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 the use of berberine for NAFLD, it is essential to note that lifestyle modifications, including a hypocaloric diet and regular exercise, are crucial components of the treatment plan. The study that demonstrated the efficacy of berberine in combination with lifestyle modifications involved a diet with a 500 kcal/day reduction and medium-intensity aerobic exercise for more than 150 minutes per week 1. Some key points to consider when using berberine for NAFLD include:
- The importance of combining berberine with lifestyle modifications, as the beneficial effects on liver enzymes and hepatic fat content were observed in the context of a comprehensive treatment plan 1.
- The potential for berberine to be used as an adjunctive treatment, rather than a replacement for established therapies, such as pioglitazone or metformin, which have also been shown to be effective in improving liver function and reducing hepatic fat content in patients with NAFLD 1.
- The need for further research to fully elucidate the long-term safety and efficacy of berberine in the treatment of NAFLD, as well as its potential interactions with other medications. In terms of dosing, the study that demonstrated the efficacy of berberine in combination with lifestyle modifications did not specify the exact dose used, but typical doses of berberine range from 500mg to 1500mg per day, taken in divided doses with meals 1. Overall, berberine may be a useful adjunctive treatment for NAFLD, particularly when used in combination with lifestyle modifications, due to its potential to improve liver function and reduce hepatic fat content, as evidenced by the study published in the Journal of Hepatology 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.