Is berberine beneficial for blood sugar control?
DEAR DR. ROACH: I would like your advice on the supplement berberine. My husband is a Type 2 diabetic, and he recently read an article about the benefits of berberine for lowering blood sugar. It's supposedly better than cinnamon, which he is currently taking. -- A.H.
ANSWER: A few years ago, cinnamon was very popular as a treatment for diabetes, in addition to a healthy diet, regular exercise and appropriate medications, if necessary, taken as prescribed. However, with further study and analysis of all the available literature, the supposed benefit has not really held up, and few people use cinnamon for control of blood sugar (but I have at least one patient who grew to like the taste of putting a teaspoon of cinnamon in their coffee when brewing it). We have thousands of years of experience showing cinnamon is safe when consumed in food, but one warning: DO NOT inhale cinnamon, which is easy to do if trying to take it as a powder with a spoon.
Some small trials have shown that berberine, a yellow compound extracted from many shrubs including barberry -- from which comes its name -- can improve both cholesterol and blood sugar. A 2008 study from China showed impressive reductions in blood sugar, similar to those seen with the prescription medication metformin. In addition, cholesterol levels also improved. About a third of people had gastrointestinal symptoms, such as diarrhea and upset stomach.
Although there is some promising research, it is still too early for a conservative physician like me to recommend it for general use. Like cinnamon, more rigorous trials may very well show it does not have the benefits suggested by early research. Further, it has the potential for drug interaction, and a careful evaluation by a doctor or pharmacist should be done before trying this in people taking other medicines. Finally, as is always the case, supplements are not well regulated, and it is possible that what you buy as berberine really isn't, or has a different dose from, what it says on the bottle.
DEAR DR. ROACH: Would you please address vaccines and people with autoimmune conditions? My son has psoriasis and what some of his providers are calling "full body inflammation." His acupuncturist has told him not to get the vaccine because it would be dangerous for him. He has hung his hat on this and refuses to get the shot. I tell him that it's probably safer to get the vaccine than COVID-19. What are your thoughts? -- P.O.
ANSWER: Psoriasis is an immune-mediated inflammatory disease that shows up as changes in the skin and joints, among other possible sites. Since we sometimes think of vaccines "revving up" the immune system, it is reasonable to think that they might temporarily make inflammation worse.
However, the increase in immune system activity from a modern vaccine is specific to a very precise part of the SARS-CoV-2 virus, the cause of COVID-19. The risk of worsening autoimmune diseases has proved to be more theoretical than real.
COVID-19 is more likely to cause severe disease in people with chronic immune and inflammatory diseases. Some of the medications used to treat psoriasis can also predispose a person to a more severe course of COVID-19. I think your advice that the vaccine is much less risky than the disease was exactly right.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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