Berberine long term use: impact on potassium levels

For 00tmg (@00tmg), With my doctor's okay, I've successfully used berberine rather than metformin for many years to keep my diabetes2 under control. (My fasting test this AM was 79.) I also eat a banana daily, and bananas are a known source of potassium. The following probably doesn't have to do with your problem, but whenever I try something that's new for me, I do so gradually to give my body a chance to adjust. Perhaps you might research what various causes of high potassium are to see what might ring a bell in your experience. Best wishes for figuring it all out. Life can get complicated, can't it?

@00tmg Welcome to Mayo Connect.
And congratulations on asking the most challenging question of the day so far. Using berberine is a more complicated than many other supplements because it has the potential to interact with many medications - increasing the effect of some, reducing the effectiveness of others.

Any impact on potassium levels has the potential to cause issues with the heart because it is a critical part of the body chemistry that helps in conduction and regulation of the electrical impulses there, along with proper levels of sodium and calcium. That is probably why the doctor recommended stopping when the cause was unknown.

Keep in mind that the study of supplements, exactly how they work and why, their impact on the human body, both short and long term, and their interaction with other drugs and supplements, is in its infancy. Very few full blown scientific studies have been undertaken, complete with human trials and long-term results tracking. I will take a shot at answering this, based on some research on Google Scholar, because berberine is a supplement I considered using to help with total cholesterol and had to reject because it has a negative effect on another medication I use. My husband also considered it for blood sugar management, but it is contraindicated with one or more of his meds as well.

That said, what little research exists actually indicates that berberine is thought to act as potassium modifier at the same time as increasing sodium and calcium blocker. Here is a recent article summarizing the findings of all the quality research studies the authors were able to identify, with citations to all the articles:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107691/
BUT the paper goes on to say that what was not studied was optimum dosage, long term use or drug interactions, among other details. Also, there have been suggestions by some that you not take berberine full-time - suggesting intervals like 8 weeks on, 4 weeks off, but I did not find evidence to support this.

So...now the questions are -
Was the increased potassium cause by the berberine or something else?
Did your potassium level return to normal after stopping?
If it did, did berberine interact with some medication you were using? you can check here:
https://www.webmd.com/vitamins/ai/ingredientmono-1126/berberine
Or do you have some enzyme deficiency that makes it work differently in your body?
Or was the dose of berberine too high for you? Remember, we each metabolize thing differently.
Finally, can you talk to your doctor about another berberine trial? Maybe with a lower dose or interval dosing?

Thanks for giving me something new to learn!
Sue

I had a slightly high potassium reading on two occasions about four years ago. The readings since have been normal. I too read about that blood rupture that can happen during a blood draw. I cannot now found where I read this, but you need to make sure that once they find the vein and the blood is flowing out, your hand is relaxed and not making a fist anymore.

@00tmg Welcome to Mayo Connect.
And congratulations on asking the most challenging question of the day so far. Using berberine is a more complicated than many other supplements because it has the potential to interact with many medications - increasing the effect of some, reducing the effectiveness of others.

Any impact on potassium levels has the potential to cause issues with the heart because it is a critical part of the body chemistry that helps in conduction and regulation of the electrical impulses there, along with proper levels of sodium and calcium. That is probably why the doctor recommended stopping when the cause was unknown.

Keep in mind that the study of supplements, exactly how they work and why, their impact on the human body, both short and long term, and their interaction with other drugs and supplements, is in its infancy. Very few full blown scientific studies have been undertaken, complete with human trials and long-term results tracking. I will take a shot at answering this, based on some research on Google Scholar, because berberine is a supplement I considered using to help with total cholesterol and had to reject because it has a negative effect on another medication I use. My husband also considered it for blood sugar management, but it is contraindicated with one or more of his meds as well.

That said, what little research exists actually indicates that berberine is thought to act as potassium modifier at the same time as increasing sodium and calcium blocker. Here is a recent article summarizing the findings of all the quality research studies the authors were able to identify, with citations to all the articles:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107691/
BUT the paper goes on to say that what was not studied was optimum dosage, long term use or drug interactions, among other details. Also, there have been suggestions by some that you not take berberine full-time - suggesting intervals like 8 weeks on, 4 weeks off, but I did not find evidence to support this.

So...now the questions are -
Was the increased potassium cause by the berberine or something else?
Did your potassium level return to normal after stopping?
If it did, did berberine interact with some medication you were using? you can check here:
https://www.webmd.com/vitamins/ai/ingredientmono-1126/berberine
Or do you have some enzyme deficiency that makes it work differently in your body?
Or was the dose of berberine too high for you? Remember, we each metabolize thing differently.
Finally, can you talk to your doctor about another berberine trial? Maybe with a lower dose or interval dosing?

Thanks for giving me something new to learn!
Sue

For about six weeks, I have been taking a berberine formula from HLTHCODE, which lowered my spiky blood pressure dramatically. It also took care of cravings and reshaped my body a bit. Now suddenly I have low sodium, 133, which I've never had before, and slightly higher potassium, at 4, which is good since my potassium is always on the low side. I have had kidney stones recently and for that was trying to keep the sodium to a minimum, plus drink huge amounts of water, which along with cutting oxalates has worked very well to keep them at bay. Research suggests the berberine should be raising sodium, not lowering it, but there may be a genetic element here.
Has anyone heard of a good berberine researcher? I hate to depend on the many studies from China, and there really hasn't been a lot of reliable work done here. It works so well for me except for the sodium element, which makes me dizzy and alarms my endocrinologist, who I see for osteoporosis. She has not mentioned using berberine for osteoporosis, but that seems to be a known remedy in the bones world.

If you are drinking a lot of water and your sodium is falling, you may need to supplement, either with electrolyte balancing drinks or salt tabs. Low sodium poses significant cardiac risks. Be sure to let your docs know what is happening.