Berberine, a naturally occurring alkaloid found in plants such as Berberis Vulgaris, has been used for centuries in a wide array of illnesses.  Given the tremendous therapeutic benefits of Berberine, it’s worth highlighting the various conditions it can be used for and discuss some of the mechanisms and research behind it.

Berberine activates the AMP-sensitive protein kinase (AMPK), which downregulates HMG Co-A reductase, along with the enzymes involved in triglyceride and glycogen synthesis. It also enters the cell nucleus and blunts transcription of PCSK9, thus inhibiting cholesterol production via various pathways.  Another effect of Berberine is to increase insulin receptor expression and promote the translocation of Nrf-2 (which codes for our antioxidant and detox enzymes), and has a favorable effect on the GI microbiome (the first recorded use of Berberine was in the treatment of bacterial dysentery).

Thus, berberine’s primary benefits are in Hyperlipidemia (elevated cholesterol), Diabetes Mellitus Type 2, PCOS (Polycystic Ovarian Syndrome), weight loss, H. Pylori infection, Inflammatory Bowel Disease amongst others. Its benefits have even been studied in cancer and Alzheimer’s! One very interesting randomized, double-blind, placebo controlled trial from Oct 2020, called the PREMOTE trial, found that berberine had a synergistic effect when used with Probiotics, than by itself or placebo in the treatment of Type 2 Diabetics suggesting the gut microbiome may be involved in the mechanism of berberine’s antidiabetic effects. 

Berberine is inexpensive and non toxic. 5-10% of patients have GI side effects such as constipation or diarrhea which resolves with dose reductions. The standard dose used is 500 mg twice a day which can be increased to 1000 mg twice a day. More awareness needs to spread amongst practitioners regarding the therapeutic potentials of Berberine in our increasing burden of metabolic disease.

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