Ep. 18: No, berberine is not "nature’s Ozempic." So let’s talk about what it actually is.

Welcome to Notes from Your Acupuncturist, the podcast for anyone who's interested in acupuncture, complementary medicine, holistic health, and self-care. I'm your host, Alexa Bradley Hulsey. If you enjoy this show, you can help other people discover it by leaving a rating or a review, by following or subscribing on your favorite podcast listening app, or simply by telling someone about it. And if you'd like to support this show financially, you can become a paid subscriber on Substack for just a few dollars a month. Just head over to Substack.com and search Notes from Your Acupuncturist or click the link in the show notes. And one more thing before we get started, just a disclaimer that this podcast is for educational purposes only and is not a replacement for medical care from a qualified healthcare provider. Okay, on with the show. 

Hello, everyone. Welcome to Notes from Your Acupuncturist. I'm your host, Alexa. Thank you for being here. Today is a solo episode, and I'm talking about an herbal supplement that seems to be having a moment, Berberine. So Berberine has become a bit of a TikTok star as of late with lots of people on TikTok and other social media platforms claiming that Berberine has helped them lose weight. Some people are even calling it Nature's Ozempic. And this is how it came to my attention because I saw a New York Times headline asking that question, is Berberine Nature's Ozempic? And spoiler alert, it's not. Ozempic is a prescription drug for diabetes, and Ozempic does cause weight loss in some patients and it's being prescribed more and more as a weight loss drug. Berberine, on the other hand, is a chemical compound found in certain plants. It's not just a natural version of Ozempic, and there's not conclusive evidence of Berberine causing weight loss. But Berberine is very interesting. So I'm going to take advantage of Berberine's 15 minutes of fame to talk about how cool it is. 

So what is Berberine? Like I said, it's a chemical compound found in certain plants belonging to the Berberus genus. These include Goldenseal, tree turmeric, Oregon grape, and Coptis rhizome. And we'll talk more about Coptis rhizome in a minute. Berberine is also found in a fruit called Barberry, which is not a fruit that's consumed in high quantities in the West. But honestly, it's probably just a matter of time before it becomes popular and touted as the next superfood, because it does have high concentration of Berberine. By the way, I've never tried Barberry fruit, and I have no idea what it tastes like. Maybe it's terrible. I don't know. If you've tried it, let me know how it tastes. 

Anyway, Berberine is the major active compound in the Chinese herb, Huang Lian, also known as Coptis rhizome, which I just mentioned. Huang Lian is a super important herb in the Chinese Materia Medica. The name Huang Lian means yellow threads, and that's exactly what the dried herb looks like, like little yellow threads. And side note, many other plants containing Berberine are yellow in color, like Goldenseal. Anyway, I have tasted Huang Lian, and it is terrible. It is arguably the most bitter substance in the Materia Medica, and it has just this all-consuming, overwhelming, pervasive bitterness. You take one sip of it, and you feel like your mouth is just consumed by the flavor. When I was a first-year acupuncture student, my herbs teacher prepared an infusion of Huang Lian and made all of us sample it. And all these years later, ugh, I can still bring up that sense memory of that really strong bitter taste. Now, after I graduated from acupuncture school and became a teacher myself, I subjected my own students to the same rite of passage of sampling Huang Lian. Because here's the thing. That extreme bitterness is actually Huang Lian's superpower. So let me explain. Every Chinese herb has a flavor profile. And maybe it has a single flavor property or maybe a combination of flavors. And there are five flavors, which we call the Wu Wei. Sweet, salty, bitter, sour, and acrid. And the flavor of the herb is a reflection of its therapeutic action. So sweet herbs tonify and harmonize. Salty purges and softens masses and accumulations. Sour, astringes, acrid disperses. And bitter, bitter clears heat and drains dampness. Each herb also has a temperature property. Cold, cool, neutral, warm, or hot. And the temperature also determines its therapeutic action. So herbs that are bitter in flavor are often also cold in temperature. And the combination of bitter plus cold will give an herb an especially strong action to purge excess heat. And like I said, Huang Lian, which contains all that berberine, is one of the most bitter and coldest substances in the Chinese materia medica. So when we say that an herb like Huang Lian clears heat, what we're often talking about in biomedical terms is either reducing inflammation and or clearing out infections. And Huang Lian indeed has well documented antibacterial, antiviral, and antifungal actions. It's really one of the most powerful herbs for treating intestinal infections, gastrointestinal bleeding, gastritis, and peptic ulcers. And when we explore its use for stomach ulcers, this is when things get even more interesting. 

So let's take a little detour and talk about gastritis and peptic ulcers for a minute. Gastritis is an inflammation of the lining of the stomach. And peptic ulcers are open sores that form in this lining, either in the stomach or in the upper part of the small intestine called the duodenum. The most common symptom of a peptic ulcer is burning stomach pain. And in the allopathic medical world, until the 1980s, it was a firmly entrenched belief that stomach ulcers were caused by stress and spicy foods. But in 1981, a pathologist in Australia, Dr. Robin Warren, started biopsying the stomachs of his peptic ulcer patients. And he noticed something interesting. He noticed bacterial colonies in about 50% of cases. And one of his colleagues, Dr. Barry Marshall, became interested in his findings. And together, they started performing more biopsies. And they started biopsying tissue from all of their patients with peptic ulcers. And what they found was a previously unknown bacterial species in nearly all of the tissue samples. And so they named this bacteria Helicobacter pylori or H. pylori. Marshall and Warren published their findings, but they still had a hard time convincing the medical establishment that peptic ulcers were actually caused by an infection and not by lifestyle factors. So in 1984, Marshall decided to experiment on himself to prove his theory. He had a baseline endoscopy, which showed a normal gastric lining. And then he drank a culture of H. pylori bacteria. He quickly developed nausea. And then eight days later, he had an endoscopy and a biopsy which showed marked gastritis and a positive H. pylori culture. After another week, he began treatment with antibiotics and he quickly recovered. And the scientific community took notice this time. It's kind of hard to argue with the research who dedicates his own body to science. And today, it has been clearly established that H. pylori causes more than 80% of peptic ulcers. And it is widely accepted in the medical community. Marshall and Warren were even awarded a Nobel Prize in 2005 for their discovery. It was really one of the major medical breakthroughs of the 20th century. 

But wait, weren't we talking about berberine? Yes, yes we were. And here's the connection. Berberine is the major active compound in the herb Huang Lian, also known as Coptis rhizome. And for centuries, Chinese doctors have used Huang Lian to treat burning stomach pain, heartburn, nausea, and vomiting blood. All symptoms of what in Chinese medicine we call excess stomach fire, but otherwise known as gastritis or peptic ulcer. And that's all because of Huang Lian's bitter and cold properties. Chinese medicine has long understood the connection between pathogenic infection and gastrointestinal disease. It just took allopathic medicine a few centuries to catch up. And we will get back to the subject of berberine and our original question, is berberine nature's ozempic? But first I'm going to take a quick break for a word from this episode's sponsor. 

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Okay, so getting back to our original question, is berberine nature's ozempic? It's not. Like I said, ozempic is a pharmaceutical drug that was developed in a lab, and berberine is a chemical compound that is naturally found in plants. So why is it being touted by some TikTokers as nature's ozempic? Well berberine has been the subject of a number of research studies, some of which have shown that it can help reduce blood pressure, regulate immunity, inhibit inflammation, and improve insulin sensitivity. It's also been shown to improve blood sugar control and fasting blood glucose and reduce triglycerides and bad cholesterol. So it has really great action to affect a lot of change in the body. And yes, some studies have even shown a link to weight loss, although its efficacy for weight loss is not as thoroughly documented as ozempic. Berberine does have some great potential health benefits, and it's being researched as a treatment for diabetes, high cholesterol, and polycystic ovarian syndrome. But before you run out and start taking it, it's important to remember that because it is a powerful chemical compound, it's not appropriate for everyone to take. Berberine has strong antimicrobial properties, which means that long-term use can impact the gut biome and kill off the healthy bacteria that live in your digestive system. Also, when you extract a single chemical compound from a plant, you're stripping away all of the naturally occurring safeguards that Mother Nature infuses into a plant. The therapeutic property of an herb is much more than just the sum of its component parts. Berberine is just one element of an herb like Huang Lian. All of its other molecules and alkaloids are crucial parts of the whole. This is why, even though we have the technology to extract individual compounds, Chinese herbalists will prescribe herbs in their wholly intact form. 

In fact, if you do ingest a single compound extracted from an herb, the results can be disastrous. This happened with the Chinese herb Ma Huang, also known as ephedra. Ephedra has been used in China for thousands of years for the treatment of asthma because it's a powerful bronchodilator due to the presence of the pure alkaloid ephedrine. So ephedrine causes vasoconstriction, which has significant cardiovascular effects, including raising blood pressure. And in the 1990s and early 2000s, products containing ephedrine were marketed as weight loss and energy enhancing supplements. But ephedrine on its own is far too powerful a substance to be sold in an unregulated dietary supplement market. The FDA received over 18,000 adverse event reports regarding ephedra, including several deaths. And in 2004, it banned the sale of Ma Huang, ephedra and products containing ephedrine. I was in acupuncture school when this happened. Ma Huang is the first herb listed in the standard Chinese Materia Medica textbooks. Acupuncturists learn its uses, its actions and indications, and how to safely prescribe it. In the hands of a qualified practitioner, ephedra is a safe herb. But because in the US it was considered a nutritional supplement and not a prescription drug, there was no way to regulate it and therefore no way to ensure its safety on the open market. The FDA did what it needed to do to protect the public, but we lost a potent substance in our Materia Medica. I remember at the time some of my classmates and I asking one of our teachers what we could use as a substitute for ephedra once it became banned. And his response was simply, there is no substitute. 

So single herbs, when taken in their whole form, have these built-in safeguards. And in fact, a Chinese herbalist will never prescribe a single herb. We use herbs in combination. When we give someone herbs, we give them a carefully balanced formulation made up of multiple herbs because we know that one herb can't do everything. And many herbs have side effects that we will temper with other herbs in a formula. Huang Lian, as I mentioned, it's bitter and cold, which means that it can quell the body's natural internal warmth needed for digestion. So when we prescribe Huang Lian, we'll do so in a formula that includes other herbs to protect the stomach and the spleen, which need warmth to function optimally. And for some patients, we wouldn't prescribe it at all if they have a spleen and stomach organ system that is too deficient. Huang Lian just wouldn't be appropriate. A concoction of pure Huang Lian, in addition to tasting awful, it just isn't balanced. Plants in the wild coexist with one another. They support and benefit each other. So the same principles apply when we use Chinese herbs therapeutically. They need each other. 

And one final point that I really want to emphasize. Herbs are powerful. They are strong medicine, and they shouldn't be taken just because they sound interesting or it's the latest fad on TikTok. You should only take herbs under the guidance of a qualified practitioner. This could be an acupuncturist or Chinese medicine doctor, an Ayurvedic doctor, a Western herbalist, a certified homeopath, or someone who studied flower essences. These are not substances to dabble in. They have profound and far-reaching effects. So please only take herbs under the advisement of someone who knows how to use them safely. Don't take an herb just because you saw it on TikTok. Herbs deserve better than that. And so do you. Be well out there, friends. Thanks for listening. 

Thank you for listening to today's episode of Notes From Your Acupuncturist. If you liked what you heard, please follow this show, leave a rating or review, or just tell someone about it. And if you want to join the conversation, you can subscribe to Notes From Your Acupuncturist on Substack where you can comment, ask questions, participate in discussion threads, watch videos, and read more of my reflections on acupuncture and healing. Huge thanks, as always, to our paid subscribers for helping keep this work sustainable. You too can become a paid subscriber for just a few dollars a month. Just head over to Substack.com and search Notes From Your Acupuncturist or click the link in the show notes. Until next time, this is Alexa Bradley Hulsey, your acupuncturist, signing off with love and gratitude.