Taking Berberine If You Have Diabetes

Corin asked

Could I take berberine while on Trulicity? Is it safe to take if I have been diagnosed with diabetes?

Answer

Berberine is an organic compound, known as an alkaloid, that is found in the roots and bark of a variety of plants, including:

• Goldenseal
• Goldthread
• Oregon grape
• European barberry (Berberis vulgaris)
• Phellodendron

It is a popular over the counter supplement, used for numerous indications, including:

• Canker sores
• Diabetes
• Hypercholesterolemia (high cholesterol)
• Glaucoma

Diabetes

There is a growing body of evidence pointing to the effectiveness of berberine in moderately lowering blood glucose levels in certain individuals, including those diagnosed with type 2 diabetes.

One study found that berberine, dosed at 500 mg twice daily for up to 3 months, improved the following clinical markers:

• HbA1c
• Fasting plasma glucose
• Post-prandial glucose

Another study found that berberine, dosed at 500 mg 2-3 times daily for 2-3 months, has similar effectiveness as a commonly used medication (metformin) in regulating glucose metabolism in patients with type 2 diabetes.

Mechanism

The exact mechanism of berberine's hypoglycemic effect isn't well known but is thought to be due to multiple factors, including:

• Increasing insulin receptor expression.
• Increasing AMP-activated protein kinase (AMPK) activity, stimulating glucose uptake in skeletal muscles.
• Increasing glucagon-like peptide-1 (GLP-1) secretion, important in glycemic control.

Safety

Regarding whether or not berberine is safe if you have diabetes, it certainly depends on the individual. There is a general precaution since, as noted above, it can lower blood glucose levels. Therefore, there is a chance that it increases the risk for hypoglycemia (low blood sugar), especially in those already taking insulin or other hypoglycemic medications.

It is important to monitor blood glucose levels closely if you add berberine to your medication list and you should speak with your doctor prior to doing so.

Other potential issues with berberine may exist in those who have low blood pressure or are on anti-hypertensives. Evidence suggests that berberine can lower blood pressure, increasing the risk of hypotension.

Interactions

Drug interactions studies with berberine are scarce, unfortunately, and there isn't conclusive evidence with many drugs.

There is some evidence however that berberine can inhibit certain metabolizing enzymes in the body, including:

• CYP2C9
• CYP3A4
• CYP2D6

If you are taking a medication that is metabolized via any of the enzymes above, there may be a potential interaction. Be sure to discuss your medications with your doctor or pharmacist.

There are no known interactions with berberine and Trulicity (a glucagon-like peptide-1 (GLP-1) receptor agonist). However, as discussed above, the hypoglycemic effects of berberine could potentially increase the risk of blood sugar levels dropping too low (i.e. hypoglycemia).

Symptoms of hypoglycemia include:

• Increased heart rate
• Shaking
• Sweating
• Hunger
• Weakness
• Fatigue
• Dizziness

If you experience any of the above effects while taking medication for diabetes, it is important to check your blood sugar and take appropriate action.