Traditionally used for gastrointestinal symptoms, berberine has emerged as a potent cardiometabolic aid with diverse benefits and mechanisms of action. It has hypoglycemic effects, via both an inhibition of alpha-glucosidase activity and an upregulation of insulin receptors in peripheral tissues, thereby improving insulin sensitivity.1,2 Furthermore, it activates Nrf2, a key regulator of cellular antioxidant defense, and attenuates glucose induced neurotoxicity, suggesting a therapeutic potential for diabetic neuropathy.3
In controlled trials it reduced HbA1c levels in diabetic participants with comparable efficacy to metformin. Among participants with the metabolic syndrome it has been shown to reduce waist circumference and body weight, blood pressure, triglycerides, and improve insulin resistance compared to placebo, with similar benefits in women with PCOS.4,5 Berberine targets multiple cardiometabolic risk factors, as it has been shown to also lower total and LDL cholesterol among diabetic participants in several controlled trials.6,7 Additionally, a clinical trial comparing standard therapy with or without berberine among patients receiving percutaneous coronary intervention showed improvements in multiple inflammatory markers, including C-reactive protein, IL-6, MMP-9, ICAM-1, and VCAM-1
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