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This is a great review, including the preamble with other meds used to ”help” with weight loss. In terms of talking with your doctor about berberine, I think you’ve presented more than most of us know about it! The many unknowns are typical of the natural supplement industry, with “natural” as an adjective encompassing both fluffy bunnies and venomous snakes.

Gut modulation is anything but simple, and doing this through antibiotic means instead of prebiotic ones sounds like a red flag to me, too.

I’ll skip recommending berberine based on this post. Buyer and microbiome beware.

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Yes! 'Buyer and microbiome' beware sums it up!

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1. Semaglutide is one of the strangest looking molecules I have seen.

2. I take several plant supplements to reduce inflammation, like fisetin and quercetin. I feel somewhat different about taking alkaloids, though, because of their greater reactivity and potential toxicity. The multiple pathways for Berberine metabolism is also a bit odd.

3. These are very interesting discussions.

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Thanks, Tom! It's tricky to wade through the different activities of these ingredients for sure. The metabolism of these herbal ingredients is so fascinating. Previously, there has been little info on which cytochrome P450 enzymes are affected by different herbal compounds, but there has been recent growth in research in the field, which is helping to fill in some of those gaps. I'll share some links to resources in my next post.

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