Berberine long term use: impact on potassium levels

@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 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?

Indeed life can get complicated! 🙂 From what I see, constipation can cause potassium level increase (and I was suffering from that when I did the analysis) and also a rupture of blood cells in the blood sample can give a false reading. I will re-talk to my doctor about it and see if she is willing to let me do another berberine trial but this time of shorter duration.

Hi Sue. Sorry, I replied to your message but must not have clicked on something because I don't see it here. To summarise, the potassium levels were back to normal a month later , I am not taking any medication but I did check what might make potassium levels go higher and things like constipation and dehydration might impact levels. Also, it is possible for the blood cells in the blood sample to rupture and give a false high reading during the analysis. I will definitely talk to my doctor about maybe doing a shorter period on berberine (3-4 months maybe) and see if she is willing to consider it. Thanks for the suggestion!