There are lots of supplements out there, but have you ever heard of berberine? Some people use it to lower their blood sugar or cholesterol. Like any supplement, there are potential benefits and risks.
What Is Berberine
Berberine is a naturally occurring compound that’s found in several types of plants, including:
— European barberry.
— Chinese goldthread.
— Indian barberry.
— Oregon grape.
— Tree turmeric.
Similar to turmeric, berberine has a bright yellow color, says Lake Geneva, Wisconsin-based herbal researcher Daniel Powers, founder of The Botanical Institute, a resource for information on herbs and botanical information.
Berberine is considered an alkaloid, which is another name for compounds that have pharmaceutical properties when used in the body, says Eleva, Wisconsin-based Tracy Adkins, a board-certified women’s health care nurse practitioner, National Ayurvedic Medical Association-certified Ayurvedic practitioner and founder of the Ayurvedic-geared skincare line Jivana. Codeine and morphine are in the same family of alkaloids as berberine.
Berberine is more commonly used in Chinese, East Asian and Ayurvedic medicine. But berberine is available in the U.S. as well, sold over the counter as an oral supplement.
Berberine has been studied for several potential health benefits, including:
— Diabetes management and lowering blood sugar. A 2021 meta-analysis of 46 clinical trials published in Oxidative Medicine and Cellular Longevity studied berberine alone and berberine along with standard therapies for diabetes. The researchers found that both approaches helped to significantly lower hemoglobin A1C as well as cholesterol and body mass index.
— Lowering cholesterol. A 2015 meta-analysis in the Journal of Ethnopharmacology that included 27 trials and more than 2,500 patients found that berberine helped to lower total cholesterol and LDL cholesterol — often referred to as “bad” cholesterol — and helped to raise HDL, or “good,” cholesterol. Berberine was particularly effective when combined with cholesterol-lowering medications versus the use of lifestyle changes alone or a placebo. The same review also tracked berberine’s effect on type 2 diabetes and blood pressure management and found positive results.
— Lowering blood pressure. Berberine may reduce blood pressure when used in combination with blood pressure medication, says registered dietitian Veronica Rouse, owner of The Heart Dietitian in Ottawa, Ontario. The 2015 review mentioned above found that using berberine lowered blood pressure more effectively on its own or combined with blood pressure-lowering medications or lifestyle changes versus placebo or lifestyle changes alone.
— Improving gut microbiome health. Berberine helps to balance the gut microbiome by regulating bacteria and promoting cellular detoxification, according to Dr. Mahmud Kara, founder and CEO of the natural remedies company KaraMD, based in Cleveland.
[Read: What Is the GOLO Diet?]
Most formulations of berberine are sold in 1,000 mg to 1,200 mg per two capsules. These same manufacturers recommend taking berberine once a day before meals or with a meal. As with any new supplement, it’s best to speak with your health care provider first. They can help answer any questions you may have about dosing.
Berberine Side Effects and Who Should Avoid It
Berberine is tolerated well throughout the body, according to studies. Like any supplement or medication, there are always some people who experience side effects. For berberine, those side effects can include:
— Abdominal pain.
— Low blood sugar if used in high doses.
— Nausea or vomiting.
Although berberine appears safe in studies, more long-term safety research is needed, Powers says. Like many other supplements, which aren’t regulated by the FDA so they don’t undergo the same level of scrutiny, there aren’t large clinical trials to evaluate its long-term safety. Berberine, like many other supplements unregulated and evaluated by the FDA, lacks large clinical trials to evaluate long-term safety.
You should avoid berberine if you’re:
— Using the oral chemotherapy drug bosutinib. Berberine may increase concentrations of this drug in the body, MSKCC reports.
— Using the immunosuppressive drugs tacrolimus or cyclosporine. Berberine may increase levels of these drugs in your blood or lead to kidney toxicity.
— Using medications for diabetes. Berberine and the diabetes medications you use may lower your blood sugar too much, Adkins says.
As with any type of medication or supplement, it’s important to speak with your health care provider before using berberine. You’ll want to make sure it doesn’t have a negative interaction with other medications you use. In addition to diabetes medications, it’s especially important to discuss berberine use with your health care provider if you use:
— Blood thinners.
— Blood pressure medications.
— Cholesterol medications.
— Sleep aids.
That’s because you want to avoid a potentially negative interaction, Kara says.
Other Precautions With Berberine
If you plan to try using berberine, here are a few other precautions to keep in mind:
Shop around for a transparent company. Comparison shopping for the best berberine supplement or any type of supplement isn’t just about price. It’s about finding a company that makes safe, reputable products, Kara says. He recommends asking a few questions as you choose a supplement company:
— Does the product clearly display a supplement facts panel with ingredients, dosage information and ingredient quantities?
— Are the claims about the product, either online or in the packaging, detailed and/or supported by research? Conversely, are they vague?
— Does the company include customer feedback, both positive and negative, or do they only show you the 5-star reviews?
— What’s the company’s return policy?
If faced with a choice, use the product that’s made by a company more transparent about what it offers, Kara advises.
Look for a supplement that’s been third-party tested. Supplements are not approved by the FDA like medications are. This means that supplements may contain other ingredients beyond what they purport to have. For this reason, many supplement companies will seek out third-party testing for purity and potency, Powers says. He recommends looking for an NSF® seal from the National Sanitation Foundation, a third-party, independent organization that visits manufacturing facilities and ensures that the product contains only what it claims to. Other third-party testers include U.S. Pharmacopeia and ConsumerLab.com.
Keep in mind that a supplement doesn’t replace a medication, Rouse cautions. Using too much of any supplement could cause a bad side effect. It’s yet another reason to confirm with a health care provider beforehand that it’s OK to use berberine.
If you already use berberine and you have an appointment with a health care provider, make sure to let them know that you are using it along with any other over-the-counter medications or supplements.
More from U.S. News
Update 12/15/22: This story was previously published at an earlier date and has been updated with new information.