Written by Katie Koschalk, a health and wellness writer, certified holistic nutritionist, and certified personal trainer based in California.

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Berberine has quickly become one of the most talked-about natural supplements for supporting blood sugar balance, metabolic health, and weight loss. But there’s one not-so-glamorous catch: digestive side effects.

Many people who try berberine report bloating, cramping, constipation, or diarrhea—enough to make them stop taking it altogether. Fortunately, you don’t have to choose between your gut and your goals. Simple adjustments, like taking it with food, drinking plenty of water, or switching to its more absorbable form (dihydroberberine), can often help minimize or even prevent these side effects.

In this guide, we’ll break down the most common berberine side effects, why they happen, and how to manage them naturally.

What Is Berberine?

Berberine is a natural compound found in several plants, including barberry, goldenseal, and Oregon grape. Studies suggest berberine may help control blood sugar, reduce inflammation, aid in weight loss, and improve insulin sensitivity, leading some to compare its effects to medications like metformin, Ozempic, and Wegovy.

Berberine is thought to work at a cellular level, activating an enzyme called AMPK (often referred to as the body’s “metabolic master switch”), which plays a key role in energy balance and glucose metabolism.

What Are the Side Effects of Berberine?

Common berberine side effects include:

●      Bloating

●      Diarrhea

●      Constipation

●      Nausea

For some people, the side effects fade over time as the body adjusts. For others, they can be persistent enough to interfere with daily life or cause them to stop taking it.

How to Manage the Side Effects of Berberine

If berberine is upsetting your stomach, don’t throw in the towel just yet. These simple tips can help ease or even prevent side effects, so you can keep reaping the benefits without the discomfort.

#1: Start with a low dose

Typically, the dosage is 500 milligrams, three times daily. But jumping straight into the full dose can increase the risk of side effects. Start low—250 mg once a day—and slowly increase over time to the standard dose. This gives your body a chance to adjust.

#2: Take it with food

Taking berberine on an empty stomach can make digestive symptoms worse. Try taking it with a meal to buffer your stomach and reduce nausea.

#3: Stay hydrated

Some people experience constipation when taking berberine. Drinking more water and increasing fiber intake can help keep things moving.

#4: Add a probiotic

Berberine has natural antimicrobial properties, meaning it can kill harmful and beneficial bacteria in your gut. This disruption to your gut’s microbiome can lead to digestive issues. Adding a probiotic to your routine can help offset this effect by replenishing the good bacteria and supporting a healthy microbial balance.

#5: Switch to dihydroberberine

Consider taking dihydroberberine (DHB)—the active metabolite of berberine. When you take berberine, your gut has to convert it into DHB before your body can use it. This conversion process can put stress on your digestive system, which may be one reason some people experience side effects like bloating, gas, or cramping.

By taking DHB directly, you skip that conversion step, which may reduce the likelihood of digestive upset. DHB is also more bioavailable, meaning your body can absorb and use it more efficiently.

If you’re considering dihydroberberine, look for products that contain GlucoVantage® by NNB Nutrition—the only DHB brand supported by research. In a 2022 study, GlucoVantage® was shown to deliver five times more berberine to the bloodstream than standard berberine and remain active in the body twice as long.

The Bottom Line on Berberine Side Effects

Berberine offers promising health benefits, but digestive side effects can be a dealbreaker for some. Fortunately, with a few simple strategies, you can get the benefits of berberine—sans bellyache.