Is Supplement Berberine really “Nature’s Ozempic”? Experts weigh the pros and cons

I would say it is a great exaggeration to call it nature Ozempic, said Dr. Melinda Ring, executive director of the Osher Center for Integrative Health at Northwestern University, Chicago.

But berberine has been associated with a variety of health benefits, including modest weight loss, lowering cholesterol and improving blood sugar levels, she said.

Ring said he wouldn’t switch to one another if someone has already been prescribed medication for any of these conditions.

Berberine also has its drawbacks. It can cause potentially dangerous interactions when used with other drugs and shouldn’t be used by pregnant or nursing women or children, Ring warned.

But that said, it’s one of my favorite compounds, she continued. The safety profile is good and the potential benefits are several. So I actually like it for people who have weight issues. Especially if they have weight issues and blood sugar issues, insulin resistance and high cholesterol, then I think it might be a good option.

Berberine has been used in traditional Chinese medicine for at least 3,000 years, Ring noted.

Berberine is not a plant per se. It’s an alkaloid compound found in a variety of plants, he explained.

Plants that contain berberine include European barberry, goldenseal, golden thread, Oregon grape, phellodendron and tree turmeric, according to the US National Center for Complementary and Integrative Health (NCCIH).

People who use those different herbs are taking berberine, Ring said. Commonly, what is popular now, is used as an extract, a compound in and of itself, just a berberine supplement.

Some studies have associated berberine with modest weight loss, though experts note that the evidence is scant.

For example, a meta-analysis of 10 previous studies on berberine found that the supplement reduced body mass index (BMI) by about 0.29 on average and waist circumference by about an inch, according to one report of 2020 into Complementary therapies in clinical practice. (BMI is a measure of body fat based on height and weight.)

That’s a very small drop in body mass index, said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston.

Apovian added that the report included a bunch of badly done studies, and when you put a bunch of badly done studies together, you get a badly done meta-analysis.

Even in specific studies that found a reduction in body weight of about 6 pounds when using berberine, greater weight loss was seen with Ozempic and greater sustained weight loss if someone stays on the drug, Ring said.

But other research has shown that berberine has the potential to help treat other health issues associated with obesity, Ring added.

These studies have shown that berberine can lower blood sugar and improve insulin resistance, she said.

The compound has also been shown to potentially increase good HDL cholesterol while lowering bad LDL cholesterol and triglycerides, Ring said. It might also help control blood pressure.

Berberine might also help health and weight by affecting the gut microbiome, Ring said.

We’re aware that some bacteria are really good at extracting calories and some aren’t, so they could modulate the gut microbiome, she said, adding that this effect could improve a person’s overall gut health.

Historically, Ayurvedic medicine has used berberine as a remedy for gastrointestinal ailments, as well as for wound healing and infection treatment, according to the NCCIH.

A review from July 2020 in Biomedicine and Pharmacotherapy evaluated all of these effects on weight loss and obesity-related health problems and concluded that berberine might be beneficial.

Berberine is not only effective for obesity, but also for other systems and consequences of obesity such as diabetes and cancer, the review concluded.

There are safety issues related to berberine, experts have noted.

Berberine can cause kernicterus, a rare type of brain damage in newborns who have extreme jaundice, according to the US National Institutes of Health (NIH).

The compound may also prevent the liver from removing bilirubin, a chemical made when old red blood cells break down, the NIH said. This can cause brain problems, especially in newborns.

For these reasons, pregnant women and nursing mothers should avoid taking berberine and it shouldn’t be given to children, says the NIH.

Berberine can also affect how the liver processes different medications, increasing or decreasing the effect of specific medications.

There are reports in the literature suggesting that if berberine is used, it may impair the absorption or penetrance of other drugs, Apovian said. Whenever you use an herbal supplement, let your doctor know you are, even if the supplements are over-the-counter. Just because it’s over the counter doesn’t mean it’s safe.

The NIH specifically warns against interactions with cyclosporine, losartan and dextromethorphan, a cough suppressant found in Robitussin DM, and other cold remedies.

Interactions can also occur with diabetes and blood pressure medications and blood thinners, the NIH said.

Theoretically, if someone is taking blood thinners like warfarin to prevent clots and then took that too, they could have a potential increased risk of bleeding, Ring said.

Similarly, a person could end up with hypoglycemia if berberine lowers blood sugar in addition to another prescribed diabetes drug, Ring said.

Apovian said he would prefer people try other weight-loss drugs like Ozempic or Alli.

I never advise a patient to try an over the counter weight loss drug unless it has been approved by the [U.S. Food and Drug Administration], and the only one that has ever been approved by the FDA is Alli, Apovian said. But if a patient sees their primary care physician or an obesity medicine specialist, we are happy to try to get that patient on any of the six medications we have available for weight management.

Ring agreed that there are many other weight loss measures that have been shown to be more effective than berberine.

We always start with all the lifestyle stuff of nutrition, movement, sleep, managing stress, avoiding toxins, she said. If someone is doing all of this and we’ve also ruled out that there’s something else that might be a hindrance, like, that they have thyroid issues or something, at that point, I’d say berberine might be supportive in their journey .

But, added Ring, “I wouldn’t say that continuing to eat a quarter-pounder and berberine is just going to take the pounds off that’s not going to happen. But is it supportive? Potentially yes.”

The Cleveland Clinic has more on berberine.

SOURCES: Melinda Ring, MD, executive director, Osher Center for Integrative Health, Northwestern University, Chicago; Caroline Apovian, MD, co-director, Center for Weight Management and Wellness, Brigham and Women’s Hospital, Boston; Complementary therapies in clinical practiceMay 2020; Biomedicine and PharmacotherapyJuly 2020