What is berberine?
Berberine is an alkaloid from the isoquinoline group [1] that has been known to humans for a long time and is used, for example, in Chinese medicine [2].
It can be found in plants such as:
- Goldenseal,
- Coptis,
- Oregon grape,
- barberry,
- tree turmeric [2].
It has antimicrobial [2], anti-inflammatory, and antioxidant properties [1].
Berberine can positively impact glucose and lipid metabolism, making it a great supplement for metabolic-related disorders [1].
Moreover, in animals, berberine also shows cardio- and neuroprotective results [1].
Can berberine lower my A1C test?
Yes, berberine has been found to lower the A1C test and the average blood glucose levels.
For example, berberine treatment decreased A1C results from 9.5 to 7.5% in people newly diagnosed with type 2 diabetes [3].
Similarly, in patients with diabetes type 2 and dyslipidemia, berberine lowered the A1C from 7.5% to 6.6% [4].
Taking berberine reduces blood glucose levels before and after food [3, 4]. This leads to lower average glucose levels, and when continued for more than 3 months, it will impact the A1C results.
Nevertheless, berberine can help manage sugar levels but is not a substitute for diabetes treatment.
How does berberine lower glucose levels in the blood?
One primary mechanism by which berberine decreases the blood glucose level is enhancing glucose metabolism [5].
Berberine increases the activity of the Akt enzyme, promoting the bonding of glucose into glycogen, the sugar-storing compound in the human body [5].
At the cellular level, berberine stimulates glucose absorption in muscle and fat cells. It does so independently from insulin [6].
This effect is linked to the activation of the AMP-activated protein kinase, an enzyme that regulates cell energy balance [6].
Furthermore, in the intestine, berberine slows down the absorption of glucose by inhibiting disaccharidase. This enzyme is responsible for the degradation of complex sugar into simple parts. Due to the inhibition, complex parts have to wait longer for their splitting [7].
Also, berberine increases insulin sensitivity and glycolysis, the metabolic use of glucose [8]. Both effects allow for improved glucose shift from the blood inside the cells into the metabolic cycle.
What are the target values of A1C?
The A1C (or HbA1C) test is crucial to monitoring diabetes. It allows for assessing therapy and disease. Generally, the American Diabetes Association recommends that the A1C be below 7% [9].
However, more specific diabetes guidelines advise that the A1C test be lower than 6.5% or 8%, depending on the patient [10].
It is crucial to remember that there is no standard target for the A1C test. The general population should have an A1C below 7%, but the recommendations must be adjusted to individual conditions [9].
Does berberine have side effects?
Berberine is a plant-extracted substance that is considered safe. However, like most active substances, it can have certain side effects in some people.
Among the side effect of berberine are:
Berberine suppresses a key enzyme called P450, which is responsible for the metabolism of many medications. Therefore, higher berberine doses can lead to slower clearance of other medications . It can lead to a culmination of drug concentration in the body and effects potentiation.
Why is berberine not an official medication?
Berberine receives strong attention from the researcher due to its wide range of pharmacological effects. However, it has some limitations [13].
The biggest problem with berberine is its low bioavailability. It is reported to be below 1%, which is very low and limits any serious clinical use [14].
The reasons for this problem of berberine include its hepatic-intestinal metabolism and poor water solubility [13].
Moreover, in rats, berberine has shown a high affinity for liver tissue, which extracts most of the available concentration. The difference between the blood levels of berberine and this in the liver is more than 70-fold [15].
Additionally, the body extensively metabolizes berberine, producing metabolites that can block the metabolism of other medications and lead to interactions [16].