Herbal Encyclopedia
Aug
Berberine
Berberine is a compound (specifically an isoquinoline alkaloid) found in some plants. It is yellow, so it has been used as a dye. Berberine is also used in traditional Chinese medicine.
Some of the plants that contain berberine include Coptis chinensis (Huanglian), Rhizoma coptidis, Hydrastis canadensis (goldenseal), Berberis aquifolium (Oregon grape), Berberis vulgaris (barberry), Berberis aristata (tree turmeric), Tinospora cordifolia, Coptidis rhizome, Arcangelisia flava, and Cortex phellodendri.
Berberine has been studied for its potential effects, including controlling an irregular heartbeat and lowering lipid levels, blood pressure, and blood sugar levels. For these reasons, berberine is being looked at to use as a supplement for several conditions.
This article discusses the potential uses of berberine and some of the evidence used to create a basis for future clinical studies.
Dietary supplements are not regulated like drugs in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. When possible, choose a supplement tested by a trusted third party, such as USP, ConsumerLabs, or NSF.
However, even if supplements are third-party tested, that doesn’t mean they are necessarily safe for all or effective in general. Therefore, it is important to talk to your healthcare provider about any supplements you plan to take and check in about potential interactions with other supplements or medications.
Supplement Facts
Active ingredient(s): Berberine
Legal status: Available over the counter (OTC)
Suggested dose: 500 milligrams (mg), 2 or 3 times a day
Safety considerations: May overlap with the effectiveness of some prescription medications and should therefore be used with caution
Uses of Berberine
Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
Canker Sores
Sores in the mouth, canker sores (also called aphthous stomatitis), are common, but there aren’t many good treatments available. A randomized control trial was done on berberine for canker sores. People in the study used a gel that contained berberine. It was applied to an ulcer in the mouth four times a day.
The study showed that the ulcers got smaller and caused less pain over six days. It’s thought that berberine gelatin might be an effective treatment for canker sores.
Diabetes
It’s thought that berberine might be helpful as a complementary treatment for diabetes. One parallel triple-blind clinical trial showed that berberine helped lower blood glucose levels.
In a triple-blind study, the participants, clinicians, and data analysts are all unaware of which participants are getting the drug and which are getting the placebo (an inactive or sham treatment).
The participants receiving berberine were taking 480 mg of the supplement each day. This was considered low and was used because it wasn’t known if taking more could be a safety problem. After 12 weeks, blood sugar levels were lower in participants with type 2 diabetes. The effect was similar to that of Glucophage (metformin).
However, the authors note that berberine didn’t work in all cases. In some cases, blood sugar wasn’t controlled, and five participants left the study for that reason. The authors said no safety problems concerned them and called for more research to understand which people might benefit from berberine.
One of the review articles on berberine for diabetes points out that the trials done so far have limitations and are not comprehensive or rigid enough to support making any recommendations.
High Cholesterol
Berberine may have a lipid-lowering effect. It sets off a chain of events that reduces the body’s ability to uptake long-chain fatty acids. The result could be the prevention of weight gain and cholesterol buildup.
A small, double-blind, placebo-controlled trial was done on 144 White people with high cholesterol but no other risk factors for heart disease. Seventy-one participants received 500 mg of berberine twice a day for three months.
At the end of the trial, low-density cholesterol (LDL), considered “bad” cholesterol, and total cholesterol levels were lower in the group that received the berberine than in the group that received a placebo.
A meta-analysis of 27 studies found that berberine, along with lipid-lowering medications, was more effective in lowering total and low-density cholesterol than medications alone.
High Blood Pressure
Many studies on berberine for high blood pressure (also called hypertension) have been done in China.
A meta-analysis that included those done in China showed that berberine effectively lowered blood pressure when paired with lifestyle changes. This was in comparison to lifestyle changes alone or with a placebo. Berberine paired with a medication was also more effective than the medication used alone.
Another meta-analysis of five randomized controlled trials found little evidence that berberine helps lower high blood pressure levels. There was concern that many trials comparing berberine with other treatments were not of high quality.
The authors of the meta-analysis point out that berberine is used widely in Eastern cultures, but better studies are needed to show that berberine is effective and safe for high blood pressure.
Polycystic Ovary Syndrome (PCOS)
A trial of berberine in 644 people with PCOS (a condition that often impairs fertility) compared medication (letrozole) to berberine and a combination of the two in pregnancy outcomes. There were fewer live births in the group taking berberine.
Birth weights were similar across all groups, and there were no twin births in the berberine group. The authors write that the combination of medication and berberine was not better than the medication alone.
In another study of 89 people with PCOS, berberine was compared to metformin in treating the signs and symptoms of PCOS. The berberine group showed a decreased waist circumference, waist-to-hip ratio, and levels of total cholesterol, triglycerides, and low-density lipoprotein cholesterol compared to metformin.
High-density lipoprotein (HDL) cholesterol, considered “good” cholesterol, and sex hormone–binding globulin levels were higher in the berberine group. The authors concluded that berberine improved some of the signs of PCOS, which may be because it resulted in weight loss and lowered cholesterol levels.
Antibacterial/Antimicrobial
Berberine may also have antibacterial properties. However, it has some drawbacks and limitations. It is not easily taken up in the gastrointestinal tract. Plus, it is used up and cleared by the body relatively quickly. This means that it’s difficult for it to be used effectively by the body without help to make it easier to absorb and stay in the body longer.
However, much of the study done on berberine as a way to fight infections is in animal models and in laboratory cells. There is little information on how berberine could be best used as an effective antibacterial or antimicrobial agent in humans.
Finding a better delivery method and formulation for berberine that can fight bacteria and viruses is under active study. One idea, for instance, would be using berberine in wound dressings and using it to combat wound infections.
What Are the Side Effects of Berberine?
Berberine is largely considered to be safe. Most studies didn’t bring up any safety problems. Side effects were considered comparable among the drugs being studied and the berberine. There were no serious side effects reported
Some of the side effects that occurred in trials were considered to be minor and included:
- Abdominal distention (bloating)
- Abdominal pain
- Constipation
- Diarrhea
- Nausea
Precautions
People should talk with a healthcare provider before taking berberine. This supplement can be as effective as some medications. For that reason, it’s important to not take it along with certain medications unless directed to do so. It could, for instance, lower blood sugar too low if taken with another drug that has the same effect.
Berberine is not recommended during pregnancy or while breastfeeding. This is because it may have an effect on a fetus or a newborn. It’s not well understood yet, but it’s thought that berberine could lead to a worsening of newborn jaundice (yellowing of skin and eyes).
Dosage: How Much Berberine Should I Take?
The dosage of berberine used in various studies has been between 0.3 and 3.0 grams per day. The total amount is usually divided over two or three doses during the day. In some trials, people took berberine for up to two years.
It’s still unclear exactly how much berberine should be used for each condition because most of the studies are preclinical (done to establish safety rather than the effect on conditions), and there are no guidelines. However, the dosage that’s frequently used in trials is 500 mg three times a day.
There is no safe or effective level of berberine established for children.
What Happens If I Take Too Much Berberine?
Some people may have gastrointestinal side effects from berberine. In that case, reducing the dosage for a time may help.
There is no set dosage and no upper dosage for berberine. It’s thought to be safe at the doses used in studies, but a healthcare provider should always be consulted about its use.
Interactions
It’s not currently known how berberine interacts with many medications.
Care should be taken when using berberine with other drugs for diabetes and high blood pressure. Berberine may work similarly to those drugs and therefore could cause an over effect.
It is crucial to carefully read the ingredients list and nutrition facts panel of a supplement carefully. This will help in understanding the ingredients and the dosing. Please review supplement labels with a healthcare provider to look for potential interactions with foods, other supplements, and medications.
How to Store Berberine
Supplements should be stored in a cool, dry place and out of the reach of children. Discard any leftover supplement after the expiration date on the bottle.
Sources of Berberine and What to Look For
Berberine is available in capsules, soft gels, tablets, liquid, and powder. It can be bought in drug stores, health food stores, or online.
Berberine has also been used in eye drops for eyes or gels meant for use in the mouth for canker sores. However, these forms might not be available for purchase in many places.
Summary
Berberine has been the subject of many clinical trials and studies, most frequently in China. It does show promise in treating some conditions, most commonly in combination with medications. However, there aren’t yet enough large high-quality studies to support its widespread use,
Some people will naturally be interested in trying berberine, based on the evidence gathered so far and its positive safety profile. However, it is important to discuss its use with a healthcare provider first.
Because it can be effective for some people, it might not be compatible with some prescription medications or other supplements meant to treat the same condition.
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