The recent popularity of Ozempic has raised concerns about the delivery of the injectable drug to patients who really need it for its intended purpose.
Ozempic is approved in Canada for the treatment of type 2 diabetes, as is Rybelsus, a similar drug that comes in a tablet. But it’s increasingly being used off-label here and there for weight loss by otherwise healthy people especially in the United States.
With supplies sometimes running low, some influencers on TikTok and other social media are now touting a supposed “miracle” herbal supplement, berberine, as another weight-loss shortcut — even calling it “nature’s Ozempic.”
“Everyone said, ‘Weight loss in a needle? That’s great!'” said Dr. Peter Lin, director of primary care initiatives at the Canadian Heart Research Center and GP of the Ozempic craze.
“Then when you try to catch that wave, you say, ‘Here’s a natural version of the thing that you can’t get right now.'”
But with most things sounding too good to be true, this claim is, doctors say — and may even carry some risks.
Here’s what you need to know about berberine.
What is it?
Berberine is a chemical found in several types of plants, including European barberry, gold seal, gold thread, Oregon grape, phellodendron, and tree turmeric. It is yellowish and has a bitter taste.
It has been used for thousands of years in traditional Chinese and Ayurvedic medicine, often to treat upset stomach, diarrhea or other gastrointestinal problems.
What it does, it doesn’t and could do
There have been studies the effect of berberine on people with type 2 diabetessome more recent research whether it might work to treat insulin resistance.
Other studies have shown that it “has some efficacy in lowering blood sugar, correcting your cholesterol levels … some of the things that obese people tend to have,” said Dr. Sean Wharton, a physician of internal medicine and assistant professor at the University of Toronto and McMaster University in Hamilton.
But Wharton, who has done work for the company that produces Ozempic says many of the studies that suggested some weight loss benefits were short-term were not randomized and not done against a placebo.
In other words, not scientifically rigorous.
“When we do studies, we really try to eliminate confounding factors in bias. But if it’s a small study and it’s not a well-conducted study, then there’s always bias,” he said.
For the average healthy person who might want to lose 10, 15, or 20 pounds and keep it off, says Wharton, the science on berberine just isn’t there.
“Does berberine have any health benefits? Certainly, through probably very natural processes.
“But is it a natural Ozempic? My thoughts would be no,” he said, though more research in that direction would be “interesting.”
How is berberine different from Ozempic?
Ozempic mimics a hormone, GLP-1, which tells the brain that food is coming in and to stop eating.
“The rest of the body knows what to do once you give the signal that food is coming,” Lin said.
“It turns out that in patients with diabetes, that signaling system isn’t working properly. That GLP-1 isn’t coming out in the right amount or at the right time. And what we’re doing instead is we’re giving you an injection of Het.”
But berberine doesn’t work like Ozempic, says Lin.
“It’s not a messaging system.”
It’s not entirely clear how berberine works, but it seems the only reason it’s being touted as a natural alternative to Ozempic is the hint that it might contribute to some weight loss in some people. But doctors say large-scale, solid data to support the claim is lacking.
“We all have anecdotes of things that have worked for us,” Wharton said. “That doesn’t mean they’ve been proven effective for the whole world.”
Are there any potential downsides?
Natural substances are not regulated by Health Canada like manufactured medicines, but berberine is included in this country’s regulations regulations for natural health productsor NHPs.
In an email to Breaking:, Health Canada said it “recommends that consumers use only authorized NHPs under the approved terms of market authorization listed on the label.”
“In the herbal world, we don’t do that much research and the approval process isn’t quite there. So we don’t know exactly what all the side effects are,” said Lin.
He says that while berberine is one of the more studied herbs, there’s still a lack of information when it comes to benefits versus risks — which is why doctors don’t prescribe it.
“Until we know that relationship, how will I know I’m not harming you?”
He says herbs are traditionally used in small amounts — extracted from plants, perhaps used as a tea — so if people experience side effects like nausea or diarrhea, it’s just from taking it in small doses.
His concern is that if people think that taking more berberine will help them lose more weight, or if the supplement is modified so that the body absorbs more of it, the negative side effects may also increase.
“That’s why a lot of doctors, when you talk to them, will say, ‘You know, it might have some effect, but we don’t know exactly what it’s doing in your body’s systems, we need to make sure it’s not doing any harm,'” he said.
And because it’s unregulated, Wharton says, it brings other uncertainties.
“Do you get real berberine? What dose do you get? What concentration do you get? And does it matter?” he said.
“It would matter if there were serious adverse effects associated with it, if there were drug interactions, if there were things that caused a real problem. Then Health Canada would have to regulate it because it would be a toxin. At this stage it would being a toxin. , it’s just a natural food.”