From the Guidelines
Berberine is a well-supported, evidence-based treatment for certain conditions, including non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), as demonstrated by its ability to reduce liver fat content, ALT, and AST levels, with a recommended dosage of 500mg to 1500mg daily. The most recent and highest quality study, published in the Journal of Hepatology in 2020 1, shows that berberine, in combination with lifestyle modifications, can lead to significant improvements in liver function and fat content. Specifically, the study found that after 16 weeks, berberine treatment resulted in a mean change in ALT of -14.1 IU/L, a mean change in AST of -6.5 IU/L, and an 11.4% reduction in hepatic fat content via H-MRS.
- Key benefits of berberine include:
- Reduction in liver fat content and improvement in liver function
- Decrease in ALT and AST levels
- Potential for improvement in metabolic parameters, such as insulin sensitivity and glucose metabolism
- The recommended dosage of berberine is typically in the range of 500mg to 1500mg daily, divided into 2-3 doses taken with meals, as seen in the study 1.
- Berberine's mechanism of action involves the activation of AMP-activated protein kinase (AMPK), which improves insulin sensitivity, reduces glucose production in the liver, and enhances fat metabolism, as well as potential anti-inflammatory properties and influence on gut microbiota.
- While generally well-tolerated, berberine may cause mild side effects, including digestive issues like constipation, diarrhea, or stomach pain, and should be used under healthcare supervision, especially for people taking medications, due to potential interactions with certain drugs, such as blood thinners and some antibiotics.
From the Research
Berberine Evidence
- Berberine is an isoquinoline alkaloid with a wide range of pharmacological properties, including anti-obesity, antidiabetic, antibacterial, and anti-inflammatory effects 2, 3, 4.
- Studies have shown that berberine has beneficial effects on various health outcomes, including type 2 diabetes, gastrointestinal disorders, schizophrenia, metabolic syndrome, and dyslipidemia 2, 3, 5.
- A meta-analysis of 27 randomized controlled clinical trials found that berberine has comparable therapeutic effects to conventional medications for type 2 diabetes, hyperlipidemia, and hypertension, with no serious side effects reported 5.
- Berberine has been shown to improve glucose metabolism, fat metabolism, and weight loss, and has potential therapeutic applications for various diseases, including cancer, digestive diseases, and neurological disorders 3, 4, 6.
- However, the quality of evidence for berberine's therapeutic effects is limited by the relatively low quality of included studies, and further research is needed to fully substantiate its benefits 2, 5.
Therapeutic Applications
- Berberine has been shown to have potential therapeutic applications for:
- Type 2 diabetes: improving glucose metabolism and reducing HbA1c levels 2, 5.
- Gastrointestinal disorders: inhibiting toxins and bacteria, protecting the intestinal epithelial barrier, and ameliorating liver injury 3.
- Schizophrenia: improving symptoms and cognitive function 2.
- Metabolic syndrome: improving glucose and lipid metabolism, and reducing body weight 2, 4.
- Dyslipidemia: reducing triglycerides and increasing HDL-C levels 5.