From the Guidelines
Berberine is a valuable adjunctive treatment for non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), as evidenced by its ability to reduce liver enzymes and hepatic fat content when combined with lifestyle modifications, as seen in a 2020 study published in the Journal of Hepatology 1.
Key Benefits of Berberine
- Reduces liver enzymes: In the study, berberine combined with pioglitazone and lifestyle modifications resulted in a mean change in ALT of -14.1 IU/L and AST of -6.5 IU/L after 16 weeks 1.
- Decreases hepatic fat content: The same study showed an 11.4% reduction in hepatic fat content via H-MRS after 16 weeks of treatment with berberine and lifestyle modifications 1.
- Improves compliance with lifestyle modifications: The study found that compliance with lifestyle modifications was high, with 94.5% of participants in the berberine group adhering to the diet and exercise plan 1.
Mechanism of Action and Potential Interactions
Berberine works by activating an enzyme called AMPK, which regulates metabolism and energy production in cells. However, it may interact with certain medications, particularly those processed by the liver, so consulting with a healthcare provider before starting supplementation is crucial, especially for those on prescription medications, pregnant women, or people with chronic health conditions.
Dosage and Administration
While the optimal dosage of berberine for NAFLD and NASH is not established, the study used a combination of pioglitazone and berberine, suggesting that berberine may be effective as an adjunctive treatment when combined with other therapies and lifestyle modifications 1.
Side Effects and Precautions
Common side effects of berberine include digestive issues like diarrhea and stomach discomfort, which can be minimized by starting with a lower dose and taking it with food. However, the study did not report any significant adverse effects associated with berberine treatment 1.
From the Research
Berberine Overview
- Berberine is an isoquinoline alkaloid with a wide range of pharmacological properties, including hypoglycemic, anti-inflammatory, and anti-cancer effects 2.
- It has been used to treat various diseases, such as type 2 diabetes, cancer, digestive, metabolic, cardiovascular, and neurological diseases 2, 3, 4.
Glucose-Lowering Effects
- Berberine has been shown to have a glucose-lowering effect in patients with type 2 diabetes, reducing fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and 2-hour postprandial blood glucose (2hPG) levels 5, 4, 6.
- The glucose-lowering effect of berberine is associated with its ability to inhibit the voltage-gated K+ channels of pancreatic β-cell membrane and promote insulin secretion without causing hypoglycemia 5.
- Berberine also improves insulin sensitivity, reduces insulin resistance, and enhances glucose uptake in peripheral tissues 3, 4.
Safety and Efficacy
- Berberine has been shown to be safe and effective in the treatment of type 2 diabetes, with no significant increase in adverse events or hypoglycemia 5, 4, 6.
- The efficacy of berberine is enhanced when combined with other hypoglycemic agents, and its effects are modified by factors such as dosage, treatment duration, and patient age 6.
Mechanisms of Action
- Berberine's mechanisms of action include inhibiting toxins and bacteria, protecting the intestinal epithelial barrier, and ameliorating liver injury 2.
- It also inhibits the proliferation of cancer cells, impedes invasion and metastasis, and regulates glycometabolism and lipid metabolism 2, 3.
- Berberine's neuroprotective effects include antioxidative, antiapoptotic, and anti-ischemic actions, and it also exerts protective effects against other diseases such as cardiovascular and neurological disorders 2.