Dihydroberberine vs. berberine for diabetes: What research shows

Key Points

• Berberine is a natural plant compound that may help manage blood sugar, reduce cholesterol, and support weight loss
• Dihydroberberine (DHB) is a modified form of berberine designed to improve absorption and reduce digestive side effects
• Animal studies show dihydroberberine may be absorbed 5x better than regular berberine, but human studies are extremely limited
• Neither supplement should replace prescribed diabetes medications without medical supervision.
• Proper nutrition and exercise are key factors in controlling blood sugar levels.

Dihydroberberine, or DHB, is being promoted as "Berberine 2.0” by supplement companies and their influencers on TikTok and other social media platforms. 

They claim that it offers the same benefits as berberine supplements with fewer side effects.

But what does the research actually show?

Is DHB really worth the higher price tag, or is regular berberine a better option? What’s the best way to manage your diabetes, lose weight, and stop those carb cravings?

Let's cut through the marketing claims and look at what science tells us about these two supplements.

What is berberine?

Berberine is a bright yellow compound found in several plants, including barberry, goldenseal, goldthread, Oregon grape, and tree turmeric. 

It's been used in traditional Chinese and Indian Ayurvedic medicine for centuries.

Modern research has found that berberine may:

• Lower blood sugar levels
• Improve cholesterol profiles
• Support moderate weight loss
• Help reduce inflammation

Regular berberine (or berberine HCL) may have its benefits, but it has a low bioavailability—the amount of drug or supplement that is actually absorbed and used by the body.

So, that means you will need a higher concentration of berberine to achieve the health benefits you’re looking for. A higher dose may lead to different issues—digestive discomfort as side effects like constipation, gas, bloating, and even diarrhea.

Enter dihydroberberine: a new type of berberine developed to help improve how well berberine is absorbed in the body at lower doses.

What is dihydroberberine?

Dihydroberberine, also known as ‘berberine DHB,’ is simply a modified form of berberine with a slightly different structure.

The modification is meant to help DHB pass through the gut barrier into the cells much easier, where it converts back to berberine in order to work. Think of it as putting on a hat, coat, and boots when you go outside in the winter and taking them off once you're back indoors.

Keep in mind that dihydroberberine is relatively new, and our knowledge about it is limited, especially regarding how it works in humans. Berberine itself has been more extensively studied as a supplement, though we still lack long-term or large-scale studies.

How do berberine and dihydroberberine work?

Both berberine and dihydroberberine (DHB) work through similar mechanisms to help manage blood sugar levels. In fact, DHB is just a modified form of berberine until it crosses the gut barrier and enters our cells, after which it’s converted back to berberine (known as berberine HCL).

Research shows that berberine activates an enzyme called AMP-activated protein kinase (AMPK)—the puppet master behind your metabolism and energy levels.

When activated, AMPK helps:

• Increase glucose uptake by your muscles
• Improve insulin sensitivity
• Reduce glucose production in your liver
• Increases fat burning

Overall, AMPK helps improve how your cells respond to insulin so they become more efficient at absorbing your blood sugar and converting it to energy.

Berberine's mechanism actually resembles how the common diabetes drug metformin works, which is why it's sometimes called "nature's metformin."

A few studies show that berberine may also activate GLP-1, the hormone that regulates appetite and slows down digestion, but more information is needed before we know for sure.

Is dihydroberberine better than berberine?

The main advantage of dihydroberberine is meant to be improved absorption. This matters because less than 1% of regular berberine gets absorbed and used when taken as a supplement.

The issue with regular berberine’s low absorption is that it:

• Doesn't dissolve well in the digestive tract
• Gets broken down by bacteria in your gut
• Is actively pumped back out of intestinal cells (by P-glycoprotein)
• Undergoes extensive first-pass metabolism in the liver

To compensate for this poor absorption, clinical studies use higher doses of berberine during a day, about 1,000 to 1,500 mg a day, split into 2-3 doses. 

However, these higher doses may cause digestive issues.

Dihydroberberine was developed specifically to overcome these absorption problems, and its appeal is the promise of delivering benefits with fewer side effects than berberine, metformin, and even Ozempic.

What does the science say about dihydroberberine vs. berberine?

Here's where things get interesting—and where we need to separate hype from reality. There are many bold marketing claims being made by people who sell dihydroberberine supplements and the influencers who profit from them.

Let’s see if the science backs their claims.

Does dihydroberberine provide 5X the absorption of berberine?

An animal study suggested that dihydroberberine could be absorbed 5 times better than regular berberine. This study is the basis of claims that dihydroberberine has 5X the absorption rate as berberine.

It has not been proven in humans, and we have no idea about whether DHB actually works as it has been intended to. We do not know the side effects and long-term effects of taking dihydroberberine.

What do human studies say about dihydroberberine?

There is only one small human study that compares dihydroberberine to berberine. “How small?” you may ask. The answer is that there were just five male participants in total.

The study (funded by NNB Nutrition, a company that sells dihydroberbrine supplements) also only studied DHB vs. berberine over the span of four meals.

The participants were healthy and had not been diagnosed or treated for heart disease or metabolic conditions like obesity and diabetes.

In this tiny pilot study:

• Both 100mg and 200mg doses of dihydroberberine produced significantly higher blood levels of berberine than a 500mg dose of berberine itself
• The total absorption was about 2-4 times higher for dihydroberberine
• Despite better absorption, there were no significant differences in blood glucose or insulin levels between the groups during the short study period

While this is a great start and provides a foundation for more research on DHB and berberine, it is too early to determine if dihydoberberine is better than berberine.

The researchers of this study concluded that more research was needed and that the sample size was too small to determine if the improved absorption translates to better blood sugar control.

What does the research say about berberine for diabetes?

Before taking berberine for diabetes, it helps to learn about its results in clinical trials.

A review of 46 clinical trials involving more than 2,000 people taking berberine found some interesting results.

• On average, people saw their morning blood sugar drop by about 0.89 points
• Their 3-month blood sugar average (HbA1c) decreased by 0.75 percentage points
• The after-meal blood sugar levels (post-prandial) went down by 1.3 points

Some studies showed that berberine seemed to work better when taken with regular diabetes medications.

However, even berberine research has important limitations:

• Most studies on this are pretty small, with fewer than 100 people each. You might see articles claiming "research on 17,000 or even 2,000 people," but those numbers come from adding up participants across multiple small studies in a review paper (meta-analysis), not from one large study.
• There is no long-term safety data on berberine; most studies last 3-6 months
• Most berberine studies are conducted on Chinese adults, with few independent replications in Western populations. So, the effect on different body types is yet to be determined
• The quality and methodology of berberine studies vary widely, and more robust research is needed

It’s also important to note that berberine and dihydroberberine are considered dietary supplements, so they are not regulated by the US FDA. 

This means that the quality and the amount of berberine or DHB may vary greatly from brand to brand. They are also not authorized by the FDA to treat medical conditions.

If you plan to take a supplement, look for third-party quality certifications and information about how the product has been tested.

Safety and side effects comparison

In general, berberine has a good safety profile, but higher doses may lead to some digestive issues.

Berberine side effects may include:

• Diarrhea (most common)
• Constipation
• Cramping
• Nausea
• Flatulence
• Abdominal pain

The digestive issues from berberine usually improve after taking it for a few weeks, but some people can't tolerate it at all. 

Ultimately, it’s best to see how your body responds to any medication or supplement and talk to your doctor about any discomfort you may feel.

Dihydroberberine side effects may include:

• Nausea
• Headache
• Dizziness

However, these side effects are based on one very small human study.

In theory, dihydroberberine should cause fewer digestive problems since you may be taking a lower dose compared to berberine HCL. However, with only one tiny study, we simply don't have enough data to make definitive claims.

Important drug interactions

Both berberine and dihydroberberine can interact with medications, which is crucial to know if you have diabetes and take prescription drugs.

Potential interactions include:

1. Diabetes medications: Both supplements can lower blood sugar, potentially causing hypoglycemia (dangerously low blood sugar) when combined with diabetes drugs like metformin, sulfonylureas, or insulin
2. Blood thinners: Berberine may enhance the effects of anticoagulant medications like warfarin
3. Statins: Berberine is processed by the same liver enzymes (CYP3A4) as many statins, potentially increasing statin levels in the blood
4. P-glycoprotein substrates: Berberine can inhibit P-glycoprotein, potentially increasing levels of drugs transported by this protein (including cyclosporine, digoxin, and certain cancer drugs)

Always consult your healthcare provider before starting any supplement, especially if you take prescription medications or have been diagnosed with a medical condition.

How to "reverse" diabetes?

When people talk about "reversing" diabetes, they're referring to diabetes remission: achieving blood glucose levels below or equal to an A1C of 6.5% for at least three months without medication.

While supplements like berberine might help, true remission requires a comprehensive approach.

Weight loss is key

For many with type 2 diabetes, weight loss is the most powerful intervention. Losing just 5-10% of body weight can significantly improve blood sugar control, with more substantial loss potentially leading to remission.

Diabetes diets that work

Diets to lower your blood sugar include:

• Low-carbohydrate diets, where carbohydrates are 20-30% of total calorie intake
• The Mediterranean diet which emphasizes whole foods and small amounts of healthy fats)
• Calorie restriction through intermittent fasting or consistent reduction

Overall, the key is finding a sustainable approach that fits your lifestyle.

Also, do not lose hope if food cravings or “food noise” threaten to derail your best efforts to eat healthy. Food cravings are complex and influenced by the body's resistance to rapid weight loss, poor gut health, chronic stress, and emotional eating triggers.

An experienced registered dietitian can guide your weight loss journey. They can help you develop mindful eating habits and create sustainable strategies to maintain results without feeling deprived of foods you enjoy.

Exercise is medicine for diabetes

Remember that berberine helps you lower your blood sugar by activating AMPK, the enzyme that helps you burn glucose for energy? Well, here’s a fun fact: exercise is the best way to activate AMPK!

When you exercise, your muscles contract and naturally activate AMPK, which increases glucose uptake into your muscles, improves insulin sensitivity, and enhances your metabolism—all without side effects!

You could:

• Aim for 150 minutes of moderate activity weekly (just 20-25 minutes daily)
• Take short 10-minute walks (even 2-5 minutes will do) to dull glucose spikes
• Incorporate movement throughout your day—muscles actively absorb glucose from your bloodstream when they're being used.

💡Tip: If you’re at work and need to be discreet, consider doing calf raises under your desk at regular intervals

Measure beyond A1C

While A1C shows your average blood sugar over months, it misses daily spikes that could contribute to blood vessel damage.

Consider regular glucose monitoring to identify trigger foods, or ask about continuous glucose monitoring (CGM) for real-time insights into how your body responds to foods and activities.

Get expert support

Reversing diabetes isn't a solo journey.

Team up with diabetes-focused healthcare professionals to boost your success: primary care providers or endocrinologists for medical management. Plus, specialized registered dietitians can create custom meal plans that work with your preferences and goals.

Final thoughts: Dihydroberberine vs. berberine

Berberine has been shown to lower blood sugar and “bad” cholesterol (LDL) levels and even trigger modest weight loss. For dihydroberberine, there is only one human study and a few trials on rats. So, it’s too early to tell if dihydroberberine lives up to the marketing claims.

Additionally, while dihydroberberine is promoted as having a better absorption rate, there is no evidence that this amounts to better health benefits compared to taking berberine.

Whether you’re on medication or take supplements, lifestyle factors have powerful effects on diabetes management. Consider adopting:

• A diabetes-friendly diet rich in vegetables, lean proteins, and healthy fats
• Regular physical activity (both cardio and strength training)
• Stress management and adequate sleep
• Working with healthcare providers who specialize in diabetes care

Get a personalized diabetes plan from a diabetes dietitian who accepts your insurance.

Frequently Asked Questions (FAQs)

1. What's the recommended dosage for berberine and dihydroberberine?

There is no recommended or standard dosage for berberine or dihydroberberine.

For berberine, most studies use 500mg, 2-3 times daily (for a total of 1,000-1,500mg), taken with meals.

For dihydroberberine, there’s only one small human study that used 100 mg and 200 mg doses. Supplement labels typically recommend 100-200mg, 1-2 times daily, but, again, these recommendations are based on very little scientific evidence.

2. How long does it take to see results from berberine or dihydroberberine?

Berberine studies show changes in blood sugar levels within 1-3 months. There's not enough data on dihydroberberine to make specific claims about timing.

3. Can berberine or dihydroberberine replace my diabetes medication?

It’s important to never discontinue prescribed medications without consulting your healthcare provider. Also, please do not adjust the dosage of your prescriptions without medical supervision.

While berberine may help manage blood sugar, it hasn’t been studied as a replacement for standard diabetes treatments. It also has no long-term data yet to learn how it affects the liver and other organs.

4. Are there quality concerns with berberine or dihydroberberine supplements?

Dietary supplements are not regulated by the US FDA. This just means that there are no stringent testing and clinical study requirements, so the quality may vary from one brand to another.

If you plan to take berberine, look for a brand that:

• Has been third-party tested for purity and potency
• Is made by reputable manufacturers with good quality control
• Provide clear information about dosage, ingredients, and side effects
• Provides sufficient proof about how it makes its marketing claims

Lower your A1c and lose weight. Find a diabetes dietitian covered by 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.