DOES BERBERINE HELP WITH WEIGHT LOSS?
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Episode 233:
Show Notes
Episode 233:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:16) And this is the Real Health and Weight Loss podcast!
Dr Lucy Burns (0:17) Good morning gorgeous one, how are you today? Dr Lucy here again with the beautiful and if you're not watching this on video, she's very rainbow-y, Dr Mary. How are you today Miss?
Dr Mary Barson (00:29) Good, I'm good. Deep in sparkle season right now. I mentioned this last week, it's all about the dress rehearsals and the concerts right now for my performance-loving daughter and I'm having to upskill in stage makeup and applying, I think I'm relatively, relatively proficient at applying makeup to myself at the age of 43. This is a skill I've generally mastered. Applying it on someone else when you're not practised at it is, well, it's really very different. So that's what I'm doing at the moment, spending my afternoons practising that.
Dr Lucy Burns (01:10) Especially if you have to do it without poking them in the eye.
Dr Mary Barson (01:13) I know, that's right. And to a child who doesn't really, really like the application of makeup anyway, it's good. It's a bit of a mother-daughter bonding experience. But I do feel like the stakes are quite high, so it's actually quite anxiety-producing.
Dr Lucy Burns (01:27) Indeed. I'm just looking at my hair in the video. For anyone who's watching the video, I don't know what's happened to it. It's just turned into some sort of bouffant.
Dr Mary Barson (01:35) I love it. I'd go with it, Lucy.
Dr Lucy Burns (01:35) I blame the headphones. Yeah, it is the headphones, but I'm just going, what the hell's going on there?
Dr Mary Barson (01:43) It's actually just fabulous. Let's pretend we meant it.
Dr Lucy Burns (01:44) Excellent. Goodie. All right. Well, we are deep into the world of supplements. The pros, the cons, the fors, the against, the yays, the nays. And we've done two so far, which if anyone is listening to this and hasn't listened to the others, we did mature hop extract, which got a big fat nay from us. And it certainly was promising a whole heap of things that would be good, like visceral fat reduction, with a whole lot of rubbish substance behind it. Then we did NMN, which is not only hard to say, but actually required a bit more research from us because it has had a lot more studies. And we got a cautious nay, mainly because there are no longevity studies on it. And that some of the short-term studies were contradicting. And it is heavily marketed with many, many very clever companies selling subscriptions of powders and all sorts of potions. So yeah, we said, watch this space. We're saying no at the moment, but we reserve the right to change our minds when more data is available. And this week, I think we've stumbled upon a yay.
Dr Mary Barson (03:08) Oh, I reckon definitely a good old cautious yay. I think we're cautious yay with everything supplements and medication. I think you need to be chatting about Berberine today. Berberine's been around a long time. It's a medication or a herbal supplement. So it's a bioactive compound that's extracted from several plants. It's sort of this bitter yellow substance that you can get from the bark of various plants, including the barberry plant. And it's traditionally been used in Chinese and Ayurvedic medicine for various reasons for a really long time. So it's not a new kid on the block. It is a new kid on the block in Western medicine, I'd say, which is where you and I Lucy have our grounding, but it has been around for a long time in more traditional medicines.
Dr Lucy Burns (03:59) Absolutely. And, you know, we use bark in traditional medicine, willow bark. I'm sure most of you know this, but in case you don't, willow bark is aspirin. And, you know, so bark has medicinal properties.
Dr Mary Barson (04:14) It totally does. Plants have medicinal properties. So many of our modern-day medications originally came from plants and herbal medicines. They really are medicines, you know, just because they come from plants doesn't mean that they don't have medical actions. Not so much in Australia, I think, Lucy, you'd agree, we probably don't get a good grounding in herbal medicine. In other places in the world, in medical school, they definitely do, like various medical schools in Germany, in Europe, especially Germany, I've heard of, they do actually learn about herbal medicine a lot more than you and I have learned about herbal medicine. But it just brings the point that I view supplements in a very similar way as I would view medicine, in that they can be really powerful, and that they need to be really targeted and specific and taken for a specific reason and monitored somehow as well. A lot of them are less potent than medicines, a lot of them are safer than medicines, so both less effective and less dangerous, but that doesn't mean that they're not effective and not dangerous as well.
Dr Lucy Burns (05:29) Absolutely, absolutely. And, you know, the thing that happens with, again, we talked about this, I think, a couple of weeks ago, the one that is very front of mind for me at the moment is pyridoxine toxicity. So that's just vitamin B6. Vitamin B6 is in everything, and that's the problem.
Dr Mary Barson (05:48) I just chuck it in lots of things, that's right. And people can be taking, if they're taking, I just want some magnesium to help me sleep, or some big vitamins for energy, or geez, I'm feeling a bit tense, I might take that calming supplement, and my nails aren't that great, maybe I'll take a nail supplement as well, and oh, just have that energy drink, because geez, I'm tired. They could be taking five or six doses of vitamin B6 without realising it, and vitamin B6 toxicity is real.
Dr Lucy Burns (06:13) Yeah, absolutely. So yeah, I think you're right, it's definitely worth the mind shift that a supplement is like a medication. And the majority, I mean, the things that we take medications for that are for chronic disease, they only work while you take them. So really, I mean, the only thing I can think of short term that you would take that you don't need to take again is like an antibiotic. So you know, you've got an infection, you take some antibiotics, it fixes the infection, you don't need to keep taking them to remain well.
Dr Mary Barson (06:46) That's right. Or painkillers while you have the pain.
Dr Lucy Burns (06:49) Yeah, anti-inflammatories if you've injured something. But for many things, blood pressure, you know, dare I say it, cholesterol medication, the jury is still out, but not that out on the GLP-1s. So the injectable weight loss medications, probably need to be taken long term, certainly not short term. So supplements are the same. If you're looking for something to fix your hair and nails, and you don't know what is causing the problem with your hair and nails, and you take the supplement and it fixes it, well, you're probably going to have to take that supplement all the time, unless you can find out what the cause of you needing the supplement in the first place was.
Dr Mary Barson (07:40) That's right. That's it. So even though these things are freely available at the chemist, the supermarket online doesn't inherently make them safe long term. That's just, I think, that's important to understand. Doesn't necessarily mean they're dangerous, but doesn't necessarily mean they're safe. But berberine, interestingly, has really come, it's been a topic of scientific research in recent years, and science has been exploring its effects on metabolic conditions like insulin resistance, type 2 diabetes, obesity, cardiovascular health. And I think that the state of evidence is really interesting and that it is something that definitely we should be paying attention to. And Berberine is actually a really potent and powerful supplement that I think should be put in, definitely put in the same class as a mechanism, same class and as a medication. And we could, yeah, chat a little bit more about what we think it does, and, you know, whether or not it's something that people would want to explore.
Dr Lucy Burns (08:46) Absolutely. So I guess, alright, so step one, berberine, what does it do? What's it good for?
Dr Mary Barson (08:53) Seems like it does a lot. It does a lot. So it plays a role in reducing insulin resistance or improving insulin signaling. And it does this largely through, I probably wouldn't know that too much, but a biological mechanism where it activates our AMPK pathways, which is a pathway that boosts our energy metabolism in our cells, and plays a critical role in how our cells use and make energy. And when we're talking about metabolism, we are talking about how our bodies, you know, take the energy from our fuel, and then how they're able to burn that and utilise that to create energy to keep us alive. And then how we're able to store that energy, the excess energy as fat, and how we're then able to utilise that fat, how we're able to utilise our sugar, all of this is energy. Berberine seems to play a few roles in improving metabolic health, largely through increasing the activation of this AMPK pathway, which leads to improved insulin sensitivity, leads to improved glucose uptake of the cells, so the sugar can sort of use the sugar better, and also allows us to burn our fat better. So it is really interesting that this plant substance can do all of that. But that's not its only proposed mechanism. There's also research showing that it has benefits on our gut microbiome in much the same way that metformin and other antidiabetic medications. It does at least some of its influence in the gut microbiome, promoting more of those beneficial ones.
Dr Lucy Burns (10:42) That's sort of new, isn't it, this discovery on metformin in the gut microbiome. So I mean, this is the other sort of slightly dodgy thing in medicine sometimes is that we don't always know how things work. These days, I think, new medications have to have a proposed mechanism. But back in the olden days, sort of things just started to work and we go, oh, that's good. And we didn't really know how. And metformin, weirdly, for a widely and wildly prescribed medication, we didn't really understand its mechanism.
Dr Mary Barson (11:16) Totally. Yeah, the black box theory was widely accepted. Drug goes in, effect comes out. What does the drug do? But with improved technology, we are sort of unravelling a lot of these mechanisms behind medications we've used for ages. And look, berberine, talked about Chinese and Ayurvedic medicine. Berberine is a medication that we humans have been using for ages. So yeah, berberine and metformin exert similar effects by promoting the beneficial bacteria and inhibiting the harmful strains, which is, I think, absolutely fascinating.
Dr Lucy Burns (11:52) Absolutely. So okay, so back to Berberine. So berberine is great for improving insulin resistance by increasing insulin sensitivity, essentially. Correct. Yes. As part of that, the flow affects metabolic health.
Dr Mary Barson (12:09) Yes, that's right. And it also, I mean, that's not all. There's also there's a lot of data on berberine. It contrasts greatly with mature hops extract in that regard. Also has some anti-inflammatory effects, which is also beneficial for conditions like insulin resistance and cardiovascular disease. And one of the ways in which cells get resistant to insulin in the first place is because of inflammation. But then also insulin resistance causes inflammation. So it's this chicken and egg, which can actually result in this kind of vicious cycle of inflammation that you can get with diabetes and obesity. So it has a few anti-inflammatory effects because it can sort of dampen down pathways that can feed into that cycle of anti-inflammatory, particularly with some cytokines. It inhibits some of the inflammatory signalling molecules in our body. So that's interesting, too.
Dr Lucy Burns (13:11) So we've got improved insulin resistance. And as part of that, we'll improve inflammation but also a separate mechanism for improving inflammation as well. Huzzah.
Dr Mary Barson (13:26) Hmm, Has its fingers in so many metabolic pies looking at the research. It's really, really interesting. Also has a modest effect on our cholesterol profile, and it inhibits our PCSK9 enzymes. We've actually got drugs that target these now. So PCSK9 inhibitors are a new type of cholesterol-lowering medication, been around for a few years now. But yeah, berberine has sort of a modest impact on that as well. So that's interesting. It increases our ability to use and recycle LDL cholesterol. So that's also interesting to see. And finally, it has an effect on the liver. Not finally, but we're capping it here. These are the most relevant points. It helps the liver be able to use glucose more effectively and also helps our muscle cells be able to use glucose more effectively. So it's interesting. You hear all that and you're like, wow, it's a wonder drug. Everybody needs to take it. We need to put it in the drinking water. But it is really interesting to see all of that.
Dr Lucy Burns (14:37) I've got one other thing, one other area, though, that I'm interested in, which I know you know, PCOS. So polycystic ovarian syndrome. Where does Berberine fit in with that?
Dr Mary Barson (14:49) Yes. So there are studies looking at its role in PCOS and its role in various aspects of PCOS, including everything I've mentioned just already that I've said, is about improving insulin signalling and insulin sensitivity, which is really important in PCOS because one of the main drivers of polycystic ovarian syndrome is insulin resistance, particularly in the ovaries. And yeah, there are also studies looking at using berberine with other ovulation-inducing medications to help improve ovulation in PCOS. Metformin, which has many parallels. Metformin and berberine are very similar in many regards. So metformin is already used in this setting and berberine can be used as well to help improve ovulation and fertility. So yes, it is something certainly that I think we should be paying attention to. And it's powerful and potent. I think that's important. And I think that we've got a reasonably good handle on the potential risks and side effects of berberine. I would say that there's probably still some caution and that we haven't done really long-term studies looking at its safety data, but it does seem to be well tolerated. There are common side effects of berberine reported in the literature, which include diarrhoea, constipation, stomach cramps, and these sorts of abdominal issues. Again, quite similar to metformin, which is interesting. Indeed, I was about to say that, yes. Yeah, yeah. And absolutely can interact with other medications. And I think that's critical. So if you are thinking, hey, berberine might be worth a go, I want to give it a try. Really, if you're on medications or even if you're not, just chat to your doctor, because I think we need to think of berberine as a medicine. It is a medicine. And the way that we break down different medicines is really important to understand how we break them, and how our body eliminates drugs because those pathways can compete with each other. So in particular, berberine is broken down by a pathway in our liver called the CYP450 system. It's a really common way that our body detoxifies. And our liver can only do so much. Our liver is amazing. It's amazing. It's amazing. It's amazing. But if it's really busy, you have some berberine and it's going to be really busy breaking down the berberine and metabolising the drug. If you're then on other medications that need that same pathway in your liver, then you can get into problems. So it's just important to have a chat to your doctor about this.
Dr Lucy Burns (17:38) Absolutely. And it doesn't mean you can't have it. Sometimes people just need to be aware because what that may mean is that you need to decrease the dose of a different drug or increase the dose of a different drug to compensate for that pathway competition. I think it's amazing. And again, it's so interesting to me that here's a product that's been around for a long, long time. Obviously not a lot of money in it because it's not being marketed as much. I mean, it's in a few brochures, but it's not getting the same marketing as, say, NNM. There's no pop-up multi-level marketing like the matured hop extract that we discussed. You can buy it in shops in chemists or pharmacies in Australia or online at places like iHerb and things like that. There are a couple of things that I think people just need to be mindful of when looking or deciding whether they should go on and which one they should choose. And the couple of things that I think are that it's meant to be taken with food like its best effect is with food. So you just need to be mindful of that. Maybe if you take all your meds at night, you don't take berberine at night, you take it with your food. So that can be good and bad. It can be a bit inconvenient if you've got to take it three times a day. And one of the things we know with metformin is if people are unwell, so if they've got gastro or they've got a bad flu or there's something other sort of significant illness going on, people sometimes need to stop their metformin. They can get just changes and develop sort of something called acidosis, which is rare but serious. And we were trying to look for safety data on berberine recommendations and there doesn't seem to be a lot of information on it. But I would suggest that given what you've spoken about today, Miss, and it's parallel with metformin, it probably needs to be stopped if you're unwell.
Dr Mary Barson (19:58) I think so. I reckon it is prudent to sort of treat it like metformin in that regard. And probably another caution I'd throw in there would be low blood sugar. And this is probably only if you're already taking other medications that would lower your blood sugar, like insulin or other glucose-lowering drugs. Berberine could potentially increase the risk of getting low blood sugar in that setting.
Dr Lucy Burns (20:21) Yeah, absolutely. And again, another plug for the, if you're taking the weight loss, injectable weight loss drugs. And again, I just want to always caveat, there is no judgment from us around that. I mean, people sometimes think that because we promote lifestyle medicine, we're anti-other medicine. We're most definitely not that. It is all a tool and people need all the tools they can get their hands on. But just be mindful that if you are using one of the injectable weight loss meds and you're taking berberine, just be mindful of your blood sugar.
Dr Mary Barson (20:56) Yes. Yeah. While we're on the subject of cautions, I guess it would be sensible to say, because I did talk about PCOS earlier, that we don't really have any safety data on pregnancy or breastfeeding. So I think berberine should not be recommended in pregnant or breastfeeding women. It does cross the placenta in mice, in animal studies. So we don't know, we just don't. Yeah, that's a good point. Absolutely. If you're a fabulous woman who's growing or feeding a baby, you just want to be really cautious.
Dr Lucy Burns (21:30) Yeah. And I guess that's the thing, isn't it? It's a bit like, you know, there's that concept of the Ozempic baby. So, people who have previously had what is now called sub-fertility, they've managed to, you know, maybe lose some weight and improve their metabolic profile. And so their insulin resistance has got better and their ovaries are gone, oh, hurrah, plop out an egg and bang, there's a baby. And so yeah, for the baby now, yeah. And again, the same recommendation, stop your Ozempic or your other medication, stop your berberine. And then when you're looking for a berberine supplement, interestingly, I discovered, like lots of things, that they're not all equal. So just look at the ingredients because one of them I looked at had maltodextrin in it, one had sunflower oil in it, and there was one lot that came with it as a liquid. And it was 40% alcohol. It's like, oh, don't want that when you're pregnant. No, no, no, you know, in the middle of young, you're taking small amounts, but honestly, we probably don't, you know, you probably don't need to add that in because there are alternatives. There seem to be other brands out there that didn't have all of that rubbish in it. So, you know, if you get the opportunity to look at the ingredient list on the back of the bottle, do so.
Dr Mary Barson (22:55) That sounds very sensible. So yeah, I mean, it's promising, isn't it? I think it is. It is really promising and really interesting. And yeah, just use all your tools, but use them cautiously and carefully. And I think ideally with medical supervision.
Dr Lucy Burns (23:12) Yeah, yeah. So I guess, you know, we've given a hard nay, a soft nay, and now we're giving, you know, yeah, a yay with supervision. Don't, you know, like everything, it's not, don't just run out there and, and, you know, eat five bottles of berberine in the hope that you'll lose five kilos. It won't work like that. But it does seem to have, especially if it's got 40% alcohol in it, does seem to have some pretty solid evidence to improve that insulin resistance that we're always banging on about. So, huzzah.
Dr Mary Barson (23:46) Huzzah, indeed.
Dr Lucy Burns (23:48) Indeed. All right, lovelies, that's it from us for this week. Have the most spectacular week and we will be back next week.
Dr Mary Barson (23:56) Bye now.
Dr Lucy Burns (23:58) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
