Berberine: Benefits, uses, side effects, and risks of “Nature’s Ozempic”

Key Points

• Berberine shows promise for blood sugar control, heart health, PCOS, and fatty liver disease
• Despite being called "Nature's Ozempic," berberine produces modest weight loss compared to Ozempic, Wegovy, and similar medications
• Early and small studies suggest berberine may have anti-inflammatory properties and may even impact mood disorders like depression, but more research is needed
• Most people tolerate berberine well, but it's not recommended during pregnancy, for newborns, or with certain medications

Berberine is a plant compound gaining popularity for its potential health benefits. 

This article examines what berberine may do for blood sugar, cholesterol, weight management, and other health conditions.

We'll look at what's known about this traditional herb, discuss common side effects, who should avoid it, and considerations for anyone looking to start taking berberine.

What is Berberine?

Berberine is a bright yellow substance used in traditional Chinese and Indian ayurvedic medicine for over a thousand years, mainly to treat digestive issues and infections.

Nowadays, the bitter-tasting compound is available as a dietary supplement in capsule, tablet, or powder form. Modern research has been exploring its use in metabolic conditions like type 2 diabetes, high cholesterol, weight loss, and more.

In nature, berberine is found in several plants, including European barberry, goldenseal, goldthread, Oregon grape, and tree turmeric.

Berberine controls blood sugar levels

Research suggests berberine may help lower blood sugar levels. Multiple clinical studies show that berberine could be helpful for people with type 2 diabetes by lowering fasting blood glucose and HbA1c (a 3-month average of blood sugar).

In one head-to-head study, berberine (1.5g daily) produced similar blood sugar improvements as the same dose of metformin, a common diabetes medication.

Other research shows that adding berberine to existing diabetes medications might provide additional blood sugar control for some people.

Berberine appears to work by activating certain cellular processes that help:

• Move glucose from the bloodstream into cells
• Reduce sugar production in the liver
• Improve insulin sensitivity
• Support healthy fat metabolism

Gia Eapen, MD, notes, “While these results are promising, most studies on berberine for diabetes have been relatively small and short-term. As with any supplement, it's important to discuss berberine with your healthcare provider before trying it, especially if you're taking medication for diabetes.”

Berberine may improve heart health

Research suggests berberine may benefit heart health in several ways. Some studies show it can improve cholesterol levels by reducing total cholesterol, "bad" LDL cholesterol, and triglycerides. This appears to work because berberine helps liver cells remove more cholesterol from the bloodstream.

Some studies focused on people with metabolic syndrome, a cluster of conditions that includes high blood pressure, high blood sugar, excess waist fat, and abnormal cholesterol. These studies found that berberine combined with lifestyle changes may help lower blood pressure more effectively than lifestyle changes alone.

A very small study in humans and a few animal studies show that berberine may offer benefits for people with heart failure.

While these findings are promising, most studies on berberine for heart health have been relatively small and short-term, so larger studies are needed to confirm these benefits.

Berberine for weight loss

While berberine has gained attention for weight loss benefits, it's important to understand what the research actually shows about its effects on body weight and fat.

Modest weight loss

Berberine can contribute to modest weight loss. An analysis of 12 studies found that berberine helped people achieve an average weight loss of 4.4 lbs over the course of a few months.

Some people also reduced their waist circumference by a small amount (0.4 inches) and lowered their BMI (by about 0.5 points).

So, berberine’s weight loss effects are moderate and depend on getting a nutritious diet and regular exercise.

Targets belly fat

Berberine may help slightly reduce belly fat, though the actual amount of fat lost in studies has been small.

Berberine is not "Nature's Ozempic."

Despite being nicknamed "Nature's Ozempic" on social media platforms like TikTok, berberine's weight loss effects are significantly smaller than those of GLP-1 agonist drugs like semaglutide (Ozempic, Wegovy). While GLP-1 drugs can induce 15-20% body weight loss, berberine typically produces only a modest weight loss of around 5 pounds.

This comparison is more hype than reality, and it's important to maintain realistic expectations about berberine's weight management benefits.

Berberine for PCOS

Research suggests berberine may help women with polycystic ovary syndrome (PCOS). Small clinical studies show it improves insulin resistance while potentially increasing ovulation frequency.

Berberine shows promise for hormonal health by potentially helping to lower elevated testosterone levels. People with PCOS often experience insulin resistance, which is why medications like metformin are commonly recommended.

Early research suggests berberine may be similar to metformin for improving insulin sensitivity, while possibly offering additional benefits for waist size and triglyceride levels in some studies.

Note: Studies of berberine vs. metformin are few, small, and short in duration. More information is needed to make definitive claims about berberine for PCOS.

Some women in these studies experienced modest weight loss and reduced triglyceride levels.

Most research on berberine for PCOS has been limited in size and duration, so larger, longer studies are needed to confirm these early findings.

Berberine for fatty liver disease

Research suggests berberine might benefit non-alcoholic fatty liver disease (NAFLD). Small clinical studies show improved liver enzyme levels and reduced liver fat in participants who took berberine.

It appears to work by addressing underlying factors like insulin sensitivity and cholesterol levels.

While generally well-tolerated with only mild digestive side effects reported, most studies have been small and short-term, so more research is needed to fully understand its long-term effects.

Other potential benefits of berberine

Beyond its primary applications, berberine shows promise in several other health areas, though some require more research.

Anti-inflammatory effects

Some animal studies and experiments in a lab suggest that berberine has anti-inflammatory and antioxidant properties. More studies in the future may help us learn details about how it reduces inflammation and oxidation.

Potential effect on mood

Early research suggests berberine might have antidepressant effects, although these results have been seen in animal models so far. While it remains an interesting topic to explore, there is a long way to go before berberine can be used to treat depression or other mood disorders in people.

Berberine safety and side effects

Berberine is generally well tolerated, but some may experience mild side effects.

The most common side effects of berberine are gastrointestinal discomfort—including diarrhea, constipation, gas, and bloating. These are typically mild and often improve after a few days or weeks. Individual results may vary.

There is no long-term research on berberine. It has been known to suppress the effects of certain liver enzymes, but there is no information yet on its long-term effects on the liver and other organs.

Berberine drug interactions

Due to its blood sugar- and blood pressure-lowering effects, berberine may accentuate the effects of diabetes or blood pressure medications. Berberine can interact with medications processed by the liver, including metformin, statins, blood thinners, and anticoagulants like warfarin.

Do not take berberine if you are taking cyclosporine.

Who should avoid berberine?

Healthcare professionals advise against using berberine during pregnancy or breastfeeding due to potential harm to the fetus. Plus, in animal studies, berberine has been shown to cross the placenta and induce muscle contractions in the uterus.

Berberine is also not for infants because it may increase bilirubin levels. This raises the risk of neonatal jaundice and kernicterus, which is brain damage caused by untreated jaundice in newborns.

Do not take berberine if you are on immune-suppressing drugs like cyclosporine or are undergoing chemotherapy for cancer.

To be safe, talk to your doctor before taking berberine.

How to take berberine supplements

Dosage

There is no standardized dose for berberine. The typical dosage used in clinical studies is 500 mg, taken 2–3 times daily for a total of 1,000–1,500 mg per day.

Timing

As an oral supplement, berberine may cause mild digestive discomfort in some individuals, so product labels usually recommend taking berberine right before or along with a meal.

Duration

Most berberine studies are of a short duration of between 3-6 months. There is not much evidence of berberine’s effects in the long term. More research is needed to understand the effects of berberine over time.

Please consult a medical professional before taking berberine for a longer period of time.

As with any supplement, it's important to:

• Consult with your healthcare provider before starting berberine, especially if you take medications
• Choose a high-quality supplement from a reputable manufacturer (consider looking for third-party accreditations or quality certifications)
• Try starting with a lower dose and gradually increase to minimize digestive side effects
• Be patient, as some benefits may take several weeks to become noticeable
• Stop if you experience discomfort or notice any side effects that do not go away. In this case, consult a healthcare provider right away.

Final thoughts: Berberine supplements

Berberine is a supplement made from an ingredient found in nature. It rose to popularity when influencers online marketed it as “Nature’s Ozempic,” claiming that it had similar weight loss effects compared to Ozempic, the popular GLP-1 semaglutide-based medication.

Berberine has been shown to lower blood sugar levels. Some studies say its effects are comparable to metformin, the standard diabetes drug.

When it comes to weight loss, berberine may offer moderate benefits from its effects on insulin resistance.

While not the miracle cure sometimes portrayed on social media, berberine may offer benefits. However, clinical studies so far are usually small and of a short duration. More research on berberine can help us truly understand how it works, its benefits, and its risks.

Frequently Asked Questions (FAQ)

How fast does berberine lower blood sugar?

Berberine may lower fasting blood sugar and HbA1c levels. It may take a few weeks to a few months to work, depending on how each person responds to the supplement. Also, HbA1c levels are a 3-month average, so it may take 3-4 months before you notice a change.

Notably, people who achieved weight loss on berberine also made dietary and lifestyle changes, including regular exercise.

Can I replace metformin with berberine?

Eapen, MD, says, “Berberine is not a substitute for metformin or other blood-sugar-lowering medication and may even interfere in how metformin is processed in the liver. If you would like to explore the possibility of taking berberine to lower high blood sugar, medical supervision is required.”

While berberine has been shown to improve insulin sensitivity in some studies, individual responses may vary.

Remember, while berberine may be marketed as a “natural” alternative to metformin or Ozempic, berberine supplements are concentrated and highly processed forms of berberine. In the United States, dietary supplements are also not regulated by the same standards as pharmaceutical drugs, so quality and effectiveness may vary widely from brand to brand.

Does berberine work for weight loss?

Berberine may offer modest weight loss benefits. Studies show about a 4-5 lb weight loss in a few months. It is not a substitute for GLP-1 drugs like Ozempic, Wegovy, Mounjaro, or even standard options like metformin.

Is berberine safe for long-term use?

As of now, berberine studies are usually small and limited to 3-6 months in duration. So, we do not know the effects of berberine in the long term for sure.

Can I take berberine with my statin medications?

According to Eapen, MD, “Some early and limited research suggests that berberine can complement the cholesterol-lowering effect of statins, but berberine can interfere with how statins work by suppressing liver enzymes involved in processing medications like statins. This could potentially lead to a higher level of statin circulating in the blood. It is very important to talk to your healthcare provider before taking berberine with a statin.”

How does berberine compare to metformin?

Some research shows that berberine may impact blood sugar levels similar to metformin. However, so far, berberine studies have been small in size and last only 3-6 months.

Metformin, on the other hand, is a standard diabetes medication that has been studied for its long-term effects.

More robust research is needed to know how berberine compares to metformin.

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The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.