Step aside, Ozempic — there’s a trending, alternative weight-loss supplement on the scene.
The supplement berberine has been branded as “nature’s Ozempic” on social media. Ozempic is a type 2 diabetes drug known by the generic name semaglutide that also is used for weight loss. Semaglutide has skyrocketed in popularity as an often effective (albeit sometimes very expensive) weight-loss measure.
Tara A. Schmidt, M.Ed., RDN, LD, a registered dietitian with Mayo Clinic, thinks the term “nature’s Ozempic” for berberine is good marketing — but not necessarily honest or helpful.
Although research suggests some good uses for berberine, it’s not ready for prime time as an obesity treatment. And you should always take a beat to scrutinize a claim that a supplement is “natural,” Schmidt says.
“If you are looking at something that’s being considered a ‘natural’ version of a medication, it can look really appealing,” says Schmidt. But the natural label does not guarantee a pure and unprocessed substance, and consumers may not realize that a supplement can seriously interfere with other medications they are taking.
And even if a supplement truly comes from natural sources, it’s still unlikely to provide a quick and easy fix for health conditions such as obesity.
“With weight loss and with diabetes management, even when (we offer) a prescription medication, we always, always, always also combine it with lifestyle interventions,” she says. “So when people get excited about supplements out there, even if there is some evidence, we can’t just assume that it’s magic — even Ozempic’s not magic in itself.”
What is the supplement berberine?
Berberine is a type of plant substance known as an alkaloid, and is found in a variety of plants, including barberry, goldenseal, Oregon grapes and coptis. These plants have long been used in traditional medicines — including Native American and Chinese practices — to treat a wide variety of illnesses, including eye conditions, diarrhea, jaundice and acne.
Today, berberine is available in supplement form and taken orally, though it is sometimes delivered intravenously or topically.
What is berberine used for?
According to TikTok, a whole lot. Alongside first-person online testimonials about weight loss, skim through social media and you’ll find people who are using berberine for ailments like high cholesterol, insulin resistance and polycystic ovary syndrome (PCOS).
While such a wide array of benefits seems too good to be true, a look at the research shows that berberine is indeed ripe with possibility. Researchers are exploring many possible uses of berberine including as a treatment for diabetes, obesity, cancer, PCOS, high cholesterol and more.
However, research is still limited, especially as some of the studies done thus far were small or performed on animals, Schmidt says. Even so, some of the most encouraging results for berberine thus far are for:
- Lowering cholesterol. Studies have demonstrated that berberine may reduce low-density lipoprotein (LDL, or “bad”) cholesterol, total cholesterol and triglycerides.
- Diabetes. Berberine may improve blood sugar measures such as fasting glucose and hemoglobin A1c (HbA1c) in those with type 2 diabetes, and by some measures may work about as well as the commonly prescribed oral diabetes medication metformin.
- PCOS with insulin resistance. Berberine supplements may lower testosterone levels, improve cholesterol, lower fasting blood sugar levels and decrease measures of insulin resistance in people with PCOS and insulin resistance.
You may notice that obesity didn’t make the shortlist. That’s because there aren’t enough high-quality studies on the subject, though there has been some research showing that berberine supplementation may help reduce weight.
What are the risks of berberine?
Berberine may be safe when taken in recommended amounts — with the exceptions that it should not be used by children or people who are pregnant or breastfeeding.
The main side effects are gastrointestinal (GI) and include nausea, constipation, diarrhea, gas and vomiting. But Schmidt sees a much more pressing potential risk than GI symptoms.
“The scary thing is that it interacts with a ton of medications. There is a very long list of meds that could possibly interact with the berberine,” Schmidt says. “Don’t take this unless you speak to your medical provider first.'”
Possible interactive medications include anti-clotting drugs, sedating medications such as zolpidem (Ambien, Edluar) and diabetes drugs including metformin.
How does berberine work?
It potentially works in a bunch of different ways. It’s considered antimicrobial and may alter the bacteria in your gut. In addition, berberine may affect a wide variety of body functions, and is thought to act as an anti-inflammatory, antioxidant and anti-cancer substance.
Berberine’s effects on insulin and gut microbiota may be partially responsible for potential weight loss, Schmidt says. And one animal study showed that it affected glucagon-like peptide 1 (GLP-1) — a hormone involved in insulin secretion — which semaglutide also affects.
Some people on social media are claiming that the supplement berberine is helping them lose weight by lessening their appetite.
“One week in. 3 pounds down. All the snack chatter in my head has disappeared,” one TikTok commenter wrote. Another chimed in, “Same thing happened to me! Food noise gone and hunger really reduced.”
Better blood sugar regulation may explain a more regulated appetite, Schmidt says.
“If you’re not having those highs and lows in your blood sugar, you might not feel that more extreme hunger,” she says.
It’s also possible that some people experience a reduced appetite due to berberine’s possible GI side effects such as nausea, she says. This can lead to the question, “Did the side effects impact my hunger, or is the supplement actually regulating my appetite?”
How much berberine should I take?
As with any supplement, it’s best not to take any berberine until you’ve talked with a member of your health care team, especially as berberine may interact with other medications or supplements. Definitely don’t drop a prescription drug such as metformin in favor of berberine without talking to your prescribing doctor or a pharmacist.
It’s thought that taking 1.5 grams of berberine every day — sometimes split into multiple doses — for six months or less is safe. The six-month limit is due to a lack of longer term data, Schmidt says.
The ‘natural’ dilemma
Berberine shares some issues with all other supplements, Schmidt says. Supplements are not subject to the more-rigorous regulation that the U.S. Food and Drug Administration (FDA) applies to medications, and they are not proved to be safe or effective.
Because of this, medical professionals may shy away from taking a stand on a supplement, citing lack of research, Schmidt says. People looking for alternative solutions — maybe because they can’t afford prescription medications, maybe because they are looking for alternative solutions after being ignored or failed by the medical system — may then turn elsewhere for insight.
“We get TikTokkers — who are not physicians, who are not pharmacists, who are not registered dietitians — giving advice, and now we have consumers listening to people who are outside of the medical industry, because no one in the medical industry is comfortable enough to endorse it or not,” Schmidt says.
“We just have to wait sometimes for research to catch up. But research requires money. And research requires time.”
While research plays catch-up, there are many pharmaceutical and lifestyle evidence-based interventions backed up by years of research to help address the same issues berberine may help with, including gut health, blood sugar problems and weight loss, Schmidt says.
And although many supplements are touted as a natural solution, this is not always an accurate representation — whether due to manufacturer malfeasance (such as weight-loss supplements found to contain unlisted prescription drugs) or the realities of processing the supplement.
“(For example), people aren’t eating stevia leaves. Stevia is still an artificial sweetener unless you’re putting the leaf in your coffee. So natural or not, these are still processed supplements; they come out of a factory,” Schmidt says.
Finally, just because something is naturally occurring or seems beneficial does not necessarily mean consuming it in supplement form will be helpful. For example, it’s possible that supplemental vitamin E increases the risk of prostate cancer.
“(The assumption is) taking more vitamin E is going to be a good thing, right? It’s a vitamin,” Schmidt says. “You can’t assume anything is going to be beneficial until it’s studied.”
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