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Berberine

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Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • Acetone, barberry, benzophenanthridine alkaloid, berberin, berberin hydrochloride, berberine alkaloid, berberine bisulfate, berberine chloride, berberine complex, berberin hydrochloride, berberine hydrochloride, berberine iodide, berberine sulfate, berberine sulfate trihdyrate, berberine tannate, Berberis aquifolium, Berberis aristata, Berberis vulgaris, Coptis chinensis, coptis, goldenseal, goldenthread, Hydrastis canadensis, isoquinoline alkaloid, jiang tang san, levo-tetrahydropalmatine (l-THP), Oregon grape, protoberberine, protoberberinium salts, rhizoma Coptis chinesnsis, tetrohydorprotoberberine, tree turmeric.

Background
  • Berberine is a bitter-tasting, yellow compound found in plants. It has a long history of medical use in Chinese and Ayurvedic medicine. Berberine is found in the roots and stem bark of many plants, including goldenseal, coptis or goldenthread, Oregon grape, barberry, and tree turmeric. Berberine has also been used as a yellow dye.
  • There is some evidence to support the use of berberine for eye infections, bacterial diarrhea, and some parasite infections (leishmaniasis). Berberine may also protect against viruses, fungi, protozoans, worms, and chlamydia. More research is needed in these areas, as well as heart disease, skin disorders, and liver disorders.
  • Berberine is generally thought safe. However, it may interact with many prescription medications. Berberine should not be used by pregnant or breastfeeding women, due to the risk of problems in the newborn.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Berberine may help improve blood sugar control. It has been studied in people who have diabetes. Although findings appear promising, more research is needed to compare the benefits of berberine with other diabetes treatments.

B


Early research suggests that a combination treatment including berberine may improve heart function and quality of life in people with congestive heart failure (CHF). More research is needed before a firm conclusion can be made on the safety and effectiveness of this therapy.

B


Berberine applied to the skin as part of an ointment has been found to benefit people with second-degree burns. The treatment has been compared to standard wound dressing changes in terms of healing time and rate of bacterial infection. Although promising, more high-quality research is needed on the effects of berberine alone.

C


A form of berberine may benefit people addicted to heroin by decreasing dependence, reducing cravings, and easing the withdrawal process. More high-quality research is needed in this area.

C


Berberine has been studied for glaucoma, an eye condition that leads to damage of the optic nerve. However, the safety and effectiveness of berberine are unclear. More research is needed.

C


Early research has compared berberine to standard antibacterial drugs for the treatment of H. pylori. Berberine may be less effective than some of these drugs for ulcer healing, but may be more effective for clearing H. pylori infection. The safety and effectiveness of berberine for this condition remains unclear. More high-quality research is needed in this area.

C


A combination product containing berberine was found to lack an effect on blood pressure in people with high blood pressure. Further study on berberine alone is needed.

C


In early studies, berberine both used alone and in combination with other treatments has been found to help lower cholesterol. However, the evidence is mixed. Higher quality trials on the use of berberine alone are needed.

C


Berberine has been studied as a treatment for infectious diarrhea. However, the overall evidence is mixed. More research is needed in this area.

C


Early research in people with type 2 diabetes and liver conditions suggests that berberine may have health benefits. However, more high-quality research is needed in this area before any firm conclusions may be made.

C


Berberine has been shown to increase platelet production in people who have low blood platelets, both alone and in combination with other therapies. More research is needed.

C


Early study suggests that a combination treatment including berberine may benefit people who have drug-resistant malaria. However, more research is needed to confirm these findings.

C


Berberine has been studied for symptoms of menopause. However, further research is needed in this field.

C


Armolipid Plus®, a treatment that contains berberine, has been found to improve heart health measures in people with metabolic syndrome. Further study is needed on berberine alone.

C


Berberine is widely accepted as a treatment for the parasite infection leishmaniasis. Berberine may be as effective as standard drugs for this condition. However, more research is needed to support these findings.

C


Early research suggests that berberine may improve health in women with polycystic ovarian syndrome, compared to standard drugs. However, research is limited in this area and further studies are needed before any firm conclusions may be made.

C


Studies have looked at the effects of berberine on bone health in women undergoing menopause. Although early evidence suggests promising bone protective effects, the impact of berberine alone is unclear at this time. More high-quality research on the effects of berberine alone is needed in this area before any firm conclusions may be made.

C


Early evidence suggests that berberine may reduce lung and intestine damage caused by radiation in people with cancer. Although promising, research is limited and more high-quality studies are needed.

C


Berberine has been found to be effective for trachoma, a type of eye infection. However, more research is needed on the safety of berberine for this condition.

C


Early research suggests that berberine may promote weight loss and lower cholesterol in obese people. Well-designed study is needed.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Abnormal heart rhythms, allergy, antibacterial, antifungal, anti-inflammatory, antimicrobial, antioxidant, antiviral, anxiety, arthritis, bile secretion, cancer, dental conditions, depression, diarrhea, eye infections (general), eye inflammation, fatigue, fatty liver (non-alcoholic), fever, headaches, heart disease, hormonal effects, immune function, irritable bowel syndrome, kidney disorders, low white blood cell count, protection from cyclosporine toxicity in organ transplant patients, respiratory disorders, sedative, seizures, skin infections, stomach disorders, stomach ulcers, tonic (liver, heart), urinary tract infection, vascular problems (blood vessel function).

Dosing

Adults (18 years and older)

  • For type 2 diabetes, berberine or berberine hydrochloride have been taken by mouth in doses of 0.5-0.6 grams, 2-3 times daily for 2-3 months.
  • For heroin addiction, levo-tetrahydropalmatine (l-THP, a form of berberine) has been taken by mouth in doses of 30 milligrams twice daily for one month.
  • For H. pylori infection, 300 milligrams of berberine has been taken by mouth three times daily for six weeks.
  • For high cholesterol, 0.5 grams of berberine has been taken by mouth twice daily for three months. Doses of 300-500 milligrams of berberine or berberine hydrochloride have been taken by mouth 1-3 times daily for one month.
  • For infectious diarrhea, 400 milligrams of berberine sulfate has been taken by mouth as a single dose.
  • For liver disease in diabetics, 0.6 grams of berberine has been taken by mouth twice daily for 12 weeks.
  • For weight loss, 500 milligrams of berberine has been taken by mouth three times a day for twelve weeks.
  • For polycystic ovarian syndrome, 500 milligrams of berberine hydrochloride has been taken by mouth three times daily for three months.
  • For damage caused by radiation, 20-300 milligrams per kilogram of berberine has been taken by mouth 1-3 times daily for 5-6 weeks.
  • For low platelet counts, 5 milligrams of berberine bisulfate has been taken by mouth three times daily (20 minutes before meals) for 15 days.
  • For heart failure, an infusion of berberine at a dose of 0.2 milligrams per kilogram per minute has been injected into the vein for 30 minutes.
  • For glaucoma, eye drops containing 2.5 milligrams of berberine hydrochloride have been applied to the eyes.
  • For trachoma eye infection, 0.2 percent berberine eye drops have been applied to the eyes for eight weeks.

Children (under 18 years old)

  • There is no proven safe or effective dose for berberine in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with known allergy or sensitivity to berberine, plants that contain berberine (such as goldenseal, coptis or goldenthread, Oregon grape, barberry, and tree turmeric), or members of the same family.

Side Effects and Warnings

  • Berberine is possibly safe when used in recommended doses for up to six days to treat diarrhea in otherwise healthy children as young as two months. Berberine is possibly safe when taken by mouth in doses of up to 2 grams daily for eight weeks.
  • Berberine may cause abnormal heart rhythms, abortion, eye irritation, feeling of burning or tingling in the skin, fertility problems, flu-like symptoms, flushing, giddiness, heart failure, jaundice (in newborns), kidney inflammation or irritation, liver toxicity, low white blood cell counts, lung failure, muscle pain or weakness, sedation, skin discoloration or swelling, stomach problems (changes in gut bacteria levels, constipation, diarrhea, gas, irritation, nausea, pain, and vomiting), shortness of breath, toxic light reactions, uterus stimulation, and worsened lung disorder symptoms.
  • Berberine may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
  • Berberine may affect blood pressure. Caution is advised in people taking drugs or herbs and supplements that lower blood pressure.
  • Berberine may affect the risk of bleeding. Caution is advised in people with blood disorders or bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
  • Berberine may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system.
  • Use cautiously in people who have cancer, heart disease, high exposure to light, hypertyraminemia, kidney disease, liver disease, low white blood cell counts, lung disorders, and stomach or intestine disorders, or those taking prescription medications (such as pentobarbital, metformin, simvastatin, tetracycline, and fluconazole) and sedatives.
  • Use cautiously when using berberine for longer than eight weeks.
  • Avoid taking by mouth in doses of greater than 500 milligrams of berberine.
  • Avoid using berberine in newborns and in pregnant or breastfeeding women.
  • Avoid in people with known allergy or sensitivity to berberine, plants that contain berberine (such as goldenseal, coptis or goldenthread, Oregon grape, barberry, and tree turmeric), or members of the same family.

Pregnancy and Breastfeeding

  • There is a lack of scientific evidence on the use of berberine during pregnancy or breastfeeding. Avoid in pregnant or breastfeeding women.

Interactions

Interactions with Drugs

  • Berberine may affect the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Berberine may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Berberine may affect blood pressure. Caution is advised in people taking drugs that lower blood pressure.
  • Berberine may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be altered in the blood, and may cause altered effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Berberine may also interact with 1,3-bis (2-chloroethyl)-1-nitosurea (BCNU), acetaminophen, acetylcholine, agents for abnormal heart rhythms, agents for kidney disorders, agents for mental disorders, agents that are toxic to the liver, antibiotics, anticancer agents, anti-inflammatory agents, carbon tetrachloride (CCl4), cholesterol-lowering agents, COX-2 inhibitors, cyclosporine, dexamethasone, dextromethorphan, fluconazole, heroin, losartan, L-phenylephrine, metformin, midazolam, neostigmine (Prostigmin®), pentobarbital, P-glycoprotein inhibitors, sedatives, simvastatin, strychnine, vasopressors, weight loss agents, and yohimbine.

Interactions with Herbs and Dietary Supplements

  • Berberine may affect the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
  • Berberine may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may be altered in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
  • Berberine may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Berberine may affect blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
  • Berberine may also interact with antibacterials, anticancer herbs and supplements, anti-inflammatory herbs and supplements, antioxidants, berberine-containing herbs and supplements, cholesterol-lowering herbs and supplements, herbs and supplements for abnormal heart rhythms, herbs and supplements for kidney disorders, herbs and supplements for mental disorders, herbs and supplements that are toxic to the liver, isoflavones, P-glycoprotein inhibitors, policosanol, red yeast rice, sedatives, stanols, strychnine, tyramine-containing herbs and supplements, vasopressors, vitamin B, vitamin D, weight loss herbs and supplements, and yohimbe.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
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Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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