Berberine: Benefits, Dosage, Contraindications
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Indications
Rating methodology
EFSA approval.
Type 2 diabetes ✪✪✪✪✪
Clinical research shows that taking berberine at a dose of 500 mg 2 to 3 times daily for 2 to 3 months can reduce glycated hemoglobin (HbA1c), fasting blood glucose, and postprandial blood glucose in subjects with type 2 diabetes, compared to placebo, and may be as effective as metformin (medication) at 500 mg 2 to 3 times daily or rosiglitazone (medication) at 4 mg daily. A meta-analysis confirms that berberine, taken at 900 mg to 3 g daily, for 1 to 11 months, reduces fasting blood glucose, postprandial blood glucose, and HbA1c compared to lifestyle interventions alone. Similarly, taking berberine in combination with oral hypoglycemics seems to have better results compared to hypoglycemics alone.
Posologie
Oral
900 - 1500 mg
Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis
Efficacy of berberine in patients with type 2 diabetes mellitus
Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression
Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine
Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension
Effect of a New Formulation of Nutraceuticals as an Add-On to Metformin Monotherapy for Patients with Type 2 Diabetes and Suboptimal Glycemic Control: A Randomized Controlled Trial
Combined berberine and probiotic treatment as an effective regimen for improving postprandial hyperlipidemia in type 2 diabetes patients: a double blinded placebo controlled randomized study
Hypercholesterolemia ✪✪✪✪✪
Clinical research conducted on individuals with hyperlipidemia shows that berberine alone or in combination with lipid-lowering drugs can reduce total cholesterol, triglycerides, and LDL cholesterol while increasing (good) HDL cholesterol by 2 to 3 mg/dL. These results are more significant compared to a placebo or lifestyle interventions. In another meta-analysis, berberine alone was as effective as simvastatin (medication). The berberine dosage used in these studies was 500 mg twice daily, or 200 to 500 mg three times daily for 6 to 24 months. Berberine has also been studied in combination with other supplements. Taking a combined product containing 500 mg of berberine, 10 mg of policosanol, and 200 mg of red yeast rice per day for up to 12 months reduces total and LDL cholesterol levels compared to placebo or ezetimibe 10 mg. Daily intake of another combo product containing berberine, red yeast rice, policosanol, folic acid, coenzyme Q10, and astaxanthin, for up to 12 months, reduces total cholesterol by 10 to 13% and LDL cholesterol by 14 to 21%, and increases HDL cholesterol by 4 to 5% compared to baseline or placebo values. These effects are comparable to those observed with pravastatin at 10 mg per day. It is possible that the majority of the therapeutic effect is due to an ingredient in red yeast rice (monacolin K) which is identical to lovastatin.
Posologie
Oral
500 - 1500 mg
Synergies
Nutraceutical pill containing berberine versus ezetimibe on plasma lipid pattern in hypercholesterolemic subjects and its additive effect in patients with familial hypercholesterolemia on stable cholesterol-lowering treatment
The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials
Nutraceutical approach to moderate cardiometabolic risk: results of a randomized, double-blind and crossover study with Armolipid Plus
Efficacy and Safety of Berberine Alone or Combined with Statins for the Treatment of Hyperlipidemia: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials
Long-term effects of nutraceuticals (berberine, red yeast rice, policosanol) in elderly hypercholesterolemic patients
Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension
Efficacy and safety of berberine for dyslipidaemias: A systematic review and meta-analysis of randomized clinical trials
Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study
Effects of a nutraceutical combination containing berberine (BRB), policosanol, and red yeast rice (RYR), on lipid profile in hypercholesterolemic patients: A meta-analysis of randomised controlled trials
Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins
Polycystic Ovary Syndrome ✪✪✪✪✪
Clinical research conducted on women with polycystic ovary syndrome (PCOS) and insulin resistance shows that taking 500 mg of berberine three times daily for 3 to 6 months before controlled ovarian stimulation for in vitro fertilization reduces fasting blood glucose, markers of insulin resistance, total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, testosterone levels, and waist-to-hip ratio compared to placebo. It may also increase high-density lipoprotein (good HDL cholesterol) and sex hormone-binding globulin (SHBG) levels. Low SHBG concentrations are indicative of insulin resistance, common in PCOS. The effect of berberine on pregnancy and birth rates in women with PCOS is unclear. One clinical study shows that taking berberine 500 mg three times daily for three months before controlled ovarian stimulation almost doubles the rate of clinical pregnancies and births compared to placebo. These effects are comparable to those of taking 500 mg of metformin three times daily for three months.
Posologie
Oral
1500 mg
The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment
A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome
Randomized controlled trial of letrozole, berberine, or a combination for infertility in the polycystic ovary syndrome
Metabolic Syndrome ✪✪✪✪✪
Preliminary clinical research conducted on adults with metabolic syndrome shows that taking 500 mg of berberine hydrochloride three times a day before meals for 3 months reduces body mass index by 0.6 kg/m2, systolic blood pressure by 8 mmHg, triglycerides by 18 mg/dL, and serum glucose levels by 2 mg/dL, and may also improve insulin sensitivity compared to baseline values. The validity of these results is limited by the absence of a control group. Further preliminary clinical research shows that taking a combination containing 500 mg of berberine, 200 mg of red yeast rice, 10 mg of policosanol, 0.2 mg of folic acid, 2 mg of coenzyme Q10, and 0.5 mg of astaxanthin per day for 18 weeks improves systolic blood pressure, left ventricular mass, and flow-mediated dilation in patients with metabolic syndrome compared to the control group.
Posologie
Oral
1500 mg
Synergies
Effects of a nutraceutical combination on left ventricular remodeling and vasoreactivity in subjects with the metabolic syndrome
Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion
The effect of berberine supplementation on obesity parameters, inflammation, and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials
Helicobacter pylori Infection ✪✪✪✪✪
Preliminary clinical research shows that in individuals with duodenal ulcers associated with H. pylori, taking 300 mg of berberine three times daily for 6 weeks is more effective in eradicating H. pylori than taking ranitidine (a medication) at 150 mg twice daily, but is less effective in promoting ulcer healing. Other preliminary research shows that taking 100 mg of berberine twice daily in conjunction with esomeprazole, clarithromycin, and amoxicillin for 14 days is not inferior to bismuth tartrate at 220 mg daily for eradicating H. pylori. Another open clinical study in H. pylori-infected patients shows that taking 300 mg of berberine three times daily with amoxicillin and 10 mg of rabeprazole for 14 days is not inferior to quadruple therapy that includes amoxicillin, rabeprazole, clarithromycin, and bismuth tartrate. Additionally, berberine triple therapy may be better tolerated than quadruple therapy.
Posologie
Oral
900 mg
[Comparison of acid and Helicobacter pylori in duodenal ulcer disease ulcerogenesis]
Efficacy and safety of triple therapy containing berberine hydrochloride, amoxicillin, and rabeprazole in the eradication of Helicobacter pylor
Liver Disorders ✪✪✪✪✪
Preliminary clinical research shows that taking one gram of berberine daily for two months reduces blood sugar, triglycerides, and markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), in subjects with type 2 diabetes and hepatitis B, compared to the control group. Additional preliminary clinical research shows that taking 600 mg of berberine twice daily for 12 weeks reduces blood lipids and markers of liver damage, including aspartate aminotransferase (AST) and alanine aminotransferase (ALT), compared to baseline values in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes. Further preliminary clinical research shows that taking 500 mg of berberine three times daily for 16 weeks reduces liver fat content by 21% compared to lifestyle modifications. Berberine also seems to reduce liver fat content, AST, and ALT similarly to pioglitazone (a medication) at 15 mg daily, while significantly reducing body weight, body mass index, and total cholesterol more than pioglitazone.
Posologie
Oral
1200 mg
[Research on therapeutic effect and hemorrheology change of berberine in newly diagnosed patients with type 2 diabetes combining nonalcoholic fatty liver disease]
Efficacy of Berberine in Patients with Non-Alcoholic Fatty Liver Disease
Canker Sores ✪✪✪✪✪
Clinical research shows that applying a gel containing berberine (5 mg/g) four times daily for 5 days can reduce pain, inflammation, and ulcer size by 30% compared to placebo in patients suffering from recurrent minor canker sores.
Posologie
Oral
Hypertension ✪✪✪✪✪
A meta-analysis shows that taking 900 mg of berberine daily in conjunction with amlodipine (a medication) for 2 months reduces systolic blood pressure by 5 mmHg and diastolic blood pressure by 2 mmHg compared to amlodipine alone.
Posologie
Oral
900 mg
Properties
Hypoglycemic
The hypoglycemic effect of berberine has been attributed to its ability to increase the expression of insulin receptors in peripheral blood lymphocytes of patients with type 2 diabetes. Additionally, in vitro and animal research suggests that berberine increases the activity of AMP-activated protein kinase (AMPK), which can stimulate glucose uptake in skeletal muscles, increase fatty acid oxidation in adipose tissue, and reduce glucose production in the liver. Other in vivo animal research suggests that berberine increases the secretion of glucagon-like peptide-1 (GLP-1). GLP-1 is a hormone that plays a role in maintaining glycemic control.
Usages associés
Anticancer
In vitro research shows that berberine can reduce tumor cell proliferation by inducing cell cycle arrest or causing apoptosis. Some research suggests that berberine can also inhibit tumor cell progression by inhibiting the activity of arylamine N-acetyltransferase (an enzyme involved in drug resistance to anticancer medications). Furthermore, in vivo animal research shows that berberine can inhibit lung cancer metastasis to lymph nodes. Other in vitro research also shows that berberine can inhibit the metastasis of melanoma cells. In addition to its anticancer effects, berberine may enhance the effects of conventional anticancer treatments, including radiotherapy and chemotherapy, against certain types of cancer. Indeed, berberine increases the efficacy of tamoxifen against breast cancer cells by inducing the upregulation of the cyclin-dependent kinase inhibitor P21, which is involved in the growth and development of breast cancer and plays a role in tamoxifen resistance.
Cardiovascular
Berberine may be effective in cases of congestive heart failure and arrhythmia due to its positive inotropic, negative chronotropic, antiarrhythmic, and vasodilatory properties. In humans, berberine reduces myocardial lesions and seems to have an antihypertensive effect, due to its ability to block alpha-adrenergic activity. Other in vivo animal research suggests that berberine can reduce oxidative stress and vascular inflammation.
Usages associés
Anti-aging
Berberine helps reduce age-related metabolic issues through its action on AMPK activation. It is known that metabolic dysregulation can lead to cancer, and berberine appears to be an excellent agent in fighting cancers as well. Berberine is particularly promising in several types of cancer, such as brain, breast, cervical, colon, liver, lymphomas, mouth, and thyroid cancers. One of the strategies for fighting cancer cells is depriving these cells of glucose. Berberine can help in this regard due to its hypoglycemic properties.
CANCER: A SIMPLE AND NON-TOXIC TREATMENT - Dr. Laurent Schwartz
Berberine ameliorates cellular senescence and extends the lifespan of mice via regulating p16 and cyclin protein expression
Anti-inflammatory
Two meta-analyses show that berberine can lead to a slight reduction in C-reactive protein levels, a marker of systemic inflammation. Evidence from animal research shows that berberine can reduce chemically induced swellings, possibly by inhibiting the expression of various cytokines. Preliminary and human research suggests that berberine blocks the production of pro-inflammatory cytokines interleukin-1 (IL1)-beta, and tumor necrosis factor (TNF)-alpha, possibly by blocking nuclear factor kappaB, the transcription factor responsible for regulating cytokine production. Therefore, berberine could be useful in the treatment of alcoholic liver disease, which is associated with increased levels of IL1-beta and TNF-alpha. Berberine also seems to decrease the production of IL-8, which is involved in inflammatory processes. Preliminary research suggests that berberine selectively inhibits the expression of cyclooxygenase (COX)-2.
Effect of Berberine on C-reactive protein: A systematic review and meta-analysis of randomized controlled trials
Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials
Antimicrobial
Berberine has antimicrobial effects, including antibacterial, antifungal, and some antimycobacterial and antiprotozoal activity. Berberine exhibits activity against Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Shigella boydii, Vibrio cholerae, Mycobacterium tuberculosis, Candida albicans, Candida tropicalis, Trichophyton mentagrophytes, Microsporum gypsum, Cryptococcus neoformans, Sporotrichum schenckii, Entamoeba histolytica, Giardia lamblia, Entamoeba histolytica, Trichomonas vaginalis, Helicobacter pylori, Clostridium perfringens, Clostridium paraputrificum, Aspergillus species, Leishmania donovani, and Plasmodium falciparum. Preliminary research suggests that berberine may inhibit bacterial sortase, a protein responsible for anchoring gram-positive bacteria to cell membranes.
Usages associés
Hepatoprotective
Preliminary research suggests that berberine might protect the liver from toxins. In an animal model, berberine reduced liver lesions induced by N-nitrosodiethylamine. Other animal research shows that berberine prevents the increase of alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) when administered before exposure to acetaminophen or carbon tetrachloride. Other animal research suggests that berberine has antifibrotic effects and may increase bilirubin excretion by the liver.
Usages associés
Hormonal metabolism
In women with polycystic ovary syndrome, berberine has been shown to increase levels of sex hormone-binding globulin and decrease free androgen index.
Usages associés
Safety dosage
Adults 18 years and older: 900 mg - 1500 mg
The standard dose of berberine is 900 to 1500 mg per day, divided into three or four doses. Berberine should be taken with a meal, or shortly thereafter, to benefit from the postprandial blood sugar and lipid spike.
Interactions
Médicaments
Cytochrome P450 2C9: moderate interaction
Preliminary clinical research shows that berberine can inhibit CYP2C9. Taking berberine with drugs metabolized by CYP2C9 could increase drug concentrations and increase the risk of adverse effects. Example: CYP2C9 is the enzyme that metabolizes coumarin anticoagulants like acenocoumarol or warfarin.
Cyclosporine: strong interaction
Berberine may reduce the metabolism and increase serum levels of cyclosporine. Berberine may inhibit cytochrome P450 3A4 (CYP3A4), which metabolizes cyclosporine.
Cytochrome P450 2D6: moderate interaction
In vitro and preliminary clinical data show that berberine can inhibit CYP2D6. Taking berberine alongside drugs metabolized by CYP2D6 could increase drug concentrations and increase the risk of adverse effects. Example: Codeine, metabolized into morphine, dextromethorphan, along with antidepressants, neuroleptics, beta-blockers.
Cytochrome P450 3A4: moderate interaction
In vitro and preliminary clinical research shows that berberine moderately inhibits CYP3A4. Using berberine with drugs metabolized by CYP3A4 could increase drug concentrations and increase the risk of adverse effects. Example: cardiovascular drugs; antiarrhythmics: quinidine, lidocaine, amiodarone; statins: simvastatin, atorvastatin; calcium channel blockers: nifedipine, nitrendipine, nimodipine, amlodipine, felodipine, verapamil, diltiazem...
Dextromethorphan: moderate interaction
Preliminary clinical research shows that berberine can inhibit cytochrome P450 2D6 (CYP2D6) activity and reduce the metabolism of dextromethorphan. This may increase the side effects of dextromethorphan.
Midazolam: moderate interaction
Preliminary clinical research shows that berberine can inhibit cytochrome P450 3A4 (CYP3A4) activity and reduce the metabolism of midazolam.
Tacrolimus: weak interaction
Increase in circulating levels of tacrolimus following the administration of berberine, with enhanced renal toxicity of this medication.
Statins: weak interaction
Possible increase in statin concentrations.
Contraindications
Children up to 6 years: prohibited
The oral use of berberine in newborns can be dangerous. Berberine may cause kernicterus (a type of brain damage caused by an excess of unconjugated bilirubin in the gray matter nuclei and brain stem nuclei), especially in preterm newborns with hyperbilirubinemia.
Pregnant women: prohibited
Berberine can cross the placenta and cause harm to the fetus. Kernicterus (a type of brain damage caused by an excess of unconjugated bilirubin in the gray matter nuclei and brain stem nuclei) has developed in newborns exposed to berberine. Additionally, berberine may stimulate uterine contractions.
Nursing women: prohibited
Berberine may pass into breast milk.
