Ozempic (semaglutide) is an injectable diabetes medication that has reached an unprecedented peak of popularity since it was shown that it also helps fight obesity effectively, significantly increasing its demand among people who have problems to maintain a healthy weight. Now, another substance that is cheaper and easier to obtain: berberine – which has been dubbed the ‘natural Ozempic’ – has become fashionable on social networks such as TikTok and on nutrition blogs for its alleged slimming ability.
Berberine is a chemical compound that is extracted from certain plants and is often marketed as a dietary supplement, usually in the form of capsules, but is it really useful for losing weight? Does it have medicinal properties? What are its advantages and disadvantages? Is its consumption safe, or does it entail any health risk? Dr. Clotilde Vázquez (@doctoraclotilde), Head of Endocrinology and Nutrition at the Fundación Jiménez Díaz in Madrid, clarifies these doubts.
What is berberine and what are its therapeutic properties
“This extremely interesting molecule has demonstrated its efficacy in numerous pathologies that are very frequent in our developed societies and its benefits are multiple. Berberine is an alkaloid that is extracted from the root of various plants, such as the best known Berberis vulgaris. Used since ancient times as a remedy in traditional Chinese medicine, it has aroused scientific interest for quite some time due to its effects on some diseases such as diabetes, metabolic syndrome, hypercholesterolemia, or Alzheimer’s,” says Dr. Vázquez.
Among the main health benefits attributed to berberine are:
- Helps in the control of diabetes and insulin resistance. Although the mechanisms of action in these cases are not “fully clarified, the increase in glucose uptake by the cell, the decrease in gluconeogenesis, the decrease in the digestion and absorption of starch and glucose in the intestine and the potent anti-inflammatory effect of berberine”. In fact, one study showed that berberine decreased hyperglycemia, improved insulin sensitivity, and reduced intestinal glucose absorption in diabetic mice. And another study evaluates its potential to treat type 2 diabetes in combination with other therapies.
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Improves metabolic function. According to a study carried out in mice fed a high-fat diet, the administration of berberine increased energy metabolism, glucose tolerance and the expression of the gene for uncoupling protein 1 UCP1, which influences mitochondrial energy expenditure in the brain. brown adipose tissue, and reduced the expression of proinflammatory cytokines.
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It favors the intestinal microbiota. “Another interesting property is the positive effect on the intestinal microbiota, increasing the presence of beneficial families such as lactic acid bacteria.”
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Helps reduce cardiovascular risk. “Berberine lowers cholesterol, has relaxing and anti-inflammatory activity of the blood vessel, improves blood pressure and has an antiarrhythmic effect, so that the global cardiovascular risk decreases a lot.” Its therapeutic effects in cardiovascular and metabolic diseases are summarized in a study published in Theranostics.
- It has an antibacterial effect. “It preserves the integrity of the intestinal barrier and is a powerful anti-inflammatory, so its protective effects against multiple organ damage in sepsis have been studied in animal experimentation with promising effects.”
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Potential anticancer properties. “The antineoplastic properties of berberine are being actively studied. Numerous experimental and in vitro studies show its beneficial properties in breast, pancreatic, stomach, colon and other cancers. In the future, it is possible that these properties can be confirmed in vivo and in humans”.
The endocrinology specialist points out that “the enormous number of basic (in vitro) and experimental (animal) studies that have revealed the enormous number of molecules or metabolic pathways (cellular receptors, enzymes, transcription factors, mediators of inflammation and a large number of different types of proteins, including cell cycle proteins) on which berberine can act and, therefore, produce effects. In addition to this, there are currently clinical trials in humans that demonstrate global benefits for cardiovascular disease, lipid levels, diabetes, and non-alcoholic fatty liver disease.”
So, is berberine useful for weight loss?
Although it is called the ‘natural Ozempic’, the truth is that berberine is very different from semaglutide –the active ingredient in Ozempic– and, despite the fact that it has been proven to have metabolic effects on the body, no evidence is yet available. scientific evidence on its ability to induce weight loss.
“Overall, this is an excellent compound that has done well,” says Melinda Ring, an integrative medicine specialist at Northwestern Medicine, in statements to The New York Times. However, Ring adds that the many comments online about the effects of berberine on weight loss are greatly exaggerated, saying, “Don’t think you’re going to take it and the pounds will just drop off.”
Dr. Clotilde Vázquez explains that “in basic experimentation it has been shown that berberine decreases appetite, increases satiety and increases the secretion of some GI hormones, such as GLP1. Therein lies its ‘similarity’ with Semaglutide (Ozempic) which is an analogue of GLP-1. But its main effect on obesity and its complications seems to be focused on the adipose tissue itself, as studies have shown in humans and, above all, in basic experimentation (animals), in which berberine has been shown to have a thermogenic effect (increase heat production) in adipose tissue and powerful anti-inflammatory, contributing to its reduction and remodeling. In addition, berberine would be beneficial in many of the complications of obesity: dyslipidemia, fatty liver, insulin resistance, or diabetes.”
But, the expert warns that, “although there is already a lot of published knowledge regarding its effects and, what is even more important, about the mechanisms that underlie its effect, the data in humans are still insufficient, contrary to the extraordinarily well-studied in the long term Ozempic”. In fact, one of the most cited studies regarding the benefits of berberine is a meta-analysis from the Espen clinic, which filtered through more than 2,300 studies in this regard, 1,270 of which were among animals, and of which finally only 8 made the cut. Most of them, as reflected in the paper, have fewer than 70 participants, have only lasted one to three months, and generally do not measure their effects on body weight. Thus, as Deborah Cohen, a professor of Clinical and Preventive Nutrition at Rutgers University, points out in Esquire, although “some studies have found that berberine could prevent obesity by affecting the expression of genes that promote the growth of fat cells- fats”, as she points out in The Guardian, “obesity is a chronic disease and three months is a very short time. To know if there are really long-lasting effects, the studies need to be much, much longer.”
Risks of Taking Berberine: Possible Side Effects
The Head of Endocrinology and Nutrition of the Jiménez Díaz Foundation affirms that in clinical trials carried out on humans, adverse effects are rare, but it can cause gastrointestinal discomfort such as:
- Nausea.
- Diarrhea.
- Constipation.
- Flatulence.
However, it also points out that there are no long-term safety studies, and that “in studies carried out in diabetes, it has been seen that berberine potentiates the action of metformin, being able to cause hypoglycemia, but there are no specific studies on interaction with other drugs.
Regarding the possible risks associated with the consumption of berberine, taking this supplement, even in standard doses, can cause nausea and vomiting, elevated blood pressure, and a tingling sensation in the hands and feet, as explained to the New York Times by Pieter Cohen, professor associate at Harvard Medical School who studies supplements.
“In short, berberine is a very promising substance with tremendously interesting potential effects on many highly prevalent diseases, including obesity and its cardiometabolic complications. But many more clinical trials are needed to elucidate its true potential, the necessary doses, its long-term effects and its safety profile. Despite its popularity on social networks, the advice is clear: you have to wait a bit. Research is going very quickly and soon we will have more precise data on this ancient substance”, concludes Dr. Vázquez.
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