Berberine Has Been Touted for Weight Loss—But Are There Real Benefits for Cyclists?
Compared to the average Joe or Jane, athletes tend to be a little more discerning when navigating health and wellness trends. We know too much about the way our bodies work—our capabilities and our limitations—to be duped by quick fixes and “miracle” products.
Yet, sometimes a supplement like berberine gains attention and piques our interest. A critical ingredient in Ayurvedic and traditional Chinese medicine, berberine has been used for thousands of years to treat everything from wounds and inflammation to diabetes and gastrointestinal issues.
Today, berberine is touted as “nature’s Ozempic” by TikTok and Instagram influencers who are popping over-the-counter capsules and reporting benefits like weight loss and better blood sugar regulation.
For a cyclist with weight management goals or concerns about diabetes, incorporating berberine into their wellness routine sounds like a relatively low-stakes experiment. The supplement is affordable and widely available, and it’s naturally derived from plant sources. Is there any harm in giving it a shot?
To find out, we looked at the research and spoke with Tamanna Singh, M.D., sports cardiologist and co-director of the Sports Cardiology Center at the Cleveland Clinic in Cleveland, Ohio, and Marie Spano, R.D., C.S.C.S., certified sports dietitian. Here’s what you need to know.
What is berberine?
Berberine is an organic compound found in multiple plant sources, including the bark and roots of tree turmeric, the stem and roots of barberry, and the roots of Oregon grape. Traditionally, practitioners of Ayurvedic, Chinese, and Middle-Eastern medicine used berberine extracts and decoctions (boiled-down concentrations) for their antibacterial, antiviral, antifungal, antispasmodic, and anti-inflammatory properties.
Today, berberine is typically sold in capsule and powder form and marketed to individuals seeking support for weight loss, diabetes/pre-diabetes, cardiovascular health, immunity, polycystic ovary syndrome (PCOS), and other conditions. You can consume berberine through plant sources but they are not common to most diets, so those who want to increase their berberine intake typically do so with supplements.
Berberine isn’t Ozempic, Wagovy, Mounjaro, or any of the much-discussed medications that contain the hormone GLP-1. These drugs, which have been shown to lower blood sugar, slow stomach emptying, and quell appetite, have been approved by the FDA for treating type 2 diabetes (weight loss is often a welcome side effect). “Berberine is a supplement, and supplements are not regulated by the FDA,” Singh says. “Like any supplement, you really have no idea what you’re taking in.”
What are the potential benefits of berberine?
While berberine isn’t a proven treatment for any health conditions, some research suggests that it may be effective in helping the body to lower blood sugar, reduce cholesterol, and lose weight.
“Berberine basically works by impacting how much cholesterol is absorbed,” Singh explains. “It seems to work by upregulating LDL-receptors [low-density lipoprotein cholesterol, a.k.a. “bad” cholesterol, receptors] in your liver. So if you increase the number of those receptors, it helps reduce the amount of cholesterol absorbed.”
Berberine may also downregulate the expression of the protein PCSK9, which destroys receptors in the liver that remove cholesterol. Inhibiting PCSK9 can free up receptors that clear LDL cholesterol, thereby lowering the amount of cholesterol in the bloodstream.
“In the cardiac world, when we think about high cholesterol, PCSK9 inhibitors are an injectable medication that we use in a lot of people who have very difficult-to-control cholesterol or have very high cardiovascular risk and cannot tolerate statin therapy,” Singh explains.
Regarding blood sugar regulation, the exact mechanism for how berberine works is less clear. “Essentially, it improves insulin sensitivity and promotes glucose uptake from the blood,” Singh says. And, yes, it is linked to appetite suppression and weight loss, but the results aren’t comparable to those of prescription medications. “There was a study with 12 randomized control trials, and on average, people lost about 5 pounds. So that’s not even substantial,” Singh says.
Should athletes take berberine?
Neither Singh nor Spano recommends that athletes take berberine, noting the quality of the available research.
“At this time, berberine isn’t a miracle cure for anything,” Spano says. “Although berberine has been used for weight loss, blood sugar regulation, and managing cholesterol, it isn’t proven to help any of these conditions,” she says, citing a variation in formulation and doses, inconsistent outcomes, and a high risk of bias among many studies.
Singh also points out that a significant portion of available research on berberine is based on animal studies. “There’s really limited human data, and I didn’t come across any athlete data. So, in the athlete world, you’re trying to translate minimal human data over to a very different population,” she says.
And athletes do have different needs than the general population. Singh explains how appetite suppression and an increase in glucose uptake—two of berberine’s proposed benefits—may actually be detrimental to active individuals who rely on glucose for fuel. “If it’s suppressing your appetite and promoting hypoglycemia [low blood sugar], that could lead to really dangerous hypoglycemia,” she says. “Profound hypoglycemia can cause seizures, unconsciousness, and rapid heart rates.”
Plus, if cyclists don’t experience any catastrophic events, low blood sugar could lead to extreme fatigue, lightheadedness, irritability, and a host of other unpleasant symptoms that can negatively affect training and performance.
Singh encourages athletes who are curious about berberine to get back to basics and what they know is proven effective in regard to performance, overall health, and weight loss. “Sleep habits and recovery, hydration, fueling, all of that,” she says. “Just understand that that’s going to get you closer to your goals than an unregulated supplement that could cause more harm.”
What are the downsides of berberine?
People who are pregnant or breastfeeding should not take berberine. “It definitely crosses the placenta. It can be found in breast milk. I can cause brain damage in the fetus and worsen jaundice in babies,” Singh says.
Other potential side effects, Spano says, include gastrointestinal symptoms such as nausea, abdominal pain, bloating, constipation, and diarrhea.
Berberine can also interact with certain medications, Singh warns. “It can interact with anticoagulants, it can interact with antibiotics, and blood pressure medications. And who’s to say it can’t interact with a lot of other things that we are just not aware of,” she adds.
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