Hey there. Alright, I'm going to start by saying something in life, right? I like to have a multi-tool with me. You can get a leatherman, Gerber, whatever. It's like a pair of pliers. It's got three or four knife blades, a file wire cutter, bottle opener. It's got things like that on it, like a modern version of a Swiss Army knife. So I keep one in the truck, I keep one in my backpack. If I go hunting, I have one with me. It's just a really compact way or efficient way to get a lot of different things done if you need to. Well, we also have those in functional medicine, a multi-tool of sorts. We have several of them, but absolutely without a doubt one of them, one of the best and probably one of the better well-known ones, at least as far as functional medicine practitioners go, is berberine.
(00:55)
So berberine isn't extract of certain plants. You can get it from several different species, but it's an extract of those plants. I would consider it a very effective multi-tool when it comes to practicing functional medicine and dealing with some of the main problems that we deal with in our patients today. So as I go through the list of the three or four things, berberine is probably most well known for and what I tend to use it for most, you'll see that those are some pretty heavy hitting things in today's world. So it's an alkaloid from plants. You can get it from, there's a couple different species that sound like berberine. There's ber berberis, Arista, and then believe it or not, you can get berberine from Philodendron. Who knew, right? Anyway. So historically, I mean it's been used forever. Like Ayurvedic medicine, which is more Indian related than Chinese medicine.
(02:03)
They all use berberine in various forms for different issues. But it's been around forever. It's been used medicinally for a long period of time. So one of the first things I want to talk about as far as activity of berberine is going to be what it does for blood sugar. I don't know that there are many patients, well, I have some patients that come in that have no sign of blood sugar issues at all. Well, I look for blood sugar five different ways, blood sugar issues. When we do labs, we look at a fasting blood sugar, we look at a hemoglobin A1C, we look at their triglycerides, we look at uric acid, and then we look at their fasting insulin level. So we get a very broad look of either developing or well entrenched blood sugar management issues or dysregulation if it's there. So to me, there we go.
(03:00)
To me, blood sugar is a very common problem and it leads to multiple other downstream issues. So getting blood sugar under control is a huge, huge component of doing functional medicine. So berberine activates, there are a couple things I want to say on blood sugar, it activates something called a MP or cyclic A MP. So a MP kinase, A MPK, that is an activated protein kinase. It's almost like a little switch that turns your metabolism on and off. As we age, we see a decrease in A MPK and when we have a decrease in A MPK, you start to see your metabolism slow, start to see some weight gain. You lose a little muscle mass each year. Hormones tend to calm down. So losing A MPK is kind of seen like a significant part of the aging process. So if you have a supplement that can ramp up A MPK, then it's anti-aging, right?
(04:01)
It fights that decline and part of that decline is losing your sensitivity to insulin, losing that reactivity to insulin. And so A MPK when it gets activated helps you respond better to insulin and it helps lots of other stuff as well. So berberine can help improve insulin sensitivity. It helps improve something called gluconeogenesis, which is taking fat, turning it back into glucose in the liver, and it helps glucose uptake into the cells. So it can help control blood sugar and control the amount of insulin you have. Because remember, if you've seen some of my other videos, high blood sugar can cause trouble in your body. It can do damage over time, but high insulin can also do damage. So while we want the blood sugar well controlled, we don't want it to take large amounts of insulin to do that. If you get an insulin test, like a blood test for insulin while you're fasting eight to 10 hours without food, you should have a fasting insulin level below 10.
(05:05)
If it's really dialed in, well, it'll be around six or maybe a little bit below that that says that you're very insulin sensitive. It takes very little insulin to get the job done. So you want blood sugar and insulin both relatively low, well managed and under control. You can compare berberine's effectiveness in insulin sensitivity and blood sugar management to metformin for type two diabetics. They've done research that shows that berberine given in the right dosage is pretty much every bit as effective. Some studies even say more effective than taking something like metformin. So very important herb as far as blood sugar control goes. Now what else does it do? Because remember I said it was a multi-tool, right? So we talked about a knife blade. Now we got to talk about the pliers. So for blood cholesterol levels and some cardiovascular benefits, it's also very powerful for that.
(06:02)
I'm not going to get into a big discussion of how big of a role cholesterol levels play in the development of heart disease. It's not irrelevant, but it's not the whole deal. A lot of people say it's, but I'm not going to go any deeper than that today. It's a whole different discussion. But what they found with berberine is it tends to reduce LDL, it tends to reduce triglycerides, and you get a modest bump in HDL. Now remember, we want a one to one triglyceride to HDL ratio, maybe a one and a half to one triglyceride to HDL ratio. So if you've got a supplement that can kind of drop the triglycerides a little bit and raise the HDL, you've just gone quite a ways toward controlling some risk toward cardiovascular disease. The fact that it lowers total cholesterol, I think it's kind of irrelevant. I don't know that lowering LDL generally makes that big of a difference in heart disease, but berberine does that as well. What I haven't seen is good research into doing the cholesterol breakdown, like when you actually look at particle sizes and particle types and seeing what berberine does for that, I haven't seen that research yet, but I'm sure somebody's working on it.
(07:17)
It works partly by upregulating the LDL receptors in the liver so that liver can deal with LDL better and it modulates something called A-P-C-S-K nine receptor. Now there are also statin like or cholesterol medications. I think it's an injection that works on that PCSK nine expression. So berberine does some of this very same stuff and then it improves the function of the lining of the arteries and it can reduce your tendency to develop arterial plaques. So all of that's fantastic stuff. So that's what it does, and by doing a lot of that, when you talk about endothelial function, reducing plaque formation, that can have an effect on blood pressure as well. It can help normalize blood pressure that was getting up because the arteries were getting too stiff over time where that top number on your blood pressure spikes, but the bottom number looks pretty good.
(08:20)
Berberine over time can help with that according to the research into what it does cardiovascularly. Now, next tool in the multi-tool that we're going to talk about is what it does for gut health, right? So we've got blood sugar, we've got cardiovascular, including cholesterol numbers and some endothelial lining of the blood vessel help. Now we've got gut and microbiome help, so it reduces gut dysbiosis. Now, dysbiosis is having the wrong stuff living in the gut. I mean, I suppose it could be anywhere, but we're talking about the gut. So it's a general term. It can mean anything from not having good normal flora like you're supposed to all the way to having infections. Those would both fall under the heading of dysbiosis when you're talking about the microbiome. So it has some antimicrobial properties that help kill off some of the bad stuff. It selectively inhibits pathogens like e coli and Clostridium and candida, and it also spares the good bacteria, the normal flora in that process.
(09:25)
So it's very rare in the fact that it is selective, like it can inhibit the bad stuff and support the good stuff that's supposed to be in there. You don't see that very often. It's like throwing a hand grenade in a room and you only kill the bad guys and you give the good guys some lunch. That's not a bad deal. It also promotes the production of something called short chain fatty acids. So when the bacteria in your gut are finishing the digestive process of your food, they break down or ferment your food into byproducts. One of those byproducts can be long-term and short-term fatty or long chain, excuse me, and short chain fatty acids. So the bacteria and the lining of our intestines tend to feed on the short chain fatty acids. So fermenting your food into more of the short chain fatty acids, really good for gut health, good for the lining of the intestines, just like it was good for the lining of the blood vessels by making short chain fatty acids.
(10:27)
It's very good for the lining of the intestinal tract and then something called tight junction integrity. So if these are cells in your intestines, they have the little VII that help you absorb nutrients. They're glued together or welded together at little spots. Think of it almost like being buttoned together, right? It's button down there. Those are tight junctions, and when the intestines get inflamed, those tight junctions tend to fail, and now you've got a gap between the cells. Even if this stuff is healthy, you now have kind of a pathway where undigested or not fully processed food can slip between the cells and get into your bloodstream. That's called leaky gut, right? Because you've destroyed those tight junctions. So berberine helps repair those tight junctions and weld those cells together again. So food particles, undigested, unprocessed food can't get between those cells. Everything has to be processed through the receptor sites on these VII like it's supposed to be.
(11:32)
That way you do a better job of keeping the bad stuff out, but allowing the nutritional stuff into your bloodstream, because remember, 70% of your immune system surrounds the gut because if you get leaky gut, you're basically getting your own poop into your bloodstream, and so your immune system really has to guard against that. If you're doing that, you are activating probably 70% of your immune system at any given time, and that can lead to a lot of mistakes. Autoimmune problems, lots of inflammation. You don't want leaky gut if you can avoid it, but it happens all the time. So anyway, berberine is helpful for that as well. It also has anti-inflammatory effects. We've talked about things like if your blood sugar is better controlled, if your blood vessels have healthier linings, if you don't have leaky gut, all of those things can decrease inflammation because it decreases the cause of inflammation, but it also has a direct effect on some of the inflammatory messengers.
(12:31)
If my body wants to make inflammation somewhere, it sends out a messenger that calls in all the inflammatory products so that I end up having inflammation there presumably to heal. But if it happens without a good purpose, then it's problematic. So berberine suppresses something called cytokines, which are those messengers. It suppresses the pro-inflammatory cytokines, TNF alpha, it suppresses interleukin six, and it suppresses NF kappa B. So those are ones that normally call in all those inflammatory cells, and berberine works to suppress those and calm them down, and they stop calling for help. It modulates something called the NLRP three inflammasome, which is another one that can set off a lot of inflammation and actually kind of develop autoimmune reactions. So it's good that it suppresses that as well. It can also increase the expression of interleukin 10 in some cases, which is an anti-inflammatory cytokine, and it's useful in inflammatory conditions.
(13:49)
I mean, that could be inflammatory bowel disease, it could be PCOS, metabolic syndrome syndrome, certain arthritises. It is helpful in those because of what it does with inflammation. Common dosages, a lot of that depends on the preparation. You can get preparations that are really strong. You can get preparations that are more mild. So the dosage is going to vary a little bit, but usually somewhere between four and 500 milligrams once or twice a day, it doesn't stay active in you for very long. When you take it, it's kind of half-life that's relatively short, less than eight hours and half of it's out of your system. If you take a big dose and you're not used to it, you can get a little bit of GI upset, but we don't see it very often. And suppose, I mean, I shouldn't say supposedly, the terminology they use here I disagree with when they talk about drug interactions and they say, be careful about taking it with metformin or with statin drugs, it's not that it's going to interact with them.
(14:49)
It's not going to get in a fight with 'em. What they're trying to say is, if you're taking metformin to lower your blood sugar and you add in burberine, that can also lower your blood sugar. You can have an additive or a cumulative effect that lowers your blood sugar more than you would expect. Statin drugs. It could. If you have a statin drug that's lowering your cholesterol and you take berberine on top of it, it could have an extra lowering effect and you would have a lower cholesterol than you would expect to have. So I would say maybe conditionally, be careful. Just be aware. If you know how to take your blood sugar and you're already on metformin, you start taking berberine, keep checking your blood sugar. If it starts to get too low, you have a choice. You can talk to your prescribing doctor about maybe backing off the metformin and staying on the berberine and seeing how that does.
(15:39)
Or you can back off the berberine and stay on the metformin, but the blood sugar gets too low, you're going to have to do something. Or if it keeps getting too low. So anyway, I think it's more just be aware. I wouldn't say that it's an actual interaction, it's just that it would have a cumulative or additive effect to that. So helps with blood sugar, helps with blood sugar regulation, helps with cholesterol levels and the lining of the blood vessels for better cardiovascular health. We already said that it supports the gut microbiome. It's suppressive to some of the bad actors in there. It's supportive to the good ones, and it has very specific anti-inflammatory effects to calm down inflammation. So I think it's absolutely a multi-tool. You can see why that would be a home run to give a patient and with one supplement or one preparation, you're able to help four very important distinctive processes that easily lead to long-term chronic inflammatory and even autoimmune conditions.
(16:50)
Now, if you have significant autoimmune conditions, is taking berberine going to be the long-term answer? It's going to be helpful, but I got to be honest, if I'm just giving people berberine to try to calm down inflammation so their autoimmune stuff calms down, I'm kind of taking a very pharmaceutical approach to that. I'm giving a pill for a symptom, but if I do that to calm things down and gain control while I figure out what root causes led to that autoimmune problem, infections, hormone imbalances, food reactions, leaky gut problems, toxins, whatever, if I deal with those issues while they're on the berberine to stay comfortable and workable and livable and all of that, I'm getting a great result. If I just keep giving them berberine and saying, wow, they feel better, let's just keep going. I'm probably missing the mark, right? It's nice to have that tool.
(17:47)
If nothing else works, at least you've got it. But the real answer would be find the root cause, mitigate that root cause, and then their body doesn't have a reason to have that autoimmune reaction anymore. Okay, so that's our discussion of berberine. I thought I'd share that with you today. We have berberine in a couple of different forms from different companies here at the office. Lots of berberine available out there in the market. Just make sure that you talk to your functional medicine doctor, get a reputable brand, and I guess most importantly, if you take it and it's working for you, then that's a win. If you take it and it doesn't work, make sure you try at least a good quality physician regulated brand to see what effect you get when you take one that has kind of a known strength and a known purity. Okay, so that's it now. Hope that served you well, and I'll see you on the next one.
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