Berberine is a botanical with a long history of use in supporting many aspects of gastrointestinal health. Several recent studies have explored berberine’s potential to influence biochemical mechanisms related to both the inflammatory response and gut health. 

A recent animal study investigated the potential efficacy of berberine administration on animals with ulcerative colitis (UC). UC is a chronic inflammatory bowel disease involving harmful changes to the mucosa of the lower bowel. Berberine was shown to help modify several parameters related to the inflammatory response including interleukin (IL)-1β, IL-6, and tumor necrosis factor-ɑ (TNF-ɑ). It also helped improve intestinal microflora species diversity. In studies related to acute and chronic colitis, berberine has also been shown to help regulate Th17/Treg balance and help support intestinal glial-epithelial-immune cell interactions. 

An animal study assessed the potential changes in intestinal histomorphology and gut microbial composition after high-dose administration of berberine. Increases in villus length and CD3+ T-lymphocyte infiltration were observed. Low CD3+ counts have been associated with negative outcomes related to certain gastrointestinal-related pathologies. Improvements in jejunal villus-to-crypt ratios were also observed. In addition, shifts in certain populations of gut microbes occurred alongside potential improvements in parameters related to intestinal inflammation. 

A recently published review by Sahoo and colleagues explored the potential efficacy of micronutrients that support antioxidative stress on intestinal inflammation in inflammatory bowel disease. Berberine, alongside many other polyphenols, was included in this comprehensive review. The authors highlight berberine’s potential to modulate apoptosis of colonic macrophages and help decrease colonic proinflammatory cytokine production. In addition, berberine may help modulate several cell signaling pathways including AMPK, MAPK, and NRF2. It may also help suppress the expression of NADPH oxidase to help decrease oxidative stress. 

Another recently published review by Laurindo and colleagues detailed the potential efficacy of berberine and its metabolites, alongside many other phytochemicals, to support inflammatory bowel diseases through the regulation of nuclear factor κB (NF-κB). Berberine was shown to deactivate NF-κB in several animal studies. It also helped increase superoxide dismutase and IL-10, alongside decreases in the expression of TNF-ɑ, IL1β, IL-6, iNOS, and COX-2.

A randomized double-blind placebo-controlled trial evaluated the efficacy of berberine and berberine combined with a probiotic on lipid metabolism in individuals with T2DM. This study involved 365 individuals and a treatment period of three months. Berberine, alone and in combination with probiotics, was shown to help improve postprandial total cholesterol and low-density lipoprotein levels. Greater improvements were reported in the combination treatment arm, suggesting a potential synergistic relationship between berberine and probiotics. 

While more clinical research is needed, emerging studies suggest that berberine may help promote healthy microbial populations, support a normal response to inflammation, and help maintain gut mucosal health. Berberine may also help promote optimal lipid and glucose metabolism.

By Dr. C. Ambrose, ND, MAT