Berberine: An Agent of Metabolic Change


Berberine is a multi-tasking botanical compound that has been gaining popularity in integrative health circles over the past decade (and on TikTok over the past year) for its potential benefits in the realms of blood sugar control, healthy weight management, PCOS, healthy lipids, gut balance, and liver health.

Berberine is an alkaloid--a naturally occurring constituent--with a distinct yellow color, primarily found in the roots, rhizomes, and stem bark of various plants like goldenseal, barberry, and coptis.  In traditional systems of medicine, berberine-containing plants have historically been used for their antimicrobial and heat-clearing properties.  

Modern research has shifted focus towards its impact on gut health and metabolic processes.  When you start looking at the research, you begin to think, “What doesn’t berberine do?”  Here is a brief review of some of areas in which is holds promise as an agent for metabolic change.  

Blood Sugar Control:

A 2020 study published in "Metabolism" found that berberine significantly improved insulin sensitivity and glucose uptake in patients with type 2 diabetes. This effect is comparable to that of metformin (a common diabetes medication used to promote insulin sensitivity), and possibly has the same mechanism action—the activation of AMP-activated protein kinase (AMPK).  AMPK is an enzyme that plays a crucial role in cellular energy homeostasis and metabolism. It is often referred to as a cellular energy sensor because it helps regulate various metabolic pathways in response to changes in the energy status of a cell.  Berberine also shows promise in the management of Polycystic Ovarian Syndrome (PCOS), which has insulin resistance at its root.  

Cholesterol and Lipid Management:

Research in the "Journal of Clinical Endocrinology & Metabolism"  reported that berberine modestly lowers LDL cholesterol (“bad” cholesterol) and triglycerides while raising HDL cholesterol (“good” cholesterol). This suggests a potential role for berberine in managing dyslipidemia.

Healthy Weight Management: 

A 2021 study highlighted that berberine supplementation led to a significant reduction in body weight and body mass index (BMI) of individuals considered to be overweight by conventional medical standards. This property of berberine may be attributed to its role in enhancing fat oxidation and inhibiting adipogenesis.

Improving Gut Health:

The "European Journal of Pharmacology" published findings that berberine positively alters gut microbiota, which is crucial for metabolic health. It showed efficacy in reducing inflammation and improving gut barrier function.  Given that the gut is the core of our being, and influences inflammation levels throughout the body, this is no small thing!  As a broad-spectrum anti-microbial, berberine is often a cornerstone of natural protocols to correct gut flora imbalances such as SIBO, yeast overgrowth, and dysbiosis.  

Liver Health and Non-Alcoholic Fatty Liver Disease (NAFLD):

A study in the "American Journal of Physiology" demonstrated berberine's effectiveness in improving liver enzymes and reducing liver lipid accumulation in patients with NAFLD, which is often linked to metabolic syndrome, a constellation of risk factors that puts one at risk for diabetes and cardiovascular disease.   

Safety Profile and Other Considerations

Berberine should not be taken by pregnant and breastfeeding people, or by children.  While berberine is generally well-tolerated, it can cause gastrointestinal side effects like diarrhea, stomach upset, or bloating in some individuals. Alkaloids are potent medicinal compounds and may interact with medications.  Also, given that some berberine-containing plants are endangered or at risk, it is important to obtain berberine from abundant (or even invasive) sources such as barberry.  

It's crucial to consult with a healthcare professional before starting berberine, particularly for those with pre-existing conditions or on other medications.

The amount used in studies is often 1500 mg per day, which usually equals 3 capsules of standardized berberine.  So, taking one cap a day, or taking it occasionally, will not yield the benefits seen in studies.  Some research suggests that like other potent plant compounds, berberine may be hard to absorb.  However, it’s interesting to note that some of berberine’s mechanisms of action may be gut-dependent, so absorption may not be as big an issue as we think.  That said, there are liposomal preparations available, and if we are looking for systemic effects from berberine—like shifts in metabolism—it could be helpful to take it in this form which enhances absorption.  

Concluding Thoughts

As with every natural substance, it’s not a cure-all, and it’s not right for everyone; nor is it "Nature's Ozempic," as posts on social media would have us believe. That said, we are excited about berberine here at Farmacopia and are looking forward to more research emerging. One compound rarely shows promise in so many arenas:  blood sugar regulation, cholesterol levels, body composition, gut health, and liver function.  


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