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What is berberine? Experts explain the supplement trending for weight loss

Berberine is the latest supplement craze, gaining attention on social media as a "natural" weight loss option. 

With more than 69 million views for the hashtag #berberine on TikTok, users are touting the option as "nature's Ozempic," comparing it to the injectable drug created for diabetes that leads to weight loss.

Advocates of the less expensive supplement, which comes in a pill form, say berberine has health benefits and may help suppress appetite, lower cholesterol, aid in gut health and control blood sugar and blood pressure.

Experts, however, caution about a lack of sufficient data and oversight. 

"The FDA doesn't regulate supplements like berberine the way they do medications. The FDA can't weigh in on the safety and effectiveness of dietary supplements," says Dr. Céline Gounder, a CBS News contributor and editor-at-large for public health at KFF Health News. "People are desperate to lose weight. Understandably, they want to do so cheaply, easily and quickly. But even Ozempic isn't a silver bullet."

Here's what else to know about the trendy supplement: 

What is berberine?

Dr. Carl Giordano, whose work focuses on healthy aging, says berberine is a natural compound found in several plants that has long been used in traditional Chinese and Ayurvedic medicine. Giordano is also the chief science officer and co-founder of Rebesana, a supplement that uses berberine as one of its ingredients.

"Berberine has gained attention in recent years for its potential health benefits and therapeutic properties. It has been studied for its antimicrobial, anti-inflammatory, antioxidant and anti-diabetic effects," he says. 

Dr. Carolyn Jasik, obesity medicine specialist and chief medical officer at Omada Health, says berberine is most commonly used as a naturopathic, alternative choice for diabetes, but it is not routinely recommended or prescribed in standard weight management clinics or obesity care.

"One of the big challenges with these more natural solutions is we don't have as many eyes on the manufacturing, so you can sometimes get versions of it that either have a higher or a lower dose than was anticipated and it's not as highly regulated," she says, adding the other reason it's not typically prescribed by traditional providers is because "it has not been shown through studies to be as effective or more effective than the other medications that we have available to us."

How does berberine work?

Gounder says we don't know exactly how berberine works, but we do know it doesn't operate like Ozempic. 

"Ozempic imitates the natural hormone glucagon-like-peptide-1 (GLP-1). It works by helping to regulate blood sugar levels and causes people to feel full and sometimes nauseous. Berberine does not imitate GLP-1, thus it's false to claim that berberine is 'nature's own Ozempic,'" she says. 

We also know the effectiveness of berberine hasn't been compared to FDA-regulated medications like Ozempic. 

"It's false advertising to call berberine comparable to Ozempic. There's no data to support this claim. You'd need randomized clinical trials of Ozempic versus berberine to prove this," Gounder says. 

Berberine supplement side effects

Side effects of berberine can include diarrhea and gastrointestinal upset, Gounder says. People may be seeing weight loss as a result of these side effects, she adds. 

Other side effects may include constipation, nausea or abdominal discomfort or swelling, according to the Cleveland Clinic.

Because of a lack of berberine studies that are randomized and controlled clinical trials, Gounder points out we also have no data on the long-term risks of taking berberine, nor on whether people regain the weight when they stop taking the supplement. 

In rare cases, Giordano says allergic reactions to berberine have been reported. 

"Symptoms may include rash, itching, swelling, dizziness, or difficulty breathing," he says.

Key berberine drug interactions to know

Because berberine is metabolized by the liver, Gounder says it can interact with other medications that are broken down this way, including medications for: 

  • blood pressure
  • cholesterol
  • mental health disorders
  • seizures
  • organ transplant
  • autoimmune disease

"These drug-drug interactions could be life-threatening," she says. 

Berberine has also been shown to inhibit the absorption of vitamin B12 and iron, Giordano says, meaning "prolonged use of berberine may potentially lead to deficiencies in these nutrients."

It is recommended to avoid berberine during pregnancy and breastfeeding as well, since limited information is available regarding its safety for these circumstances, Giordano adds. 

"Whenever the topic of safety comes up, or the topic of interactions with other medications come up, obviously, the public needs to consult their medical doctor regarding their specific usage," he says.

For anyone considering the supplement, Jasik says the biggest risk is not telling your provider.

"People are hesitant sometimes because they really just want the weight loss and they might feel shy to talk with their provider, but the more people can open up these conversations with their doctor, they put themselves at less risk for complications."

What other options are there?

Jasik understands that cost is a real issue when it comes to certain weight loss drugs, which can make less-studied alternatives a tempting choice — but there are other options.

"We do find ourselves in a difficult predicament right now with the cost of GLP-1 medications," she says, but suggests exploring "other treatments for obesity that are covered... rather than looking at alternative therapies that aren't as effective."

On a bigger scale, Jasik highlights the importance of creating an environment where people can feel comfortable speaking up.

"There's so much shame and shyness about going to your provider and saying, 'Hey, weight loss is a really big goal of mine,' and that's why I think we get people wanting to take advantage of some of these other alternative regimens. For me, it's less about the berberine, and it's more about what's the gap that people are looking for in their health care that they're trying to fill with these supplements."

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