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Berberine: The Plant Alkaloid that Helps Treat Diabetes & Digestive Problems


Berberine - Dr. Axe

Berberine comes to us from China and India, where it was first used in traditional Chinese medicine and Ayurvedic medicine. It’s a natural alkaloid found in a wide variety of traditional herbs, including goldenseal, barberry, goldthread, Oregon grape, tree turmeric and phellodendron. Within these plants, the berberine alkaloid can be found in the stem, bark, roots and rhizomes (rootlike subterranean stems) of the plants.

Berberine extracts and supplements, such as berberine HCL, are generally inexpensive, safe and well-known for their broad antibacterial activities — and can help naturally treat conditions without always resorting to antibiotics. For example, berberine has been proven to have many pharmacological effects, including antimicrobial, antitumor, anti-inflammatory and blood glucose–lowering effects. (1, 2, 3, 4)

Berberine Nutrition

Berberine is an alkaloid, which is defined as a class of organic compounds of plant origin containing mostly basic nitrogen atoms that have pronounced physiological actions on humans. There is a robust amount of research on this alkaloid that has been conducted to date with repeated double-blind clinical trials.

Findings of these studies have shown definitive or likely benefits for a very wide range of serious health ailments, including:

  • Anti-aging
  • Diabetes
  • Gastrointestinal infections
  • Heart disease
  • High cholesterol
  • Hypertension (high blood pressure)
  • Immune challenges
  • Joint problems
  • Low bone density
  • Weight control

Why is this? It’s due to the molecule structures berberine possesses. Its molecular formula is C20H18NO4, and like other protoberberine alkaloids — such as jatrorrhizine — it can do wonders for health. (5)

What is berberine? - Dr. Axe

7 Berberine Benefits

1. Potential Diabetes Treatment

As the rate of diabetes rises steadily around the world, studies show that berberine deserves a place among other natural remedies for diabetes. During one study, berberine was found to lower blood glucose, helping prevent and treat type II diabetes and its complications, including diabetic cardiovascular disease and diabetic neuropathy. (6, 7)

One of the most impressive studies compared taking 500 milligrams of the compound two to three times daily for three months with taking the common diabetes drug metformin. Berberine was able to control blood sugar and lipid metabolism as effectively as metformin, with researchers describing it as a “potent oral hypoglycemic agent.” (8)

Additional studies have also indicated that berberine improves glucose uptake and lipid metabolism disorders. For example, a study published in Evidence-Based Complementary and Alternative Medicine found that berberine can improve insulin sensitivity by adjusting adipokine secretion. (9)

Sodium caprate, another chemical compound, helps with the absorption of berberine, and together, they’ve been shown to “suppress hepatic gluconeogenesis in rat model of diabetes at least in part via stimulation of AMPK activity and this action of BER is augmented by sodium caprate.” (10)

Thanks to its effects on insulin sensitivity, this diabetes-fighting effect may also help prevent kidney damage. For example, research published in the International Journal of Clinical & Experimental Pathology examined the effects of this alkaloid on rats fed a high-fat diet to induce kidney damage. Here’s what researchers found: (11)

Western blot was used to detect the proteins adiponectin, adipoR1, adipoR2 and p-AMPK expression level. These encouraging findings suggest that berberine has excellent pharmacological potential to prevent kidney damage.

2. Lowers High Cholesterol 

There is evidence that berberine can help lower high cholesterol levels. A study published in the journal Metabolism showed that berberine reduced serum cholesterol along with triglyceride levels in type 2 diabetic patients. (12) Whereas dangerous statin therapy (the conventional pharmaceutical treatment of high cholesterol) increases the risk for type 2 diabetes, among other dangers, berberine likely has the opposite effect.

A separate study found that the combined administration of red yeast rice — well-known for its ability to naturally lower cholesterol — and berberine may provide a broader range of cholesterol protection with a lower risk of serious adverse effects compared with prescription statin therapy. (13) Berberine also has been shown to decrease abnormally high concentrations of fats and lipids in the blood of hamsters by promoting the excretion of cholesterol from the liver and inhibiting the intestinal absorption of cholesterol. (14)

Furthermore, research from the Department of Veterans Affairs Palo Alto Health Care System in California published in the Journal of Biological Chemistry found that “administration of BBR to hyperlipidemic mice and hamsters lowered circulating PCSK9 concentrations and hepatic PCSK9 mRNA levels without affecting the gene expression of HNF1α.” (15)

What does this mean? It means berberine inhibit PCSK9, which, as research from Harvard Medical School notes, helps lower cholesterol. (16)

3. Combats Obesity 

Due to serious adverse effects and the limited effectiveness of currently available pharmaceutical therapies for obesity, many research efforts focus on the creation of natural treatments for obesity — including anti-obesity drugs from natural products.

Along those lines, berberine is one of the few compounds known to activate adenosine monophosphate-activated protein kinase or AMPK. AMPK is an enzyme inside the human body’s cells, which is often called a “metabolic master switch” since it plays a crucial role in regulating metabolism. AMPK activation boosts fat burning in the mitochondria. Studies have demonstrated that berberine can fat accumulation in the human body.

In one pilot study published in Phytomedicine, obese human subjects (caucasian) were given 500 milligrams of berberine orally three times per day for a total of 12 weeks. The efficacy and safety of the treatment was determined by measurements of body weight, comprehensive metabolic panel, blood lipid and hormone levels, expression levels of inflammatory factors, complete blood count and electrocardiograph. Overall, this study demonstrated that berberine is a potent lipid-lowering compound with a moderate weight loss effect. (17)

Benefits of berberine - Dr. Axe

4. Potential Alzheimer’s Disease Protection

Studies have evaluated the therapeutic potential of berberine against neurodegenerative diseases like Alzheimer’s disease, Parkinson’s disease and trauma-induced neurodegeneration. One study found that there are multiple positive effects of berberine, some of which enhance neuroprotective factors/pathways and others that counteract neurodegeneration. (18)

The promising results seen so far provide a convincing and substantial basis to support further scientific exploration and development of the therapeutic potential of this alkaloid against neurodegenerative diseases. 

5. Treats SIBO 

Patients who suffer from small intestine bacterial overgrowth (SIBO) symptoms have excessive bacteria in their small intestines. Present conventional treatment of SIBO is limited to oral antibiotics with inconsistent success. More and more, people who suffering from SIBO are interested in using complementary and alternative therapies for their gastrointestinal health.

The objective of one study published in Global Advances in Health and Medicine was to determine the remission rate of SIBO using an antibiotic versus an herbal remedy. It found that the herbal treatment, which included berberine, worked just as well as antibiotic treatment and was equally safe. (19)

6. Supports Heart Health 

Part of berberine’s positive effect on heart health likely stems from the compound’s ability to help keep blood sugar levels and obesity in check, both of which can raise the risk of coronary heart disease. It also stimulates the release of nitric oxide, a signaling molecule that relaxes the arteries, increases blood flow, lowers blood pressure and protects against arteriosclerosis.

In research published by the University of Maryland Medical Center, people who took berberine for eight weeks had better heart function and were better able to exercise than those who took a placebo. (20) The recommended dosage from this study was 300 to 500 milligrams four times per day. The cardiovascular effects of berberine also suggest its possible clinical usefulness in the treatment of arrhythmias and heart failure. (21)

7. Boosts Lung Health 

Berberine’s potent anti-inflammatory properties are also excellent for lung health. In fact, this alkaloid has been shown to reduce the effect of cigarette smoke-induced acute lung inflammation.

In one study published in the journal Inflammation, mice were exposed to cigarette smoke to cause acute lung injury and were then given 50 mg/kg of berberine intragastrically. Upon examination of lung tissues, it was shown that cigarette smoke caused inflammation of the lung’s alveoli along with cellular edema or abnormal fluid retention. However, pretreatment with berberine significantly lessened lung inflammation and ameliorated cigarette smoke-induced acute lung injury through its anti-inflammatory activity. (22)


Berberine has been a revered plant alkaloid in traditional Chinese and Ayurvedic medicine for centuries. It is the main active component of an ancient Chinese herb Coptis chinensis French, which has been used to naturally treat diabetes for centuries. It has also been been used to treat bacterial gastroenteritis, diarrhea and other digestive diseases for more than 1,000 years. 

There is increasing research on the regulation of cancer cell metabolism by berberine hydrochloride. That’s because berberine induces cancer cell death. Its anticancer activity, specifically inhibiting growth and proliferation of cancer cells, makes it likely to become a natural component of the nanoparticulate delivery systems used for cancer berberine therapy. (23) For example, berberine induced apoptosis of human tongue cancer cells in research conducted at China Medical University. (24)

It has also been shown to have a possible potential role in osteoporosis treatment and prevention in human and animal studies. (25)

Some people apply berberine directly to the skin to treat burns and also to the eye to treat bacterial infections, like trachoma, that frequently causes blindness. It has been shown to be effective against a wide range of bacteria, protozoa and fungi. Animal studies have also shown that it may help fight depression. (26)

Where to Find and How to Use It

Berberine can be found in supplement form, most commonly as berberine HCL, online or in most health food stores. Be careful not to confuse berberine with piperine (black pepper extract), berberrubine (a metabolite) or berberol (a brand name mixture of tree turmeric and milk thistle).

Since berberine has a short half-life, you generally need to take this supplement three times a day to keep stable levels in your blood. Many studies use dosages of 900 to 1,500 milligrams per day. It’s most commonly recommended to take 500 milligrams three times per day for a total of 1,500 milligrams per day.

It should be taken with a meal, or shortly after, to take advantage of the blood glucose and lipid spike that comes with eating a meal. High doses taken acutely may cause stomach upset, cramping and/or diarrhea, which is another good reason to take berberine in multiple doses throughout the day.

You can work with a natural health care practitioner to determine the dose that works best for you.

Possible Berberine Side Effects

If you have a medical condition or are on any medications, including antibiotics, then it is recommended that you speak to your doctor before taking berberine. This is especially important if you are currently taking blood sugar-lowering medications.

Since it can lower blood sugar, diabetics who are controlling their blood sugar with insulin or other medications must use caution when using this supplement to avoid dangerously low blood sugar levels. People with low blood pressure should also be careful when using it since it can naturally lower blood pressure. Pregnant and nursing women should not take berberine.

Overall, this alkaloid has an outstanding safety profile. The main side effects are related to digestion and are minor, as there are some reports of cramping, diarrhea, flatulence, constipation and stomach pain. Again, by sticking with recommended smaller dosages — spread out through your day and after meals — these possible minor negative berberine side effects can be avoided all together.

Final Thoughts

  • Popular in traditional Chinese and Ayurvedic medicine treatments, berberine is a natural alkaloid found in a wide variety of herbs.
  • It’s proven to possess antibacterial, antimicrobial, antitumor, anti-inflammatory and blood glucose–lowering effects.
  • Berberine benefits include potentially treating diabetes, lowering high cholesterol, combating obesity, protecting against neurological diseases, treating SIBO, supporting heart health and boosting lung health.
  • It also shows potential for cancer inhibition, digestive issues, osteoporosis, burns, bacterial infections and even depression, though further research is needed.

Read Next: Diabetic Diet Plan + Supplementation

Josh Axe

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