Berberine for diabetes: Benefits, risks, and more

Key Points

• Berberine may help regulate blood sugar by improving insulin sensitivity and stabilizing glucose levels, similar to metformin
• It could reduce hunger and cravings by affecting hormones like leptin and ghrelin, but weight loss effects are modest
• Berberine is not FDA-approved to treat medical conditions, it can interact with medications, and the quality of berberine supplements may vary based on brand
• Pregnant individuals, children, and those on certain medications should consult a doctor before taking it

Berberine is having a moment. This yellow-colored compound found in plants like barberry, goldenseal, and Oregon grape is generating buzz for its potential to lower blood sugar and cholesterol levels in ways that resemble metformin, a common diabetes medication.

While it might seem like a new discovery, thanks to TikTok and Instagram, berberine is actually an ancient remedy. Traditional healers in India and China have been using it for over 2,000 years to treat everything from infections to digestive problems and diabetes.

Today, berberine has found new life on social media, where influencers promote it as "nature's Ozempic" for weight management, blood sugar control, and reducing those persistent food cravings. Its growing popularity is also because it's a supplement and available without a prescription, and is a fraction of the cost of standard diabetes medications.

But is berberine the answer to your blood sugar concerns? Before you stock up on this supplement, let's take a closer look at how it actually works, what benefits you might reasonably expect, its limitations, potential side effects, dosage, and more. 

Dr. Gia Eapen, MD, an experienced physician, and Rebecca Blake, RD, a registered dietitian, also weigh in with their expert insights.

What are the benefits of berberine for diabetes?

Registered dietitian Rebecca Blake, RD, explains, “Berberine has been used to treat diabetes for thousands of years and is shown to increase insulin sensitivity as well as to reduce glucose absorption, both of which can reduce the complications related to diabetes.”

Let’s take a closer look.

1. Lowers blood sugar

Berberine helps control blood sugar in type 2 diabetes in two main ways:

Helps your cells use sugar better: Some studies show that berberine makes your body more sensitive to insulin, so your cells can take in sugar from your blood more effectively. When sugar gets into your cells more easily, your blood sugar levels go down.

Keeps your blood sugar more stable: Berberine may slow down sugar production in your liver and the breakdown of carbs in your digestive system. This helps prevent those big spikes in blood sugar after meals, keeping your levels more steady throughout the day.

2. Reduces cravings and “food noise”

In animal studies and anecdotally in humans, berberine appears to help reduce excessive hunger or constant food-related thoughts. This could potentially be for two reasons:

Cellular energy and satiety signals: When berberine helps blood sugar enter cells more efficiently, those cells receive the fuel they need and send "fullness" signals to the brain rather than hunger signals. This may reduce food cravings as the brain receives satiety signals.

Helps balance hunger hormones: Berberine seems to affect hormones like leptin (the "fullness" hormone) and ghrelin (the "hunger" hormone). By helping these return to normal levels, berberine might help you feel fuller and have fewer cravings, especially for sweet foods. In people with insulin resistance, these hunger hormones often don't function properly, creating a cycle where hormone imbalances increase hunger, leading to higher food intake and worsening insulin resistance.

3. Weight loss

Losing weight can play a key role in managing type 2 diabetes because losing even 5-10% of your body weight can help improve your health, including how your body handles insulin and controls blood sugar levels.

A review of 12 randomized controlled trials found that berberine reduced body weight by approximately 4.6 pounds, BMI by 0.47 points, and waist circumference by 0.4 inches over the study periods. These changes were consistent enough across studies to be considered reliable effects.

“It's worth noting that weight loss from berberine is modest. Studies show people typically lose just a few pounds over several months. This is significantly less than the 10-20% weight loss seen with newer prescription medications like Ozempic, Wegovy, and Mounjaro,” according to Dr. Eapen. “However, neither berberine nor diabetes drugs like GLP-1 agonists and metformin are magic solutions. If you have type 2 diabetes, you will also need a healthy diet and lifestyle.”

Having realistic expectations about berberine can help you maintain motivation while working toward your health goals.

How can you improve the effects of berberine for diabetes?

“Diabetes is a disease that impacts how our body breaks down and uses sugar, says Blake, RD. “Learning what kinds of carbohydrates (the primary macronutrient in bread, pasta, rice, cereals, fruits, juices, and sodas, and sweets) are essential to understanding how we can get the best control over our blood glucose (or blood sugar) levels.”

Maintaining stable blood sugar levels with diabetes can be challenging, but when we are armed with the knowledge of the best ways in which to eat carbs, we can get the best control over our blood glucose levels and reduce the complications associated with diabetes. 

The most effective way to manage type 2 diabetes remains a balanced diet and regular physical activity—with or without berberine.

Here are some practical tips to lower your blood sugar levels.

Reduce “food thoughts"

One major challenge in maintaining weight loss is how to stop food cravings and intrusive "food thoughts" that can sabotage your best efforts to eat healthy. 

Anecdotally, some people say that berberine helps reduce food cravings. If it works for you, it’s a great time to learn how to eat mindfully and enjoy nutrition-dense whole foods.

Pair carbs with protein and healthy fats

According to Blake, RD, “Whole grains like brown rice will spike blood sugar levels less than white rice and spike them much less than a cookie, even though all of those foods contain carbohydrates. For even better blood sugar control, pair a whole grain carbohydrate with a protein and a healthy fat, which will help slow the rate at which the carbohydrate in the brown rice turns to sugar.” 

So, instead of a slice of white toast eaten alone, consider a slice of whole-grain toast (carb) with an egg (protein) and some avocado (healthy fat).

Balance your plate

Consider eating balanced meals with half your plate containing non-starchy whole vegetables, a quarter with lean protein, and the remaining quarter with whole grains or starchy vegetables, and even a little fruit

Consider the Mediterranean diet

Following a diabetes-friendly diet like the Mediterranean diet can help. This nutrition plan emphasizes fresh produce, whole grains, healthy fats, and lean proteins. 

Blake, RD says, “The Mediterranean diet has been well established to help prevent chronic disease such as diabetes. And for those who have diabetes, the Mediterranean diet can be easily customized to provide ideal glycemic control.”

Combining berberine with these strategies increases your chances of seeing sustainable improvements in blood sugar and overall health.

Lower your blood sugar with a personalized diet plan that works for your lifestyle. Work with a diabetes dietitian who accepts your insurance.

What are the risks of taking berberine for diabetes?

While berberine has its benefits, like any other medication or supplement, it’s important to understand the potential risks before starting on berberine.

1. Berberine interacts with other drugs

Dr. Eapen says, “Berberine can affect how your body processes certain drugs. While some studies indicate that berberine can enhance the effect of diabetes drugs, depending on the dose and your unique condition, there is a risk of hypoglycemia or low blood sugar. So, medical supervision is required.”

Berberine may interfere with medications metabolized by liver enzymes—particularly CYP3A4. This includes some statins, calcium channel blockers, and certain antidepressants. The NIH specifically identifies interactions with cyclosporine, an immunosuppressant drug used to prevent organ rejection in transplant recipients and treat autoimmune conditions like psoriasis and rheumatoid arthritis. 

A word of caution: if you are undergoing treatment for cancer or taking potent medication for any chronic or autoimmune condition, consult with your medical team if berberine affects your medication.

2. Berberine is not FDA-approved to treat medical conditions

Berberine is classified as a dietary supplement, not a medication. Before starting berberine, it's important to understand that the US FDA has not authorized it to treat diabetes or any other medical conditions.

This doesn't mean berberine has no effect on blood sugar. It simply hasn't undergone the rigorous testing and review process required for FDA approval as a medical treatment.

3. Not all berberine supplements are alike: focus on quality

Berberine may be found in nature, but berberine supplements are manufactured in factories. Their quality and dosage can vary significantly. Since the supplement industry lacks strict regulation, how do you know that a brand lives up to its marketing claims?

If you plan to take berberine, look for products that have undergone rigorous testing and may have been verified by reputed third-party testing organizations.

Blake, RD, adds, "Current research is focused on improving the delivery system for potential medications using berberine as the active agent. This is because berberine is naturally insoluble in water, making it difficult to absorb and for the body to fully utilize in its natural state.”

4. Side effects from too high a dosage

According to the National Institutes of Health (NIH), berberine may cause several side effects. The most commonly reported side effects of berberine are:

• Nausea
• Abdominal pain
• Bloating
• Constipation
• Diarrhea

These digestive issues tend to be mild to moderate in most people but may become more pronounced at higher doses.

Berberine typically stays in your body for only a few hours, so some people take it before each meal, especially before carb-heavy meals. It’s best to start with a lower dose to see how your body responds. Discuss the appropriate dosage with your healthcare provider before starting.

5. More peer-reviewed research is needed

“Berberine found in nature has a long history of use in traditional medicine, but modern supplements deliver higher doses in a concentrated form,” says Dr. Eapen. “The long-term effects of these higher doses remain uncertain, and more peer-reviewed research is needed to fully understand its impact on overall health.”

Who should avoid berberine?

• Pregnant or breastfeeding individuals: Limited safety data makes avoidance advisable during these periods
• Children and adolescents: Safety hasn't been well established in younger populations
• People with low blood pressure or liver conditions: Berberine may further lower blood pressure and affect liver enzyme activity

If you're taking prescription medications like diabetes drugs, statins, blood pressure medications, antidepressants, immunosuppressants, or heart medications or undergoing therapy for cancer, talk with your healthcare provider before adding berberine to your routine.

Your doctor can help determine if berberine might work well alongside your current medications.

Frequently Asked Questions (FAQs)

1. Is berberine better than metformin for diabetes?

According to Dr. Eapen, “Studies comparing berberine and metformin show both can effectively lower blood sugar in type 2 diabetes. A few suggest that berberine offers similar results as metformin. However, metformin remains the first-line treatment due to its extensive long-term, peer-reviewed studies, established safety profile, and predictable effects.”

Berberine is generally considered a complementary approach rather than a replacement for metformin. Always discuss potential changes with your healthcare provider.

2. How much berberine do you need?

Most clinical studies have used 900–1500 mg daily, divided into 2–3 doses taken with meals. Improvements in blood sugar typically appear within 2–3 months, with some measures like fasting glucose often improving sooner.

“Remember that berberine typically functions as a supplement to standard care, not a replacement for prescribed medication,” cautions Dr. Eapen. “Consult your healthcare provider before starting berberine, and don't discontinue any current diabetes or cholesterol medications without medical guidance.”

3. How long does it take for berberine to lower blood sugar levels?

Initial improvements may begin within a few weeks, but significant changes usually require about 2–3 months of consistent use. Individual results vary based on factors including initial blood sugar levels, dosage, and overall lifestyle habits.

4. How long can you take berberine for diabetes?

Most research in this area studied the effects of berberine for up to six months, with some studies extending beyond this period without major safety concerns. However, long-term use exceeding six months hasn't been thoroughly studied.

If you’re already on prescription medication, it's advisable to use berberine under healthcare provider supervision, with regular monitoring to assess effectiveness and detect any potential side effects or medication interactions.

Get a personalized diabetes nutrition plan made just for you. Find a diabetes dietitian who accepts your insurance.

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.