Berberine: a natural wonder

Berberine is a naturally occurring alkaloid found in various plants, including Berberis aristrata (tree turmeric), Berberis vulgaris (barberry), goldenseal plants, and even the California poppy (Eschscholzia californica). It boasts a rich history of use in traditional Chinese and Ayurvedic medicine and first caught the attention of researchers in 1980s China when it was employed in the treatment of type 2 diabetes.

Type 2 diabetes is a metabolic disorder characterised by reduced insulin production or insulin resistance and can be managed through a combination of oral medications, lifestyle adjustments, or insulin injections. In contrast, type 1 diabetes is an autoimmune disease requiring lifelong insulin injections.

Ozempic and similar prescription medications have gained considerable attention recently, largely thanks to celebrities and individuals achieving remarkable weight-loss results. This surge in interest has prompted people to seek alternative solutions.

The potential benefits of berberine

Let’s dive into the research on berberine and its effects.

In October 2022, a comprehensive review of clinical studies and meta-analysis examined the efficacy of berberine supplementation on various cardiovascular disease risk factors. The authors reviewed 49 clinical trials and aggregated the results for a comprehensive analysis.

Their findings revealed that berberine use correlated with reductions in systolic blood pressure, weight, BMI, triglycerides, total cholesterol, fasting blood glucose, insulin, and haemoglobin A1C (a measure of average blood glucose over the past three months). The average weight loss across all studies, doses, and time frames was relatively modest, averaging 0.84 kilos. However, these results were primarily observed in individuals with room for metabolic or weight improvements.

For instance, only studies involving individuals with elevated fasting blood sugar showed improvements in blood sugar levels. Participants with normal BMI (18.5-24.90) demonstrated that berberine supplementation had no effect on improving various health markers. Only two studies in the review assessed people with normal BMI ranges and no underlying health conditions, with no significant impact observed or with the placebo outperforming berberine.

The findings also suggested that longer durations of berberine supplementation were necessary to see notable results, with most studies lasting at least eight weeks and optimal outcomes occurring around the 12-week mark.

Regarding blood sugar control, a meta-analysis of 14 studies assessed berberine in people with type 2 diabetes. When compared to oral diabetes medications, prescription medications proved more effective in glycemic control. However, when combined with lifestyle modifications, berberine showed some benefits in improving fasting, post-meal, and haemoglobin A1C levels.

A short-term, placebo-controlled study revealed that in healthy adults, taking four doses of 500 mg of berberine with meals over two days did not influence glucose or insulin levels. This suggests that berberine at this dose and timing does not affect glucose or insulin in individuals with normal glucose tolerance and a normal BMI.

While numerous studies have evaluated berberine, many were found to have a high risk of bias, leading to inconsistent outcomes. The meta-analysis by Zamani et al. concluded that the quality of evidence was generally low for studies assessing the impact on lipids, glucose, insulin, and blood pressure and moderate for weight and BMI outcomes.

Comparing berberine to Ozempic

It’s essential to note that berberine is available as a dietary supplement and is regulated by the FDA in the United States. While it lacks FDA approval for efficacy, it must adhere to laws and regulations regarding proper labelling and manufacturing, as per the Federal Food, Drug, and Cosmetic Act.

In contrast, Ozempic and its counterpart, Wegovy, are prescription-only medications that underwent rigorous research and clinical testing before gaining FDA approval for specific uses. Ozempic and Wegovy both contain semaglutide as the active ingredient, with Wegovy being a higher-dose version approved by the FDA for individuals with elevated BMI and other metabolic health issues such as high blood pressure, diabetes or high cholesterol.

Ozempic, on the other hand, is FDA-approved for managing type 2 diabetes and is prescribed by healthcare professionals as a once-weekly injection, in conjunction with diet and exercise, to help lower blood sugar levels. Semaglutide mimics the hormone glucagon-like peptide-1 (GLP-1) in the body, which targets areas of the brain that regulate appetite. It operates by increasing insulin production, blocking the release of stored glucose from the liver, and slowing down gastric emptying, thereby promoting a feeling of fullness.

While Ozempic is not FDA-approved as a weight-loss drug, studies on adults with type 2 diabetes revealed that those taking Ozempic lost approximately 3.6 kilos over 30 weeks and an average of 6.8 kilos in a 40-week study with a higher dosage. These weight-loss benefits persisted for individuals who continued taking it in a longer-term study spanning two years.

Berberine, on the other hand, operates in the body through different mechanisms than insulin or GLP-1 agonists like Ozempic. Animal studies suggest that it plays a role in regulating adipose tissues, increasing mitochondrial sirtuin activity, normalising mitochondrial function, activating AMP-activated protein kinase, inhibiting fat storage, and activating glucose transporter 1 (GLUT1).

Two systematic reviews focusing on BMI and weight effects reached similar conclusions. Berberine at doses of 1000-1500 mg per day appeared to have a modest impact on reducing body weight (0.2-2 kilos) when taken for at least three months.

Does berberine work?

Berberine may be beneficial for managing metabolic concerns and weight in individuals who require such outcomes. Based on clinical studies, the most effective dosage appears to be 1000 to 1500 mg per day, typically divided into two or three doses.

Before starting berberine or any supplement, it’s crucial not to discontinue prescription medications and consult with a healthcare provider, as there may be potential side effects or contraindications to consider.

Notably, berberine can interact with various drugs, including cyclosporine, dextromethorphan, losartan, medications metabolised by the liver, diabetes medications, blood pressure medications, metformin, midazolam, phenobarbital, sedatives, and Prograf (tacrolimus). Pregnant or breastfeeding individuals should avoid berberine. Clinical studies have reported some side effects, such as diarrhoea, constipation, gas, and stomach upset.

Conclusion

Research on berberine holds promise and suggests its potential to support healthy glucose levels, cholesterol, and weight management. Its multifaceted benefits, grounded in both traditional use and modern research, make it a valuable addition to the arsenal of natural solutions for promoting overall well-being.

As always, it’s advisable to consult with a healthcare professional before starting any new supplement regimen. However, berberine’s compelling attributes make it an exciting avenue for those seeking a holistic approach to better health.