in those with metabolically related conditions is promising, the clinical evidence is still lacking in overall quality and consistent findings.[7]

Q: Does berberine affect reproductive health and function?

The largest body of evidence for berberine in reproductive health is as a treatment for people with PCOS.[27][4][7] Some research has been done on berberine’s effects on uterine fibroids[28], premature ovarian failure,[29] and dysmenorrhea,[30] but these studies are few and/or still in preclinical phases. In people with PCOS, clinical evidence suggests that berberine, at doses ranging from 300 mg/d to 2000 mg/d, may be beneficial for pregnancy and/or conception: when compared with placebo or no treatment at all, berberine may aid in reducing of testosterone and the ratio of LH to FSH.[4] It is unclear, however, whether this is a direct effect or simply a result of berberine’s impact on other factors such as glucose and blood lipid regulation.[4][7] Another point worth consideration is that it does appear that higher doses of berberine are more prone to adverse events, and there simply is not enough evidence available to confirm the safety of berberine in (or surrounding) pregnancy.[7]

Q: Does berberine affect immune health and function?

A more recent topic of exploration has been berberine’s immune modulation through reductions in inflammatory biomarkers (IL-6, IL-1-beta, CRP, and TNF-α) generally in those already with some form of metabolic distress (diabetes, metabolic syndrome, cardiovascular disease).[31][5][8][32][3] In another apparent connection between berberine and immune health, three recent studies suggest that berberine (0.3-0.6 g/d) could reduce recurrence of colorectal polyps in those with a history of colorectal cancer, when compared to placebo controls.[9] Though more recent results may be a bit more promising, caution is warranted since there are still some concerns over the quality (and sometimes quantity) of the studies producing the findings.[7]

Q: Does berberine have antimicrobial effects?

Some of the longest-standing research on berberine’s health effects concerns its use as an antimicrobial.[2][3] Berberine has mixed results when studied for its properties as an antiviral (HIV, coronaviruses, influenza), antibacterial (H. pylori, V. cholerae, S. aureus), and even as an antifungal. Taking this body of evidence into account, berberine’s best use as an antimicrobial seems to be as an adjunctive or combination therapy.[33][3][34]

Q: How does berberine reduce blood lipids and cholesterol?

As mentioned in the section above, berberine activates AMPK, which (among other things) suppresses the synthesis of lipids while promoting their breakdown, leading to a net reduction of their concentration in the blood.[13][18] Alongside its AMPK-dependent effects, berberine additionally benefits blood lipids by increasing the abundance of low-density lipoprotein receptors (LDLR). While it doesn’t increase expression of LDLR, it does increase the stability of the mRNA transcripts that go on to become LDLR proteins, which increases the abundance of LDLR receptors in cells and increases the rate at which they remove LDL cholesterol from the blood.[19] Additionally, berberine also lowers cholesterol by interfering with its absorption in intestines and its release into the blood.[20] One noteworthy thing that berberine doesn’t do is interfere with cholesterol synthesis in the body. This contrasts with the most common class of cholesterol-lowering medications, statins, which directly inhibit the rate-determining enzyme of cholesterol synthesis, HMG-CoA reductase.[19] Because its mechanism of action is distinct from that of statins, it means berberine has potential to be useful either in conjunction with, or as a replacement for, statins. Current clinical studies on this topic, while hopeful, are still unclear, due to inconsistent findings across the body of evidence.[3][21][22] In a similar vein, perhaps through its influence on blood lipids (or perhaps via effects on inflammation), berberine shows some promise as an antihypertensive when used as an add-on to standard of care treatments.[23] There are few good-quality clinical studies on this topic though, so more evidence is needed.[24]

Nick Milazzo

Berberine

•Last Updated: August 7, 2023

Berberine is a plant alkaloid with a long history of use in Ayurvedic and traditional Chinese medicine for the management of various health conditions. Its seemingly potent ability to reduce blood sugar rivals that of some anti-diabetic drugs.

Dosage

Examine Database

Research feed

Berberine is most often used for

Nick Milazzo, MSc, MPH

•

Daryl Nault, BA, MS

Antonis Damianou, MSc

•

Natalka Roshak, AB

Last Updated:August 7, 2023

Dosage Information
Examine Database
Research feed
Frequently asked questions
Update History
References

What is berberine?

Berberine is an alkaloid found in the barks, leaves, twigs, rhizomes, roots, and/or stems of various plants, such as barberry, Oregon grape, and tree turmeric. Traditionally, berberine has been used as an antimicrobial, antiprotozoal, and antidiarrheal agent in Ayurvedic medicine and traditional Chinese medicine.^[1]^[2]^[3] Most research in humans has examined berberine’s effects on markers of glycemic control, blood lipids, markers of liver function, and anthropometric parameters in people with metabolic disorders.

What are berberine’s main benefits?

Evidence from clinical trials conducted in people with type 2 diabetes (T2D) suggests that berberine’s glucose-lowering effect may be on par with some anti-diabetic drugs or standards of care.^[4]^[5] In people with metabolic disorders, limited research suggests that berberine may improve blood lipids and liver enzymes, and reduce body weight and fat mass.^[6] However, most of the available trials examining the effects of berberine on the aforementioned outcomes are of poor methodological quality.^[7] The best-quality clinical evidence on berberine’s effects to date are related to improvements in hormonal health in polycystic ovarian syndrome (PCOS) and to immune system response. Even these studies, however, warrant interpretation with a degree of caution due to the imprecision and inconsistency of their results.^[7] In those with PCOS, the evidence suggests that berberine may improve hormonal outcomes.^[4] In those with a variety of metabolic conditions (T2D, dyslipidemia, cardiovascular disease), berberine may be able to lower C-reactive protein (CRP), a biomarker of inflammation.^[8] Finally, in those with a history of colorectal cancer, it was found that berberine could potentially reduce the recurrence rates of colorectal polyps.^[9]

Does berberine help with weight loss?

Does berberine affect reproductive health and function?

Does berberine affect immune health and function?

Does berberine have antimicrobial effects?

What are berberine’s main drawbacks?

Although berberine appears to be generally safe, more long-term safety research is needed. Supplementation with berberine (especially in doses above 300 mg/day) has been reported to cause gastrointestinal side effects in some people, including diarrhea, constipation, flatulence, and stomach pain.^[10] Due to its ability to reduce blood sugar, berberine may increase the risk for hypoglycemia in high doses. Additionally, berberine inhibits several enzymes involved in drug metabolism, so there’s a risk of serious drug interactions when taken alongside other medications or supplements.^[11]

How does berberine work?

Berberine seems to produce most of its benefits through acting on high-level controllers of energy homeostasis, including the enzymes adenosine monophosphate-activated protein kinase (AMPK), protein kinase c (PKC), and sirtuin 1 (SIRT 1), all of which regulate biological processes related to metabolism, immunity, and inflammation.^[12]

How does berberine reduce blood sugar?

How does berberine reduce blood lipids and cholesterol?

What are other names for Berberine?

Berberine should not be confused with:

Piperine (Black Pepper extract)
Berberol (Brand name)
Berberrubine (Metabolite)

Dosage information

The standard dose of berberine is 900-2,000mg a day, divided into three to four doses.

Berberine should be taken with a meal, or shortly after, to take advantage of the blood glucose and lipid spike associated with eating.

Too much berberine at once can result in stomach upset, cramping, and diarrhea.

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