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Q: Recently I’ve heard a lot about taking berberine for weight loss. Does it work? Is it safe to take?

If you spend time on social media, you may have noticed that berberine is trending. On TikTok and other social platforms, the supplement is touted as a “miracle weight loss pill.”

Some influencers even refer to berberine as “nature’s Ozempic,” comparing it to the Type 2 diabetes medication that also causes weight loss.

But this doesn’t mean that berberine is effective for shedding excess weight. Nor does it mean that just because berberine is a natural health product it’s without side effects or risks.

Here’s what to know about the latest fad diet product.

What is berberine?

Berberine is a yellow-coloured compound that comes from the roots and stems of various plants including goldenseal, barberry and tree turmeric. (Tree turmeric is not the same as Curcuma longa, the plant that turmeric spice comes from.)

The plant compound has a long history of use in traditional Chinese and Aruveydic medicine to treat bacterial infections, diarrhea and inflammatory disorders.

As a supplement, berberine is marketed to improve insulin sensitivity, curb hunger, slash belly fat, lower cholesterol and improve mood among other health claims.

Does it work for weight loss?

There’s sparse evidence from randomized controlled trials that supplementing with berberine leads to clinically important weight loss (more than 5 per cent of starting weight).

A 2020 review of 12 clinical trials, most lasting one to three months, concluded that daily berberine supplementation led to a modest weight reduction (average of 4.5 lbs.) among people with obesity.

It wasn’t clear, though, if these results were clinically significant. What’s more, most of the studies were small and of low quality.

That’s not much to go on. Berberine is not the miraculous weight loss supplement it’s cracked up to be.

Berberine’s potential health benefits

A few small clinical studies have shown that taking berberine moderately lowers fasting blood glucose and hemoglobin A1c in people with Type 2 diabetes. Hemoglobin A1c is a measure of a person’s average blood glucose level over the past three months.

Some research has suggested that berberine’s blood-glucose-lowering effect is similar to that of metformin, a drug used to treat elevated blood sugar.

Berberine also seems to lower elevated triglycerides and LDL (bad) cholesterol in the blood stream, but the effect may be small.

There’s some evidence that taking berberine may benefit women with polycystic ovary syndrome who have insulin resistance.

How berberine and Ozempic work

The suggestion on social media that berberine is a natural form of Ozempic is misleading.

Berberine and semaglutide, Ozempic’s active ingredient, work very differently in the body.

Berberine lowers blood glucose by increasing the activity of an enzyme called AMP-activated protein kinase (AMPK). AMPK increases insulin sensitivity which allows muscle cells to take up glucose from the bloodstream more effectively.

Semaglutide mimics the action of a gut hormone called GLP-1 (glucagon-like peptide-1) which is released after eating. In so doing, semaglutide stimulates insulin secretion and helps control blood glucose.

The drug also slows the emptying of food from the stomach, which increases the feeling of fullness, and acts on the brain to dampen appetite.

Berberine’s side effects, risks

Berberine is generally well tolerated. The most common side effects include abdominal pain, constipation, diarrhea, gas, nausea and vomiting.

In daily doses up to 1.5 grams, berberine has been used safely in studies lasting six months.

Berberine is, however, unsafe for people who are pregnant or breastfeeding and should not be taken.

Supplementing with berberine could be risky if you take certain prescription medications.

Berberine been shown, for example, to inhibit the action of liver enzymes that break down various medications. This effect could potentially increase the concentration of these drugs in the bloodstream and lead to adverse effects.

As well, taking berberine in combination with some medications, including ones used to manage blood glucose and blood pressure, could lead to additive effects.

If you take medications and are considering taking berberine, check in with your doctor or pharmacist first.

Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD

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