Berberine is having a moment, with the dietary supplement receiving lots of attention as a purported weight-loss aid.
Some TikTok users are calling it “nature’s Ozempic,” claiming it can help reduce appetite and improve blood sugar levels. (There isn't enough evidence to back up these claims, experts tell TODAY.com.)
Savannah Crosby of San Antonio, Texas, said she lost 7 pounds after taking berberine for seven weeks and noticed her clothes fit better. She turned to berberine because it was more affordable than Ozempic, the Type 2 diabetes treatment many people are using off-label for weight loss.
“I was noticing that no matter what I was doing, the scale was going up, and I felt like I was gaining weight,” Crosby told NBC News Now. “If it were up to me, I would have done Ozempic, but because of the cost of it, it’s just outrageous.”
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The list price for Ozempic is $935 per injector pen, which usually contains a month’s worth of medication. The cost of a bottle of 60 capsules of berberine ranges from $22 to $38 on Amazon.com.
But is berberine really “nature’s Ozempic”?
“It’s not,” Dr. Daniel Monti, chair of integrative medicine and nutritional sciences at Thomas Jefferson University in Philadelphia, and an integrative medicine physician at Jefferson Health, tells TODAY.com.
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“Ozempic is a diabetes drug. It also does significantly suppress appetite, and people get significant weight loss taking Ozempic. For those who need it, it works. … With berberine, we can’t be as clear about any of those things.”
Berberine has nothing to do with Ozempic — "that’s a complete misnomer," adds Dr. Pieter Cohen, an associate professor at Harvard Medical School who leads the Supplement Research Program at the Cambridge Health Alliance in Massachusetts.
Berberine is unlikely to reduce appetite and potentially leads to very little, if any, weight loss, Cohen says.
It doesn’t work for weight loss, agreed NBC News medical correspondent Dr. John Torres in a TODAY show segment aired June 15.
There is very little evidence supporting any of the claims about berberine, adds Dr. Christopher McGowan, an obesity medicine specialist in Cary, North Carolina.
The Council for Responsible Nutrition, a trade group that represents dietary supplement manufacturers, says promising metabolic benefits of berberine have been explored in recent years.
"Some research indicates its potential to support weight management," Jeff Ventura, a spokesperson for the Council for Responsible Nutrition, told TODAY.com in a statement.
"It is important to understand that berberine dietary supplements are not meant to cure or treat any medical condition and should not be used as a substitute for prescription drugs like Ozempic and Wegovy. As always, CRN recommends individuals consult with their health care provider before beginning a weight-loss plan.”
What is berberine?
Berberine is a bitter-tasting yellow-colored substance found in plants such as goldenseal, Monti says.
It was first isolated in 1917 and has been used as a dye, though its main use now is as an over-the-counter herbal dietary supplement, according to the American Chemical Society.
“It’s been around for a while, but everything has its day and today is berberine’s,” Monti notes.
“It’s not because there was some overwhelming clinical trial that said, ‘Wow, berberine — this is your new weight-loss drug.’ It’s because of the right people who had a good anecdotal response to it got the right amount of attention.”
It’s a plant extract, so the U.S. Food and Drug Administration categorizes it under dietary supplements, he says. Supplements are regulated as food, not as drugs, according to the FDA.
"There’s no checking of any bottles or any accuracy of the labels, and unless people are getting sickened by berberine, the FDA wouldn’t do anything," Cohen notes.
Because it's regulated as food and not a medication, consumers may not get the amount of berberine listed on the label — a company might put in less to try to save money or put extra in, perhaps because it wants the supplement to have a bigger effect, Cohen says.
What does berberine do for weight loss?
Studies have shown it doesn’t really help that much at all, Torres said.
A systematic review and meta-analysis of 49 studies, published in Frontiers in Nutrition in 2022, found that "although (berberine) may affect weight, it does not have a statistically significant and considerable effect" on body mass index, resulting in about a quarter point reduction in BMI.
Monti calls any weight loss benefits the paper found “pretty modest."
“For people who have a mild weight issue, it might curb appetite enough and help to regulate blood sugar enough that it gives them a little bit of an edge while they’re dieting,” Monti says.
In one small study, seven people with obesity who took 500 milligrams of berberine three times a day for 12 weeks lost 5 pounds, on average.
There could be potential for very modest weight loss — a few pounds or so — but that hasn't been studied long-term so no one knows if the weight would stay off in six months, Cohen says.
Berberine "is not a game changer," he notes. "I would discourage my patients from using berberine for weight loss."
Berberine appears to possibly have a small impact on weight in “small, lower-quality studies,” but there’s no robust scientific evidence showing it can help a person slim down, McGowan adds.
“As far as impact on weight, in particular, that is unproven,” he says. “If someone is looking to use this for the treatment of weight, I would advise against it. There is simply insufficient evidence, so to me there’s only potential risk.”
While Ozempic’s mechanism of action is understood — its active ingredient, semaglutide, mimics a hormone the body releases when a person eats food, reducing appetite — berberine’s mechanism of action is not clear, Monti and McGowan note.
What does berberine do for the body?
There may be a benefit for its impact on cholesterol, McGowan and Cohen say. It seems to be able to lower cholesterol a little bit and can help maintain blood sugar, Torres said.
“There was a little bit of data (indicating) that it could lower blood pressure, lower blood lipids and have a stabilizing effect on blood sugar regulation,” Monti adds. “(But) I don’t feel convinced about some of these things where there’s one little, tiny study on something.”
Most botanicals like berberine undergo limited study because there’s little reason to study them, while medications like Ozempic have to go through extensive clinical trials, he adds.
After those large trials show a drug is safe and effective, and the medication gets FDA-approval, there are very stringent rules that require the drug dispensed by a pharmacy to be precisely what it’s labeled to be, Cohen says.
"All of that does not exist for berberine. Berberine exists as a food, basically," he notes.
Is there a downside to taking berberine?
The most common side effects of berberine include diarrhea, constipation, gas and upset stomach, according to the National Library of Medicine.
If a person is already taking medication to lower blood sugar and also takes a large amount of berberine, there’s a theoretical risk of hypoglycemia, or low blood sugar, Monti notes.
Monti also warns that berberine can impact the effect of drugs including anti-coagulants, which slow blood clotting, and cyclosporine, an immunosuppressive medication, so patients taking those medications shouldn’t take the supplement.
Is it safe to take berberine daily?
Berberine is "possibly safe" for most adults in doses up to 1.5 grams daily for six months, the National Library of Medicine notes.
For most healthy adults who don’t have any issues with their liver or kidneys — the organs that clear drugs from the body — the data suggests it’s relatively safe, Monti says. He advises consumers to keep the dose to less than 1 gram per day — perhaps 500 milligrams.
If a person takes berberine at those levels, the primary risk is possibly getting stomach issues, Torres said.
But pregnant or breastfeeding women shouldn’t take berberine because there’s a risk of it crossing the placenta or being in breast milk, and children should also not take it, according to the National Library of Medicine.
“It’s not something that I recommend people just take on their own without consulting their physician because their physician will know if they have any risk factors that would warrant extra caution,” Monti says.
Is berberine safe to take long term?
Nobody knows, Monti and Cohen warn.
"We need to be cautious. We need long-term studies, and those are not available for berberine," Cohen says.
“Natural doesn’t always mean safe,” Monti notes. “Just because it’s over the counter doesn’t mean it’s safe and can be taken without regard,” Monti adds.
Asked about the safety of berberine and its side effects, the Council for Responsible Nutrition recommended consulting with a health care provider before taking berberine for weight loss.
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