What is berberine? Is it a “natural Ozempic”?

If you’ve been looking for options to treat type 2 diabetes or lose weight, you’ve most likely heard of Ozempic. And if you spend any time on social media, especially TikTok, you’ve probably heard of its supposed “natural” alternative, berberine. 

But what, exactly, is berberine? Is it as effective as Ozempic? (Spoiler alert: it’s not.)

Read on as we break down what you need to know about berberine.

Berberine is a plant-derived chemical compound used in traditional Chinese and Indian Ayurvedic medicine. Berberine is primarily extracted from the bark, stem, root, and rhizome of the Chinese goldthread (Coptis chinensis) and huanglian (Rhizoma Coptidis). But, you can find berberine in other plants and herbs like barberry root, Oregon grape, tree turmeric, and goldenseal. Once extracted, berberine resembles a yellow powder which is then turned into a capsule or tablet you can take as a supplement. 

Traditionally, berberine was used to treat infections, heal wounds, and cure gastrointestinal conditions as wide-ranging as hemorrhoids and diarrhea to intestinal parasites. Given its potential benefits in reducing blood sugar, cholesterol, and inflammation, berberine has attracted the scientific community. Currently, berberine is being studied for its potential application in metabolic conditions like type 2 diabetes mellitus, obesity, gout, non-alcoholic fatty liver disease, and hyperlipidemia (high cholesterol).

So far, the research indicates that berberine tends to be well-tolerated, but more research is needed to fully understand its potential side effects, especially if used long-term. In the right doses, berberine doesn’t seem to impact liver function negatively, and its side effects are typically mild and gastrointestinal in nature. These may include:

• Anorexia

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Flatulence

• Bloating

Berberine is available over the counter, but that doesn’t mean it’s safe, especially if you have any underlying health conditions or take other medications. As a supplement, berberine is not regulated by the US Food and Drug Administration (FDA). 

Other dietary supplements have been found to contain heavy metals, and other ingredients that can be toxic or may interact with other medications. They can contain more or less of the active ingredient than advertised. And, because they don't require a prescription, some people overdo it with supplements, which may increase your cancer risk. 

Berberine may interact with other drugs or affect how quickly your body breaks down other medications, including blood thinners or medications you take to lower blood sugar or blood pressure. If you take prescription drugs or other OTC medication, talk to a healthcare professional before taking berberine supplements.

Berberine may lead to a little weight loss, but only a little, especially when compared to Ozempic. In one study, people with obesity took 500 mg of berberine three times a day for three months.  They lost about 5 pounds, on average. Berberine has also been shown to reduce body mass index, or BMI, by about 1, within six months. Depending on your body weight and height, a BMI change of 1 could represent anywhere from about 5 to 8 pounds. But keep in mind that these studies are often done in a small number of people, and they don’t come close to high-quality data from large clinical trials.

Compare this to Ozempic, which can reduce a person’s body weight by nearly 15%, on average, within a year and a half. 

The bottom line: If weight loss is your goal, you may want to stick with FDA-approved pills like Ozempic.

Research suggests berberine may have some health benefits, from better blood sugar control to lower cholesterol. But keep in mind that when we’re talking about the potential health benefits of a supplement, that doesn’t mean that it can replace FDA-approved medications which have been studied for their safety and effectiveness in large clinical trials. 

Talking to your healthcare provider before starting any dietary supplement is always a good idea. 

1. Improved insulin sensitivity

Berberine may offer benefits for people with type 2 diabetes. It is linked to improvements in insulin sensitivity and reduction of insulin resistance. 

Type 2 diabetes is often treated through lifestyle changes like diet and exercise, as well as medications like metformin. On its own, berberine may slightly lower HbA1c levels and fasting blood glucose. But adding berberine to diabetes medications like metformin could increase the effects, leading to bigger reductions in both HbA1c and fasting blood glucose levels.

Additionally, some research found that combining berberine with other diabetic medications led to larger improvements in blood glucose and cholesterol than were achieved using the diabetes drug alone. Berberine’s ability to improve insulin resistance, coupled with its ability to improve ovulation, may also be helpful for people with polycystic ovary syndrome (PCOS). 

2. Lower cholesterol

Multiple animal studies have shown that berberine can reduce total cholesterol and low-density lipoprotein (LDL, aka “bad”) cholesterol while increasing high-density lipoprotein (HDL, aka “good”) cholesterol. 

As for people, studies show taking berberine twice a day for three months lowered total cholesterol, triglycerides, and LDL levels. 

When it comes to lowering cholesterol, a meta-analysis found that berberine combined with lifestyle changes is more effective than lifestyle changes alone. And, combining berberine with oral lipid-lowering medications may be more effective than medication alone at reducing both total cholesterol and LDL cholesterol.

3. Lower inflammation

Inflammation may play a role in developing many conditions, including type 2 diabetes. For example, chronic inflammation is a hallmark of metabolic syndrome, a group of health conditions that increase your risk of cardiovascular disease and diabetes. 

Berberine may have anti-inflammatory properties and help with obesity, a risk factor for metabolic syndrome. Specifically, berberine may reduce inflammation in adipose fat tissue, slow fat production, and accelerate fat metabolism. And by activating the amp-activated protein kinase (AMPK) pathway, berberine may increase energy consumption. Together, these effects may lead to some weight loss and cause changes that lower the risk of metabolic syndrome. 

4. Lower blood pressure 

When taken on a long-term basis, berberine may positively affect blood pressure and help reduce hypertension (high blood pressure). According to research, combining berberine with lifestyle changes lowered blood pressure to a larger extent than lifestyle changes alone.

5. Reduced cancer risk

Researchers are still working to understand the anti-inflammatory potential of berberine and how it may help slow the growth of cancer cells. 

To date, some research has looked into the potential benefits of berberine in colon, breast, pancreatic, liver, lung, ovarian, oral, bone, prostate, intestine, and thyroid cancers. And some researchers suggest berberine may have anticancer potential, but we need more studies in humans to confirm that, and berberine is far from being a “cure” for cancer.

No. While no studies directly compare berberine and Ozempic (semaglutide), they work differently and have different therapeutic impacts. 

Like Ozempic, berberine can encourage the release of insulin. However, they affect insulin production through different pathways. Berberine is believed to encourage the release of insulin through an enzyme called adenosine monophosphate-activated protein kinase (AMPK), which helps your body keep your energy levels in balance. Ozempic, on the other hand, mimics GLP-1, a gut hormone that helps regulate blood sugar by encouraging insulin production. 

It’s also worth noting that in addition to regulating blood glucose levels, Ozempic delays gastric emptying, so people tend to feel full sooner while taking Ozempic, and eat less. This is a key difference between how Ozempic and berberine work.

Unlike Ozempic, berberine has low bioavailability, and the body doesn’t absorb it well, so people take it multiple times a day. Ozempic only requires a once-weekly injection. 

Finally, while berberine’s effects are still being actively researched, Ozempic has been proven to improve blood glucose levels, reduce cardiovascular risk, and lead to significant weight loss in people with type 2 diabetes or obesity. Ozempic is safe and well-tolerated in most people, with mild to moderate gastrointestinal side effects that go away with time. 

The bottom line on berberine and Ozempic: Berberine’s therapeutic benefits may make it a good option as a supplement to the rest of your therapy and drug regimen, but it shouldn’t be the main event. 

The jury is still out on berberine's full therapeutic potential. And while the research thus far is exciting — especially given berberine’s potential benefits for cholesterol levels, blood glucose, inflammation, and body composition — there simply haven’t been enough high-quality trials to prove out its clinical benefits. 

If you want to try berberine, talk to your healthcare provider first.

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Current version

June 08, 2023

Written by

Amelia Willson

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.