Key takeaways
  • Berberine affects metabolism through multiple pathways, which have a positive effect on glucose levels and insulin sensitivity, benefiting those with diabetes and obesity
  • Berberine positively alters lipid profiles by reducing LDL cholesterol and triglycerides, crucial for heart disease prevention and management
  • Whilst safe for most, taking berberine long-term requires monitoring by  a health professional

Insulin resistance, diabetes, heart disease, and obesity are becoming increasingly prevalent, raising concerns worldwide. As more people seek to manage these conditions, the demand for natural alternatives to medications like statins and metformin is growing, driven by a desire for solutions with fewer side effects.

Berberine, an alkaloid derived from many plants, is an effective option. Clinical studies have shown that berberine can effectively reduce blood glucose levels, enhance insulin sensitivity, and promote weight loss.

In this article, you'll learn about berberine and why it’s gaining popularity for its numerous health benefits.

What is berberine?

Berberine has been used in traditional Chinese and Ayurvedic medicine for centuries to treat a variety of ailments. It's a powerful bioactive compound derived from various plants renowned for their medicinal properties. Among the most common sources are the berberis species, particularly Berberis vulgaris, also known as barberry.

Another significant source is Hydrastis canadensis, commonly referred to as goldenseal, which has a long history in traditional medicine. Additionally, Coptis chinensis, or Chinese goldthread, is a key provider of berberine, especially in Asian herbal practices.

The Amur cork tree, scientifically known as Phellodendron amurense, also yields this beneficial compound. Each of these plants contributes to berberine's growing reputation as a natural remedy with a wide range of health benefits

How does berberine work?

Key metabolic actions of berberine

Berberine affects metabolism through multiple pathways, which collectively have a very positive effect on glucose and insulin levels.

Influence on glucose metabolism and glycolysis

Berberine has been shown to improve glucose metabolism. Research highlights how berberine induces glycolysis, the process by which glucose is broken down to produce energy. This means that berberine helps the body to more efficiently process and use glucose, reducing blood sugar levels.

Enhancement of insulin receptor expression

Another significant action of berberine is its ability to increase insulin receptor expression. This is akin to increasing the number of docking stations available for insulin in the body, thereby improving insulin sensitivity. Improved insulin sensitivity means that the body can better respond to insulin and manage blood glucose levels more effectively.

Enhances fat metabolism

One of the primary mechanisms through which berberine exerts its effects is the stimulation of fatty acid oxidation via activation of an enzyme called AMP-activated protein kinase (AMPK), which plays a pivotal role in regulating metabolism.

Fatty acid oxidation burns diet-derived fats, converting them into ATP (energy). This can be helpful for anyone trying to reduce weight or body fat, enhancing existing diet and exercise efforts.

When berberine activates AMPK, it's like flicking on a switch to reduce energy storage (weight gain) and increase energy production from the fuel (foods) being consumed. This action is particularly beneficial in conditions like insulin resistance, obesity, polycystic ovarian syndrome, and type 2 diabetes, where metabolism is impaired.

Positively alters the microbiota

The balance of the microbes in the gut is involved in the genesis of metabolic disease including diabetes. Coincidentally, berberine also positively affects the abundance and diversity of the ecology in the large bowel. The benefits are increased short-chain fatty acid (SCFA) production.  

It’s also speculated that berberine enhances the growth of specific strains of bacteria that produce branch chain amino acids (BCAA), which also contribute to alleviating insulin resistance.

Uses of berberine

Berberine in managing type 2 diabetes, insulin resistance and metabolic syndrome

Berberine helps regulate blood glucose levels directly by impacting glut 4 and glut 1 transporter expressions, and insulin receptor expression, by upregulating the burning of fats and carbohydrates into fuel. This provides the person with metabolic disturbance the support they need in reversing metabolic dysfunction.

Metabolic syndrome (AKA dysfunction) is the prelude to diabetes where blood pressure, triglycerides, blood pressure, weight, waist circumference and cholesterol are all gradually climbing. This is an ideal time to take action and utilise the benefits of substances like berberine.

A meta-analysis of pooled studies demonstrates that berberine reduces LDL (bad) cholesterol and triglycerides, and is unlikely to reduce HDL (protective) cholesterol.  

This is crucial in preventing and managing cardiovascular diseases, as a balanced lipid profile helps to protect against heart-related issues.

It’s much easier to effect change early before the diagnosis of diabetes is made.

These are the ideal metrics for avoiding metabolic disease:

  • Waist measurement below 80cm (women) and 92cm (men)
  • Blood pressure below 130/85mmHg
  • Blood triglycerides below 1.7mmol/L
  • HDL cholesterol above 1.0mmol/L (men) and 1.3 mmol/L in women
  • Fasting glucose below 4.95mol/L
  • Fasting insulin below 7.0

Efficacy in polycystic ovary syndrome (PCOS)

PCOS is often characterised by insulin resistance. Berberine, by improving insulin sensitivity, can help in managing this aspect of PCOS. Consequently, it may also be useful in treating acne related to PCOS and weight gain, as some acne is very sensitive to glucose and insulin levels.

Considerations for long-term prescribing and Liver Function Screening


Pure or raw berberine is quite unabsorbable in the human gut. This is why it can act so well on the bacterial populations in the large intestine.  

However many new and novel preparations are being developed to enhance the bio-availability, for example, liposomal technology.

Other substances, such as St Mary’s thistle may also enhance the effectiveness of berberine, whilst at the same time providing liver support and protection.

Safety profile and potential side effects

While berberine is generally considered safe, like any potent compound, it comes with its own set of considerations. Potential side effects, though usually mild, can include gastrointestinal discomfort, such as cramping or diarrhoea.

It’s always recommended to start on lower doses of any herbal medications that are likely to affect the digestive system and gradually work your way up to the therapeutic level.

Liver function and the need for screening

One specific area of concern with long-term berberine use is its impact on liver function.

In some people, high-alkaloid herbal medicines might affect liver function, especially if the liver is already overburdened by other medications or pre-existing inflammation.

It’s a good idea to test your liver function before, during (at 6 weeks) and at the end of a 12-week cycle of berberine.

As mentioned before, coupling the berberine with St Mary’s thistle can be both liver protective and enhance its therapeutic activity.

Dosage and administration guidelines

The typical dosage of berberine ranges from 500 to 1500 mg per day, usually divided into two or three doses taken with food for the best effect on metabolism.

It's important to start with a lower dose and gradually increase it, allowing the body to adjust.

Before beginning berberine supplementation, it's crucial to understand your current health status and your desired outcomes.

A trained professional, like our practitioners, will conduct comprehensive functional and general pathology testing to provide a clear starting point and guide your progress.

As a supplement, berberine can have a powerful action on metabolism, positively shifting glucose, lipid and cholesterol metabolism, in the right direction, and consequently helps with weight loss as well.

Keep in mind though, that Berberine is not a miracle drug. You still need to take the right actions with diet and activity. If you’re unsure whether you’re on the right track with those habits, consult a healthcare professional who can provide valuable guidance.

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Rebecca Hughes
Rebecca delivers high-quality, results-oriented care, specialising in treating acne, eczema, psoriasis, menstrual issues, thyroid, and IBS with vast clinical experience.
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{ "datePublished": "May 24, 2024" }