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Berberine has been used in China for a long time. Its usage was as an over-the-counter remedy for bacterial diarrhea. Recently, it has been discovered to have a significant impact on blood glucose levels. How significant? Can berberine replace metformin? 

Berberine sources

Berberine was originally made from the plant Rhizoma coptidis, but this was too expensive. Now they are using different types of plants. The most popular one appears to be goldenseal. It is also known as barberry. In the United States, you may have seen this plant. It has a yellow flower, green leaf, and a bright red berry. The berries form after the flowers have dropped.

Berberine mechanisms

Berberine was originally used in China as an over-the-counter remedy for bacterial diarrhea before they found out that it decreases blood sugar levels. The mechanisms, though, appear to be jumbled up. With metformin, it’s not clear whether it’s affecting the liver’s ability to create glycogen or cellular sensitivity to insulin. It could be a gut biome issue or maybe certain combinations.

With berberine, it appears to: 

  • Activate AMPK (activated protein kinase). 
  • Enhance insulin sensitivity. 
  • Reduce weight gain in insulin-resistant patients
  • Decrease hemoglobin A1c. In a study titled “Effects and mechanisms of berberine in diabetes treatment,” Yin and co-authors said they found a two-point decrease in hemoglobin A1c. This appeared to be a fairly rigorous clinical trial. They said this decrease is comparable to metformin. (However, I would like to see more clinical trials.)
  • Lower fasting insulin but did not appear to increase insulin secretion, except in certain types of patients with more advanced diabetes. 
  • Have potential beta cell protection which affects the activity of insulin-secreting pancreatic islets. 
  • Decrease triglycerides. If you decrease blood sugar and hemoglobin A1c, then it’s expected that you’re going to decrease triglycerides. Look at my video about HDL over triglyceride ratio. You’ll learn that if you have an increased blood sugar level, and you chew up your HDL, you’ll have more triglycerides. 

Can berberine replace metformin?

Some sources say it’s as effective as metformin. (One of our YouTube viewers mentioned he’s using berberine instead of metformin.) Other sources say the benefits of berberine are unproven. But looking at the cost, berberine is more expensive than metformin, and you can even get metformin free from several pharmacies. 

How about me? I’d like to try it. You can make a case that it has level 1 evidence because there are clinical trials around it. I’m not going to drop my metformin, though. I would continue to monitor my blood glucose levels as I add this berberine supplement. 

My name is Ford Brewer. My team and I work to prevent heart attack,  stroke,  cancer, and dementia. Our goal is to help you understand how to prevent major killers and disablers. Most of them are driven by the process of cardiovascular inflammation. If you want to know more about the science of preventive medicine, check out and subscribe to our YouTube channel.

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