09/06/2025
Berberine is quite trendy these days due to its well-researched effects on metabolic health and its use as a gut anti-microbial.
In our clinic, though, we rarely use it.
Why, you might ask?
Because over the past 2+ decades of my practice, I've consistently observed negative impacts on microbiome composition with long-term use.
A recent human study had results that mirrored what I see in practice, where taking 600 mg twice daily for 12 weeks resulted in significant reductions in levels of beneficial species (4 species of Bifidobacterium and a wide range of butyrate producing species, like Faecalibacterium, Roseburia, Eubacterium, and more), as well as increased populations of pro-inflammatory species like E. coli, Klebsiella, Citrobacter, Bilophila, and Fusobacterium. These are not positive changes!
Hence, I am cautious about using berberine (and berberine-containing herbal medicines) long-term or at high doses.
Sometimes, we forget that herbal medicines, and their isolated constituents like berberine, can have complex effects and will have more than one effect or target, and perhaps even different outcomes with short-term vs long-term use.
Some herbs are far more selective in their range of anti-microbial activity, or have positive impacts on the microbiome when used.
But others, like the herbal constituent berberine, are best used under the guidance of a healthcare provider well-versed in herbal medicine so they can work out the best dose, duration of use, and whether berberine is right for you at all.
Have you used or recommended berberine?
Share your experience in the comments!
