Many people with diabetes use supplements to help them manage their blood sugar. They use everything from bitter melon and gymnema sylvestre to cinnamon and fenugreek to help them control their diabetes. And now to judge from the many emails I get, berberine has become the big hope.
Most people who take supplements for blood sugar control do that because they worry about the side effects of prescription medication. The problem is that they imagine that their supplement of choice doesn’t have any side effects.
Any medication that does anything for us also has side effects. Some are obvious, but many others don’t show up until lots of people have used them for years. Then it is too late for the early adopters.
All supplements are medication. They are all drugs. I wish I could understand why so many people don’t appreciate this.
Recently, someone read my article "Metformin Forever" and contacted me. "After reading about metformin I was curious," he wrote. "But I’m drug averse, and berberine sounds like it should be added to our drinking water." He went on to write that he has taken berberine for three days "and so far I have had no adverse effects."
I told him that I too have read good reports about berberine. But I have many concerns, some of which I laid out in the next two paragraphs of this message.
I began by saying that the differences between prescription drugs and supplements are not favorable for supplements. First, prescription drugs have been tested, and, second, we know what different doses do for us. In neither of these cases do we know that about supplements. That includes berberine.
And if I were to take any prescription drug or supplement to manage my blood sugar now (I don’t, since I manage my diabetes on a very low-carb diet), it would be metformin. It has been carefully tested, and millions of people have used it since the FDA approved it in 1995. We know that it works well for managing diabetes.
One of its side effects seems to be that it reduces the risk of cancer. Another is that people may lose some weight using it, although generally it is weight neutral, which in itself is remarkable, because almost all diabetes drugs lead to increases in weight, including insulin, the sulfonylureas, Actos, and Avandia.
The only diabetes drugs that generally lead to a lot of weight loss are Byetta (which I took very successfully for two years), Victoza, and Bydureon. But these are are in a class of drugs that has recently become somewhat suspect for serious side effects.
I forgot to tell my correspondent a smaller difference between supplements and prescription drugs. Health insurance won’t cover the cost of supplements.
Some supplements, particularly multivitamin and mineral pills, are probably good for us. But few of them are well tested either.
Any supplement or prescription drug can be dangerous. Each supplement or prescription drug has both a therapeutic and a toxic dose. Sometimes these levels can be awfully close together, and the toxic dose can have serious side effects.
The bottom line is that all supplements are drugs. Anything that works has side effects.
David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.