Berberine is an active compound from Huang Lian, Rhizoma Coptidis, that has been used for thousands of years in Chinese medicine to treat bacterial diarrhea and diabetes. Numerous research studies have found many benefits of berberine.
These benefits include general antioxidant and anti-inflammatory effects as well as specific effects such as:
- Antidiabetic effects
- Glucose-lowering effect
- Significantly increased glucose disposal rate
- Antihyperlipidemic (treats high levels of fats (lipids), such as cholesterol, in the blood)
- Decreases cholesterol
- Decreases triglycerides
- Decreases LDL-c
- Cardiovascular effects
- Reduces arrhythma
- Lowers blood pressure
Berberine and Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease is characterized by excess fat in the liver due to causes other than excessive alcohol use. This is closely related to insulin resistance and the metabolic syndrome. Insulin sensitizer drugs such as metformin and thiazolidinediones (such as pioglitazone) are often prescribed.
One 16 week study involved 184 subjects who were randomly assigned to three groups:
- 62 lifestyle intervention
- 60 lifestyle intervention and pioglitazone (15 mg per day)
- 62 lifestyle intervention and berberine (500 mg three times a day)
This study showed that the subjects using lifestyle intervention and berberine lost significantly more weight, lowered their BMI significantly more, and reduced their waist circumference significantly more than the other two groups.
Lipid profiles and liver enzymes in the group using lifestyle intervention and berberine also improved more than the other two groups.
Berberine and Type 2 Diabetes
In one study three month long study, 110 patients with type 2 diabetes completed the study. They were randomized into groups taking berberine (500 mg twice a day) or a placebo.
The study wanted to determine the effects of berberine on fasting glucose levels, the 2 hour blood glucose levels during an oral glucose tolerance test, triglycerides, HDL-c, LDL-c, HbA1c levels, and the glucose disposal rate. Also of interest were the changes in BMI and blood pressure.
As in other clinical trials, subjects receiving berberine showed significant improvements over those taking a placebo. In particular, significant improvements were seen in both the fasting blood glucose levels as well as the 2 hour oral glucose tolerance test levels. Also significantly better were many blood components including HbA1c, a 35.9% reduction of triglycerides, an 18% reduction in total cholesterol, and a 21% reduction of LDL-c levels.
In fact, the reduction of HbA1c were similar to the reduction seen in existing prescription drugs used to treat type 2 diabetes.
Significantly more body weight was lost in the berberine group resulting in a greater reduction in BMI. And a significant drop in both systolic and diastolic blood pressures were observed.
The weight loss, though significant, was not thought sufficient to bring about the broad scope of improvements demonstrated in the study. Something else is playing a role.
Berberine and Metformin for Type 2 Diabetes Treatment
One study involved 84 subjects (49 women and 35 men) from an outpatient clinic with type 2 diabetes. The main purpose of the study was to determine the effects of berberine on glycemic control as measured by HbA1c levels. Also of interest were fasting blood glucose levels, after meal blood glucose levels, triglycerides, total cholesterol. HDL-c and LDL-c levels.
36 of these patients who were recently diagnosed with type 2 diabetes were assigned to study A. This involved a two month period during which the patients modified their diet. After that the patients were randomly assigned to take either berberine or metformin for 13 weeks.
During the 13 week trial, half the subjects in group A were assigned to take 500 mg of berberine three times a day prior to eating and the other half took 500 mg of metformin three times daily after meals.
The remaining 48 type 2 diabetes patients were not being helped by diet modification and drug therapy using sulfonylureas, metformin, acarbose or by using insulin alone were assigned to study B.
The unrespponsive patients in study B were assigned to take 500 mg of berberine three times daily in addition to their regular medication for a period of 3 months.
Both berberine and metformin had significant effects in lowering blood glucose including HbAc1, fasting blood glucose and post meal blood glucose in study A. Berberine, however, showed better lipid controlling activity than metformin. Triglycerides and total cholesterol were significantly lower in the berberine group compared to the metformin group.
In study B where berberine was added to the existing medication, berberine produced significant results within the first 7 days. Both fasting blood glucose and after meal blood glucose were significantly lowered.
After 5 weeks HbAc1 levels were significantly lower. Fasting blood glucose and after meal blood glucose levels continued to decline. Blood lipids including triglycerides, total cholesterol and LDL-c were significantly lowered. Also waist and the waist to hip ratio registered a significant drop.
Berberine and Gut Bacteria
Since the Chinese have been using berberine for thousands of years to treat bacterial diarrhea, we need to understand more about how it berberine affects bacteria in the gut.
One study is particularly revealing in this area. A group of 187 patients were included in the final results of a study to help treat type 2 diabetes. The study tested a Chinese formula containing Gegen (Radix Puerariae), Huangqin (Radix Scutellariae), Huang Lian (Rhizoma Coptidis from which we get the active ingredient berberine) and Gan Cao (a honey-fried Licorice Root Radix Glycyrrhizae).
Patients were give this formula in high, moderate or low dose, or a placebo for 12 weeks. The formula provided clinically meaningful and dose-dependent reductions in fasting blood glucose and HbA1c (a measure of average plasma glucose concentration). The high dose of this formula also significantly improved HOMA-β (a measure of insulin resistance).
Equally as important, the study showed the formula modified the gut microbiome in a dose dependent manner. Significant improvements were observed in the gut biome, enriching the number of beneficial bacteria. And, this change in the gut microbiome took place before improvement of the type 2 diabetes symptoms.
This indicates that the change in the gut microbiome was not a consequence of symptom relief. Rather, it appears that the improvement of the gut microbiome contributed to the improvement of glucose regulation in type 2 diabetes patients. The idea is that the change in the gut microbiome, rather than the herbal formula, was the cause of the relief of the type 2 diabetes symptoms.
Berberine and Your Health
Berberine has been used for thousands of years. It’s healthy benefits are widely known and have been scientifically investigated and proven.
It has an effect of the gut microbiome that enhances health-giving organisms that help regulate a number of systems including lipid (fat) metabolism, the cardiovascular system, and provide help in treating diabetes that seems equal that of modern drugs.
Your gut microbiome is often called your second brain or the forgotten organ. Read more about your gut biome at Can You Lose Weight and End Obesity by Managing Your Gut Microbiome?
- Structural modulation of gut microbiota during alleviation of type 2 diabetes with a Chinese herbal formula as published in The ISME Journal
- Efficacy of Berberine in Patients with Non-Alcoholic Fatty Liver Disease as published in PLOS One
- Treatment of Type 2 Diabetes and Dyslipidemia with the Natural Plant Alkaloid Berberine as published in The Journal of Clinical Endocrinology & Metabolism
- Modulating gut microbiota as an anti-diabetic mechanism of berberine as published in the Medical Science Monitor
- Efficacy of Berberine in Patients with Type 2 Diabetes as published in the journal Metabolism