Is Berberine Really ‘Nature’s Ozempic’ or Just Hype?

The list of chronic ailments and illnesses that the drug Ozempic promises to mitigate seems to lengthen daily. Sure, there’s diabetes regulation, the principal reason for taking semaglutide, the active ingredient in Ozempic. But myriad off-label uses are what catapulted the drug into the spotlight.

It started with weight loss. Elon Musk tweeted that he used a semaglutide variant called Wegovy to help shed pounds. Andy Cohen shaded the spate of Real Housewives for using Ozempic for the same reason, a nod to how pervasive the drug has become among the Hollywood glitterati.

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Next came claims that Ozempic curbs addictive behavior, like smoking, drug, and alcohol abuse and other compulsive vices. Now, reports suggest that semaglutide may be helpful in combating polycystic ovary syndrome, Alzheimer’s and Parkinson’s disease, and even cancer.

But is Ozempic truly a miracle drug that cures all that ails you? That’s unclear; the science has yet to catch up to the claims, though research is underway. And a host of negative side effects from semaglutide are giving potential patients reason for pause—more on that in a second—and leaving them searching for a more holistic and natural alternative.

Enter berberine. A compound found naturally in many plants, the chemical has been around for ages, a mainstay in Chinese medicine. And it’s now being touted as “Nature’s Ozempic.”

To find out whether that moniker is scientifically apt, we asked two leading longevity doctors to share their thoughts on berberine—how it works within your body, whether it’s good for weight loss, safe for long term use, and if it’s truly a natural alternative that works like Ozempic. Oh, and how much berberine to take, should you decide to start the supplement.

First, Is Ozempic Really a Miracle Drug?

“Yes and no, though mostly yes,” says Dr. Neil Paulvin, a New York–based board-certified longevity and regenerative medicine doctor. “It works really well for weight loss. And studies show it helps with food cravings. Now, studies are showing it boosts natural ‘killer cells,’ which help fight off viruses and bacteria, decrease inflammation, and lower blood sugar. Initial studies around semaglutide and dementia are promising; the thought is it can decrease brain inflammation and brain tangles that can lead to Alzheimer’s and Parkinson’s. But it’s very early research now.”

“I use Ozempic a lot in my clinic,” echoes Dr. Rahi Sarbaziha, a Los Angeles–based double board-certified anti-aging and integrative aesthetics doctor. “It can protect your liver and heart, while helping you lose weight. And it can prevent pre-diabetes, and complications associated with weight loss.”

Anecdotally, Sarbaziha notes many of her patients do notice addictions lessening while taking the drug, including drinking compulsions, though “if people on Ozempic drink, they often feel ill, and their hangovers are worse. The reason for this is alcohol aggravates the gut, and Ozempic slows down intestinal movements, so the alcohol will remain in your system for much longer, leading you to feel much worse. I tell all patients not to drink, but some still do.”

As to the “no” portion of Paulvin’s response: Assuming that one pill can change your life without you doing anything else is never the case.

Ozempic
Ozempic

What Are the Downsides and Negative Side Effects From Ozempic?

In short, there are a bunch. “The main side effects are nausea, vomiting, diarrhea, and headaches,” Paulvin says. “Then there’s sagging skin that comes as a result of rapid weight loss, which is being shared under all these buzzy names like Ozempic Face, Ozempic Butt, Ozempic Fingers.” And lastly there’s muscle loss, another downside of rapid weight loss, though if you lose weight naturally through diet and exercise, you will also lose a little muscle mass, Paulvin points out.

What Is Berberine and How Can It Benefit Your Body?

Berberine is a chemical that’s found in plants and fruit, like barberries. “That compound does a lot for the body,” says Paulvin, “and it affects the body in similar ways to Ozempic, though not as strongly.” It can help reduce insulin resistance by reducing overwhelming sugars, and it decreases inflammation and increases the microbiome in the gut, Paulvin explains. The sum of those benefits is what can lead to weight loss for some people. “I suggest berberine to patients with high cholesterol,” adds Sarbaziha, noting that it’s effective for reduction.

How Are Berberine and Ozempic Different?

Ozempic works within your brain to make you feel full, whereas berberine doesn’t, Paulvin says. Berberine slows the gastric emptying process down, though Ozempic also does this, and on a much greater scale. Still, berberine is effective because it takes longer for food to leave your gut, “you get bloated, feel fuller, and have to eat smaller meals,” Paulvin says.

Is Berberine a Replacement for Ozempic?

“If you’re treating poorly controlled diabetes, then no,” says Sarbaziha. “You need to work with a physician to make sure you’re on the right medications to get your blood sugar under control. But if you’re someone who wants to lose weight, you’re committed to lifestyle and diet changes, and you’re working with a doctor, then yes, berberine is a great option.”

What Are the Advantages of Berberine Over Ozempic?

Cost and availability. “You can get berberine for around $50 a bottle,” explains Paulvin. “Ozempic will run you between $900 and $1,200 per month, and 95 percent of Ozempic is not covered by insurance—unless you have diabetes. There’s also a shortage of Ozempic and other semaglutide drugs because of the high demand, so it can take longer to find a pharmacy that’s able to fill your prescription, whereas you can get berberine quite readily.”

How Much Weight Can You Lose With Berberine?

“Weight loss with berberine differs by individual,” Paulvin says, citing factors such as metabolism, hormone levels, and lifestyle and diet choices. Both doctors emphatically note that without changing your diet and lifestyle, shedding weight—and keeping those pounds off—is nearly impossible. Both also agree that people could expect to lose about 10 pounds. “If you haven’t tried any other medications, then yes, you’ll lose weight,” Paulvin says, adding, “If you’ve tried other weight loss meds before and they’ve not worked, then you may not lose much of anything.”  It won’t help you shed pounds if you’re morbidly obese, Sarbaziha notes. “It’s not a magic pill.”

One older study, from 2012, noted that participants who took 500 milligrams of berberine three times per day lost, on average, about five pounds. A 2020 review of 12 studies indicated that berberine led to a “significant reduction of body weight, BMI” and other markers. Those numbers pale when compared to Ozempic. During clinical trials, those on semaglutide lost an average of 6 percent of their weight after 12 weeks, and 12 percent of their weight after 28 weeks.

Is Berberine Safe to Take Daily? Are There Negative Side Effects?

Yes, it’s safe. And except for bloating and perhaps nausea, berberine has limited side effects, Paulvin says. There aren’t many studies done on supplements like berberine because they’re not controlled by the FDA in the same way prescription drugs are, but a short six-month human study did note a reduction in sugar trends, per Paulvin, and few problems.

“With any supplement, you should cycle on and off,” Sarbaziha says. “You should be following up with a doctor regularly every three to six months to have labs checked to see how your body is reacting.” Sarbaziha runs basic metabolic panels when testing her patients, and recommends scrutinizing things like free and total testosterone, thyroid levels, and vitamin D or B12 levels for deficiencies.

Pay attention to what else is mixed in with your berberine, Paulvin says. “The supplements aren’t always just the pure berberine compound; there are other ingredients added to amplify the effects, so you want to be aware of what else is in there.”

Who Is Berberine Right For? And who Should Avoid Berberine?

“Berberine is right for people who like daily oral supplements,” says Sarbaziha, given that semaglutide is only available via injectable form. “If you’re someone who wants to regulate blood sugar, help with weight management, lower your cholesterol, increase your antioxidants, then it’s right for you. You need to commit to taking berberine daily, and follow up with lab work regularly to ensure you’re on the right track. I can’t stress this enough: You have to commit to a lifestyle change, too. Berberine doesn’t work if you eat McDonalds every day.”

As for who should skip the supplement, that group includes pregnant women or women who are breastfeeding (berberine can be transmitted through the placenta and may harm a fetus). Children and newborns should also not take it, and people on any prescription medications—particularly those on beta-blockers, antidepressants, and immunosuppressants—should consult with a doctor before adding berberine into their system.

Can You Take Berberine and Ozempic Together?

Maybe, but only under strict medical supervision. “I wouldn’t let a patient combine the two unless they were 100 percent stable on one medication first and had no extreme side effects,” says Sarbaziha. “I’d hesitate to allow this unless I was closely monitoring the patient.”

What’s the Ideal Way to Take Berberine?

Sarbaziha personally has been eating barberries for a long time, noting they taste sour and tangy. “When you consume things for nutritional benefit, it’s always better in whole form; if you eat the berry fruit, your body will absorb it better,” she says. The problem is that you’re not getting a terribly high dosage, in milligrams, so most forms of berberine are pills. “Even then, a very small percentage of berberine is absorbed into your system after it goes through the digestion process,” she adds.

Paulvin suggests looking for dihydroberberine (DHB) as opposed to regular berberine. “DHB is much more bioavailable, so your body will absorb more, and, anecdotally, there are reports of less bloating and fewer side effects,” he says, sharing that many people have made the jump to DHB after trying berberine.

What’s the Best Berberine Supplement?

“My clinic uses Thorne,” Sarbaziha shares. Paulvin suggests Ignite+, a bundle of supplements from Healthgevity. “It has DHB, but also other things like bitter melon and l-baiba, which combine to help with weight loss and building muscle mass,” he says. (A study into the effects of l-baiba on weight loss is currently underway.)

What’s the Ideal Berberine Dosage?

To start, keep it small, between 250 and 500 milligrams per day, Sarbaziha suggests. “Anything that aggravates your gut, as berberine does—semaglutide, too—can cause nausea and vomiting, so you want to increase it incrementally to mitigate side effects.”

What Are Other Good Supplements to Put in a Stack With Berberine?

Stay away from things like metformin or anything that affects insulin levels, advises Paulvin, because you’ll get fatigued faster and run into other problems. Sarbaziha recommends magnesium, “because it helps the body regulate every process better. You want something that has a good level of absorbable magnesium, so avoid magnesium oxide, which has low bioavailability. Instead, go for magnesium glycinate, magnesium citrate, or magnesium threonate.” She also pushes for vitamin D.

Beyond that, if you’re hoping to lose weight, you’ll probably be eating less, which means you’ll want a better balance of electrolytes to keep your body running smoothly, says Sarbaziha. “Drinking Liquid I.V. or coconut water is best because they have all of the electrolytes; they’re much better than Gatorade, which has too much sugar.”

The Bottom Line

Berberine isn’t a weight loss miracle, but it’s a good supplement for longevity. When thinking about increasing your healthspan to, in turn, increase your lifespan, everything needs to be viewed holistically. Ozempic may give a quick fix to sloughing off excess weight, and, yes, you’ll look good immediately. “But that’s not thinking about longevity,” Sarbaziha posits. “A lot of people hear that if you’re off Ozempic, then you’ll regain the weight you lost. That’s only true if you haven’t changed your diet, cut out the booze, and incorporated more exercise. Maintaining a good, healthy weight is 70 percent diet.”

Berberine may lead to a little weight drop, though nothing drastic. Still, the overall benefits of lowering inflammation in the gut, increasing insulin resistance, lowering cholesterol and other lipids in the blood, and reducing high blood pressure make it a solid longevity supplement.


Dr. Neil Paulvin has certifications in Family Medicine, Osteopathic Manipulation, and Anti-Aging and Regenerative Medicine. His practice in Manhattan combines traditional and alternative medicine to help patients live a healthy lifestyle and perform at their best. He specializes in Peptide Therapy, Sports Medicine, Mitochondrial Health, Bioidentical Hormone therapy, Longevity Medicine, and the brain-gut connection. As a leading expert in biohacking and human optimization, Dr. Paulvin is recognized for his exceptional work applying a hyper-personal approach to help his patients, including Fortune 500 executives, Olympic athletes, and A-list celebrities, optimize their health, perform better under pressure, recover faster, and move beyond the baseline.


Dr. Rahi Sarbaziha is a Persian American double board-certified Integrative Medicine Doctor and Aesthetics Specialist based in Beverly Hills, Calif. Internationally recognized for her unique holistic and integrative approach to Cosmetic Rejuvenation and Inner Health, Dr. Rahi caters to her patients’ specific needs to help them achieve long-lasting results. With the combination of functional medicine and aesthetics, Dr. Rahi helps patients reach optimal physical beauty and health from the inside out. With A-list celebrity clientele and a waitlist for new patients, Dr. Rahi is carving out a new lane for wellness by taking a 360-degree approach that goes beyond medicine and cosmetic treatments.

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