Is Berberine Safe? The Internet Calls It 'Nature's Ozempic'

While medications like Ozempic and other semaglutide drugs have gained popularity in recent years for their potential to stabilize blood sugar and aid in weight loss, a natural supplement called berberine has been gaining traction as an alternative. Social media influencers claim that berberine can improve insulin sensitivity, lower blood glucose, and aid in weight loss. However, it is important to note that dietary supplements often make health claims unsupported by evidence and unauthorized by the FDA, leaving many confused about their benefits.

Berberine is a bioactive compound derived from various shrubs such as barberry, Oregon grape, and goldthread. It has medicinal roots going back thousands of years in Chinese and Ayurvedic medicine, and recent research suggests that it may offer several health benefits including reducing inflammation and cancer risk.

Experts note that berberine can lower blood sugar by increasing glucose intake in muscle cells, and activating an enzyme called AMPK with anti-cancer and anti-aging properties. It can be found in doses ranging from 500-1,500 milligrams and is available in powder or capsule form. However, individuals are urged to consult with their healthcare provider about berberine before taking it on their own to determine the correct dosage and suitability for their individual needs.

While online influencers liken berberine to a "natural Ozempic" for its ability to lower blood sugar and aid in weight loss, the main difference between the two lies in the way they work. Berberine impacts multiple body systems by activating AMP-activated protein kinase (AMPK) to regulate metabolism, while semaglutide drugs help the pancreas release insulin when blood sugar is high and also slow down the movement of food through the stomach to decrease appetite and promote weight loss. While research suggests that berberine is effective in reducing A1c, fasting glucose, and insulin levels, and post-meal glucose levels, individuals should consult with their healthcare provider to determine if it is suitable for their needs.

While all these berberine benefits sound promising, the supplement isn’t a one-to-one replacement for semaglutide—and a lack of research makes it difficult to measure the two against each other. “To my knowledge, there are no randomized clinical trials comparing berberine to semaglutides, so we can’t say for sure whether berberine is as effective as medications like Ozempic,” McKenzie Caldwell, MPH, RDN, fertility dietitian and creator of The Insulin Resistance Mini Course, told Health. 

Meanwhile, some experts caution that, though berberine may improve blood sugar levels, it won’t have the same effects as Ozempic on weight loss. “Berberine will not have the weight loss properties because it does not have the appetite suppressant properties,” Dr. Seltzer said.

Since it’s readily available over the counter, you might expect berberine to come without significant side effects, but that’s not necessarily the case. Though berberine may not share Ozempic’s lengthy list of potential side effects, Yawitz noted that some people may experience diarrhea, gas, nausea, and constipation with large doses.

And just like prescription meds, berberine may interact adversely with other drugs and supplements. Because berberine lowers blood glucose, it could give you dangerously low blood sugar (hypoglycemia), especially when paired with other anti-diabetic medications, like metformin.

People with other conditions may need to steer clear of berberine, too. “Caution should be used in patients currently taking additional medications or herbs with hypotensive, hypoglycemic, or anticoagulant effects, as berberine may cause too strong of an added effect alongside these products,” Caldwell said. Berberine should not be taken alongside the medication cyclosporine, or by women who are trying to conceive, pregnant, or breastfeeding, she added.

There’s also always the possibility that an OTC supplement will contain more (or less) than you bargained for. Since the FDA does not test supplements before they hit the market, there have been numerous reports over the years of pills packing prohibited substances—or none of the ingredient they claim. It’s always best to choose supplements from a reputable manufacturer whose products undergo third-party quality testing, such as an NSF certification.

Ultimately, the decision of whether to try berberine is one to make with your healthcare provider.

While it’s not an exact replacement for drugs like Ozempic or other semaglutide medications, it may be a first line of defense for some people before trying a prescription.

“We do know that it can be helpful, and we also know that it has significantly less side effects when compared to semaglutide injections,” Caldwell said. “For this reason, many of my clients opt to try this natural alternative first before trying a stronger medication to help them manage insulin resistance alongside nutrition and lifestyle changes.”

Still, don’t expect berberine to be a miracle pill. Especially for weight loss, it’s unlikely to yield the same results as semaglutides.

“There are a few studies that show berberine can suppress appetite, but the impact is negligible compared to Ozempic,” Dr. Seltzer said. “If you can’t procure Ozempic, it may be worthwhile to try berberine, but I would not expect too much from a weight loss standpoint.”