Ask the Expert: Berberine and Weight Loss
By Toby Amidor, MS, RD, CDN, FAND
Vol. 25 No. 9 P. 6
Q: My clients have been asking me about taking the supplement berberine for weight loss. What does the scientific evidence say?
A: With the increased popularity of the prescription drug Ozempic for weight loss, people have been turning to over-the-counter supplements like berberine for weight management. This article provides an overview of this supplement, the research behind it, and whether it’s contraindicated in certain individuals.
What Is Berberine?
Berberine is a plant-derived compound found in plants such as European barberry, goldenseal, goldthread, Oregon grape, phellodendron, and tree turmeric.1 The yellow hued, bitter-tasting chemical has a long history of use, particularly in Ayurvedic medicine. It’s commonly used to help regulate blood glucose in people with diabetes and may help lower blood cholesterol and high blood pressure. Berberine also has been used to treat burns, canker sores, liver disease, and other ailments, although there’s little scientific evidence to support these uses.1
Taylor Wallace, PhD, CEO at Think Healthy Group, LLC, editor-in-chief of the Journal of Dietary Supplements, an adjunct clinical associate professor in the School of Medicine and Health Sciences at George Washington University, and an adjunct associate professor in the Friedman School of Nutrition Science and Policy at Tufts University in Washington, D.C., says, “While larger clinical studies are needed to confirm the effects in relatively small trials, berberine does seem to show promise, especially in those who are obese and/or have type 2 diabetes.” A 12-week 2012 study of people with obesity found that taking 500 mg of berberine three times per day led to an average weight loss of 5 lbs and a significant reduction in blood lipid levels, including a 23% decrease in triglycerides and 12.2% decrease in blood cholesterol.2 In addition, a 2019 systematic review of 12 studies also found significant reductions in BMI and waist circumference with the use of berberine.3 The studies were short term in duration, so the effects of berberine on long-term weight loss require further research.
The purported mechanism by which berberine may cause weight loss possibly centers around its ability to help regulate how the body uses blood sugar. Berberine may help improve how cells respond to insulin and promote better movement of glucose into the cells. In turn, once the cells have glucose, this leads to less hunger and the potential to eat less.4
Furthermore, a 2020 review study examined the body of evidence of berberine on weight loss and on the treatment of obesity.5 The review includes in vitro, human, and animal studies to determine berberine’s mechanism of action related to weight loss and obesity treatment. The human preclinical data showed that berberine can modulate the diversity of the gut microbiome at 500 mg/day. Berberine also was found to have a beneficial impact on gene regulation for the absorption of cholesterol at 300 mg/day. In addition, the study showed that 40 mg/kg/day to 380 mg/kg/day of berberine decreased lipid levels in rats, which consequently reduced weight gain. Researchers conclude that for the aforementioned reasons, along with numerous others, “This review gives an important good account of the impact of berberine in obesity treatment and prevention.”5 However, the body of evidence still isn’t strong enough, and longer-term research is needed. A recent summary on berberine by ConsumerLab.com states that higher quality studies are needed to determine berberine’s effects on reducing blood sugar in people with type 2 diabetes or metabolic syndrome and improving cholesterol levels.6 In addition, ConsumerLab.com explains that “Berberine hasn’t been shown to cause weight loss.”6
Dosage recommendations depend on the individual product. For instance, consumers should take 400 mg of NOW’s Berberine Glucose Support Softgels one to three times daily with food or as directed by a health care provider to support glucose and lipid levels that are already within the normal range.7
Solaray offers ProSorb Berberine capsules that contain 550 mg of berberine phytosome (standardized to 30% berberine hydrochloride) per single capsule in addition to a 500 mg Berberine capsule formula.8,9 For weight loss, Max Willis, MIM, chief innovation and science officer at Solaray, says, “There aren’t great studies to date around berberine’s usage for weight loss, although there are protocols expanding this research that haven’t been finished/published yet.” For blood glucose support, Willis recommends taking 500 mg two to three times per day with a meal, which is a higher dosage than what’s suggested on a supplement label. ConsumerLab.com confirms this amount when taken in the form of hydrochloride or sulfate.6
Safety and Contraindications
According to the National Institutes of Health National Library of Medicine, “Berberine is possibly safe for most adults” when taken orally. It’s been used safely in doses up to 1.5 g per day for six months.1 Common side effects include diarrhea, constipation, gas, and upset stomach. The supplement is contraindicated during pregnancy and breast-feeding, as well as in children and infants.
There are also numerous interactions with medications that clients should be aware of, including cyclosporine, dextromethorphan (ie, Robitussin DM), losartan (Cozaar), antidiabetes drugs, Cytochrome P450 2C9 (CYP2C9) substrates, Cytochrome P450 2D6 (CYP2D6) substrates, Cytochrome P450 3A4 (CYP3A4) substrates, antihypertensive drugs, anticoagulant/antiplatelet drugs, metformin (Glucophage), midazolam (Versed), pentobarbital (Nembutal), CNS depressants, and tacrolimus (Prograf).1
Recommendations for RDs
According to Wallace, berberine isn’t a magic pill, and if clients take the supplement for weight loss, they should pair it with a healthful lifestyle and dietary pattern as well as disclose and discuss this information with an RD before starting supplementation. In addition, Wallace recommends telling clients that short-term studies suggest weight loss potential, but long-term supplementation of berberine for weight loss needs further study.
— Toby Amidor, MS, RD, CDN, FAND, is founder of Toby Amidor Nutrition (tobyamidornutrition.com) and a Wall Street Journal bestselling author. She’s written 10 cookbooks, including Up Your Veggies: Flexitarian Recipes for the Entire Family and Diabetes Create Your Plate Meal Prep Cookbook: 100 Delicious Plate Method Recipes. She’s also a nutrition expert for FoodNetwork.com and a contributor to U.S. News and other national outlets.
1. Berberine. National Institutes of Health National Library of Medicine website. https://medlineplus.gov/druginfo/natural/1126.html. Updated August 25, 2023. Accessed September 4, 2023.
2. Hu Y, Ehli EA, Kittelsrud J, et al. Lipid-lowering effect of berberine in human subjects and rats. Phytomedicine. 2012;19(10):861-867.
3. Asbaghi O, Ghanbari N, Shekari M, et al. The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: a systematic review and meta-analysis of randomized controlled trials. Clin Nutr ESPEN. 2020;38:43-49.
4. What to know about berberine: benefits, uses and side effects. Cleveland Clinic website. https://health.clevelandclinic.org/berberine-for-insulin-resistance-weight-loss/#:~:text=Once%20your%20cells%20have%20their,breaks%20down%20and%20uses%20energy. Published June 19, 2023. Accessed September 12, 2023.
5. Ilyas Z, Perna S, et al. The effect of berberine on weight loss in order to prevent obesity: a systematic review. Biomed Pharmacother. 2020;127:110137.
6. Berberine and Goldenseal supplements review. ConsumerLab.com website. https://www.consumerlab.com/reviews/berberine-goldenseal-supplements-review/berberine/?search=Berberine. Accessed September 13, 2023.
7. Berberine glucose support softgels. Now Foods website. https://www.nowfoods.com/products/supplements/berberine-glucose-support-softgels
8. ProSorb berberine 9x 550mg. Solaray website. https://solaray.com/products/prosorb-berberine-9x
9. Berberine 500. Solaray website. https://solaray.com/products/berberine-500?_pos=1&_sid=f47583208&_ss=r