As we’ve been seeing over and over, a new class of medications, GLP-1 agonists — including Ozempic, Wegovy and Mounjaro — has gained immense popularity since their release. These medications work by mimicking hormones that influence the body’s control over appetite and food intake, as well as slowing digestion to promote a sense of fullness. Common side effects include gastrointestinal issues and injection site reactions.

These drugs have been a breakthrough for those dealing with weight-related conditions such as diabetes, high blood pressure, and heart disease. However, as with any new medication hailed as a “miracle” solution, some people use them to shed a few pounds for aesthetic reasons.

Susan B. Trachman, M.D., in her article in Psychology Today, writes that she is particularly concerned about how these “miracle” drugs might impact mental health. She reminds us that previously, weight-loss drugs like Zimulti were pulled from the European market due to increased reports of suicidal thoughts and behaviors. In the U.S., Qnexa (Vivus), containing phentermine and topiramate, was rejected by the FDA due to concerns over potential risks, including suicidal ideation, despite demonstrating significant weight loss.

Alarming side effects of GLP-1 drugs

While the research on the subject remains limited and conflicting, suicidal ideation has been linked to other weight-loss drugs in the past. For example, Sanofi’s Acomplia, which was never approved in the U.S., was withdrawn from the European market in 2008 due to similar concerns. Contrave, another weight-loss drug, carries a “black box warning” for suicidal thinking, and Qsymia includes a warning advising users to stop taking it if they experience such thoughts.

A recent study, published in the journal JAMA Network Open, examined reports of suicidal thoughts among individuals using semaglutide, whether for diabetes management or weight loss. The researchers analyzed data from a World Health Organization database that tracks adverse drug reactions in over 140 countries.

Out of more than 30,500 people taking semaglutide, 107 reported experiencing suicidal thoughts. Similarly, 162 cases of suicidal ideation were found among over 52,000 patients using liraglutide, another injectable diabetes medication from the same drug class as semaglutide. Since liraglutide has been on the market longer, it has been used by more people.

The study highlighted a disproportionate risk of suicidal thoughts in individuals taking semaglutide, which was not observed in those on liraglutide. Comparing the frequency of suicidal thoughts in semaglutide users with those on other medications in the database, the researchers noted an approximately 45{dfac5e6feebc182a3317a1800a78117261554ecfb6a579338c4abc2638d58697} higher risk associated with semaglutide use.

Enter berberine, nature’s potentially safer alternative

Given that even a slight risk of suicidal ideation should be carefully monitored and mitigated, nature offers a potentially safer alternative for weight loss: berberine. This compound is found in various plants, including goldenseal, barberry, and Oregon grape, and has been used for centuries in Ayurvedic and Chinese medicine. Traditionally, berberine has been utilized to treat infections, skin diseases, and digestive issues. More recently, it has gained attention for its potential positive effects on diabetes and heart disease, as well as its growing popularity as a weight-loss aid.

When taken as a pill or powder, berberine enters the bloodstream and interacts with cells, influencing various biological processes. Instead of targeting a single pathway, berberine acts on multiple fronts, impacting several conditions simultaneously.

In a review published in Biomedicine and Pharmacotherapy, researchers highlighted berberine’s effectiveness in lowering fasting blood sugar levels in hundreds of patients. Additionally, the compound was found to reduce body mass index in a small group of subjects over three months. Other studies have shown that berberine supplements can reduce cardiovascular risk in postmenopausal women by lowering total cholesterol, and when combined with blood pressure medication, it has enhanced the effects of the treatment in hypertensive patients.

Berberine seems to decrease insulin resistance, which can lead to obesity and type 2 diabetes. It may also modulate gut hormones that regulate food intake and energy balance. However, scientific studies focused specifically on berberine’s weight-loss effects are limited due to small sample sizes. One such study involving individuals with fatty liver disease found that those who took berberine daily for three months experienced significant weight loss.

Berberine improves cellular responses to insulin and affects how blood sugar is utilized, helping reduce hunger signals. Additionally, it benefits gut health by promoting a balanced gut microbiome, suppressing harmful bacteria, and encouraging the growth of beneficial ones.

Thinking about trying berberine?

If you consider adding berberine to your regimen, Dr. Trachman advises:

The FDA does not regulate it. Try to source a higher-quality product to avoid side effects from additives in some less expensive forms.

Berberine does interact with some drugs because it can inhibit the clearance of these drugs from the liver, causing an elevated blood level. Check with your healthcare provider before starting this if you take prescription medication.

Berberine’s half-life is only a few hours. That means your blood level will decrease to about 50 percent within a few hours. To maintain a more constant level, many providers recommend multiple daily dosing — two or three times per day at a total of 1500mg.

On a final note, side effects, primarily gastrointestinal, include constipation, nausea, and diarrhea — similar to the side effects reported with newer weight-loss drugs. However, unlike those drugs, berberine has not been associated with mental health issues.

Your responses and feedback are welcome!

Source: “Is Berberine Nature’s Weight Loss Drug?, Psychology Today, 8/23/24
Source: “A study linking popular weight loss drug to suicide risk again raises long-standing safety questions,” CNN.com, 8/20/24
Image by Chris Abney on Unsplash