From the Guidelines
Berberine is recommended as a potential adjunctive treatment for non-alcoholic fatty liver disease (NAFLD) due to its beneficial effects on liver enzymes and hepatic fat content, as evidenced by a study where it was used in combination with lifestyle modifications, resulting in a 14.1 IU/L mean change in ALT, 6.5 IU/L mean change in AST, and 11.4% reduction in hepatic fat content via H-MRS after 16 weeks 1. When considering berberine for NAFLD, it's essential to note that lifestyle modifications, including a hypocaloric diet and regular exercise, are crucial components of treatment. The study that combined berberine with pioglitazone and lifestyle modifications demonstrated high compliance rates, with 94.5% of participants adhering to the lifestyle plus berberine regimen 1. Key benefits of berberine in this context include:
- Reduction in liver enzymes, such as ALT and AST
- Decrease in hepatic fat content
- Potential for improved insulin sensitivity and glucose metabolism
- Anti-inflammatory properties It's crucial to consult a healthcare provider before starting berberine, especially if taking other medications or if pregnant or breastfeeding, as it may interact with certain medications or have adverse effects in these populations. In terms of dosage, the study used berberine in combination with pioglitazone, but the exact dosage of berberine is not specified in the provided evidence 1. However, typical dosages of berberine range from 500mg to 1500mg per day, taken in divided doses with meals to minimize gastrointestinal side effects. Overall, while more research is needed to fully understand the effects of berberine on NAFLD, the available evidence suggests it may be a useful adjunctive treatment when used in conjunction with lifestyle modifications and under the guidance of a healthcare provider.
From the Research
Berberine Overview
- Berberine is a quaternary ammonium salt from the protoberberine group of isoquinoline alkaloids found in plants such as Berberis [(2,3)].
- It has been recognized to improve glucose and lipid metabolism disorders 3.
- Berberine has a wide range of pharmacological properties, including protective capacities in digestive diseases, anti-cancer effects, and regulation of glycometabolism and lipid metabolism 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 (2hPBG) [(2,5)].
- The glucose-lowering effect of berberine is associated with baseline mean FPG and HbA1c levels in type 2 diabetes 2.
- Berberine may be safe for use in patients with type 2 diabetes, as it does not increase the incidence of total adverse events and the risk of hypoglycemia 2.
Mechanisms of Action
- Berberine inhibits the voltage-gated K+ channels of pancreatic β-cell membrane and promotes insulin secretion without causing hypoglycemia 2.
- It also protects pancreatic β-cells and increases sensitivity to insulin in peripheral tissues via the induction of GLUT-1, GLUT-4, and insulin type 1 (Ins-1) receptors activity 6.
- Berberine inhibits FOX01, SREBP1, and ChREBP pathways, and HNF-4α (hepatocyte nuclear factor 4 alpha) mRNA that hinder gluconeogenesis processes in the liver 6.
Clinical Applications
- Berberine has been used to treat various diseases, including cancer, digestive, metabolic, cardiovascular, and neurological diseases 4.
- It has been shown to improve the efficacy and safety of chemoradiotherapies 4.
- Berberine may be used as an adjunctive therapy in the treatment of type 2 diabetes, especially in patients with dyslipidemia 5.