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clear search termsBlood-Sugar-Busting Berberine: a Diabetes Solution
Insulin resistance, the common root cause of Type 2 Diabetes, is truly epidemic in our society. Whether we realize it yet or not, I believe every one of us has a practice loaded with patients or clients with suboptimal blood sugar control and related metabolic issues. The good news is that Type 2 diabetes is absolutely reversible! Long-term healing requires a client to change their diet and lifestyle – usually substantially. And, as you know, some of them just aren’t ready emotionally for that change. It takes time. But in the interim, these clients absolutely need help alleviating the toxic oxidative effects of elevated sugar on their organs, glands, and other tissues. (We’re featuring this popular post again because it’s about a particularly powerful tool.)
As a scientist at heart, I am inherently skeptical of claims of seemingly “magical” effects of herbal remedies. Some are absolutely true, but many are overblown (just as we see with pharmaceutical remedies, marketing claims can be predatory and irresponsible). I want to introduce you, however, to an herbal solution that holds up quite well to scrutiny: berberine. Like another herbal powerhouse curcumin, berberine is a plant phytonutrient, specifically an alkaloid. It’s been used for eons as a natural antibiotic. I’ve used it successfully in my practice to help people who choose natural treatment (as opposed to prescription antibiotics) for all sorts of unwelcome microbial infections…bacteria, yeast, parasites. Berberine is extracted from a number of medicinal herbs, most commonly Oregon grape root, barberry, and goldenseal (what you see in the picture).
But that’s only the beginning of berberine’s power, and this is not “news”. A couple of ground-breaking clinical studies way back in 2008 found that berberine regulates blood sugar in Type 2 diabetes just as well as the blockbuster drug metformin (and even better than the drug, with no notable side effects). No, I am not exaggerating. In peer-reviewed studies in the medical journals Metabolism and the Journal of Clinical Endocrinology, berberine was found to lower both fasting and post-prandial (after a meal) blood sugar and insulin equally as well as metformin. And beyond blood sugar, berberine also reduced those participants’ triglycerides by an average 35% and their LDL cholesterol by an average 21% and their blood pressure by 7/5 mm Hg (three things metformin doesn’t and doesn’t claim to do). These further effects are critical benefits for our patients and clients with not just advanced insulin resistance but full-blown metabolic syndrome. (There were some concerns expressed about the experimental methodology in some earlier berberine studies, but there is a clear pattern of superiority in these follow-on studies, including the gold standard experimental design in the Journal of Clinical Endocrinology feature.)
Berberine works in this disease process for a variety of reasons. It activates a primal metabolism-regulating enzyme in the body called AMPK. When we are producing less ATP (energy) in our cells, the body secretes AMPK to ensure our survival in times of crisis. This is the same enzyme that gets triggered with severe calorie restriction (which has been shown to prolong life in animals, but is practically sustainable by very few). AMPK stimulates our cells to take in more blood sugar, thus improving insulin sensitivity. But it also slows our liver’s own production of extra blood sugar (a key issue for most Type 2 diabetics). By supporting our liver, berberine also slows the release of free fatty acids into the blood (which is what creates triglycerides) and boosts natural fat-burning in the mitochondria (the little energy factories in all our cells that turn fuel into energy). Its mode of action is also via modulating the microbiome (and thus its downstream effect on short chain fatty acid production and bile acid metabolism), all of which we know have an impact on insulin regulation and signaling (yet another excellent example of how disease begins in the gut). You may learn more about berberine’s mechanisms of action here. And more about the comparative features, risks, and benefits of metformin vs. berberine here.
For the typical adult, berberine is effective for blood-sugar management taken 400-500mg at once, twice or thrice a day, ideally about 30 minutes prior to each meal. To ensure your client gets an effective dose each time, I suggest choosing a product with a standardized berberine extract (as opposed to a whole-herb product like goldenseal). I recommend Thorne’s Berberine-500 or (if your client is struggling with GI issues as well, like gas and bloating) try the multi-herbal formula Metagenics CandiBactin-BR.
(On a side note, if your client is indeed taking metformin, make sure they take a daily Vitamin B12 supplement with a meal (e.g. 1000mcg methylcobalamin for most, to ensure cellular absorption). A significant, documented side effect of metformin is Vitamin B12 depletion, making neuropathy an even larger risk than it already is for diabetics. I have seen this in several clients.)
Don’t forget, however, that berberine is a Potent antimicrobial herb. Ongoing use can dramatically shift microbial balance in the gut. For this reason, I do not, recommend berberine for ongoing “management” of elevated blood sugar but rather as a supportive remedy while you are working with them to reverse the root causes, typically for 2-3 months. It may be best tolerated if taken in cycles of ~3 weeks with a couple of weeks off in between to allow the microbiome to recover. While short-term modulation of microbiome diversity may help improve insulin signaling, ongoing suppression may promote other GI or immune system imbalance.
If your client is an insulin-dependent diabetic (i.e. taking insulin shots), be sure to encourage them to monitor their blood sugar regularly as they start to use berberine or any new therapy (and do so in consult with the original prescribing practitioner – if that’s not you). Encourage them to start with just one dose/day and increase slowly to ensure they can stay in control. You may be surprised at just how quickly insulin sensitivity improves! They often need to cut back on their insulin dramatically to avoid dangerous blood sugar troughs. Almost all of my clients eventually end up able to stop both supplemental insulin – and eventually metformin too. While life-saving as a short-term, triage therapy, long-term insulin use makes Type 2 diabetics even less healthy. Surplus insulin promotes more inflammation in the body, imbalances hormones, and increases body fat storage, especially in the abdominal area (again, a source of inflammation and estrogen).
Perhaps like you, I still find it amazing that this type of solution (and its clinical study results) doesn’t typically make media headlines. Of course, I understand you cannot patent an herb. And so no single corporation stands to corner the market on berberine. But this is (still!) BIG news for the millions of people struggling with diabetes. Actually, it’s not the only natural remedy I’ve seen successfully stabilize and then help to reverse Type 2 diabetes, but it is definitely the most potent one.
Educate and inspire your clients and patients to believe that they are neither doomed or destined to live their entire lives with Type 2 diabetes if they are willing to change their lives. With your help and their commitment to change, they can find true healing. Type 2 Diabetes is absolutely reversible!
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Just wanted to say thank you for a very informative article.
Could Berberine be used in combination with Inositol for insulin resistance and pre-diabetes?
Yes, it could. Best in combination with dietary and lifestyle changes that support healthier blood sugar balance. Please check out this post about inositol:
https://schoolafm.com/ws_clinical_know/video-clinical-tips-part-4-pcos-and-treasure-chest-for-inositol/
Hi,
I was diagnosed with T2DM 6 mo. ago. Horrible starting numbers – 380 blood sugar, A1C was at 14. 5 mg of Glipizide, Metformin, and strict carb elimination brought me down below 200 at all times in 2 weeks. However, at the end of the second week I developed a Metformin allergy (rash and swollen lips). I continued carb elimination and 5mg Glipizide 2x per day, and was getting close to normal numbers – except first thing in the morning. Apparently, I have “Dawn Syndrome”. No matter how low I am (85 -101) before I go to bed, an hour after I wake, I am at 205 – 225. Also, my new job is stressful and my sugar numbers are starting to climb again. I would like to try Berberine in conjunction with the Glipizide.
I have two questions – 1. when is the best time to take the Berberine to counter the Dawn Syndrome? Before I go to bed, or when I wake up? 2. If I develop a Berberine allergy, is it safe to take Benedryl to counteract the allergic reaction (and then discontinue Berberine of course).
Alas, we are not able to advise on individual client cases in this venue. What you are asking is very specific and begs for more information to give you the right answer.
That being said, it sounds like you have done a lot of work already in an effort to reverse the T2DM – well done! We highly recommend working with a functional medicine-trained practitioner to get to all the details that you may have missed. We recommend this directory for finding a suitable practitioner: https://afmccertification.com/
If you are interested in further reading I recommend this article:
https://schoolafm.com/ws_clinical_know/video-clinical-tips-part-4-pcos-and-treasure-chest-for-inositol/
and also these studies:
https://pubmed.ncbi.nlm.nih.gov/34394904/
https://pubmed.ncbi.nlm.nih.gov/30264906/