Berberine is touted as "nature's Ozempic" -- but is it safe?

A TikTok trend in mid-2023 promoted the supplement berberine as "nature's Ozempic," an affordable alternative to the prescription weight-loss drug that can cost more than $900 a month without insurance. Berberine, a compound derived from plants such as Coptis chinensis and long used in traditional Chinese medicine, is available over the counter for as little as $10, and posts using the comparison drew millions of views.

Berberine has traditionally been used to help lower blood glucose in type 2 diabetes and has been studied for metabolic, cardiovascular and neurological effects. Its rise as a TikTok talking point coincided with soaring interest in GLP-1 drugs like Ozempic, and Google search interest in berberine reached an all-time high in June 2023 as the comparison spread.

What the evidence actually shows

Experts cited in coverage of the trend said the weight-loss evidence for berberine is limited and does not support the Ozempic comparison. One expert noted that metformin -- a diabetes drug with a mechanism often compared to berberine's -- "has been shown only to produce about a 3 to 5% weight loss at best," far below what GLP-1 drugs like Ozempic typically produce.

The safety concerns doctors raised

Beyond effectiveness, experts flagged specific safety risks. A functional nutritional therapist warned that long-term use "kills your probiotics and allows pathogenic bacteria to thrive," which can undercut the very weight-loss and metabolic goals users are chasing. Coverage also noted the supplement is not FDA-approved, and that pregnant or breastfeeding people should avoid it due to risks including jaundice, while anyone on blood pressure medication, antidepressants or anticoagulants was warned about potential dangerous interactions. The consistent message across experts was that a supplement being "natural" does not mean it is automatically safe, and that people should consult a doctor before taking it.

The numbers behind the comparison

Later 2023 coverage put the efficacy gap in concrete terms. Dr. Caroline Apovian, co-director of Harvard Medical School's Center for Weight Management and Wellness, said flatly, according to CBS Sacramento's report on the trend, "As for it being nature's Ozempic, there's no evidence to suggest that is true," pointing to the absence of the large-scale clinical trials that back the prescription drug. Dr. Justin Ryder of Northwestern University, discussing a meta-analysis of berberine studies in the same coverage, said the supplement produced "about a 0.25 reduction in body mass index" compared with placebo, versus roughly "4.61 BMI units" for Ozempic and Wegovy -- a gap the coverage characterized as making the prescription drugs about 18 times more effective. Naturopathic doctor Joshua Levitt, also quoted in that coverage, called berberine's weight-loss benefit "modest at best."

Fox Business coverage of the trend quoted Christopher McGowan, a North Carolina gastroenterologist and obesity medicine specialist, describing the Ozempic comparison as "mainly unfounded hype, marketing, and inaccurate publicity" and saying "there is zero similarity between berberine and Ozempic." McGowan said berberine "will never rival the GLP-1 medications in terms of efficacy," while allowing it could still have a "legitimate impact on health if studied on a larger scale." He also cautioned that the existing research base is "low-quality, small in scale, short in duration, and subject to bias," and that the FDA does not regulate herbal supplements the way it does drugs, leaving open questions about the "potency, purity, and safety" of berberine products sold over the counter.

US In News compiled this archived account from contemporaneous coverage by HuffPost, CBS Sacramento and Fox Business. It restores a story originally published on this site in June 2023; figures are as reported at the time.