Berberine vs Metformin: How Do They Compare?

Last modified on October 20th, 2023

Berberine is one of the most powerful supplements because it acts like a pharmaceutical drug in many ways. It has many of the same properties as metformin and can be helpful for diabetes, PCOS, and similar conditions. So how do berberine vs metformin compare to one another? Below, we detail what you should know about metformin vs berberine and explore more about how berberine works and what its benefits are.

What is Berberine?

Berberine has long been used in traditional forms of medicine, including Ayurvedic and Chinese medicine. For thousands of years, berberine has been relied on medicinally, and there’s modern research and evidence to suggest it may help with obesity, inflammation, and diabetes. Berberine is unique because it can make changes at a cellular level, like a pharmaceutical drug.

Berberine is a natural plant compound, and it’s considered an alkaloid.

In hundreds of studies, berberine has been tested. It appears to activate something inside our cells called AMP-activated protein kinase or AMPK. That is an enzyme with a significant role in regulating energy levels and metabolism, and it’s in cells throughout our bodies.

There’s also research to suggest that berberine can affect other molecules inside cells and could impact the genes that are turned on and off.  

Berberine Benefits

One of the more common reasons to use berberine is to help with type 2 diabetes because it can potentially significantly lower blood sugar levels.

There are different ways berberine can lower blood sugar. For example, it can reduce insulin resistance, making insulin more effective. The plant compound can increase glycolysis, which can help your body break down sugar inside of cells and decrease the production of sugar in the liver. It can slow the breakdown of carbohydrates in the gut and increase beneficial bacteria in the gut.

Along with lowering fasting blood sugar, berberine can reduce hemoglobin A1C and increase blood lipids, including triglycerides and cholesterol.

Other benefits of berberine include:

  • It may help with weight loss. Several studies show that berberine can potentially help lower total body weight, belly fat, and body mass index. There may be weight loss benefits for multiple reasons, including berberine’s ability to reduce inflammation and prevent the growth of fat cells at a molecular level.
  • Based on a review of many studies, berberine could lower cholesterol and the risk of heart disease.
  • In animal studies it’s been found to help with depression symptoms.
  • Animal and test-tube studies have shown the potential of berberine to reduce the spread and growth of different types of cancer.
  • There are powerful anti-inflammatory and antioxidant effects of berberine.
  • In test-tube studies, berberine has been found to reduce the growth of harmful bacteria, fungi, and viruses.
  • Berberine can reduce fatty build-up in the liver, protecting against or reversing symptoms of non-alcoholic fatty liver disease (NAFLD).
  • In one study, berberine reduced the risk of death and improved symptoms in people with heart failure.

Independently of the above benefits, berberine may help with polycystic ovary syndrome or PCOS symptoms. It might help improve fertility, increase insulin resistance, boost weight loss, and reduce fatty liver, which is common in PCOS.

What Is Metformin?

Metformin is a medicine prescribed for type 2 diabetes and gestational diabetes, and it’s also being increasingly looked at for other benefits, such as its anticancer potential.

Metformin was approved for treating diabetes in the 1950s in Europe, but it wasn’t approved by the FDA to be used in the U.S. until 1995. Since its approval, it’s become the most commonly prescribed medicine for people with diabetes who cannot control their blood sugar levels just by relying on diet and exercise.

The medicine is classified as a biguanide. It works by reducing insulin, allowing the body to absorb sugar more effectively, decreasing glucose absorption in the intestine, and increasing glucose uptake in the adipose tissue and skeletal muscle.

Along with lowering blood sugar in people with diabetes, metformin also has heart health benefits, and it can help people lose excess weight when they do have diabetes.

There are off-label uses of metformin, meaning it’s prescribed for certain conditions that aren’t included in its approved uses. Conditions metformin is used for off-label include:

  • Prediabetes in people with high blood sugar isn’t high enough for a diagnosis of diabetes yet. Evidence shows metformin might delay diabetes onset or prevent it if you have prediabetes.
  • Metformin is used off-label for PCOS to help regulate menstrual cycles, high blood sugar, and fertility.
  • When people take antipsychotic medications for psychiatric disorders, they can cause weight gain. Metformin may reduce weight gain from these medications.

Currently, there is extensive research looking at other potential benefits of metformin, including for conditions such as:

  • Reduced risk of cancer in people with type 2 diabetes.
  • Lowering the risk of cognitive decline, dementia, and stroke.
  • Slowing aging and increasing life expectancy by improving the health of the blood vessels, the antioxidant effects, and improving insulin response.

Berberine vs Metformin

Both berberine and metformin have some similarities to one another. They can both improve insulin sensitivity and they can reduce blood glucose.

In one study of adults with newly diagnosed type 2 diabetes, participants were assigned randomly to receive treatment with berberine vs. metformin given three times daily. Treatment continued for three months. The berberine and the metformin groups had a similar reduction in their blood glucose.

The group taking berberine had a significant decrease in their hemoglobin A1c, averaging a decline from 9.5 to 7.5. The fasting glucose levels of the berberine group, on average, declined from 10.6 to 6.9. Berberine also led to a major decline in triglycerides, considered a “bad” cholesterol type.

Another study included adults with diabetes that weren’t well-controlled. After three months, the berberine-treated group experienced lower fasting and postprandial glucose levels and reduced HbA1c. Fasting insulin levels dropped by around 28% on average.

Based on a study published in the journal Oncotarget in 2018, metformin and berberine have many similar features despite having different chemical structures. According to this research, they both can be used for treating not only diabetes but obesity, inflammation, and cardiac disease.

Overall, the hypoglycemic effects of berberine are comparable to metformin.

Berberine vs Metformin for Weight Loss

Metformin has been found to lead to some modest weight loss, especially in people who have type 2 diabetes and take it. However, for people without type 2 diabetes, metformin doesn’t appear to do much to help with weight loss, at least not substantially.

In some studies, metformin has been found to help reduce appetite, possibly through its effects on the gut-brain axis. Metformin might increase levels of hormones that help with weight loss.

Conversely, Berberine can potentially help with weight loss and treat obesity by downregulating adipogenesis and lipogenesis.

In some studies, berberine has been found to block genes that are involved in the formation of fat, reducing your body’s production of fats. Berberine can also increase the expression of protein mRNA in your skeletal muscles, increasing heat production and oxygen consumption, helping you more effectively metabolize glucose and fat.

When comparing berberine vs metformin for weight loss, berberine may come out on top and have more benefits.

Berberine vs Metformin Dosage

Since berberine is a supplement, it’s not regulated by the FDA, and there’s no standard dosage. In studies, most berberine doses for blood sugar control are around 500 mg a day. Berberine can be taken before bed or with dinner. You can also take a higher dose, with studies looking at up to 1500 mg of berberine daily. Taking milk thistle with your berberine can help improve its absorption.

One of the biggest issues with taking berberine is that it’s not very bioavailable, which means your body can’t absorb and use much of it even when you take a relatively large 1500 mg dose. That can be overcome by choosing a liposomal berberine product, which we will link to.

Liposomal supplements are encapsulated in liposomes that protect them from degrading during first-pass metabolism, making them more bioavailable.

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Metformin is available as a regular-release version and an extended-release tablet, and there are also liquid versions. Different patients will be instructed to take different doses of metformin.

For example, if the medication is used to treat type 2 diabetes, 1000 mg a day might be taken with an evening meal, and the dose can be increased up to 2500 mg per day.

If someone’s taking insulin along with metformin, they might start with 500 mg a day and then move upward by 500 mg each week until their blood sugar is under control.

Berberine vs Metformin Side Effects

Overall, metformin is likely going to have more side effects than berberine. Both metformin and berberine can cause side effects like gas, stomach pain, constipation, and diarrhea. These side effects will usually only occur with berberine if you’re taking very large doses.

Metformin is more likely to cause these side effects than berberine.

One of the more significant risks of metformin is that it can lead to a vitamin B12 deficiency. If you’re prescribed to take the medication, your doctor might advise you to take a B12 supplement with it.

Metformin won’t usually cause low blood sugar on its own, but when it’s taken with other diabetes medications, including insulin, it can. Symptoms of low blood sugar include feeling hungry, shaking or trembling, sweating, confusion, and problems concentrating.

You should avoid a combination of metformin and berberine because that can raise your risk of low blood sugar or hypoglycemia.

Among the most serious side effects of metformin is the potential for liver problems, which is rare.

Berberine again comes out on top in the comparison of side effects, compared to metformin.

Which Is Better—Berberine or Metformin?

If your biggest goal is to lower your blood sugar, berberine has been shown to be as effective as metformin. Berberine may also have more benefits for weight loss and PCOS, with fewer side effects and a reduced risk of toxicity.

That said, metformin is a very safe medication, and research is looking into its other potential benefits, including cancer prevention and anti-aging benefits.

You shouldn’t take or not take metformin without talking to your doctor, but you might discuss berberine as a viable alternative if they’re considering putting you on metformin.

Medically reviewed by — By Ashley Sutphin Watkins — Updated on October 20th, 2023
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