Berberine Is Touted As "Nature's Ozempic"—But Is It Safe?

Berberine is an herb that has been around for centuries. It may help yield modest weight loss, lower blood sugar, cholesterol and blood pressure—but it can't be compared to Ozempic. Here's why.

Reviewed by Dietitian Jessica Ball, M.S., RD

Ozempic (semaglutide), a GLP-1 receptor agonist, is typically prescribed in conjunction with healthy eating and exercise as a method of treatment for type 2 diabetes. Recently, this medication has been all over the news, with celebrities using it off-label for weight loss. Due to its popularity, Ozempic became hard to find and very expensive—perhaps forcing people interested in the drug to search for alternative options.

As a result, berberine is having its moment. Although this plant-based compound has been around for many years, social media enthusiasts are spreading claims that berberine is a 'natural' alternative to Ozempic. This TikTok trend has gone viral, generating tens of millions of views.

But, what does the research say? Is berberine safe and effective, and does it yield weight loss? Learn more about what berberine is, the research around it and how it compares to Ozempic, and whether it's safe.

What is Berberine?

Berberine is a plant-based compound called an alkaloid that is active in a number of plant species including barberry (Berberis vulgaris), Chinese goldthread (Coptis chinensis), goldenseal (Hydrastis canadensis), tree turmeric (Berberis aristata) and Oregon grape (Berberis aquifolium). It has a yellow color and is often used as a dye.

In a 2018 review published in Frontiers in Pharmacology, researchers describe its many ancient uses. For example, in Ayurveda (the study of medicine through mind, body and spirit) Berberis species have been used for treatment of infections of the ear, eye, mouth, healing of wounds, curing hemorrhoids and treatment of uterine and vaginal disorders, likely due to its antimicrobial effects.

Today, consumers can purchase berberine in capsules, tablets, liquid extracts or powders. It is sometimes used in eye drops and gels. Doses range from 500 milligrams to 1,200 milligrams. There is no specific dose for use, but dosages of 500 milligrams two-to-three times per day are commonly used.

Berberine has also been studied for its potential to reduce blood sugar, cholesterol, blood pressure, triglycerides, and weight.

What Does the Research Say?

Compared to Ozempic, berberine has a different mechanism of action. Therefore, it's difficult to make a direct comparison in regard to weight loss. One way Ozempic may yield weight loss is by delaying gastric emptying, which induces feelings of fullness and reduces intake of food.

Berberine, on the other hand, activates an enzyme called AMP-activated protein kinase (AMPK) which helps regulate blood sugar levels by reducing the amount of sugar the liver makes and reducing insulin resistance. Research has shown that it may be beneficial for lowering blood sugar, blood pressure and cholesterol, but its effect on weight isn't as clear.

A 2019 systematic literature review and meta analysis published in the Endocrine Journal notes the effects of berberine at lowering blood sugar (measured by hemoglobin A1C) are greater when it is used in conjunction with lifestyle modifications.

The research on berberine for weight loss is scarce. One 2020 systematic review and meta-analysis of 12 clinical control trials found that berberine supplementation reduced body weight by on average 2.07 kilograms or 4.5 pounds over the duration of the studies. Berberine supplementation also modestly reduced waist circumference and body mass index (BMI).

A randomized, double-blind clinical control trial published in the New England Journal of Medicine, examined a once-weekly dose of Ozempic (semaglutide) versus placebo plus lifestyle intervention of a calorie-controlled diet and exercise. They obsevered 1,961 adults with a BMI of 30 or greater for 68 weeks. Those treated with Ozempic had an average weight loss of 14.9% (roughly 33 pounds) of their body weight compared to placebo at 2.4%.

Based on the literature, Ozempic induces higher levels of weight loss than berberine. However, treatment was still used as an addition to diet and exercise.

What Are the Side Effects?

For most healthy individuals, taking berberine is likely to be safe. That said, it's always good practice to reach out to your medical provider before beginning any sort of supplementation, particularly if you take any prescribed medications. You'll want to make sure there aren't any drug-herb interactions, which your doctor or pharmacist can help clarify.

According to the National Library of Medicine, berberine has been studied up to doses of 1.5 grams per day for six months. Potential side effects include diarrhea, constipation, gas and upset stomach. Long-term studies are needed to determine if there are other side effects associated with long-term use in humans.

Is Berberine for Weight Loss a Fleeting Trend?

Nutrition trends come and go, and this one is likely no exception. While berberine may have beneficial effects for several biomarkers of health like blood pressure and cholesterol, it's effect on weight loss long term is largely unknown. Plus, it's important to understand that even medications approved for weight loss—which go through critical testing and review from the Food and Drug Administration (FDA)—are to be used in conjunction with healthy eating and exercise.

In addition, food supplements like berberine are not regulated by the FDA. If you are going to purchase berberine for use, aim to purchase a supplement that has a third party certification, such as ConsumerLab, NSF or USP. The American Academy of Nutrition and Dietetics states that these certifications verify that what the supplement label says is in it, in fact, is in it. And always talk to your health care team before trying something new.

The Bottom Line

Berberine is not nature's alternative to Ozempic; however, it might assist in lowering blood sugar, cholesterol and weight when used in conjunction with healthy diet and regular exercise. Individual responses will vary and supplementation is not meant to replace lifestyle modifications that lead to sustainable weight loss in the long term. Before you purchase this supplement, make sure to talk with your medical provider to see if it's a safe fit for you. And remember that just because you see it on TikTok doesn't mean there's science to support it.