Berberine: Benefits, Uses and Side Effects
Berberine is a popular supplement in the longevity community that is often said to be similar to metformin. We take a look at the research behind this interesting naturally occuring compound.
What is berberine?
Berberine is an ammonium salt from the protoberberine group of benzylisoquinoline alkaloids. It is part of a group of naturally occurring alkaloids that mostly contain basic nitrogen atoms.
Like many herbs and plants, it has been used in traditional Chinese medicine for centuries. This means that there are numerous anecdotal reports of its usefulness for various purposes.
It is usually found in the roots, rhizomes, stems, and bark of barberries and other plants. Due to its rich yellow color, the extract from Berberis species has traditionally been used to dye wool, leather, and wood.
Sources of berberine
Berberine is not typically present in our diet, but various plants and herbs do contain this compound.
- European barberry – Berberis vulgaris
- Tree turmeric – Berberis aristata
- Oregon grape – Mahonia aquifolium
- Goldenseal – Hydrastis canadensis
- Yellowroot – Xanthorhiza simplicissima
- Amur cork tree – Phellodendron amurense
- Goldthread – Coptis chinensis
- Heart-leaved moonseed – Tinospora cordifolia
- Mexican prickly poppy – Argemone mexicana
- Californian poppy – Eschscholzia californica
- Greater celandine – Chelidonium majus
- Wild sugar apple – Annona squamosa
- Indian barberry – Berberis aristata
It is not usually in the foods we eat, making including it in our diet challenging. With that in mind, it is, of course, offered as a dietary supplement.
What is berberine used for?
Berberine is commonly used to treat high cholesterol or other fats in the blood, a condition known as hyperlipidemia. It is also used by some people to control blood pressure.
It is also used to treat burns, canker sores, liver disease, and other conditions. However, the evidence for its use ranges from limited to nonexistent for such conditions.
Berberine may be a helpful antimicrobial agent. It can inhibit the growth of Staphylococcus aureus (MRSA) infections [1].
What does berberine do?
Berberine is a bioactive compound. It targets an enzyme in cells called AMP-activated protein kinase (AMPK). This enzyme is important for cellular energy metabolism [2].
AMPK is one of the four pathways that regulate metabolism and cellular homeostasis (a state of balance). Its deregulation is thought to be one of the reasons we age.
Some research suggests that berberine may also have anti-inflammatory properties [3]. Inflammation is known to play an important role in the aging process. If berberine can reduce inflammation this is also potentially useful in relation to slowing down aging.
Potential benefits of berberine
Many research studies have looked at berberine. We will divide these studies into different areas of interest.
For diabetes
There has been some research focused on berberine for type 2 diabetes. This condition happens when blood sugar (glucose) levels are too high. This can be caused by more insulin resistance or a lack of insulin. High blood sugar levels over a long period of time can damage tissues and organs and often leads to a shortened lifespan.
A 2015 study found that berberine worked better to lower blood sugar when combined with lifestyle changes. This was more effective than using lifestyle changes alone [4].
Another study in 2019 suggested that berberine was more effective at lowering blood sugar levels than a placebo [5]. Data from the study shows that using berberine with blood sugar-reducing drugs is more effective. This combination works better than using the drugs by themselves.
Berberine seems to target AMP-activated protein kinase (AMPK). The AMPK protein helps control metabolism and how the body reacts to blood sugar. Because of this, it may help with diabetes and related issues like obesity.
However, more research is needed, including large-scale clinical studies to properly ascertain berberine’s safety and efficacy. And due to its potential interactions with other medications a medical professional should be consulted before considering berberine.
For high cholesterol
A high level of LDL cholesterol, oversimplified as bad cholesterol, is a risk factor for heart disease and stroke. There is some evidence that berberine may be useful in lowering LDL cholesterol.
A 2015 study suggests that lifestyle changes combined with berberine are more effective to reduce high cholesterol. This is compared to just making lifestyle changes alone [4].
A 2017 review suggests that berberine may help lower LDL cholesterol and triglyceride levels [6]. However, the author concludes that more clinical trials need to be done for establishing the therapeutic effectiveness of berberine.
For obesity
Obesity can increase the risk of type 2 diabetes, heart disease, high blood pressure, and high cholesterol.
Some researchers believe that berberine works similarly to the drug metformin. A 2015 study even compared berberine and metformin. They found that both appear to modify the gut microbiome in ways that may help metabolism [7].
A 2015 study found that people with metabolic syndrome who took 200 milligrams of barberry three times a day saw weight loss [8].
In a 2017 review, people who took 750 mg of barberry twice a day for 3 months saw a significant loss of weight [6]. This effect could be due to how berberine interacts with AMPK and the resulting change of metabolism.
A 2018 study suggests that berberine activates brown adipose (fat) tissue [8]. This particular type of fat tissue helps the body to convert nutrients we consume into heat for our bodies. Increasing the activity of brown fat may help address metabolic dysfunction and conditions like obesity and metabolic syndrome.
Berberine side effects
Some mild side effects have been reported by people taking berberine as a supplement. These include an upset stomach, constipation, nausea, a rash, and headaches.
While no studies have reported serious adverse effects from berberine, its potential for causing them is high. Berberine can interfere with CYP2D6 and CYP3A4 enzymes. These are involved in metabolism and interact with drugs such as statins [10-11].
The data for long term use of berberine is not available. More research is needed before it really should be considered, as the potential for dangerous interactions is there. If you decide to take berberine and experience any adverse effects, cease taking it immediately and consult your doctor.
Disclaimer
This article is only a very brief summary. It is not intended as an exhaustive guide and is based on the interpretation of research data. That data is speculative by nature. This article is not a substitute for consulting your physician about which supplements may or may not be right for you.
We do not support the use of supplements or any product vendors. All discussions here are for scientific interest.
Literature
[1] Chu, M., Zhang, M. B., Liu, Y. C., Kang, J. R., Chu, Z. Y., Yin, K. L., … & Wang, Y. D. (2016). Role of berberine in the treatment of methicillin-resistant Staphylococcus aureus infections. Scientific reports, 6(1), 1-9.
[2] Lee, Y. S., Kim, W. S., Kim, K. H., Yoon, M. J., Cho, H. J., Shen, Y., … & Kim, J. B. (2006). Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes, 55(8), 2256-2264.
[3] Li, Z., Geng, Y. N., Jiang, J. D., & Kong, W. J. (2014). Antioxidant and anti-inflammatory activities of berberine in the treatment of diabetes mellitus. Evidence-based complementary and alternative medicine, 2014.
[4] Lan, J., Zhao, Y., Dong, F., Yan, Z., Zheng, W., Fan, J., & Sun, G. (2015). Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. Journal of ethnopharmacology, 161, 69-81.
[5] Liang, Y., Xu, X., Yin, M., Zhang, Y., Huang, L., Chen, R., & Ni, J. (2019). Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis. Endocrine journal, 66(1), 51-63.
[6] Tabeshpour, J., Imenshahidi, M., & Hosseinzadeh, H. (2017). A review of the effects of Berberis vulgaris and its major component, berberine, in metabolic syndrome. Iranian journal of basic medical sciences, 20(5), 557.
[7] Zhang, X., Zhao, Y., Xu, J., Xue, Z., Zhang, M., Pang, X., … & Zhao, L. (2015). Modulation of gut microbiota by berberine and metformin during the treatment of high-fat diet-induced obesity in rats. Scientific reports, 5(1), 1-10.
[8] Zilaee, M., Safarian, M., Kermany, T., Emamian, M., Mobarhan, M., & Ferns, G. (2015). Effect of barberry treatment on blood pressure in patients with metabolic syndrome. J Nat Prod, 8, 59-63.
[9] Hu, X., Zhang, Y., Xue, Y., Zhang, Z., & Wang, J. (2018). Berberine is a potential therapeutic agent for metabolic syndrome via brown adipose tissue activation and metabolism regulation. American journal of translational research, 10(11), 3322.
[10] Hermann, R., & von Richter, O. (2012). Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta medica, 78(13), 1458-1477.
[11] Feng, P., Zhao, L., Guo, F., Zhang, B., Fang, L., Zhan, G., … & Li, B. (2018). The enhancement of cardiotoxicity that results from inhibiton of CYP 3A4 activity and hERG channel by berberine in combination with statins. Chemico-biological interactions, 293, 115-123.
