When it comes to type 2 diabetes, it seems every day there’s a new “magic” pill being touted for weight loss and lower A1C. But one such pill — the supplement berberine — may have some real science to support its use in type 2 diabetes management.

What Is Berberine?

Berberine is a compound that’s naturally found in plants like European barberry, goldenseal, and goldthread, according to MedlinePlus. And it's nothing new — a study published in December 2014 in Biochemistry and Cell Biology notes berberine has been used in Chinese, Indian, and Middle Eastern folk medicine for at least four centuries.

In more recent years, the supplement has gained a foothold in the United States as an over-the-counter supplement. “It might be hitting the mainstream now, but the herb itself has been used for thousands of years,” says Robin Foroutan, RDN, a registered dietitian nutritionist specializing in integrative medicine, functional medicine, and holistic healing modalities with the Morrison Center in New York City. “It’s almost as though our research is catching up with something that ancient healers knew about for a long, long time.”

Proposed Health Benefits of Berberine

Research has shown berberine may help with high cholesterol, high blood pressure, polycystic ovary syndrome (PCOS), and skin issues like burns and canker sores, according to MedlinePlus. It’s also been shown to help people with type 2 diabetes because it appears to help regulate blood sugar, according to MedlinePlus. Researchers have found this effect, but aren’t exactly sure why it has these anti-diabetic properties, per the aforementioned study in Biochemistry and Cell Biology.

Research About Whether Berberine Can Treat Type 2 Diabetes

Much of the research that’s been done on berberine has explored the effect it has on people with type 2 diabetes. Below are some of the studies and their findings.

May Lower Blood Sugar

The Biochemistry and Cell Biology study notes that not only does berberine have antioxidant and anti-inflammatory properties, but it may also help reduce insulin resistance, which is the hallmark of type 2 diabetes. The researchers note that it appears taking berberine on its own or as an add-on therapy to other diabetes treatments may be beneficial. The researchers concluded that berberine may be a good treatment option to try before insulin therapy (under a doctor’s supervision, of course) and may offer better results than metformin, which is generally the first-line treatment for type 2 diabetes.

Could Reduce A1C

About a decade ago, a study published in Metabolism found that berberine not only lowered blood glucose levels, but it also lowered levels of hemoglobin A1C, triglycerides, and insulin in people with type 2 diabetes. A1C is a two- to three-month average of blood sugar levels and a test used to diagnose diabetes, according to the American Diabetes Association.

Has the Potential to Improve Fasting and Postprandial Glucose

Berberine may reduce fasting and postprandial, or post-meal, glucose levels by more than 30 percent, according to a one study. These are other markers for blood glucose control.

A Bonus Benefit: Affordability

A study published in February 2015 in the Journal of Ethnopharmacology notes that berberine is usually inexpensive, which could make it an attractive option for diabetes patients in low-income areas.

Science-Backed Benefits of Berberine for Preventing Type 2 Diabetes

“Nobody just wakes up one day with diabetes — it's a slow process,” Foroutan says. “People can start to take action when their hemoglobin [A1C] levels are starting to approach the prediabetes range.” According to the Mayo Clinic, hemoglobin is a protein in your red blood cells that transports oxygen, and A1C measures how much of your hemoglobin is covered in sugar (glycated hemoglobin).

A study on rats found berberine may help protect against diabetes because it can increase insulin expression, regenerate B cells (which lose function as diabetes progresses), provides antioxidant properties, and decreases lipid peroxidation, which is a marker for oxidative stress. Oxidative stress is linked to cell damage and various chronic health conditions, notes past research. This study on berberine was also done on rats, and this protective factor hasn’t been studied well among humans.

Side Effects and Interactions of Berberine and Diabetes Meds

Lynn Grieger, RDN, CDE, a certified diabetes educator based in Prescott, Arizona, says one of her concerns about berberine is the fact that it’s a supplement, and the supplement industry is not well regulated. “If you buy a supplement, you’re never exactly sure what’s in it, so you have to be cautious about that,” she says.

The typical dose of berberine is 500 milligrams (mg) two to three times a day, Foroutan says, and there are some side effects to be aware of. The Biochemistry and Cell Biology study notes it’s generally well tolerated, but some people have experienced nausea, vomiting, diarrhea, or constipation. Headaches, skin irritation, and bradycardia (the clinical term for a slow heart rate) may also occur when it's taken at a high dose. A past study found that 34.5 percent of patients experienced gastrointestinal side effects. Foroutan says digestive issues should go away within a few days or a week, and that you may be able to start by taking the 500 mg dose once a day and then increase the amount once your body gets used to it. (Because everyone’s different, be sure to ask your healthcare team which dosage is right for you.)

Also, even though berberine is credited with lowering blood sugar, it can create problems for people who are controlling their blood sugar with insulin or another medication by dropping blood sugar too low, according to MedlinePlus. “Berberine does seem to lower blood sugar levels in some people, so there’s a risk that, say, they’re taking metformin and then they add the berberine supplement to it and their blood sugar could drop lower than they think,” Grieger says.

Finally, berberine may interact with certain medications. Physicians typically ask what medications you’re taking, but Grieger says people often list just their prescription medications and fail to mention supplements. “People have the feeling that if it’s an herb or a supplement that it’s inherently safe,” she says. But that’s not always the case, so Grieger recommends talking with both your physician and your pharmacist before taking any type of supplement, including berberine.

Known Medications That Interact With Berberine

Research has shown berberine may interact with:

Warfarin, a blood-thinning medication sold under the brand names Coumadin and Jantoven, according to a study published in December 2015 in Chronic Diseases and Translational Medicine.

Diabetes medications, because it may drop blood sugar too low. Speak with a doctor first to see if your dosage of diabetes medication needs to be changed. And be sure to monitor your blood sugar closely.

Cyclosporine, which is a type of drug prescribed to patients who’ve received an organ transplant. (The brand name is Restasis.) Berberine may delay the breakdown of cyclosporine in the body, according to MedlinePlus.

You should also proceed with caution if you take medications changed by the liver, sedatives, and medications that slow blood clotting, according to MedlinePlus.

Groups That Shouldn’t Take Berberine Because of Health Risks

Though berberine is generally safe for adults to take short term, there are a few groups of people who should not take it, according to MedlinePlus.

Pregnant and breastfeeding women Berberine may harm the fetus if the mother takes it while pregnant, and a type of brain damage called kernicterus could occur if an infant is exposed to berberine through breast milk.

Newborns Babies are subject to the brain-damage risk mentioned above. Berberine may also delay the liver’s process of eliminating bilirubin, which is a chemical that’s made by breaking down red blood cells. This can also cause brain problems.

RELATED: Can Alternative Therapies Help You Manage Diabetes?

One Last Thing About Using Berberine to Manage Type 2 Diabetes

Berberine is a supplement that emerging research has shown can be effective in treating type 2 diabetes because of its blood-sugar-lowering properties. It’s generally well tolerated and affordable, and it can be effective for some people, but it’s not without side effects and risks. Be sure to speak with a doctor and pharmacist before taking it.

Can Berberine Help Prevent or Treat Type 2 Diabetes?