Do an online search for berberine and you’ll get nearly 3 million results. Type in berberine at pubmed.gov, and you’ll find more than 6,000 references in MEDLINE, the National Library of Medicine’s database of medical journal articles.
Yet, despite its current popularity, berberine was barely a blip on the radar just 10 years ago. Since it’s still relatively new, I get a lot of questions about berberine so I’m going to answer some of the top ones I receive.
What Is Berberine?
Berberine is a natural alkaloid found in the roots, bark, and stems of hundreds of plants that have been used for medicinal purposes for thousands of years.
Some of these plants are still used in Ayurvedic and traditional Chinese medicine, but berberine has also been isolated and is now purified, encapsulated, and sold as a nutritional supplement. This is the form used in most of the research.
How Does Berberine Work?
Berberine is a potent antioxidant and anti-inflammatory with positive effects on the gut microbiota. However, its main mechanism is increasing AMP-activated protein kinase (AMPK).
When energy runs low, AMPK signals the cells to generate more energy and conserve energy use. One way it does this is by stimulating the activity of glucose transporters that move blood sugar into the cells. It also curbs the production of excess glucose in the liver. As a result, berberine reduces blood sugar and improves insulin sensitivity, making it a popular supplement for diabetes and prediabetes.
But there’s more. Berberine lowers triglycerides, cholesterol, and blood pressure—aspects of metabolic syndrome that increase the risk of both diabetes and heart disease. It also helps with weight loss, fatty liver disease, and digestive disorders. Plus, early research suggests it has a future in the treatment of cancer, Alzheimer’s, and other neurodegenerative diseases.
Can I Take Berberine With Diabetes Drugs?
Taking berberine along with a diabetes medication could theoretically drive blood sugar too low. However, clinical trials that tested the combination of berberine plus metformin or another oral diabetes drug did not find that to be the case. The combo lowered blood sugar more effectively than either one alone, yet didn’t drive blood sugar too low.
That said, if you are on a diabetes drug—or any drug for that matter—I recommend talking to your doctor before adding berberine.
Can I Take Berberine and Turmeric Together?
There is no reason you can’t take berberine with turmeric or other supplements. That includes additional natural ingredients that have a positive effect on blood sugar, such as cinnamon and chromium. Taking them together may actually enhance blood sugar control.
Does Berberine Cause Liver Damage?
On the contrary, berberine is an effective treatment for America’s most prevalent liver problem: nonalcoholic fatty liver disease (NAFLD). NAFLD, which is common in people with diabetes and obesity, can lead to cirrhosis and liver failure. Berberine has been shown to significantly reduce fatty deposits in the liver and improve overall health.
Excessive doses of berberine could conceivably damage the liver, but multiple studies show that when taken as directed berberine is quite safe and has no liver toxicity.
What Are the Effects of Berberine on the Kidneys?
Berberine may improve diabetic nephropathy: kidney disease that is a common complication of diabetes. In a 2018 randomized controlled clinical trial of patients with diabetic nephropathy, taking berberine for six months produced significant improvements in urine albumin/creatinine ratio and serum cystatin C, two important markers of kidney function.
Does Berberine Kill Candida?
There is some promising research on berberine for curbing candida—a yeast (type of fungus) that can cause conditions like oral thrush and vaginal candidiasis as well as serious invasive infections of the blood and internal organs. Although most of the research is lab studies rather than controlled human clinical trials, the results are impressive.
Berberine has demonstrated antifungal effects, even to candida strains that are resistant to fluconazole, a drug used to treat yeast and fungal infections. This, plus berberine’s positive effects on the gut microbiota—which helps keep pathological microorganisms in check—suggest it may help control candida overgrowth.
Does Berberine Cause Insomnia?
I am unaware of berberine having any adverse effects on sleep. In fact, a 2020 study found that it alleviated insomnia in rats via its neuroprotective and metabolic effects. That doesn’t necessarily translate to humans, but I wouldn’t worry about berberine interfering with sleep.
How Should Berberine Be Taken?
The most common questions I get are logistical. How much berberine to take? What is the best time to take berberine? Can berberine be taken on an empty stomach? While it’s best to talk to your doctor before taking berberine, here are my general recommendations:
- I suggest taking 500 mg three times a day. This is the average dosage used in most of the clinical trials for blood sugar, lipids, weight, liver disease, etc. Twice-a-day dosing may be sufficient for individuals with prediabetes.
- The best time to take berberine is about 30 minutes before meals. It is better tolerated when taken with food, and mealtime dosing may help to blunt the spike in blood sugar and lipids that occurs after eating.
- You could also take it on an empty stomach as long as it doesn’t cause gastrointestinal upset.
It’s also important to talk to your doctor before adding a new nutritional supplement to your routine, including berberine.
Is Berberine Safe to Take Long Term?
Always talk to your doctor, but berberine has an excellent safety profile when taken as recommended. It can cause gastrointestinal upset and constipation, which is usually mild, but is generally well tolerated. Like other botanical-based supplements, it should not be taken by children or women who are pregnant or nursing.
As for long-term use, the clinical trials on berberine lasted from several weeks to two years. This may seem short, but phase 1 and phase 2 drug trials are of similar duration. On the other hand, many people have taken berberine for years with no reported problems. Plus, the well-documented therapeutic use of berberine-rich plants in Ayurvedic and traditional Chinese medicine provides an additional indication of long-term safety.
How Fast Does Berberine Work?
Many of the studies that demonstrated berberine’s ability to lower blood sugar—as effectively as metformin and other diabetes drugs—lasted 90 days, so I would expect results within three months. Some people report a blood sugar-lowering effect within the first month, while others get only marginal results. Like all therapies, it doesn’t work for everyone.
To get an accurate indication of how berberine is working for you, I suggest having an A1C test before you start taking berberine and retesting three months later. For optimal results, use in conjunction with a healthy low-carbohydrate diet and exercise.
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