Berberine: What It Is, Benefits and Side Effects

Spend any time online, and you’ll be bombarded with information about the latest trendy supplements. These “all-natural” remedies promise clearer skin, restful sleep, a flat belly, improved memory … the list is endless.

The problem is that these claims often lack substantial data. It’s hard to know which ones are truly beneficial. But berberine, a traditional Chinese medicine, may be a promising supplement.

“People are starting to look at more natural approaches and treatments. But not all ‘natural’ things are without side effects or proven effective,” says functional medicine specialist Layth Tumah, MD. “But berberine, in many ways, acts similarly to medication.”

What is berberine?

Berberine is a natural compound called an alkaloid. Alkaloids are naturally occurring organic compounds that contain nitrogen and are extracted from a variety of plants. They’re known for their diverse biological activities and significant pharmacological properties. Other well-known alkaloids include morphine, nicotine and caffeine.

While berberine might not be as famous as caffeine, it’s not a new substance. It’s been a staple in traditional Chinese medicine (TCM) for more than 400 years, mainly used to treat diarrhea and other gastrointestinal infections.

Research shows it may be effective for several chronic diseases, including diabetes, cardiovascular disorders and inflammatory diseases.

But most studies are small, not well-designed and need to be interpreted with caution. And like all supplements, the U.S. Food and Drug Administration (FDA) doesn’t regulate berberine for safety and effectiveness.

Berberine benefits

So, what does berberine do?

The benefits of berberine show potential for people with conditions such as Type 2 diabetes or metabolic syndrome — a collection of risk factors that make you more likely to develop serious health issues like diabetes, heart disease and stroke.

“Berberine may help regulate blood sugar, high blood pressure and lipid levels and improve the gut mycobiome (the healthy bacteria in the intestines),” notes Dr. Tumah. “Combine berberine with lifestyle changes, like losing weight, and it can positively affect those conditions.”

There’s also evidence that berberine may:

• Lower and regulate blood sugar levels: The most studied benefit of berberine is its effect on blood sugar levels and diabetes. It can be taken in conjunction with lifestyle interventions to manage diabetes, but Dr. Tumah strongly cautions against using berberine in place of your diabetes medications before consulting with your healthcare provider.
• Reduce metabolic dysfunction-associated steatosis liver disease (MASLD): A small clinical trial shows that people with MASLD may experience a decrease in body weight, triglycerides and cholesterol, but Dr. Tumah stresses that more research is needed.
• Reduce high cholesterol: Research shows that berberine may lower lipid levels. Studies focusing on berberine and heart health also show that the supplement can raise good (HDL) cholesterol while lowering total cholesterol, LDL cholesterol and blood triglycerides.
• Reduce blood pressure: Research indicates that using both berberine and hypertension medication lowered blood pressure more than medication alone.
• Improve good gut bacteria: Research shows that berberine may help balance or regulate intestinal health by reducing harmful bacteria and encouraging good bacteria to grow. It also provides your gut with protection.

Berberine side effects

Berberine is good for your gut, but ironically, its most common side effects involve the digestive system and include:

• Nausea
• Abdominal discomfort
• Constipation
• Diarrhea

Not everyone experiences berberine side effects, which should become tolerable if you reduce your berberine dosage.

“Start slow and low,” Dr. Tumah emphasizes. “Typical dosing is 500 milligrams (0.5 grams) twice a day before meals. The dose can be up to 1,500 mg per day divided in three doses.”

Is berberine safe?

Dr. Tumah says berberine can be a user-friendly supplement. But there are some things to think about before adding berberine to your daily routine:

• It may interact with other medications: If you take prescription medication, speak to your healthcare provider before taking berberine. When it comes to berberine interactions, be especially cautious if you take medication that metabolizes with similar enzymes in the liver. Berberine can interact with multiple medications such as metformin, cyclosporine, omeprazole, losartan and others.
• It isn’t regulated: Like other supplements, the FDA doesn’t review or regulate supplements. That means it’s hard to guarantee that the supplement contains the claimed dose, as well as the product’s purity. Dr. Tumah recommends choosing high-quality supplements that are third-party tested.
• It requires a strict dosage regimen: Berberine has a short half-life of several hours — which means half the dose will be metabolized and eliminated from your system within a few hours. To keep blood levels stable and benefit from berberine, spread the daily dosage (up to 1.5 grams or 1,500 milligrams daily) throughout the day. Dr. Tumah advises taking it two to three times a day before meals.

Also, while berberine is safe for adults, if you’re pregnant or breastfeeding, you shouldn’t take berberine. And it’s not recommended for young children or babies.

Bottom line?

There’s some promise when it comes to using berberine as a supplement, but it’s important to talk to your healthcare provider beforehand. And remember that any supplement shouldn’t be viewed as a cure or a replacement for medications.

“Medications are well-studied, and the dose is established. Healthcare providers know that when we order and recommend a medication, it’s highly likely that you will get the desired dose due to the FDA regulations and strict quality measures,” explains Dr. Tumah.

“The use of supplements could be beneficial as an adjunct therapy and not as a standalone treatment. Additionally, if they’re effective enough to work, they also can cause side effects, especially if they’re not taken under medical supervision.”