Wednesday, August 24, 2016

Wisdom Wednesday: Berberine

Berberine is a yellow-colored alkaloid compound found in several different plants, including European barberry, goldenseal, goldthread, Oregon grape, philodendron, and tree turmeric. It has antibacterial, anti-inflammatory, and immune-enhancing properties. It can be used topically on cuts and other wounds, and it’s perhaps most commonly used to treat gastrointestinal issues, including traveler’s diarrhea and food poisoning.

However, in recent years berberine has become a very popular research topic. Over a third of the approximately 2,800 studies on berberine listed on PubMed were published in the last 5 years. These studies indicate berberine may have a wide range of clinical applications.

Much of the benefit from berberine appears to be from its activation of adenosine monophosphate kinase (AMPK). AMPK is a cellular enzyme often called the “metabolic master switch” because it plays an important role in regulating metabolism.

AMPK regulates an array of biological activities that normalize lipid, glucose, and energy imbalances. Metabolic syndrome occurs when there AMPK-pathways are turned off, triggering a syndrome that includes hyperglycemia, diabetes, lipid abnormalities, hypothyroidism, and energy imbalances.

The hormones leptin and adiponectin also activate AMPK. So berberine can have some of the same effects as exercise, dieting, and weight loss – the lifestyle modifications considered beneficial for a range of maladies. On the other hand, AMPK suppression can have similar effects to those of eating a high-calorie diet while leading a very sedentary lifestyle.

One of the most interesting studies on berberine compared taking 500 mg of the compound 2-3 times per day for three months with the diabetes drug Metformin. Berberine was able to control blood sugar and lipid metabolism as effectively as Metformin, with researchers describing berberine as a “potent oral hypoglycemic agent”. Berberine stimulates the uptake of glucose into the cells, improves insulin sensitivity and reduces glucose production in the liver.

Clinically, to date, I have limited my use of berberine supplementation to my diabetic patients. My first choice in the treatment of diabetes remains Gymnema. But when Gymnema fails to work or its effects diminish over time, I often switch to berberine. In hindsight, those are patients that typically are unwilling or unable to improve their lifestyle to the extent necessary to reverse diabetes.

I frequently use the herbs goldenseal, Oregon grape and turmeric which contain berberine for a host of conditions. Inflammation and infection fighting are the most obvious uses.

Recently, I added berberine to the list of supplements I test when a patient presents with metabolic syndrome. Time will tell if I see the same patterns I have noted with diabetes.

The Bottom Line:
If you have signs or symptoms of metabolic syndrome and have had real difficulty in improving your lifestyle with diet and exercise, you might consider berberine. However, I suggest you do so with qualified nutritional oversight.

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