Berberine Isn't 'Nature's Ozempic.' But It May Help Manage Diabetes and Weight Loss

Photo Illustration by Lecia Landis for Verywell Health; Getty Images

An over-the-counter dietary supplement called berberine is being labeled as a "natural" dupe for Ozempic, a prescription medication used to stabilize blood sugar and may help patients with type 2 diabetes lose weight.

Users all over social media are claiming that the supplement can help lower blood glucose, improve insulin sensitivity, and go as far as helping people shed a few pounds. The search term "berberine supplement" has well over 300 million views and counting on TikTok, and #berberine has about 67 million views.

But as with all social media health hacks and trends, there's the question of whether or not any of these claims can be backed by science. Here's what experts have to say about berberine, and whether or not it could be a decent option for patients who can't get their hands on popular injectable medications like Ozempic, Wegovy, or Mounjaro.

Berberine is a natural compound called an alkaloid that's extracted from a variety of plants, including goldenseal, European barberry, Oregon grape, phellodendron, and tree turmeric, Lisa Kroon, PharmD, Professor and Chair of the Department of Clinical Pharmacy in the School of Pharmacy at the University of California in San Francisco, told Verywell.

People most who take berberine consume it as a supplement, which can come in many forms like capsules, tablets, liquid extracts, or powders, Kroon said. It has also been used in eye drops and gels.

While the drugstore supplement has recently increased in popularity due to social media, it's been used for centuries, especially in Chinese and Ayurvedic medicine, Mir B Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast, told Verywell. In fact, providers may recommend berberine for people with diabetes to help lower their blood sugar and cholesterol.

"It has also been shown to have some antimicrobial effects so it can affect the normal intestinal bacteria," Ali said.

Berberine is believed to have these effects is because it may target a protein involved in insulin resistance and blood sugar control, which positively impacts how our cells can utilize blood glucose, Megan Hilbert, MS, RDN, a registered dietitian specializing in gut health nutrition at Top Nutrition Coaching, told Verywell in an email. In turn, these alkaloids can "reduce the risk of diabetes and metabolic syndrome."

According to the National Library of Medicine, berberine can also be used for burns, canker sores, liver disease, and many other conditions. But there is not enough well-studied scientific evidence to support many of these uses.

"It's absolutely not nature's Ozempic and does not work like Ozempic, which is a GLP-1 inhibitor," Kroon said. "I think people are just grasping here and manufacturers of these supplements are just kind of creating a hype to try to be appealing for people looking for a magic potion to help them lose weight."

Berberine is available over-the-counter and can be purchased online or in stores, usually in a supplement capsule form, Hilbert said. Dosages for berberine range between 500 to 1,500 milligrams per day, but typically, it's taken in doses of 500 milligrams, three times a day.

Depending on the online retailer or store, most berberine supplements can be purchased anywhere from $12 to 50 dollars, Hilbert added.

Comparatively, GLP-1 agonist drugs like Ozempic, Wegovy, and Mounjaro require prescriptions and can cost as much as $1,000 out of pocket.

Although berberine can have similar health benefits to prescription medications when it comes to reducing blood sugar and cholesterol levels, it's not clear if the supplement is effective when it comes to weight loss, Ali said. Diabetes drugs Ozempic and Mounjaro can be prescribed off-label for weight loss, while Wegovy is indicated for weight loss.

"People are saying that [berberine] is equivalent, but there's no real evidence to show that it's equivalent to those medications," Ali said. "It has shown to have some modest amount of effect on weight loss, but it's not the same effect as the prescribed medications."

The reason berberine does not have the same exact effect as Ozempic is because its mechanism of action is different, Kroon said. Ozempic, which is a GLP-1 inhibitor, helps the pancreas release the right amount of insulin when a patient's blood sugar is high, which in turn reduces their blood glucose levels. Semaglutide medications like Ozempic slow down how quickly your stomach empties food, which can lead to decreased appetite and weight loss.

"Semaglutide also helps to reduce a hormone called glucagon after we eat and that helps reduce our blood sugar. So, [Ozempic] has many ways of how it works for diabetes, including effect on weight," Kroon said. "Berberine doesn't work anything like that; it is a completely different mechanism."

Instead, berberine activates an enzyme called AMP-activated protein kinase (AMPK), which can help regulate glucose metabolism, improve insulin sensitivity, and impact blood sugar levels.

Still, a bit of research on berberine's effectiveness for weight loss and diabetes does exist. One meta-analysis of 27 studies found that the supplement may be just as effective as certain oral diabetes medications, such as metformin and glipizide, when it comes to blood glucose control. And a study from 2012 found seven people with obesity who took 500 milligrams of berberine three times per day for 12 weeks lost on average about 5 pounds of weight. More recently, a review of 12 studies from 2020 suggested that berberine supplements can potentially impact body weight, body mass index (BMI), and belly fat.

While there are some studies to suggest berberine supplements may have a positive impact on people's health, more research is needed to draw meaningful conclusions about whether or not berberine is effective for weight loss.

According to Ali, deciding whether or not to use berberine supplements for weight loss should be a decision you make with your healthcare provider. Although it's not "nature's Ozempic," it can be a more accessible option for some patients, especially since it does not require a prescription.

"I don't think berberine would be harmful for the majority of patients, but it's still not clear how effective it is for weight loss," Ali said. "I think it's reasonable to try it as a supplement to healthy lifestyle and diet changes, but I don't want people to think that it's the equivalent of prescribed medications."

Hilbert added that even though there aren't a lot of studies showing berberine has harmful reactions or outcomes, some people who use the supplement may experience minor side effects, including diarrhea, constipation, nausea, bloating, and other gastrointestinal issues.

"Berberine does appear to be safe for adults to use in the short-term," said Hilbert. "But long-term use has not been studied and some animal studies report some severe side effects with long-term berberine use like enlarged liver/kidneys, muscle tremors, and gastric ulcers."

Before you decide to use berberine, it's important to note that these supplements are not regulated by the Food and Drug Administration (FDA) and have not been studied on a large scale, Kroon noted.

"Medications such as Ozempic and Wegovy are FDA-regulated and well-studied for indications like diabetes or weight loss, whereas nutritional supplements like berberine are not FDA regulated," she said. "I would really advise not to jump on the bandwagon here and think that berberine is going to work like a prescription medicine, because it's not going to. You could be spending a good $50+ out of pocket."

Experts say people who use berberine may not see the same results as other prescription medications intended for weight loss. Before trying berberine, you should speak with your healthcare provider, especially if you have certain health conditions like diabetes or are taking other medications and supplements.

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By Alyssa HuiAlyssa Hui is a St. Louis-based health and science news writer. She was the 2020 recipient of the Midwest Broadcast Journalists Association Jack Shelley Award.