Dr. Jonathan Wright On Berberine vs. Metformin

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I don't have it in for all MDs, and in fact it's not really their fault that they take such a dim and narrow view of the practice of medicine, because that's what they are taught.  A few though have been able to break free of their indoctrination and open their minds to a wider perspective on health, one focused on achieving health and overcoming diseases rather than just treating symptoms with a repertoire that is limited to toxic agents.

One of these pioneers is Dr. Jonathan Wright, an American MD who takes a much more functional approach to the practice of medicine than his colleagues in his profession dare to.  I want to talk about an article of his on using berberine versus metformin to treat diabetes.

There is a huge amount of bias towards Metformin among MDs, it's actually pretty rare to see an MD recommend berberine instead of Metformin, because they are trained to prescribe pharmaceuticals, they are not trained at all in the use of natural medicines, and generally are ignorant about something like berberine.

If it turns out that berberine is superior to Metformin overall though, then it would be stupid to tell people to take Metformin instead, but it's even worse not to even look at berberine and familiarize yourself with it enough to even be able to make such a decision.  This is left to naturopaths and alternative practitioners, or practitioners of so called functional medicine, conventional medical practice does not wish to consider alternatives, even if they are clearly better.

Such is the case with Metformin, which by the way is the least vile of prescription anti-diabetics, and if it came down to having to choose between Metformin and any other anti diabetic, Metformin should be preferred hands down.

However, Metformin isn't without its issues, and there are a number of them.  First off, it raises lactic acid levels, and while it's fairly rare to get lactic acidosis, which is often fatal by the way, where the kidneys can no longer clear the toxic amounts of lactic acid that Metformin causes, it's just not a great idea to have your lactic acid levels raised this high.

The body fights hard and uses up precious resources to maintain the proper acid alkaline balance, and as it is we tend to eat an acid forming diet, and the last thing we should want to do is to significantly tax this homeostasis in the way that Metformin clearly does.  This in itself likely contributes to a lot of the adverse reactions we see with this drug.

We're not even sure what the actual causes are behind the long list of side effects that Metformin causes, but it's quite clear that the body does not want this drug, and it very often makes people sick and gives them diarrhea as the body fights hard to expel the drug.

Metformin does a number of other things, and we can only talk about the ones we know about by the way, and there may be more, including interfering with thyroid function, reducing testosterone, reducing energy levels, depleting vital nutrients such as B12 and folate, elevating homocysteine, which is something we definitely don't want, and more.

On the other hand, berberine has been used safely for thousands of years, it has been shown to reduce blood sugar as well as Metformin, and even does so through similar pathways, most notably in improving AMPK signaling.  This plays a huge role in controlling liver dumping by the way, and is why both medications improve this and lower blood sugar that way primarily.

Berberine doesn't come with the litany of ill effects that Metformin does though, and actually has several benefits that Metformin doesn't.  It doesn't deplete essential nutrients.  It doesn't cause massive lactic acid production.  It doesn't lower TSH or interfere with conversion of T4 to T3, so your thyroid metabolism is left unharmed.

It doesn't raise homocysteine, it lowers it, and this is the main reason why we are finding that Metformin increases the risk of heart attack in men.  It also doesn't lower testosterone, it increases it, something that men will also really appreciate.

Berberine is also a potent antimicrobial and antifungal and in fact it's main purpose historically has been to treat infections.  It does so in a friendly way as well, unlike antibiotics, which leave you worse off.  Berberine instead maintains natural gut health by controlling what we want to control and this permits the friendly organisms to thrive as they are supposed to.

Berberine also has a beneficial effect on blood lipids, something Metformin really lacks.  In fact berberine is a pretty powerful agent in maintaining healthy lipid levels and treats all of the markers, lowers LDL and triglycerides to healthy levels and increase HDL as well.

Berberine has other benefits in addition to these, it has anti cancer properties, which Metformin has as well, and it's also neuro protective and can prevent neurogenerative disease like Alzheimer's and dementia.  Berberine can even help prevent against osteoporosis, another condition that affects the elderly a lot.

Berberine is also a natural antidepressant, and many diabetics suffer from depression to some degree, and pretty much all of us could stand to have our mood elevated a bit.  This works gently and naturally though, unlike anti depressant drugs which tend to disturb our delicate brain chemistry and can produce some real side effects.

Berberine's blood sugar lowering effects aren't just limited to AMPK signaling though.  It positively affects many mechanisms, correcting various other imbalances in signaling, and it lowers both insulin levels and insulin resistance, as well as increasing glucose uptake, some things very desirable to diabetics.  It even raises GLP-1 levels, which tend to be low in type 2 diabetics, but it does so very modestly and not in the dangerous fashion that drugs to, by elevating these levels well beyond healthy ones.

Diabetics also tend to suffer from too much fat in their liver, and berberine is a great treatment against that, and even if you don't have fatty liver, we are at risk for this from our higher insulin levels and we want to look to prevent this, and once again, berberine helps us. It also helps against fatty pancreas, which isn't talked about much but is a big problem with blood sugar regulation, as you might imagine, and affects both beta and alpha cells negatively.

Berberine also is helpful in treating leaky gut syndrome, which is a huge problem with a lot of people these days, and this is one of the big problems that arises when you up the grains in your diet, especially whole grains.  Berberine helps heal the junctions in the intestinal wall that become too large with leaky gut and permit all sorts of things to enter the bloodstream that aren't supposed to be there.

So this is an amazing medicine, and the only contradictions you will see with this are with using it in newborns, and it's also suggested that pregnant women not take it, although the evidence here isn't very strong at all and it comes from using dosages in rats that are 50-60 times higher than comparable human doses, dosages no one should be taking whether pregnant or not.

Those with gut dysbiosis who start taking it can encounter some gastrointestinal side effects if they start at too high of a dosage, if you have too much bad bacteria or fungus for instance, as berberine is very effective at killing these harmful organisms and as they die off they can produce more toxins in the short term, and in this case one should titrate the dosage, but most people have no side effects at all starting at the therapeutic doses of 1000-2000 mg a day.

Berberine isn't just the most phenomenal anti diabetic medicine out there, it might be the most phenomenal medicine known to man period, and there are a lot of reasons to think so.  When it comes down to deciding between berberine and Metformin though, it is truly a no brainer.

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26 Comments on “Dr. Jonathan Wright On Berberine vs. Metformin

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  6. Hello Ken Stephens. I came across your post doing a search for berberine / metformin . I wanted to forward it to my mom’s PA but could find nothing about you on this site. I wish you had an About page with who you are and your background. As it is, I don’t feel like I can forward it. All I know is your name. You know what I mean? Her health care people tend to be dismissive anyway and then I’m trying to get them to change from metformin to berberine with an article written on a site with just the name of the writer and absolutely no other information. I couldn’t even find a proper email address, phone number or a contact page.

    1. Hi Sam, this isn’t about me, it’s about the info, but if you’re looking for someone to point to I’d recommend Jonathan Wright MD who is one of the leading spokespeople within the medical community on berberine as a substitute for metformin, you can find his article at http://tahomaclinic.com/2011/01/berberine-diabetes/. I will warn you though, medical people tend to not be that open minded, and again, who is saying this, myself, Dr. Wright, or whomever, doesn’t have anything to do with this, these decisions need to be based upon the evidence.

      1. There’s plenty of info on this on the internet actually, someone could just google berberine as a substitute for metformin for instance, or something similar, and this is quite widely known in the holistic medical community, although conventional medical doctors and other conventional medical practitioners don’t have any real info or knowledge on this sort of thing of course. So you may run into things like, they didn’t teach me this in medical school, I don’t get salesman coming to the office peddling this, and that’s who we listen to, sorry anything we aren’t familiar with we call quackery, even though one has to be up on something to even form this sort of opinion, no matter, quackery I say 🙂

  7. while reading the article on tahomaclinic racomanded in you link above,i came upon a possible side effect of berberine which i fear of
    i suffer from life long constipation ,with terrible crumps bloating gas pains etc.which make my life unbarable,on top of indigestion and probably some other issues like gallstones etc. i have prediabetes (A1c recently uped from 5.7 to 6) i have very high insulin (found in blood work) and quiet certainly high insulin resistance.my doc.suggested me to begin taking metformin which i quiet wellcome ,hOping to prevent my to progress in full blown diabetes .
    metformin is known to have GI side effects one of which is diarea….with my condition this ,by other folks unwanted side effect ,will be wellcomed by me -i just do WISH something will cause me loos stools\diarea…but of caurse there are other side effects of metformin that are to be considered too
    I decided to look into berberine,but the one side effect of berberine that frightens me is CONSTIPATION!!!!!i am suffering so much with constipation to begin with,(COLON INERTIA PERHAPS EVEN GASTROPARESIS )THAT I AM AFFRAID TO GET IT EVEN WORST .IT IS VERY PROBABLE THAT GREAT PART OF MY GI ISSUES ,AND PERIFERAL NEUROPATY(ALSO OF THE GUT)IS ACTUALLY CAUSED BY LONGSTANDING PREDIABETES,BUT THE VERY PROBABILITY OF WORSENING THIS AGONISING CONSTIPATION BY BERBERINE SCARES ME.
    WHAT SHOULD I DO??!!

    1. I can’t tell you what to do of course, but I can tell you that side effects of berberine tend to be much milder and less common than with metformin. If this were me, I’d look to address the constipation first, even though a lot of people can take berberine without side effects. I doubt that your issues are caused by your prediabetes. Blood sugar in this range is more like the canary in the coal mine, it’s starting to chirp but the danger zone is quite a bit higher than this. While high blood sugar can contribute significantly to neuropathy, we generally see blood sugar of much higher levels for very long periods of time associated with it. A1C above 8 and usually in double digits. There are other causes of neuropathy though. If this was me, and I did have neuropathy and gastroparesis, I’d be looking at things like magnesium glycinate, a good b complex, mixed tocopherol vitamin e, benfotiamine, borage oil, and other things that have been shown to help neuropathy. Magnesium deficiency can be responsible for this, the constipation, and a load of other things. I think that looking at magnesium is the first place we should look at when we are ill, given that most people are deficient and many critically so. There’s a lot of other things that I might be looking at too, keep in mind that there’s no way that anyone can diagnose you over the internet, although you might read about certain things that you might want to try. Here’s an article for you to have a look atL https://www.thenhf.com/hfn-magazine/health-freedom-articles/125-2010-articles/638-40magnesium-and-diabetic-neuropathy. You may want to see a good functional medical practitioner if you can manage it. This sounds like a serious condition which should be addressed and not left to fester. Good luck.

  8. FOLLOW

    I WILL APRECIATE YOUR COMMENT AND ADVISE ,AND PERHAPS YOU CAN ASK FOR ME THIS QUESTION ALSO DR. WRIGHT BECAUSE I DON’T FIND ANY CONEDTION ON THAT SITE WHERE I CAN ASK HIM IN PERSON.
    BY THE WAY I MYSELF AM A(RETIRED) M.D. ,VERY MUCH IMPRESSED WITH DR.WRIGH ENDEVORE AND IDEAS.
    PLEASE KEEP ME INFORMED
    THANK YOU
    NIRA.H. M.D.

  9. Help!! I want to take this so badly for the reason you state above and I and did successfully for a couple weeks. Then I stopped. A month later took a 500mg dose. Later that night I had the most violent vomiting and diarrhea of my life! Had to go to the hospital type violent. My labs showed high WBC and neutrophils. Ok two weeks later. All labs now clear I take a half dose. I opened the capsule and dumped out half. 2 in the morning I woke covered in sweat. Ran to the toilet and started with the vomiting and diarrhea again. I have been to nervous to take it again. Any explanations ?

    1. I’ve never heard of such violent symptoms from berberine. This looks like some kind of reaction. Some people get mild GI symptoms, not as bad as you get from metformin, that’s about it, and unlike metformin, these symptoms go away fairly quickly. The recommendation is to reduce the dosage in the mean time but you’re only taking a very small dose now. I would proceed very cautiously if it were me.

      1. Thank you. It’s very perplexing as I can’t find any literature saying this is a side effect. It’s concerning and frustrating. Again thank you very very much, Tasha

        1. There are certain classes of prescription meds that are potentiated by berberine, and in the case of prescription meds, this is not an effect you want. Other than that, there may be some underlying metabolic condition that is behind this that berberine is setting in motion. There’s also the possibility that you just have such a high level of gut pathogens, and this is generally why berberine causes GI side effects, from the die off of this stuff. If your liver is compromised this will amplify these effects. This may suggest a need to strengthen liver function, for instance with things like milk thistle and dandelion root. Dandelion can also help with poor gallbladder function which may be present in cases of nausea. In any case, the negative effects here for the time being anyway far outweigh any positive benefits I would say. There are other ways to increase AMPK, Life Extension makes a formula that doesn’t have berberine for instance.

          1. Thank you for your response. I had emergency gall bladder removal
            Surgery dec 28/2016. Since then I still have horrible pains and cannot tolerate many of much food. I have non alcoholic fatty liver (excellent alt and sat levels) and metabolic issues such as Insulin resistance from PCOS… hence why this supplement would be great if I could tolerate it. My guts are terrible and am waiting to see an internist. They think maybe Gastoparesis. Hoping they can sort it out soon as I am miserable and feel terrible. I ordered the supplement you suggested. Thank you. Fingers crossed it helps. Thank you again

          2. I always want to make clear that there’s no medical advice given on the site and no site offers it really, just some suggestions of things I would try 🙂 Are you taking ox bile? A bile deficiency is nasty. Dandelion helps secrete it, do a search on helpful supplements because it’s always good to do a little research yourself and there’s some good resources out there. I don’t have gallbladder disease but I have had digestive issues, with fat in particular, I’ve found Lypo Gold to be helpful. Normal digestive enzymes don’t have much lipase in them but this does. As for the liver, there’s nothing better than milk thistle which I take for preventative reasons, people with NAFLD have also done well with pantethine, this might be even better actually. Do a search for pantethine and NAFLD 🙂

          3. Thank you and yes I completely understand this is not medical advice. I very much appreciate your input. I do remember reading about ox bile a while back and completely forgot about it. Being ill has taken such a toll. Interestingly I am very cautious with fats but raw veggies or simple carbs are brutal and come out the back end with in the hour of consuming.
            Thank you and I will do some reading on bile salts. One last query to ponder. I have kidney issues, medullary sponge kidneys and get loads of UTIs from the stones and nephrocalcinosis. I do take very good probiotics. But I do wonder if my gut flora could be so bad and the cause of the berberine issues..
            Take Care and thank you for some ideas to look further
            Cheers, Tasha

          4. Given that GI side effects from berberine are believed to be caused by excessive gut pathogens dying off, your gut flora may be just horrible. Antibiotics massacre friendly bacteria. When standard medical practitioners recommend probiotics then you know this is a big thing because they ignore just about everything else. One of the things they don’t know is just how big of a dosage we need to balance this. I’ve seen 200-300 billion a day used for a month or longer for instance. The amount they suggest is a joke really, and even something like 30 billion a day isn’t going to do a hell of a lot to make up for all this, after you’ve killed off so much, unless we’re talking quite a while. However people often go back on the antibiotics before this can happen. The idea behind these is to repopulate over time actually, it’s not an acute effect, but when you are on antibiotics the war against them rages on, that’s the biggest problem, so when you are on these you’re just getting worse but when you get off you have to be real serious about it. Cheers!

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