I have long been an amateur herbalist. I believe in the power of plants. I believe that plants are our allies; in other words, they can help us, but they cannot do everything for us. This is true of all medicines, whether plant-based or synthetic. They can help, but they cannot do it all for us. Of course, the same is often true of “mind-over-matter” therapies as well: they can do much for us, but they may not always be the entire solution. So often times the answer is in the balance of internal and external medicines – relying on external medicines to provide support and healing while also letting go of mental and emotional imbalances that have been provoking a chronic stress response. When these two “sides” come together, this is often where a lot of healing can take places.
This is the first post on this site (of which I am aware) about plant medicine. I intend to write more on this subject in the future. There are so many wonderful, amazing plants that it would be impossible for me to select one or even one group of plants to single out as my “favorite.” However, there are some plants that excite me more than others. And in this post I will write about a group of plants that I find to be very exciting – the berberine plants.
Berberine is a yellow, bitter alkaloid present in a many plants, but it is most concentrated in a handful of herbs that are used medicinally, including the well-known herb, goldenseal. It is also found in high concentrations in the barberry plant (particularly the roots,) the roots of oregon grape, as well as some other herbs that are used in Ayurvedic and Chinese herbal traditions and in folk medicine world-wide.
I like the berberine plants. I have long been attracted to them. My favorites are barberry (there are many varieties that grow wild and that are grown as an ornamental) and oregon grape (even though, to the best of my knowledge, I have never seen an oregon grape plant live and in person.) I’m not as familiar with most of the rest of the berberine plants. And although I typically prefer to work with whole herbs, I have also used berberine extract derived from Indian barberry.
Although every plant is unique, there is a long tradition of using some groups of plants interchangeably depending on availability. And so it seems that the berberine plants are, by and large, interchangeable when it comes to antibacterial and blood sugar regulation properties as well as the ability to improve impaired liver function.
The traditional uses of berberine plants tend to focus on the plants’ affinity for the digestive system. In modern scientific terms these plants can be said to possess antibiotic, anti-inflammatory, astringent, and hepatic qualities. But simply tasting berberine plants can tell you through intuition. Why? Because berberine is bitter, a taste which often imparts most of these qualities. Plus it has a clearly astringent taste that can cause a mild puckering sensation.
The antibiotic qualities of berberine plants are quite strong. The berberine plants are effective in treating infections or overgrowth of a wide range of organisms, including many strains of staphylococcus, strains of streptococcus, hepatitis B, strains of salmonella, and more. In fact, they are so effective that Stephen Buhner dedicates an entire chapter to the berberine plants in his excellent book, Herbal Antibiotics 2nd Edition. Yet it is important to understand what the berberine plants do and what they do not do when used as medicine for their antibiotic qualities. They work almost exclusively on the digestive system. They do NOT work on systemic infections. What this means is that berberine plants are wonderful for infections or overgrowth in the digestive system – things such as small intestinal bacterial overgrowth (SIBO) or cholera..
The benefits of the berberine plants are extensive, and certainly not limited to the (impressive) antibiotic properties. One of the traditional uses of berberine plants is for improving flagging liver function. I have read some studies that demonstrate that berberine (the alkaloid) is effective in various liver conditions, including liver cirrhosis, hepatitis, and non-alcoholic fatty liver disease. Traditionally we can expect berberine to benefit the liver because of the bitter taste and the yellow color, but modern studies bear this out. One would presume that berberine plants increase the flow of bile. In addition, studies show that berberine decreases the fat content of a fatty liver and stabilizes the liver by preventing the production of cells that might otherwise lead to fibrosis in the liver.
As I’ve already noted, berberine plants have antibiotic properties and increase bile flow. But what is remarkable is that they also combine the astringent property, which makes them among the best plants for treating dysentery. They are active against many organisms that can cause digestive problems, and they increase the digestive power, but the astringent quality means that berberine plants also stop diarrhea.
The quality of berberine plants that has most recently renewed my deep admiration and respect for them is that they demonstrate the remarkable, unrivaled ability to improve and even reverse insulin resistance, including type 2 diabetes. Studies have shown that the berberine alkaloid is at least as effective as the leading pharmaceutical drug for reducing blood glucose. The plants seem to not only prevent insulin resistance, but they can actually reverse it and increase insulin sensitivity.
There is even some evidence that berberine may be helpful for those with type 1 diabetes. Berberine has insulinogenic properties, and has a long (1400+ year) history of use for diabetes (presumably including type 1) that demonstrates its effectiveness.
There is even more research that shows other amazing results attributed to berberine. I cannot personally attest to any of these, but there are studies reporting berberine can help treat or prevent cancer, HIV infection, congestive heart failure, west nile virus infection, depression, schizophrenia, and Alzheimer’s!
As with all medicines, there is no one-size-fits all approach. Every person is different – with different bodies, circumstances, etc. – and therefore will respond differently. I believe that it is important to listen to one’s own body – biofeedback – to determine proper use of any medicine. Berberine plants and even berberine extract work really well for me. I like them. Sure, they are bitter. Sure they are astringent. But I really like them. The smell, the taste, the entire experience is pleasurable for me in a way that is difficult to describe. But I believe this is the nature of the experience of good medicine. Even if it is not pleasurable in the conventional sense, good medicine produces a desirable experience. So I cannot say that berberine or berberine plants are right for you or for anyone. Only you can know that.
The Mountain Rose Herbs profiles for some of the berberine plant herbs that the company sells state that one should only use the herbs for up to seven consecutive days at a time. I cannot substantiate this claim. I have never read this caution anywhere else. It is not mentioned in any of the herbals that I have read, whether old or new. And although I know of no studies that monitor the long term effects of berberine or berberine plants, I haven’t read that there are any short term results that suggest that long term use would be inadvisable. With that said, neither do I believe that it is advisable to use berberine or berberine herbs long term arbitrarily. There are some so-called adaptogenic herbs such as ashwagandha, for example, that seem to be well-suited to long term use. Berberine plants don’t strike me in the same way. Berberine seems more like a healer than a long-term, chronic use sort of solution. And I believe that this is evidence to support this view: berberine and berberine plants seem to correct imbalances and repair the body, returning it to within optimal functioning parameters. In other words, typically the need for berberine decreases over time. One does not become dependent on it, but rather berberine fosters independence and healthy functioning.
Mountain Rose Herbs also advise against taking supplemental vitamin B6 concurrently with berberine herbs. The reason given is that vitamin B6 may increase resistance of pathogenic bacteria to berberine herbs. I have seen this same caution reported elsewhere, though not often. So I cannot confirm nor deny this. The berberine alkaloid has been shown to affect B vitamin metabolism in the human body, which may support the claim that supplementing with certain B vitamins could be potentially antithetical to berberine effects.
Berberine and especially berberine plants (because they contain synergistic compounds) demonstrate the ability to increase the effectiveness of other medicines, including both plant medicines and pharmaceuticals. So if you use other medicines, particularly anything with similar properties to berberine, then it is highly advisable to closely monitor things if you choose to use berberine in conjunction with those other miedicines. For example, there are studies (and lots of anecdotal evidence) suggesting that berberine is highly synergistic with the the drug metformin (in fact, it may out-perform metformin when used alone.) As such, people who wish to use berberine at the same time as metformin need to closely monitor their blood glucose because berberine will likely greatly reduce the necessary metformin dosage.
Personally, I believe that berberine plants are unrivaled for treating infections in the digestive system as well as dysentery. I would whole-heartedly endorse the use of berberine plants or even berberine extract for these purposes. Many people diagnosed with SIBO report improvement with the use of berberine medicine. Also, as a note, Stephen Buhner mentions that berberine is effective against cholera only 50% in clinical trials, but that it is 100% effective against cholera when combined with geranium, pomegranate bark or peel, or bark or leaf of guava.
I am also very excited about the tremendous potential for berberine medicines in the treatment of insulin and glucose metabolism problems such as diabetes or pre-diabetic insulin resistance. My present working theory is that in many cases insulin resistance can be reversed in many cases by reducing dietary polyunsaturated fat (and possibly increasing saturated fat) in conjunction with berberine medicine, with the possible addition of resistant starch in some cases (raw potato starch, for example, has been shown to have powerful effects on glucose metabolism and insulin sensitivity.)
So what is the best way to use berberine medicine? There’s no one-size-fits all answer to that. I can offer a few suggestions, however. For one thing, dose is important. In particular, too much of a good thing in this case can be quite unpleasant. Overdosing on berberine medicine isn’t really easy to do, so there isn’t a great danger of this. From what I’ve read, the toxicity of berberine medicine is extremely low. But eating large amounts could result in some symptoms resulting from too much drying out – nose bleed, eye and skin irritation, and indigestion. Personally, I am sensitive to overdrying, and in my “reckless youth” I experienced some minor indigestion from eating too much berberine medicine. But most people wouldn’t be able to stomach too much of the raw herb to achieve this. So for most people this is only even a possibility with encapsulated extracts.
So in terms of dosage, I’d say that if you’re using raw herbs (i.e. fresh, dried, or powdered) then taste is going to be your guide. And if you encapsulate raw powder you’re not likely to be able to overdose. Buhner suggets 25 “00” capsules for acute dysentery, to give you an idea of an extreme senario. That is probably the equivalent of more than a tablespoon of raw herb powder, and I highly doubt that most people would be able to get that much down unencapsulated. So there’s really no danger with raw herbs. And in most cases even less than a gram a day will be effective.
More or less, much of what I’ve written about raw herbs also applies to tinctured berberine medicine. it is unlikely that you’d want to take more than a small amount in most cases. The taste of a dropperful is likely to signal berberine-satiety in most people. And for extreme cases of dysentery Buhner recommends up to a tablespoon of the tincture several times a day.
With berberine extract my best recommendation is to use a relatively low dose to start. I have used 500mg capsules from Thorne with absolutely no problem, but I wouldn’t consider that a low dose. Thorne does have a 200mg capsule berberine extract as well, which may be more suitable for someone who hasn’t tried berberine before. (I mention Thorne because it is the only reputable producer I know of that has berberine extracts with no stearates or other objectionable fillers. They do use silicon dioxide, but I find that to be rather innocuous.) The studies that I’ve perused have used 500mg capsules twice a day, and that seems reasonable. That’s a lot of berberine, but it’s low enough that it shouldn’t pose a problem for most people. Those are the doses I have read for use in improving insulin sensitivity – typically one 500mg capsule 15 minutes before the two largest meals of the day.
Another important consideration for berberine medicine is to determine what form to use. Stephen Buhner offers some valuable insights into this in Herbal Antibiotics 2nd Edition. Because several important berberine plants are endangered in the wild, many herbalists, including Buhner, recommend against using the wildharvested versions of those endanagered plants. American goldenseal is particularly notable in being endangered in the wild. Buhner suggests wildharvesting only phellodendron (corktree), barberry, or oregon grape. If buying herbs, he recommends cultivated berberine plants – in other words, if purchasing, say, goldenseal, then look for cultivated (not wildharvested) roots. (I’ll add that organic is highly preferable when purchasing cultivated herbs.)
Personally, I prefer the whole herb to the extract because I believe that the whole herb has other synergistic compounds and an essential intelligence that proves beneficial. With that said, berberine extract seems to be a reasonable option with no side effects for most people of which I am aware.