Berberine might just be one of the best supplements you’ve never heard of.
Through its powerful effects on insulin and muscle mass berberine can help lower blood sugar levels and reduce insulin levels.
This effect is so strong that it has been compared to pharmaceutical medications (more on that below!).
Beyond its effects on blood sugar and insulin berberine also shows promise in several other areas.
Among these conditions include:
- The ability to lower inflammation
- The ability to reduce gas, bloating, and overgrowth of bacteria and fungus in the GI tract
- The ability to improve cholesterol profile
- And much more…
Is berberine right for you?
Let’s talk about how to determine if you should take it, how much you should take and how long you should be taking it for:
How Berberine Helps with Weight Loss
Like other supplements that may help with weight loss, the mechanism of action of berberine alters many different pathways and has multiple benefits.
By now you should be aware that there is no “magical cure” for weight loss, or that one simple supplement or medication will result in significant weight loss by itself.
Instead, if weight loss is your goal, your focus should be on targeting specific hormonal pathways that are out of balance in YOUR body.
Berberine happens to impact several of these hormonal pathways and this is probably one of the main reasons that berberine has been shown to help with weight loss.
Before we begin I want to point out that berberine is best used if it is part of a comprehensive weight loss plan that includes other targeted supplements, hormones (as necessary), dietary changes, managing your stress, and getting enough sleep.
So now that that is out of the way, let’s talk about the many ways that berberine may help with weight loss.
#1. Targets Insulin Resistance and Helps Treat Diabetes
One of the most important effects of berberine is how it interacts with the hormone insulin.
Insulin levels drive weight gain and many diseases.
What you may not understand about insulin is that about 50% of patients in the US have insulin resistance to some degree.
In my experience, almost every patient who is overweight (defined as 10+ pounds beyond “normal” weight) has some degree of insulin resistance.
Part of the problem is in the diagnosis and management of insulin levels because most physicians don’t treat this condition until you’ve crossed the line into the diabetic range.
This is unfortunate because many people have high fasting insulin levels but technically don’t fall into the category of being diabetic, and thus they don’t receive treatment.
So how does berberine alter insulin levels?
Berberine activates a protein called AMPK.
The activation of this protein results in sensitizing your body to insulin, activates the fat-burning enzymes in your body, and helps reduce body fat stores.
This effect is so strong that berberine has been shown in studies to have the same blood glucose-lowering effects as the prescription medication metformin (1).
Patients who took both metformin and berberine in combination with each other lost 2+ inches over a 13-week period.
These inches lost in the waist/hip ratio likely indicate the burning of visceral body fat.
As you might already know, this visceral fat (2) hides under your organs and accounts for the “belly fat” that everyone wants to get rid of.
- Bottom line: Berberine helps lower blood sugar and insulin levels which can help reduce abdominal and visceral fat stores. This is mediated through its activation of a protein known as AMPK.
#2. Increases Mitochondrial Density and Boosts Metabolism
Another huge benefit of berberine is that it impacts mitochondria directly.
If you aren’t aware of the function and value of mitochondria let me fill you in:
Your mitochondria are (in part) responsible for the metabolism of your entire body (3).
That means that the more mitochondria your body has and the better that they function the more energy you will be burning at rest.
Energy that you will be burning while eating, drinking, thinking, sleeping, etc.
When we talk about weight loss we really are interested in increasing basal metabolic rate (another name for metabolism) because your metabolism is responsible for 90%+ of the calories you burn on a daily basis.
Only a few things actually increase mitochondria and one of those things is exercise (4) (this is one of the ways that exercise helps with weight loss)…
Another is berberine.
Berberine helps boost mitochondrial biogenesis (5) (meaning it increases the number of mitochondria) in muscle mass.
This is really important for several reasons:
1) High sugar/high-fat diets reduce the effectiveness of your mitochondria (it makes them run more slowly and produce energy less efficiently)
2) Mitochondria are responsible for both your basal metabolic rate (in part) as well as your subjective sense of having enough “energy”
Boosting the number of mitochondria helps increase metabolism and can revert the damage done by sugar and insulin-stimulating foods on your mitochondria.
- Bottom line: Berberine increases the number of mitochondria in muscle mass which may increase metabolism and improve the overall efficiency of existing mitochondria. This boost to metabolism helps promote weight loss.
#3. Induces Brown Fat Break Down and Increases Fat Break Down Overall
When it comes to fat cells, not all fat is bad fat.
In your body, some of your fat is known as “brown” fat, and this is the good fat.
Brown fat actually helps your body burn more fat by increasing heat production (6).
Basically, you want more brown fat and less of the other fat like visceral fat that occurs as a result of refined sugar/carbohydrates/insulin.
Berberine actually helps enhance the amount of brown fat in your body (7).
Studies have shown that this increase results in an increase in resting energy expenditure (metabolism), limits weight gain, reduces cold intolerance (by virtue of increasing body temperature), and increases brown fat production.
Not bad, right?
I want to focus on one important point mentioned above:
Berberine helps to reduce cold intolerance by increasing body temperature.
This is really important because it reflects berberine’s capacity to increase metabolism (likely through mitochondrial production + brown fat production).
The more energy your body produces at baseline, the more heat that is released, the more calories you burn, and the higher your metabolism is.
This is yet another way that berberine may improve metabolism overall and help with weight loss.
- Bottom line: Berberine enhances brown fat in the body which helps increase body temperature, burn more fat, and increase baseline metabolism. All of these factors improve weight loss.
#4. Lowers Inflammation in Fat & Liver Cells
When it comes to losing weight you need to make sure you have as little inflammation in your body as possible.
Inflammation is certainly a nebulous term nowadays and is generally thrown around loosely when we don’t exactly understand why something is happening in the body.
This leads to statements like “inflammation is the root of all diseases”.
And while there may be some truth to that statement, it isn’t necessarily helpful unless we understand how exactly it impacts our health and weight overall.
Generalized inflammation in the body is bad for several reasons:
1) Inflammation reduces metabolism by reducing T4 to T3 conversion and reducing the efficiency of thyroid hormone.
2) Inflammation leads to a condition known as adiposopathy (8) (inflammation of the fat cells) which leads to dysregulation of hormones produced from fat cells.
3) Inflammation worsens both insulin and leptin resistance which leads to weight gain directly and weight loss resistance
These are just a few of the negative effects of inflammation by the way, but it’s easy to see with these changes that inflammation makes weight gain easier and weight loss more difficult.
So how does berberine fit in?
Berberine has been shown to lower generalized inflammation through its effects on the COX2 pathway (9).
In addition, it also has been shown to reduce inflammation in liver cells (10) – and this is important because inflammation in the liver leads to a condition known as fatty liver disease.
- Bottom line: Berberine helps reduce both generalized inflammatory levels and hepatocyte inflammation. Reducing inflammation is important for weight loss because of its negative effects on metabolism, thyroid function, and hormones in the body.
#5. Treats GI-Related Issues Due to Antibacterial & Antifungal Effects
We touched on this briefly above, but inflammation is obviously not something you want when you are trying to lose weight.
Furthermore, studies have shown that the foods that we eat can specifically cause intestinal inflammation (11) which initiates the hormone imbalances that lead to weight gain like insulin resistance and adiposopathy.
This intestinal inflammation should be differentiated from systemic inflammation (meaning whole-body inflammation).
Intestinal inflammation is important because much of it stems from diet-induced changes to our intestinal microflora.
The microbiome is the super collection of bacteria and fungi that populate our GI tracts and alter and change how we digest and assimilate calories and food.
Changes to the composition of these bacteria concentrations are felt to contribute to obesity (12).
The good news is that the food you eat influences these bacterial and fungal concentrations (for better or worse).
Berberine happens to have very potent antibacterial and anti-fungal effects (13) which make it a great choice for killing the overpopulation of negative bacteria in our GI tracts.
By limiting the growth of the bacterial and fungal overgrowth in your intestines berberine can actually help lower intestinal inflammation and treat conditions like SIBO and SIFO.
Managing the inflammatory markers in your GI tract is very important for weight loss.
- Bottom line: Berberine has very active and powerful anti-bacterial and anti-fungal effects which can help lower intestinal inflammation in overgrowth syndromes like SIBO and SIFO. Inflammation in the GI tract leads to weight gain if not properly controlled.
#6. Can be Combined with Other Medications & Supplements to Enhance Results
If you’ve been reading my blog then you know I’m a big fan of adding supplements to medications to boost weight loss effects.
The combination therapy of medications plus supplements seems to have a multiplicative effect, meaning that the combination of both together is more than what would be expected by simply adding the sum of their results individually.
Unfortunately, this logic runs counter to what many patients are used to.
Most people believe that making one change at a time is the best way to determine if something is working or not.
But you need to understand that you are in your current position as a result of more than one negative stimulus: poor diet, lack of sleep, lack of exercise, high stress, etc.
The mindset of changing one variable at a time should be dropped in favor of making multiple changes at once all targeted around specific conditions.
This effect is also seen when using multiple supplements together and it applies to berberine as well (we will go over other supplements to help boost the results of berberine below).
Studies have even shown this effect to be true:
In one example the combination of metformin plus berberine was enough to completely negate the weight gain seen with the psychiatric medication olanzapine (14).
Other studies have shown that the combination of metformin plus berberine (15) is very powerful at reducing inflammation in the setting of nonalcoholic fatty liver disease.
There are other medications that can be paired with berberine to help boost results that we will go over below.
- Bottom line: Berberine can be combined with other medications like metformin to boost weight loss. Combination therapy has a multiplicative effect on reducing insulin and helping with weight loss.
How to use Berberine for the Best Results
Like many supplements and medications in order to get the best results you really need to understand how to correctly take the supplement.
This means you need to understand if YOU should be taking it, how much you should be taking (is your dose high enough), how long should you take it and what side effects should you look out for.
Whenever possible it’s best to target supplementation to your specific hormone imbalances and other problems you are dealing with.
In the case of berberine, it has multiple effects and so many patients stand to benefit from using it.
Use this guide to help determine if you should use berberine:
How to Supplement with Berberine
How to tell if you need it
Patients with the any of the following conditions should consider using Berberine:
- Problems with weight gain & weight loss resistance
- Damaged metabolism
- Known or suspected insulin resistance and/or elevated fasting blood glucose levels greater than 90
- Known diagnosis of diabetes, pre diabetes or high fasting blood glucose (patients who are also on diabetic medications like metformin)
- Diagnosis of fatty liver disease
- Diagnosis of small intestinal bacterial overgrowth or small intestinal fungal overgrowth
- Known or suspected systemic inflammation (as measured by elevated CRP and/or ESR)
How to Use
- Take up to 2,000mg per day (split throughout the day as necessary)
- Start titration at 500mg per day and increase as tolerated
- Higher daily doses will be necessary for weight loss and treating insulin resistance
- Duration of therapy should be consistent for at least 3 months (6+ months for insulin resistance + weight loss)
You can find my recommended berberine supplement here.
Combining berberine with other ingredients like alpha-lipoic acid can enhance its effects and allows you to get by with lower doses.
Make sure your dose is high enough and you take it long enough
To make sure that you are getting the most out of taking berberine you want to make sure your dose is high enough.
Dosing depends largely on which outcome you are searching for.
If you are treating diabetes, insulin resistance, or high blood sugar you may need dosages as high as 2,000mg per day.
If you are treating weight gain or weight loss resistance you may need doses as high as 2,000mg per day.
If you are treating fatty liver disease then doses of as much as 1,000mg per day may be necessary.
For treatment of SIBO and/or SIFO doses should be titrated to tolerance, but in general, this is a better supplement to treat GI-related issues (doses as high as 1,200mg per day may be necessary).
The length of treatment for weight loss and insulin resistance/high blood sugar/diabetes should be at least 6+ months (make sure to test blood sugar throughout treatment).
Other treatment durations may vary based on your response to the medication.
If you are tracking fatty liver disease then you can follow your AST/ALT levels to determine if treatment is working.
Side effects to watch out for
In general, berberine is tolerated quite well at lower doses, but as the dose exceeds 1,000mg some patients may start to experience GI-related symptoms.
Side effects of Berberine include:
- Diarrhea or loose stools
- Cramping, bloating, or an increase in gas
- Changes in bowel movements
- Sensation of acid reflux or burning in the stomach area
Symptoms may subside if you reduce your dose and slow down your titration.
How to use berberine with other supplements to boost weight loss + results
As mentioned above, to get the most benefit out of using berberine it is best to use this supplement in combination with other supplements that work in a similar yet slightly different manner.
With this method, you can boost the weight loss effects of berberine, boost the insulin lowering effects and increase metabolism more than just using any one supplement alone.
I’ve written extensively on these supplements in the past but will include some other supplements that I frequently pair with berberine for better results.
These supplements all help to lower blood sugar, boost insulin and increase mitochondrial function in some way:
- Alpha lipoic acid: ALA is a powerful anti-inflammatory agent that boosts mitochondrial function, reduces insulin resistance, and is incredibly powerful if used in conjunction with berberine. You can learn more about ALA in this comprehensive post.
- Magnesium citrate: Magnesium citrate helps sensitize the body to insulin levels, boosts energy production, and improves GI function. You can read more about how magnesium citrate helps with weight loss here. Doses range from 200-2,000mg per day (titrated based on GI tolerance).
- Glucomannan powder: This thick viscous fiber can help slow down the absorption of carbohydrates, improve GI gut bacteria and create a sensation of “fullness”. Using 4 capsules 15 minutes prior to each meal with a large glass of water is particularly effective for weight loss.
For the most benefit, it’s best to combine berberine with at least 2 of the supplements listed above.
Medications to Complement Berberine Activity to Help with Weight Loss
Berberine can also be combined with prescription medications to boost results.
If you already know you have diabetes, pre-diabetes, elevated fasting blood sugar, or insulin resistance then you may or may not be on the medications listed below.
If you aren’t then you can use berberine (in combination with the other supplements above) with these medications temporarily for a boosted weight loss effect.
Yes, you can temporarily use these medications until your insulin/blood sugar levels fall and then revert back to supplements only or even lifestyle changes after that.
List of medications that work well with berberine and ones that I frequently use on my patients:
- Metformin: Metformin is widely prescribed for insulin resistance and can help in certain cases. It is, however, a relatively weak medication compared to the others below.
- GLP-1 agonists: This powerful medication can help reduce weight, lower leptin levels, and lower insulin levels.
- SGLT-2 inhibitors: This medication works to actively lower blood glucose levels by eliminating them from your body via urine. This directly results in lower blood sugar and lower insulin levels.
- T3 thyroid hormone: T3 helps sensitize the body to insulin, boosts mitochondrial function (increasing metabolism), and can help treat leptin resistance as well.
Wrapping it Up
There is no such thing as a magic weight loss supplement or medication.
There are however many medications and supplements that can ACTUALLY work.
You just need to make sure that you are using the right dose for your body.
Berberine is one of those supplements that can help patients with a damaged metabolism, weight gain due to insulin resistance, and/or blood sugar issues.
Remember that you may need to use berberine for as long as 6+ months to get the full benefit, and dosages up to 2,000mg per day may be necessary.
Now it’s your turn:
Have you heard of berberine before?
Have you taken it? Did it work for you?
Did it help you lose weight or did you use it for another purpose? Why or why not?
Leave your comments or questions below!