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Berberine

    What is berberine?

    Berberine is a quaternary ammonium salt from the protoberberine group of benzylisoquinoline alkaloids found in such plants as berberis, such as berberis vulgaris (barberry), berberis aristata (tree turmeric), mahonia aquifolium (oregon grape), hydrastis canadensis (goldenseal), xanthorhiza simplicissima (yellowroot), phellodendron amurense (amur cork tree), coptis chinensis (chinese goldthread), tinospora cordifolia, argemone mexicana (prickly poppy), and eschscholzia californica (californian poppy) Berberine is generally discovered in the roots, roots, stems, and bark.

    Due to its yellow color, berberis types were utilized to dye wool, leather, and wood.under ultraviolet light, berberine shows a strong yellow fluorescence, making it useful in histology for staining heparin in mast cells. As a natural color, berberine has a color index.

    Biosynthesis of berberine

    The alkaloid berberine has a tetracyclic skeleton stemmed from a benzyltetrahydroisoquinoline system with the incorporation of an additional carbon atom as a bridge. Formation of the berberine bridge is rationalized as an oxidative process in which the n-methyl group, provided by s-adenosyl methionine (sam), is oxidized to an iminium ion, and a cyclization to the aromatic ring happens by virtue of the phenolic group.

    Reticuline is known as the instant precursor of protoberberine alkaloids in plants.berberine is an alkaloid stemmed from tyrosine. L-dopa and 4-hydroxypyruvic acid both originate from l-tyrosine. Although 2 tyrosine molecules are used in the biosynthetic path, only the phenethylamine piece of the tetrahydroisoquinoline ring system is formed via dopa, the remaining carbon atoms come from tyrosine via 4-hydroxyphenylacetaldehyde. L-dopa loses co2 to form dopamine 1. Likewise, 4-hydroxypyruvic acid likewise loses co2 to form 4-hydroxyphenylacetaldehyde 2. Dopamine 1 then reacts with 4-hydroxy-phenylacetaldehyde 2 to form (s)- norcolaurine 3 in a response similar to the mannich response. After oxidation and methylation by sam, (s)- reticuline 4 is formed. (s)- reticuline works as an essential intermediate to other alkaloids. Oxidation of the tertiary amine then occurs and an iminium ion is formed 5. In a mannich-like response the ortho position to the phenol is nucleophilic, and electrons are pressed to form 6. Product 6 then undergoes keto– enol tautomerism to form (s)- scoulerine, which is then methylated by sam to form (s)- tetrahydrocolumbamine 7. Item 7 is then oxidized to form the methylenedioxy ring from the ortho-methoxyphenol, via an o2-, nadph- and cytochrome p450-dependent enzyme, giving (s)- canadine 8. (s)- canadine is then oxidized to offer the quaternary isoquinolinium system of berberine. This occurs in 2 different oxidation steps, both requiring molecular oxygen, with h2o2 and h2o produced in the succeeding processes. (1 ).

    Summary

    Berberine is a chemical discovered in some plants like european barberry, goldenseal, goldthread, oregon grape, phellodendron, and tree turmeric.

    Berberine is a bitter-tasting and yellow-colored chemical. It might assist reinforce the heartbeat, which could benefit individuals with specific heart disease. It might also eliminate germs, assistance regulate how the body uses sugar in the blood, and help reduce swelling.

    People most frequently utilize berberine for diabetes, high levels of cholesterol or other fats in the blood, and high blood pressure. It is likewise utilized for burns, canker sores, liver disease, and lots of other conditions however there is no good clinical proof to support a number of these usages. (2 ).

    History

    Berberine is a cationic alkaloid that was first isolated in 1917 from goldenseal (hydrastis canadensis), a north american herb of the buttercup household. It is found in the roots, rhizomes, stems, and bark of numerous other plants, consisting of berberisspp. (worldwide), yellowroot (southwestern united states), and the amur cork tree (east asia). It typically exists as the chloride, however t. Kametani and co-workers reported the overall synthesis as the iodide in 1969.

    Berberine’s strong yellow color and yellow fluorescence made it an extensively utilized color in early days of the market. It is still used in india as a wool dye, and its fluorescence makes it useful as a histology stain.

    However berberine’s main usage is as a herbal dietary supplement. It has antibiotic, anti-inflammatory, and antineoplastic homes, and it is being investigated as a treatment for diabetes, cancer, hyperlipidemia, heart disease, and hiv. The us fda has actually not yet authorized berberine for any prescription or over-the-counter substance abuse, and it has actually sent notifications of violation to companies that have made drug claims on their web sites. Clinical trials reveal that berberine is usually safe, however it has actually revealed drug interactions and is contraindicated for pregnant and breast-feeding ladies. (3 ).

    System of action

    Berberine is called an amp-activated protein kinase (ampk) activator. Its insulin-independent hypoglycemic impact is related to inhibition of mitochondrial function, stimulation of glycolysis and activation of ampk pathway. Furthermore, berberine might also function as an α-glucosidase inhibitor. In the newly-diagnosed type 2 diabetic patients, berberine is able to lower blood insulin level by means of improving insulin sensitivity. Nevertheless, in clients with poor β-cell function, berberine might enhance insulin secretion through resuscitating exhausted islets. Additionally, berberine might have additional advantageous impacts on diabetic cardiovascular complications due to its cholesterol-lowering, anti-arrhythmias and nitric oxide (no) causing residential or commercial properties. The antioxidant and aldose reductase repressive activities of berberine may be useful in alleviating diabetic nephropathy. Although evidence from animal and human research studies consistently supports the therapeutic activities of berberine, large-scale multicenter trials are still necessary to evaluate the effectiveness of berberine on diabetes and its associated issues. (4 ).

    Benefits of berberine

    A compound called berberine is among the most efficient natural supplements available.

    It has really impressive health advantages, and impacts your body at the molecular level.

    Berberine has actually been revealed to lower blood glucose, trigger weight reduction and improve heart health, to name a few.

    It is one of the few supplements shown to be as effective as a pharmaceutical drug.

    This is a detailed evaluation of berberine and its health effects.

    It triggers a major reduction in blood glucose levels

    Type 2 diabetes is a severe illness that has actually ended up being exceptionally typical in recent years, triggering countless deaths every year.

    It is identified by elevated blood sugar (glucose) levels, either caused by insulin resistance or absence of insulin.

    Over time, high blood sugar levels can harm the body’s tissues and organs, causing numerous health problems and a reduced life expectancy.

    Lots of research studies reveal that berberine can substantially lower blood sugar level levels in individuals with type 2 diabetes.

    In fact, its effectiveness is comparable to the popular diabetes drug metformin (glucophage).

    It seems to work via multiple various mechanisms:.

    • Reduces insulin resistance, making the blood sugar lowering hormonal agent insulin more efficient.
    • Increases glycolysis, assisting the body break down sugars inside cells.
    • Decrease sugar production in the liver.
    • Slows the breakdown of carbohydrates in the gut.
    • Increases the variety of advantageous germs in the gut.

    In one study of 116 diabetic patients, 1 gram of berberine daily lowered fasting blood glucose by 20%, from 7.0 to 5.6 mmol/l (126 to 101 mg/dl), or from diabetic to typical levels.

    It also decreased hemoglobin a1c by 12% (a marker for long-lasting blood sugar level levels), and likewise improved blood lipids like cholesterol and triglycerides.

    According to a big review of 14 research studies, berberine is as efficient as oral diabetes drugs, including metformin, glipizide and rosiglitazone.

    It works extremely well with lifestyle adjustments, and likewise has additive effects when administered with other blood glucose lowering drugs.

    If you take a look at conversations online, you often see individuals with sky-high blood sugar level literally normalizing them just by taking this supplement.

    This stuff actually works, in both the research studies and the real life.

    Bottom line:

    Berberine is very reliable at lowering blood sugar level and hba1c, which are elevated in people with diabetes. It works as well as some pharmaceutical drugs.

    Berberine may help you slim down

    Berberine might also work as a weight-loss supplement.

    Up until now, 2 studies have examined the impacts on body weight.

    In a 12-week study in obese people, 500 mg taken three times daily caused about 5 pounds of weight reduction, usually. The individuals likewise lost 3.6% of their body fat (14 ).

    Another more outstanding research study was performed in 37 men and women with metabolic syndrome. This research study went on for 3 months, and the participants took 300 mg, 3 times each day.

    The participants dropped their body mass index (bmi) levels from 31.5 to 27.4, or from overweight to overweight in just 3 months. They also lost belly fat and improved lots of health markers.

    The scientists believe that the weight-loss is caused by enhanced function of fat-regulating hormonal agents, such as insulin, adiponectin and leptin.

    Berberine likewise appears to inhibit the development of fat cells at the molecular level.

    However, more research study is needed on the weight reduction effects of berberine.

    Bottom line:

    Two research studies have shown that berberine can cause considerable weight reduction, while enhancing all sorts of other health markers at the same time.

    It reduces cholesterol and may reduce your threat of heart disease

    Cardiovascular disease is currently the world’s most typical reason for premature death.

    Numerous aspects that can be measured in the blood are associated with an increased risk of heart disease.

    As it ends up, berberine has actually been shown to enhance a lot of these factors.

    According to an evaluation of 11 studies, it can:.

    • Lower total cholesterol by 0.61 mmol/l (24 mg/dl).
    • Lower ldl cholesteroltrusted source by 0.65 mmol/l (25 mg/dl).
    • Lower blood triglycerides by 0.50 mmol/l (44 mg/dl).
    • Raise hdl cholesterol by 0.05 mmol/l (2 mg/dl).

    It has also been revealed to lower apolipoprotein b by 13-15%, which is a really essential danger element.

    According to some research studies, berberine works by inhibiting an enzyme called pcsk9. This leads to more ldl being eliminated from the bloodstream.

    Bear in mind that diabetes, high blood sugar level levels and obesity are likewise major danger elements for heart disease, all of which appear to be enhanced with this supplement.

    Given the helpful effects on all these risk factors, it seems likely that berberine could dramatically reduce the threat of cardiovascular disease.

    Bottom line:

    Studies reveal that berberine reduces cholesterol and triglyceride levels, while raising hdl (the “great”) cholesterol. It may decrease the danger of heart problem in the long-term.

    Other health advantages

    Berberine might also have numerous other health benefits:.

    • Anxiety: rat research studies show that it may help fight depression.
    • Cancer: test tube and animal research studies have actually revealed that it can decrease the growth and spread of various different types of cancer.
    • Antioxidant and anti-inflammatory: it has been revealed to have powerful antioxidant and anti-inflammatory results in some research studies.
    • Infections: it has actually been revealed to combat hazardous microbes, including germs, viruses, fungi and parasites.
    • Fatty liver: it can lower fat accumulation in the liver, which ought to help protect against non-alcoholic fatty liver illness (nafld).
    • Heart failure: one study showed that it dramatically enhanced symptoms and minimized risk of death in cardiac arrest clients.
    • Much of these advantages require more research before firm suggestions can be made, but the existing evidence is very promising.

    Bottom line:

    Preliminary studies show that berberine may have benefits against anxiety, cancer, infections, fatty liver and heart failure. It also has powerful anti-oxidant and anti-inflammatory results. (5 ).

    Further more

    Clinical research and research studies with isolated berberine have shown considerable success in the treatment of severe diarrhea, irritable bowel syndrome, type 2 diabetes, hypertension, elevated blood lipids, alzheimer’s illness and cancer. Here’s more about how research suggests that berberine can assist in dealing with these conditions.

    Berberine for severe diarrhea

    Berberine has actually been found to be effective versus diarrheas brought on by a variety of organisms. These results suggest that berberine seems reliable in treating the majority of typical intestinal infections with results equivalent to standard prescription antibiotics in most cases. In fact, outcomes were much better in numerous studies.

    The benefit of berberine over conventional prescription antibiotics is that it applies selective antimicrobial action as it targets a vast array of disease-causing organisms consisting of yeast albicans, yet puts in no action against health-promoting bacterial types such as lactobacilli and bifidobacter types.

    Berberine for sibo and ibs

    Berberine has been revealed to be reliable in dealing with irritable bowel syndrome (ibs) and several preliminary studies suggest it might likewise work in resolving small digestive overgrowth (sibo). Ibs is associated with some combination of:.

    • Stomach discomfort or distension
    • Modified bowel function, constipation, or diarrhea
    • Hypersecretion of colonic mucus
    • Dyspeptic signs (flatulence, queasiness, anorexia)
    • Varying degrees of stress and anxiety or depression

    Sibo often shows other associated symptoms consisting of:.

    • Brain “fogginess”
    • Fatigue
    • Joint pain
    • Skin problems such as acne, eczema, rashes or rosacea
    • Weight loss

    In a 2015 study, patients with diarrhea-predominant ibs were randomized to get either berberine or a placebo two times a day for eight weeks. The berberine group reported significant improvement in diarrhea and less urgency and frequency in defecation. The berberine group likewise experienced a 64.6 percent decrease in stomach discomfort compared with preliminary scores at the end of the study.

    Berberine improves the overall ibs symptom score, stress and anxiety score and depression score. Lastly, and not surprisingly, it was associated with an increased lifestyle score in clients while no such change was seen in the placebo group. (6 ).

    Berberine and pcos

    Berberine can offer various advantages to ladies with pcos, consisting of improved fertility, help with weight reduction, and decreased risk for metabolic issues associated with the condition.

    Berberine can supply an emotional lifeline to ladies who know the issues pcos can develop during pregnancy, including:

    • Miscarriage
    • Gestational diabetes
    • Preeclampsia
    • Cesarean area (c-section)

    Taking berberine in no way guarantees that a lady will conceive. However it could help her feel more proactive and relaxed about the prospect. And some research suggests a link in between tension and annoyed efforts at developing.

    Improving fertility

    At least 2 studies show the promise in between berberine and fertility. In one pilot research study, 98 anovulatory women (women who do not ovulate) with pcos took berberine. Ovulation improved by approximately 25% after four months.

    A research study released in medical endocrinology showed that ladies with pcos who were randomly picked to take berberine had higher pregnancy rates than those who took metformin (an insulin-sensitizing medication) or placebo.

    They likewise felt less negative effects 12 weeks prior to in vitro fertilization (ivf) treatment. (7 )

    Why it might be helpful for gut health?

    ” one way that berberine works is that it [might help] the body accomplish a much healthier mix of gut plants,” foroutan says. While more human research studies require to be carried out to show this connection, several clinical research studies, including this one published in the journal drug metabolic process and personality, have actually revealed this in mice. Specifically, the research study found that when bacteria from mice’s lower intestine was exposed to berberine it “not just modified bacterial physiology however also altered bacterial community structure and function.”.

    Once again, there mostly appear to be mouse or in vitro (aka research studies not on living topics) studies to support this advantage, so take the claims with a grain of salt. But foroutan says berberine’s capacity for improving gut health is the top reason it’s used by health practitioners. “it’s a natural antimicrobial, implying it assists to keep gut microorganisms in balance,” she states. Having stabilized and healthy gut flora can influence numerous other elements about health, she adds, like total swelling, mood, immune function, and chronic disease danger. (8 ).

    Adverse effects of berberine

    The national center for complementary and integrative health (nccih) trusted source notes that if grownups take goldenseal, which includes berberine, by mouth it is not likely to cause serious negative effects in the short term. Nevertheless, there is not enough info to reveal that long-term use is safe.

    Berberine can cause digestive negative effects, such as:.

    • Upset stomach
    • Constipation
    • Queasiness

    It can likewise trigger a rash or headache in some individuals.

    In animal research studies, researchers have observed the list below effects, depending on the type of animal, how much they consumed, and for how long:.

    • Diarrhea
    • Vomiting
    • Queasiness
    • Muscle tremor
    • Stomach ulcers
    • Liver and kidney augmentation
    • A decrease in leukocyte

    It is important to talk with a physician before taking berberine or other supplements, as they may not be safe or appropriate for everyone to use. Anyone who develops an allergy to any natural item should stop using it at once.

    The nccih recommends people not to utilize goldenseal, which includes berberine, during pregnancy or while breastfeeding. They add that offering goldenseal to a newborn could trigger or aggravate jaundice and increase the risk of kernicterus, a potentially harmful condition. (9 ).

    Dosage

    The suggested dosage of berberine is based upon analyses of the readily available clinical literature. The results of berberine are obvious at fairly high doses due to its low absorption in the gastrointestinal system. Just how much berberine should you take daily? It is recommended to take between 900 and 1500 mg of berberine.

    The length of berberine consumption depends upon the impact you wish to achieve. Analysis of scientific research studies on berberine supplements provides some concept after how long the results of using berberine will be visible. The result of preparations with berberine is observed:.

    • In insulin resistance after 2-4 months of use from 900 to 1500 mg of berberine daily;
    • In dyslipidemia, with high blood cholesterol levels after 6-24 months of use 600 to 1500 mg berberine daily;
    • In hypertension after 2 months of taking 900 mg of berberine each day;
    • In polycystic ovary syndrome after 3-6 months of taking 1500 mg of berberine per day;
    • In weight problems after 3 months of 900 to 1500 mg berberine daily. (10 )

    Interactions

    • Cyclosporine (neoral, sandimmune) interaction ranking: significant do not take this mix.
    • The body breaks down cyclosporine (neoral, sandimmune) to eliminate it. Berberine might reduce how quick the body breaks down cyclosporine (neoral, sandimmune). Cyclosporine (neoral, sandimmune) may build up in the body and could possible trigger negative effects.
    • Medications for diabetes (antidiabetes drugs) interaction score: significant do not take this combination.
    • Berberine might lower blood sugar. Diabetes medications are also utilized to lower blood sugar. Taking berberine along with diabetes medications may trigger your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication may require to be altered.
    • Some medications used for diabetes consist of glimepiride (amaryl), glyburide (diabeta, glynase prestab, micronase), insulin, pioglitazone (actos), rosiglitazone (avandia), and others.
    • Dextromethorphan (robitussin dm, and others) interaction ranking: moderate be cautious with this combination.talk with your health service provider.
    • The body breaks down dextromethorphan (robitussin dm, others) to eliminate it. Berberine might decrease how rapidly the body breaks down dextromethorphan (robitussin dm, others). Taking berberine while taking dextromethorphan (robitussin dm, others) might increase the effects and negative effects of dextromethorphan (robitussin dm, others).
    • Losartan (cozaar) interaction rating: moderate beware with this combination.talk with your health supplier.
    • The liver activates losartan (cozaar) to make it work. Berberine might decrease how quickly the body breaks down losartan (cozaar). Taking berberine while taking losartan (cozaar) may reduce the results of losartan.
    • Medications changed by the liver (cytochrome p450 2c9 [cyp2c9] substrates) interaction score: moderate beware with this combination.talk with your health company.
    • Some medications are changed and broken down by the liver. Berberine may reduce how quickly the liver breaks down some medications. Taking berberine along with some medications that are broken down by the liver can increase the effects and negative effects of some medications. Prior to taking berberine, talk to your doctor if you are taking any medications that are changed by the liver.
    • Some medications altered by the liver consist of celecoxib (celebrex), diclofenac (voltaren), fluvastatin (lescol), glipizide (glucotrol), ibuprofen (advil, motrin), irbesartan (avapro), losartan (cozaar), phenytoin (dilantin), piroxicam (feldene), tamoxifen (nolvadex), tolbutamide (tolinase), torsemide (demadex), and s-warfarin (coumadin).
    • Medications changed by the liver (cytochrome p450 2d6 [cyp2d6] substrates) interaction score: moderate beware with this combination.talk with your health service provider.
    • Some medications are changed and broken down by the liver. Berberine may reduce how rapidly the liver breaks down some medications. Taking berberine in addition to some medications that are broken down by the liver can increase the results and side effects of some medications. Before taking berberine, speak with your healthcare provider if you are taking any medications that are changed by the liver.
    • Some medications altered by the liver include amitriptyline (elavil), codeine, desipramine (norpramin), flecainide (tambocor), haloperidol (haldol), imipramine (tofranil), metoprolol (lopressor, toprol xl), ondansetron (zofran), paroxetine (paxil), risperidone (risperdal), tramadol (ultram), venlafaxine (effexor), and others.
    • Medications changed by the liver (cytochrome p450 3a4 [cyp3a4] substrates) interaction score: moderate be cautious with this combination.talk with your health company.
    • Some medications are altered and broken down by the liver. Berberine may decrease how quickly the liver breaks down some medications. Taking berberine in addition to some medications that are broken down by the liver can increase the effects and negative effects of some medications. Prior to taking berberine, speak with your doctor if you are taking any medications that are altered by the liver.
    • Some medications altered by the liver consist of cyclosporin (neoral, sandimmune), lovastatin (mevacor), clarithromycin (biaxin), indinavir (crixivan), sildenafil (viagra), triazolam (halcion), and lots of others.
    • Medications for hypertension (antihypertensive drugs) interaction rating: moderate be cautious with this combination.talk with your health provider.
    • Berberine might decrease blood pressure in some people. Taking berberine along with medications used for reducing hypertension may trigger your blood pressure to go too low. However, it’s not known if this is a huge concern. Do not take excessive berberine if you are taking medications for high blood pressure.
    • Some medications for hypertension include consist of captopril (capoten), enalapril (vasotec), losartan (cozaar), valsartan (diovan), diltiazem (cardizem), amlodipine (norvasc), hydrochlorothiazide (hydrodiuril), furosemide (lasix), and numerous others.
    • Medications that slow blood clotting (anticoagulant/ antiplatelet drugs) interaction score: moderate be cautious with this combination.talk with your health company.
    • Berberine might slow blood clot. Taking berberine in addition to medications that likewise slow clotting might increase the chances of bruising and bleeding.
    • Some medications that slow blood clot include aspirin, cilostazol (pletal), clopidogrel (plavix), dalteparin (fragmin), enoxaparin (lovenox), heparin, ticlopidine (ticlid), and others.
    • Midazolam (versed) interaction ranking: moderate beware with this combination.talk with your health supplier.
    • The body breaks down midazolam (versed) to get rid of it. Berberine can reduce how rapidly the body breaks down midazolam (versed). Taking berberine together with midazolam (versed) may increase the impacts and adverse effects of midazolam (versed).
    • Sedative medications (cns depressants) interaction rating: moderate beware with this combination.talk with your health supplier.
    • Berberine may cause drowsiness and drowsiness. Medications that triggers drowsiness are called sedatives. Taking berberine together with sedative medications may cause excessive drowsiness.
    • Some sedative medications include benzodiazepines, pentobarbital (nembutal), phenobarbital (luminal), secobarbital (seconal), thiopental (pentothal), fentanyl (duragesic, sublimaze), morphine, propofol (diprivan), and others. (11 )

    Safety measures:

    Prior to taking berberine, talk with your physician if you dislike it or any other medications connected to it. The item can consist of some inactive components which can trigger some severe allergies and other major problems. Berberine has a high threat of hindering drugs, and a few of these reactions may be extreme. When high doses are utilized, gastrointestinal upset might occur, and because of its ability to lower blood sugar, it can increase the risk of hypoglycemia. (12 ).

    Conclusion

    Berberine and its derivatives have extensive pharmacological actions. In this evaluation, their anti-tumor results and underlying systems were systemically described based on systems pharmacology. This evaluation likewise exposed the effectiveness and prospective system of action of berberine and its derivatives when used in the treatment of intricate cancers at the molecular, cellular, and organism levels. In addition, numerous signaling pathways were also described. Nevertheless, there are limitations in the research study of berberine, as its anti-tumor mechanism has yet to be fully illuminated. More significantly, there have actually only been a couple of in vivo and pre-clinical studies examining berberine. Nevertheless, thorough investigations on the effectiveness of berberine and its derivatives are continuous, and a growing number of research studies have started concentrating on the possible anti-tumor function of berberine, perhaps moderated through immune policy. The ability of berberine to increase chemosensitivity and reduce the side effects of chemosensitizers has likewise been highlighted. Berberine and its derivatives might be promising drugs in cancer treatment, potentially enhancing medical efficacy and security. (13 ).

    Recommendations

    1. Https://en.wikipedia.org/wiki/berberine
    2. Https://www.webmd.com/vitamins/ai/ingredientmono-1126/berberine
    3. Https://www.acs.org/content/acs/en/molecule-of-the-week/archive/b/berberine.html#:~:text=berberine%20is%20a%20cationic%20alkaloid,many%20other%20plants%2c%20including%20berberisspp.
    4. Https://www.sciencedirect.com/science/article/pii/s2211383512000871#:~:text=berberine%20is%20known%20as%20an,as%20an%20%ce%b1%2dglucosidase%20inhibitor.
    5. Https://www.healthline.com/nutrition/berberine-powerful-supplement#toc_title_hdr_4
    6. Https://www.pharmaca.com/projectwellness/a-quick-guide-to-berberine/
    7. Https://www.verywellhealth.com/pcos-and-berberine-4136324#:~:text=berberine%20can%20offer%20numerous%20benefits,complications%20associated%20with%20the%20condition.
    8. Https://www.wellandgood.com/benefits-of-berberine/
    9. Https://www.medicalnewstoday.com/articles/325798#side-effects
    10. Https://ostrovit.com/en/blog/berberine-use-dosage-and-effects-1619512157.html?lang=eng
    11. Https://www.rxlist.com/berberine/supplements.htm#interactions
    12. Https://www.medicoverhospitals.in/medicine/berberine#:~:text=before%20taking%20berberine%2c%20talk%20with,reactions%20and%20other%20serious%20problems.
    13. Https://www.frontiersin.org/articles/10.3389/fphar.2019.01461/full

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