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Blood-Sugar-Busting Berberine: a Diabetes Solution

 

Insulin resistance, the common root cause of Type 2 Diabetes, is truly epidemic in our society. Whether we realize it yet or not, I believe every one of us has a practice loaded with patients or clients with suboptimal blood sugar control and related metabolic issues. The good news is that Type 2 diabetes is absolutely reversible! Long-term healing requires a client to change their diet and lifestyle – usually substantially. And, as you know, some of them just aren’t ready emotionally for that change. It takes time. But in the interim, these clients absolutely need help alleviating the toxic oxidative effects of  elevated sugar on their organs, glands, and other tissues. (We’re featuring this popular post again because it’s about a particularly powerful tool.)

As a scientist at heart, I am inherently skeptical of claims of seemingly “magical” effects of herbal remedies.  Some are absolutely true, but many are overblown (just as we see with pharmaceutical remedies, marketing claims can be predatory and irresponsible). I want to introduce you, however, to an herbal solution that holds up quite well to scrutiny: berberine. Like another herbal powerhouse curcumin, berberine is a plant phytonutrient, specifically an alkaloid.  It’s been used for eons as a natural antibiotic. I’ve used it successfully in my practice to help people who choose natural treatment (as opposed to prescription antibiotics) for all sorts of unwelcome microbial infections…bacteria,  yeast, parasites. Berberine is extracted from a number of medicinal herbs, most commonly Oregon grape root, barberry, and goldenseal (what you see in the picture).

But that’s only the beginning of berberine’s power, and this is not “news”. A couple of ground-breaking clinical studies way back in 2008 found that berberine regulates blood sugar in Type 2 diabetes just as well as the blockbuster drug metformin (and even better than the drug, with no notable side effects). No, I am not exaggerating. In peer-reviewed studies in the medical journals Metabolism and the Journal of Clinical Endocrinology, berberine was found to lower both fasting and post-prandial (after a meal) blood sugar and insulin equally as well as metformin. And beyond blood sugar, berberine also reduced those participants’ triglycerides by an average 35% and their LDL cholesterol by an average 21% and their blood pressure by 7/5 mm Hg (three things metformin doesn’t and doesn’t claim to do). These further effects are critical benefits for our patients and clients with not just advanced insulin resistance but full-blown metabolic syndrome. (There were some concerns expressed about the experimental methodology in some earlier berberine studies, but there is a clear pattern of superiority in these follow-on studies, including the gold standard experimental design in the Journal of Clinical Endocrinology feature.)

Berberine works in this disease process for a variety of reasons. It activates a primal metabolism-regulating enzyme in the body called AMPK. When we are producing less ATP (energy) in our cells, the body secretes AMPK to ensure our survival in times of crisis. This is the same enzyme that gets triggered with severe calorie restriction (which has been shown to prolong life in animals, but is practically sustainable by very few). AMPK stimulates our cells to take in more blood sugar, thus improving insulin sensitivity. But it also slows our liver’s own production of extra blood sugar (a key issue for most Type 2 diabetics). By supporting our liver, berberine also slows the release of free fatty acids into the blood (which is what creates triglycerides) and boosts natural fat-burning in the mitochondria (the little energy factories in all our cells that turn fuel into energy). Its mode of action is also via modulating the microbiome (and thus its downstream effect on short chain fatty acid production and bile acid metabolism), all of which we know have an impact on insulin regulation and signaling (yet another excellent example of how disease begins in the gut). You may learn more about berberine’s mechanisms of action here. And more about the comparative features, risks, and benefits of metformin vs. berberine here.

For the typical adult, berberine is effective for blood-sugar management taken 400-500mg at once, twice or thrice a day, ideally about 30 minutes prior to each meal. To ensure your client gets an effective dose each time, I suggest choosing a product with a standardized berberine extract (as opposed to a whole-herb product like goldenseal). I recommend Thorne’s Berberine-500 or (if your client is struggling with GI issues as well, like gas and bloating)  try the multi-herbal formula Metagenics CandiBactin-BR.
(On a side note, if your client is indeed taking metformin, make sure they take a daily Vitamin B12 supplement with a meal (e.g. 1000mcg methylcobalamin for most, to ensure cellular absorption). A significant, documented side effect of metformin is Vitamin B12 depletion, making neuropathy an even larger risk than it already is for diabetics. I have seen this in several clients.)

Don’t forget, however, that berberine is a Potent antimicrobial herb. Ongoing use can dramatically shift microbial balance in the gut. For this reason, I do not, recommend berberine for ongoing “management” of elevated blood sugar but rather as a supportive remedy while you are working with them to reverse the root causes, typically for 2-3 months.  It may be best tolerated if taken in cycles of ~3 weeks with a couple of weeks off in between to allow the microbiome to recover. While short-term modulation of microbiome diversity may help improve insulin signaling, ongoing suppression may promote other GI or immune system imbalance.

If your client is an insulin-dependent diabetic (i.e. taking insulin shots), be sure to encourage them to monitor their blood sugar regularly as they start to use berberine or any new therapy (and do so in consult with the original prescribing practitioner – if that’s not you). Encourage them to start with just one dose/day and increase slowly to ensure they can stay in control.  You may be surprised at just how quickly insulin sensitivity improves! They often need to cut back on their insulin dramatically to avoid dangerous blood sugar troughs. Almost all of my clients eventually end up able to stop both supplemental insulin – and eventually metformin too. While life-saving as a short-term, triage therapy, long-term insulin use makes Type 2 diabetics even less healthy. Surplus insulin promotes more inflammation in the body, imbalances hormones, and increases body fat storage, especially in the abdominal area (again, a source of inflammation and estrogen).

Perhaps like you, I still find it amazing that this type of solution (and its clinical study results) doesn’t typically make media headlines. Of course, I understand you cannot patent an herb.  And so no single corporation stands to corner the market on berberine. But this is (still!) BIG news for the millions of people struggling with diabetes. Actually, it’s not the only natural remedy I’ve seen successfully stabilize and then help to reverse Type 2 diabetes, but it is definitely the most potent one.

Educate and inspire your clients and patients to believe that they are neither doomed or destined to live their entire lives with Type 2 diabetes if they are willing to change their lives. With your help and their commitment to change, they can find true healing. Type 2 Diabetes is absolutely reversible!

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Anne
Anne

I am type 2 diabetic can I use these along with my meds which are furosemide rosuvastatin amlodipinebesylate clopidogrelbisulf venlafaxine and vitaminD3

SAFM Team
Reply to  Anne

To determine if any supplement is safe for your particular situation we recommend working with a certified practitioner that can do a full workup of your unique case and help you address the root causes of your particular dis-ease. One of the places where you can find such a practitioner is here: https://afmccertification.com/
You can also search for medical doctors specifically trained in functional medicine

Jeff
Jeff

Hello, I
Thank you for the very much for the informative article. I love Berberine, seems to work wonders. My interest lies in the cycling of Berberine. I had been taking it for 8 straight months with no ill effects whatsoever, but have cycled off for a month since reading your article. I had no idea you weren’t supposed to take it continuously. My question(s) is this. Can you take Berberine for several months, cycle off for a couple of months, then start up again? Or is it just supposed to help get your insulin levels back in check and functioning properly on its own and then you stop taking it altogether?
Today makes 1 full month without Berberine and I was debating whether or not to start up again.
I appreciate any thoughts you may have and thank you in advance for your time. Have a wonderful day.

Jeff

Niamh
Niamh

Hi there, I just want to say thank you for your information on berberine, I have implemented this into my management of lean PCOS and insulin resistance. I have had a hard time with doctors actually listening to me and taking me seriously because I’m slim, their only treatment option for me was the contraceptive pill. I took matters into my own hands and read various research, started taking inositol, vitamin d (which I was deficient in), and magnesium. I still struggle with low weight and nausea after a carby meal. Is this an effect of the berberine or is it common with insulin resistance, to your knowledge?

SAFM Team
Reply to  Niamh

Thank you for your comment and for sharing your experience, and congratulations on your progress! We are not able to provide personalized health advice in this venue. We encourage you to seek support from a certified FM practitioner to get to the root cause of your health issues. One place where you can find a practitioner that resonates with you is here https://afmccertification.com/

Rachel
Rachel

Thank you for this informative article. Today marks 24 hours since I started taking the supplement, and what I’ve noticed is that I feel extremely relaxed. I’m not sleepy, nor dizzy, nor anything “bad“. I just feel like I do when I come out of a good full body massage. Can you explain why am experiencing this wonderful side effect?

Samantha Hall

Is there any evidence that Berberine will be helpful simply for weight loss, if coupled with a low carb intake, in people not necessarily, or only mildly insulin resistant? Thanks

SAFM Team
Reply to  Samantha Hall

Yes, Berberine has been shown to be helpful for obesity by supporting the downregulation of adipogenesis and lipogenesis. It may also be positively impacting genes regulating cholesterol absorption. You may find these studies/reviews of interest:
https://doi.org/10.1016/j.biopha.2020.110137
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/

Sherry
Sherry

Hi Tracy, I have searched high & low on the internet to get a simple answer to this question, which contains more Berberine, Barberry Plant, or Oregon Grape Plant or Goldenseal Plant???? I have had high sugar levels & take Berberine but I want to buy the Berberine supplement that contains the highest amount of Berberine. It can get a little confusing for consumers when buying Berberine, one type is better for sugar levels (perhaps the Barberry), and one type is for the digestion (perhaps Oregon Grape), etc???? My main interest is SOLEY in lowering blood sugar, so is it Barberry that has the highest contact of Berberine vs Oregon grape & Goldenseal???? Berberine supplements come with solely Barberry, or Oregon Grape or a mixture of both, it’s so confusing. Please let me know what you find in your research. Thank you so much!

SAFM Team
Reply to  Sherry

If your sole interest is in lowering blood sugar you can make it really easy on yourself by purchasing pure berberine extract from a reputable supplement company (examples here include, Thorne, Designs for Health, Metagenics, Xymogen, Orthomolecular, etc.). That way you will also ensure a stable dose not dependent on various herbal batches.
To help you with the other question this article may be of help:
https://pubmed.ncbi.nlm.nih.gov/27671811/

Sherry
Sherry

Can berberine and Gymnema be taken together at the same time? Berberine did wonders for me, it got me off Metformin in a very short amount of time. Why is there so much hype about Gymnema which INCREASES insulin; if a person is insulin resistance isn’t the last thing they need is a herb that will cause even more insulin to be released to cells that will reject it? They do 2 different things? Thank you!

SAFM Team
Reply to  Sherry

Indeed, Berberine and Gymenma are two different herbs with quite distinct modes of action. Gymnema has been used for centuries as a remedy for T2D, and even though it may increase insulin secretion it does so by improving the health of pancreatic islet cells that produce insulin:
https://pubmed.ncbi.nlm.nih.gov/22911568/
The decision whether or not to use Berberine and Gymnema in combination will depend on the unique situation and tolerance of an individual, but in principle, there is no reason to think that these herbs would counteract each other.

Janice Ryan
Janice Ryan

Hi
I had heard that you need to take milk thistle with berberine for better absorption. Is this true?

SAFM Team
Reply to  Janice Ryan

There seems to be a benefit of adding milk thistle in combination with berberine in type 2 diabetic patients to improve their HbA1c outcomes. It is not clear if this effect is due to milk thistle improving the absorption of berberine and there. Here’s a preliminary study that talks about this effect:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838471/
Please note that the combination didn’t affect other markers that were measured.

WAYNE
WAYNE

I HAVE RECENTLY BEEN DIAGNOSE WITH TYPE 2 AT 49! I NOTICED BIG TIME THIRST,URINATION AND LOST 20LBS. IS THERE ANY COMBO OF BERBERINE AND METFORMIN THAT IS SAFE, LIKE ALTERNATING EACH DRUG MEAL TO MEAL?

Max
Max

I understand taking berberine long term isn’t recommended secondary to the microbial shifts in the gut… But if I also take a probiotic… Would that allow me to keep using the berberine? It’s allowed to me to get my fasting blood sugar 76 in the am which is… Amazing for me along with diet changes. But I am not perfect with my diet, I tend to keep my total carbs under 30. I’m afraid to stop berberine because it’s a miracle pill for me. What if I take it 3 months then off 2 weeks and a cycle year round? Or is that still not recommended? Thank you.

SAFM Team
Reply to  Max

Congratulations on the fabulous progress on your healing journey, Max! Thank you for sharing your story.
Yes, to your point, berberine is also anti-microbial and is not meant to be used without breaks and pauses. Pulsing it is a good idea and you may need a bit longer pause window than just 2 weeks (more like 4-8 week break) to give your gut microbes a chance to re-grow and thrive. Alas, probiotics in supplements rarely colonize the gut, but they do confer positive effects on the general gut microbiome and the immune system.

Gary
Gary

I have been taking 900 mg berberine supplements twice a day 10 mins after meals and yet my fasting sugar is still around 220. Do you think it will help lower sugar further if I switch it to 30 mins before meals ? I am not taking any diabetes medications. I am using ” We like Vitamins” from Amazon USA. Thank you for your help and suggestions in advance !

Tom Braun
Tom Braun

Fasting glucose 145-155, now on Metformin 500 twice per day. Can I also go on Berberine, like once before dinner?

Is it OK and safe to take both metformin and Berberine?

Lisa
Lisa

Hello! I have read your information with keen interest. I was wondering if you have seen studies of Berberine in the realm of Type II diabetes suggesting it to be more statistically effective as a stand-alone supplement or has it shown to co-support more effectively with others such as Gymnema Sylvestre, Alpha Lipoic Acid? Some supplements are delivered and absorbed more effectively when taken with support vitamins, minerals or herbs. Locating studies with this information has been a challenge. Thank you for sharing your knowledge.

Peachy
Peachy

I was prescribed metformin recently. I am not diabetic but I am showing insulin resistance. A month ago I changed my diet ( with the help of an phentermine to control my appetite), eliminating all breads, crackers, sweets etc. I ate fruits, vegetables, nuts and I use plant based protein powders with no added sugar, almond milk etc. Did high intensity workout 5-6 days per week. I lost 17 lbs last month. When I went to follow up, that’s when I was prescribed metformin. Some of my family members were a little concerned so I haven’t taken it yet. My aunt had suggested I take chromium instead or berberine. I’ve taken berberine before but at the time still had difficulty adjusting my diet. So now my concern is about the metformin dropping my blood sugar very low , since I don’t have high blood sugar to begin with (and I made adjustments to my diet), I just have elevated insulin levels. my A1c is 5.2. Thanks in advance for your feedback.

Mark
Mark

Is berberine ok to take if you are suffering from hypoglycemia ? thanks in advance for your feedback .

Shelly
Shelly

Hi,
I’m finding your information very helpful. This is the first time I’ve seen it noted taht berberine should not be used long term, was not aware of that. I have a question about the diet you recommend to reverse insulin resistance – I am trying to eat much less carbs, particularly processed ones, and mainly vegetables, healthy fats, and proteins – however I have foudn that the total elimination of carbs wreaks havoc with my digestive system and causes me to have a diarrhea – so now most days I also have some basmati rice, which helps keep my bowel movements regular. I woul dbe glad to hear of any suggestions for eliminating all carbs without having GI issues.

Thank you .

Patti Jo Knight
Patti Jo Knight

I’m type 2 diabetic and I’ve been using Berberine for a couple of months with great success. Just had my annual exam; A1C is 5.8, cholesterol is perfect (it’s NERVER been good before) and blood pressure was the best it’s ever been. However, I’ve had diarrhea from 21 days now and so far there is no explanation. Not symptoms other than extreme diarrhea. I know Berberine is supposed to be helpful for diarrhea but I’m wondering if it could be the cause of it as well? I take 500mg 3 times a day.

Patti Jo Knight
Patti Jo Knight
Reply to  SAFM Team

I did do the trial right before the Christmas break and it seemed to alleviate the diarrhea. I started it again on Saturday and after 3 days the diarrhea seemed to be starting up again (yesterday), so I stopped the Berberine again. I never stopped taking metformin while I was taking Berberine, so if I stop Berberine I guess I’ll STILL have to be on Metformin. My diet has been changed for years, yet if I stop Metformin my blood sugar goes up. This leads me to believe that perhaps in MY case the damage is done and cannot be reversed, but can be CONTROLLED by Metformin. I really don’t like the idea of taking Metformin long term, either. I feel like I’m doomed…

Patti Jo
Patti Jo

I’m a 62 year old female who was diagnosed with diabetes a couple of years ago with an A1C of 10.8 (yikes!) I’m not overweight. I suspect my years of taking Clonidine for BP (prescribed by my doctor) may have caused my insulin resistance but I can’t prove it. (Any thoughts on that??) Anyway…I no longer take Clonidine, and I have brought my blood sugar levels into a more normal & healthy range of 6.2 with diet and supplements, along with Metformin. I am currently taking Metformin 500 2x daily PLUS Cinnamon, Alpha Lipoic Acid, Chromium, B12, Magnesium and Gymnema Sylvestri – all of which are supposedly helpful for insulin resistance. I do not take any other medications although my doc has been after me to take a statin. I refuse. I have recently been researching Berberine and am eager to try it, hoping for positive results for both diabetes – and from what I understand – cholesterol. I would love to stop taking Metformin if possible. My question is, with all the other supplements I am already taking, do you advise making any adjustments (as in, eliminating some of the other things I take) or simply adding the Berberine… Read more »

Patti Jo
Patti Jo
Reply to  SAFM Team

Absolutely agree with the nutrition aspect! That is the MAIN thing we all need to do for ourselves – diabetes or not. I have eliminated flour, sugar, etc. and only consume stevia in some of the Greek yogurts I eat, and a little in my morning coffee. I routinely eat nuts, cheeses, veggies, chicken/turkey, seafood, some lean beef, and dark chocolate (88% cacao, organic.) I drink nothing but water (lots of water), coffee, tea and red wine. NO JUICES! No sodas, no fast food, no junk food – obviously. My meals are small and frequent.
I started taking Berberine 3 days ago and am paying close attention to how I feel, and of course monitoring my blood sugar. I’m aware that constipation is a side effect, and today – for the first time in a LONG time – I have not had my usual morning bowel movement. What are your thoughts as to how best to counter that effect? I have used Aloe in the past…

Sandy
Sandy

Hello, is it generally wise to take Berberine if you currently take Ibersartan, Metformin and Red Rice Yeast? I am not asking specific individual information, but as a rule does Berberine effect a persona negatively when in play with other medications and supplements? I have been gradually leaning towards a more natural way of dealing with my type 2. I am slim, exercise and take Juice Plus, Magnesium, Red Rice yeast, Magnesium and Ibersartan. I am told the Ibersarten is to protect my kidneys, I do not have high BP?? I do see that my mental state is a big factor in my BS levels, stress. For about the last year my fasting BS has been high in the AM. I test at night at 110, in the AM I am then 138, 149, 150?? Most recently I had a fasting of 212. I usually eat a paleo diet but have been recently eating a little complex more carbs it is hit and miss, sometimes great, sometimes high. What has been your experience with this scenario? I have had for 30 years and am 62 and weigh 118 and walk a lot. No one really knows if I am LADA,… Read more »

Genny

Hi. My teen daughter has shown almost all the symptoms for PCOS for 9 months and although drawing a clinical conclusion rather than lab work and scans which were inconclusive, the GP has prescribed Diane 35. The more I read, the more I resonate with the conclusions that PCOS can be misdiagnosed as the cause rather than a symptom itself of Insulin Resistance. I’m going to try and find a functional medic who can help us, but in the meantime, there’s one piece of information I can’t seem to find and wonder if you’d share your experience? If Berberine isn’t recommended as a long term solution due to gut flora, how long is it likely that someone should take 1000-1500mg/day in 2-3 doses (patient specific) for? And at that point is the body likely to be fully functioning again on its own, or is it more likely that Berberine needs to be used again…if so, after what likely period of time? Many thanks in advance.