Chronic joint pain can be an incredibly debilitating condition. Whether you suffer from arthritis or other inflammatory conditions, living with persistent pain can take a toll on your overall well-being. It’s important to know that despite all the drugs available for arthritis, pharmaceuticals used to treat arthritis symptoms are not curative and have significant potential for long-term adverse effects.
Fortunately, there is hope in the form of berberine—a naturally-occurring alkaloid found in various plants. Berberine has been used for centuries to treat a range of ailments and is gaining more popularity today for its restorative effects on chronic inflammation and joint pain, as well as its ability to help manage glucose levels.
What is berberine?
Berberine is found in roots, rhizomes, barks, and stems of barberry, goldenseal, and other medicinal plants. It has been used in traditional Chinese and Ayurvedic medicine for treating infection, diarrhea, diabetes, high blood pressure, and high cholesterol, among other conditions. It is yellow in color and has a bitter taste.
It is usually well-tolerated when taken, although, side effects may occur and include stomach-related complaints such as stomach pain, diarrhea, gas, nausea/vomiting as well as muscle pain. It can potentially cause low blood pressure, low heart rate, or abnormal heart rhythm in higher doses. Allergic reactions have also been reported.

How Does Berberine Reduce Inflammation?
Berberine helps reduce inflammation by inhibiting the release of cytokines, which are molecules involved in activating the inflammatory response. It also prevents the production and activation of several enzymes associated with inflammation, including cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX). As a result, berberine can relieve chronic inflammation on both a short- and long-term basis.
Berberine has been studied in rat models and has been shown to be effective in reducing inflammation in Rheumatoid Arthritis (RA), although, less so than a standard drug used, Methotrexate.1 In other studies, berberine was found to play a significant role in reducing RA synovitis by regulating specific inflammatory pathways.2,3 It also reduces immune t-cells which contribute to inflammation.4
Individuals with inflammatory arthritis conditions have an imbalanced gut microbiome. Berberine has been shown to reduce undesirable gut bacteria overgrowth and help with improving desirable butyrate-producing bacteria in animal studies.5 Of note, berberine may potential negate the effects of some probiotics.
What Other Benefits Does Berberine Offer?
In addition to its anti-inflammatory effects, berberine has been shown to help manage glucose levels. Many people with arthritis find that eating foods high in sugar causes increased inflammation and pain, so controlling dietary sugar intake and having balanced glucose levels in the body is important. This is especially true for people with diabetes or pre-diabetes since elevated blood sugar can increase inflammation in the body. By helping maintain healthy glucose levels, berberine may help reduce inflammation in the joints associated with diabetes.
Recently, berberine has gained popularity as a weight loss supplement. One of its main functions is activating an important enzyme called AMPK, which regulates metabolism. Weight management is an important part of managing arthritis inflammation and pain. Some individuals are comparing berberine to the medication, Ozempic, which is used for the management of blood sugar in type 2 diabetes as well as weight loss for obesity. However, the effect of berberine on weight loss, while helpful in controlling blood glucose, insulin resistance, and cholesterol, is thought to be more moderate. As an obesity preventative, berberine works by its positive effects on the gut microbiome, regulating genes, regulating intestinal permeability as well as hepatic gluconeogenesis (production of glucose by the liver from non-carbohydrates).6

How Should Berberine Be Taken?
Berberine is mostly taken as a supplement but can also be found in various teas and other herbal remedies. The recommended dosage of (berberine is 500-2000 mg per day, divided into two or three doses. It is important to always speak with a healthcare professional before taking any supplement, however, as they will be able to recommend the best dosage and form of supplementation for your individual needs.
It is also important to confer with your health professional if you are taking sedative medications, blood thinners, sulfonylureas used to manage diabetes, metformin, or immunosuppressive medications such as cyclosporine or tacrolimus. Berberine can impact blood levels of certain medications, causing kidney toxicity, or even reducing or enhancing the effects of some drugs. Care needs to be taken with medications detoxified by the liver through specific cytochrome pathways. Taking it with certain chemotherapy medications should be avoided. Caution should be taken even with some over-the-counter medications that may have interactions with berberine and affect liver function. Berberine should not be taken by pregnant or breastfeeding moms.
The Bottom Line
Berberine offers a natural alternative to help combat chronic inflammatory joint pain and arthritis. It may have therapeutic benefits for RA.7 It has few side effects and is generally well-tolerated. Not only does it work to reduce inflammation, but it can also help manage glucose levels. If you are suffering from joint pain or inflammation, speak with your healthcare professional to find out if berberine is right for you.
By taking advantage of the anti-inflammatory benefits of berberine, you may be able to reduce chronic joint pain and improve your overall quality of life. With careful monitoring of dosage and regular consultation with your healthcare professional, berberine can offer a safe and effective means of improving joint health.
In some cases, taking berberine with other botanical remedies may provide additional benefits for joint pain and inflammation. Before beginning any new supplement regimen, however, it is important to discuss it with your doctor or pharmacist. They will be able to advise you on the best course of action for your individual needs.
While more studies are needed in humans suffering from arthritis and other inflammatory joint conditions, berberine can offer a natural and safe way to relieve chronic joint pain and reduce inflammation. With proper monitoring and guidance from a healthcare professional, berberine may provide relief from persistent discomfort due to arthritis or other inflammatory conditions. Give berberine a try today—you may find that it is the key to reducing your joint pain and improving your quality of life.
References:
1. Therapeutic Effect of Berberine Versus Methotrexate on Histopathology in a Rat Model of Pristane-Induced Arthritis. Proceedings of Shaikh Zayed Medical Complex Lahore. 2022;36(1). doi:10.47489/pszmc-825361-49-55
2. Li Z, Chen M, Wang Z, et al. Berberine inhibits RA-FLS cell proliferation and adhesion by regulating RAS/MAPK/FOXO/HIF-1 signal pathway in the treatment of rheumatoid arthritis. Bone Joint Res. 2023;12(2). doi:10.1302/2046-3758.122.BJR-2022-0269.R1
3. Wang X, He X, Zhang CF, Guo CR, Wang CZ, Yuan CS. Anti-arthritic effect of berberine on adjuvant-induced rheumatoid arthritis in rats. Biomedicine and Pharmacotherapy. 2017;89. doi:10.1016/j.biopha.2017.02.099
4. Vita AA, Aljobaily H, Lyons DO, Pullen NA. Berberine delays onset of collagen-induced arthritis through T cell suppression. Int J Mol Sci. 2021;22(7). doi:10.3390/ijms22073522
5. Yue M, Tao Y, Fang Y, et al. The gut microbiota modulator berberine ameliorates collagen-induced arthritis in rats by facilitating the generation of butyrate and adjusting the intestinal hypoxia and nitrate supply. FASEB Journal. 2019;33(11). doi:10.1096/fj.201900425RR
6. Ilyas Z, Perna S, Al-thawadi S, et al. The effect of Berberine on weight loss in order to prevent obesity: A systematic review. Biomedicine and Pharmacotherapy. 2020;127. doi:10.1016/j.biopha.2020.110137
7. Huang D na, Wu F fang, Zhang A hua, Sun H, Wang X jun. Efficacy of berberine in treatment of rheumatoid arthritis: From multiple targets to therapeutic potential. Pharmacol Res. 2021;169. doi:10.1016/j.phrs.2021.105667

I am a Master’s prepared RN, National Board-Certified Health & Wellness Coach, Board-Certified Functional Wellness Coach, and Functional Diagnostic Nutrition Practitioner. I help people fix their chronic inflammation & pain with in-home lab testing, client assessments, personalized natural healing protocols, and online coaching to help them move from pain to peace so that they feel better, move better, and live better.
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