Absorption Kinetics of Berberine and Dihydroberberine and Their Impact on Glycemia: A Randomized, Controlled, Crossover Pilot Trial

Nutrients

Dec 2021

DOI: 10.3390/nu14010124

Citations:26

Influential Citations:2

Interventional (Human) Studies

Enhanced Details

Methods

Five healthy male adults (age ~26 years; 184 cm tall; 92 kg; body fat ~17%) participated in a randomized, double-blind, crossover trial comparing berberine and dihydroberberine absorption; study employed IRB oversight and informed consent.

Intervention

Four oral dosing conditions across two days: berberine 500 mg per dose; dihydroberberine 100 mg per dose (D100) or 200 mg per dose (D200); and placebo using resistant dextrin. For each condition, four doses were given: three on the day before testing with breakfast, lunch, and dinner, and the fourth dose the morning of testing; all doses taken with approximately 8 oz of water and with meals. A standardized test meal (30 g glucose powder plus four slices of white bread) was consumed ~30 minutes after the final dose. Absorption kinetics were assessed with venous blood sampling at 0, 20, 40, 60, 90, and 120 minutes after the meal.

Results

Dihydroberberine markedly increased berberine plasma exposure vs berberine alone or placebo. Berberine AUC over 0–120 min was highest with D200 (approximately 929 ng/mL×120 min), followed by D100 (≈284 ng/mL×120 min); both were higher than placebo (≈20 ng/mL×120 min) and berberine alone (≈42 ng/mL×120 min). Cmax tended to be higher with D100 and D200 than with placebo and berberine, with D100 showing a statistically significant rise versus placebo. Conclusion: dihydroberberine improves oral berberine bioavailability and peak plasma concentrations, suggesting greater potential for metabolic effects; however, these findings come from a small, short-term pilot in healthy men, and larger, longer-term trials are needed to establish clinical relevance.

Limitations

Small sample size (n=5); pilot study in healthy young men; short-term pharmacokinetic outcomes only; limited generalizability to women, older individuals, or metabolic disease populations; potential data variability/outliers in PK measures.

Abstract

Berberine is a natural alkaloid used to improve glycemia but displays poor bioavailability and increased rates of gastrointestinal distress at higher doses. Recently, dihydroberberine has been developed to combat these challenges. This study was designed to determine the rate and extent to which berberine appeared in human plasma after oral ingestion of a 500 mg dose of berberine (B500) or 100 mg and 200 mg doses of dihydroberberine (D100 and D200). In a randomized, double-blind, crossover fashion, five males (26 ± 2.6 years; 184.2 ± 11.6 cm; 91.8 ± 10.1 kg; 17.1 ± 3.5% fat) completed a four-dose supplementation protocol of placebo (PLA), B500, D100, and D200. The day prior to their scheduled visit, participants ingested three separate doses with breakfast, lunch, and dinner. Participants fasted overnight (8–10 h) and consumed their fourth dose with a standardized test meal (30 g glucose solution, 3 slices white bread) after arrival. Venous blood samples were collected 0, 20, 40, 60, 90, and 120 minutes (min) after ingestion and analyzed for BBR, glucose, and insulin. Peak concentration (CMax) and area under the curve (AUC) were calculated for all variables. Baseline berberine levels were different between groups (p = 0.006), with pairwise comparisons indicating that baseline levels of PLA and B500 were different than D100. Berberine CMax tended to be different (p = 0.06) between all conditions. Specifically, the observed CMax for D100 (3.76 ± 1.4 ng/mL) was different than PLA (0.22 ± 0.18 ng/mL, p = 0.005) and B500 (0.4 ± 0.17 ng/mL, p = 0.005). CMax for D200 (12.0 ± 10.1 ng/mL) tended (p = 0.06) to be different than B500. No difference in CMax was found between D100 and D200 (p = 0.11). Significant differences in berberine AUC were found between D100 (284.4 ± 115.9 ng/mL × 120 min) and PLA (20.2 ± 16.2 ng/mL × 120 min, p = 0.007) and between D100 and B500 (42.3 ± 17.6 ng/mL × 120 min, p = 0.04). Significant differences in D100 BBR AUC (284.4 ± 115.9 ng/mL×120 min) were found between PLA (20.2 ± 16.2 ng/mL × 120 min, p = 0.042) and B500 (42.3 ± 17.6 ng/mL × 120 min, p = 0.045). Berberine AUC values between D100 and D200 tended (p = 0.073) to be different. No significant differences in the levels of glucose (p = 0.97) and insulin (p = 0.24) were observed across the study protocol. These results provide preliminary evidence that four doses of a 100 mg dose of dihydroberberine and 200 mg dose of dihydroberberine produce significantly greater concentrations of plasma berberine across of two-hour measurement window when compared to a 500 mg dose of berberine or a placebo. The lack of observed changes in glucose and insulin were likely due to the short duration of supplementation and insulin responsive nature of study participants. Follow-up efficacy studies on glucose and insulin changes should be completed to assess the impact of berberine and dihydroberberine supplementation in overweight, glucose intolerant populations. show less