NoIn recent years, berberine has become one of the most discussed natural substances when it comes to metabolism, weight and female health. But what is berberine really and why are more and more women considering it an ally for well-being? Between promises weight loss, cholesterol control and blood sugar regulationit is important to distinguish between scientific evidence and expectations. And understand, above all, what berberine really is for, when it can be useful and what the possible contraindications are. We talked about it with the Professor Patrizia Rovere Querinidirector of the General Medicine Operational Unit addressing metabolic health and aging at the IRCCS San Raffaele Hospital.
What is berberine
There berberine it’s a natural alkaloid extracted from various plants, including Berberis vulgaris. Used for centuries in traditional Chinese and Ayurvedic medicine, it is now available as berberine supplement in the form of capsules.
From a scientific point of view, his interest derives from ability to activate a cellular enzyme called AMPK (adenosine monophosphate kinase), involved in regulation of energy metabolism. This mechanism is similar, in some aspects, to that of some drugs used for glycemic control. «It is, however, important to remember that berberine has a relatively low oral bioavailability and that its effects derive from multiple mechanisms, not completely overlapping with those of antidiabetic drugs», underlines the Professor Patrizia Rovere Querini.
Berberine: what is it for according to science
But what is it really for? berberine? The answer comes from several clinical studies. A review published on Metabolism highlighted that berberine can contribute to:
- improve insulin sensitivity
- reduce blood glucose levels
- positively influence lipid metabolism.
A comparative study published in The Journal of Clinical Endocrinology & Metabolism has shown similar effects to metformin in some patients with type 2 diabetes, although with different methods and indications.
«One of the most reported effects is a reduction in HbA1c in the order of approximately 0.5–1%, therefore clinically relevant but generally lower than standard drug therapies. However, these results derive from small-scale studies are not sufficient to consider berberine an equivalent therapeutic alternative» adds the expert. “The overall effect remains generally modest and dependent on the clinical context.”
Berberine and cholesterol: what the studies say
«In meta-analyses, the reduction in LDL cholesterol is on average in the order of approximately 20–25 mg/dL, with significant individual variability. This effect is generally lower than that obtainable with first-line lipid-lowering drugs, and does not represent an alternative in patients at high cardiovascular risk”, explains the expert. The relationship between berberine and cholesterol it is one of the most documented. According to a meta-analysis published in Phytomedicine, berberine can: reduce LDL cholesterol, lower triglycerides and improve HDL cholesterol.
The mechanism appears to be linked to the regulation of LDL receptors in the liver, promoting the elimination of cholesterol from the blood. For this reason, it is sometimes proposed as a natural support in cases of mild or moderate dyslipidemia, always under medical supervision.
Berberine for weight loss: myth or reality?
The “berberine for weight loss” It is among the most frequent searches online. But what does science really say? «Available studies generally show modest weight loss, in the order of approximately 2–3 kg in 3 months. It is not comparable to specific drugs for the treatment of obesity and cannot be considered an independent weight loss strategy”, clarifies the Professor.
A study published in Evidence-Based Complementary and Alternative Medicine one observed reduction in body weight and body mass index in subjects taking berberine for 12 weeks.
However, the effect is not direct. Berberine:
- improves sugar management
- reduces insulin-related fat accumulation
- helps stabilize appetite.
In other words, creates conditions conducive to weight loss, but does not act as a fat burner. In any case, it should always and only be taken on the doctor’s advice.
Berberine and abdominal fat
The theme of abdominal fat it is closely linked to insulin resistance. Some studies suggest that berberine can help reduce visceral fat, improve adipose tissue distribution, reduce metabolic inflammation. This makes it especially interesting for women with metabolic syndrome or PCOS (polycystic ovary), where abdominal accumulation is frequent. «These data are still preliminary and require confirmation in larger and more controlled clinical studies», specifies the expert.
Berberine, what are the benefits: when can it be useful
In summary, the main ones berberine benefits supported by scientific evidence include:
- improvement in blood sugar
- support in cholesterol control
- positive effect on insulin resistance
- possible help in weight management
- support in polycystic ovary syndrome
A review published on Frontiers in Pharmacology highlighted its potential role as multifunctional metabolic agent. «The available evidence derives largely from studies of limited size, often heterogeneous in population and design, and therefore must be interpreted with caution», adds the Professor Patrizia Rovere Querini.
Berberis vulgaris (Getty Images).
Berberine as a supplement: how and when to use it
There berberine as a supplement it is usually taken in divided doses throughout the day, often before meals. It can be taken into consideration, always on the doctor’s advice on a case-by-case basis, in the presence of altered blood sugar, high cholesterol, metabolic difficulties, PCOS (Polycystic Ovary Syndrome). However, it is essential to avoid DIY: medical evaluation is always necessary. «In clinical studies, the dosages associated with metabolic effects are generally between 900 and 1500 mg per day, divided into 2–3 administrations», explains Rovere Querini. «It is also important to consider that i get ready commercially available may have variable quality, purity and bioavailability, and do not always guarantee metabolically active concentrations”.
Berberine, contraindications
The contraindications from the berberine they are an aspect that is often underestimated. Generally it is not indicated: during pregnancy and breastfeeding, in children, in case of uncontrolled liver or kidney disease, in association with some drugs (antidiabetics, anticoagulants, antibiotics). It can in fact interfere with liver enzymes involved in drug metabolism. «Berberine can interact with enzymatic systems such as CYP450 and P-glycoprotein, increasing the risk of clinically relevant drug interactions», clarifies Professor Rovere Querini.
Possible side effects
The side effects the most common are gastrointestinal type, with the appearance of diarrhea or constipation, bloating and abdominal pain. These effects tend to be dose-dependent and often transient. In rare cases, more relevant drug interactions may occur, which is why a doctor’s evaluation is always necessary.
Natural doesn’t always mean safe
As we often remember, one of the most common mistakes is thinking that a natural product is automatically risk-free. Berberine is an active molecule, with concrete physiological effects. Precisely for this reason it must be dosed correctly, must be placed in a precise clinical context and requires medical supervision. «Overall, it can be considered a metabolic adjuvant in selected contexts, but does not replace fundamental interventions such as nutrition, physical activity and validated pharmacological therapies. Its use must always be included in a broader, personalized and supervised clinical strategy”, recalls Professor Rovere Querini.
