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With the raving success of Ozempic and other weight loss drugs over the past several years, you may have heard about a "more natural" alternative: berberine. Video above: WeightWatchers offers version of Ozempic, despite FDA concernsBerberine may be new to social media influencers, but this compound has been a part of Chinese and Ayurvedic medicine practices for hundreds of years, used mainly to treat diarrhea and other gastrointestinal infections, according to the Cleveland Clinic. Berberine is getting different attention now, sparking the interest of TikTok users as a way to lose weight. But, is it really the miracle natural alternative to weight loss drugs they say it is? We asked the experts. What is berberine? Berberine is a natural alkaloid compound found in several plants, such as the goldenseal, barberry, and Oregon grape plants, according to the National Institutes of Health. But just because it's natural doesn't mean it's harmless. "Other commonly known alkaloid compounds are things like morphine, nicotine, and caffeine," says Perri Halperin, M.S., R.D., clinical nutrition coordinator at Mount Sinai Health System. "I bring that up to say that just because something is natural or comes from a plant, doesn't mean it isn't powerful and doesn't mean it's without potentially harmful or negative side effects."What does berberine do? Research has found some impressive mechanisms for berberine, but there's still more digging to do. "Some researched benefits of berberine supplements include blood sugar control, cholesterol benefits, weight management, and gut health," says Erin Kenney, M.S., R.D., founder of Nutrition Rewired. A 2021 systematic review of berberine studies found it had a useful effect on several health factors. It's been seen to potentially help lower cholesterol and has been considered a potential treatment for type 2 diabetes who don't tolerate statins. It has been found to affect the expression of genes involved in glucose and lipid metabolism, leading to improved insulin sensitivity, Kenney says. However, these studies are very small, which means the science is still in its preliminary stages. Berberine is also anti-microbial, "so some say that it could improve the gut microbiome. There's whole other area of research where the makeup of the gut microbiome can influence weight loss and also overall health," says Halperin. It's most known for its rumored assistance in weight loss. But the answers there aren't quite solidified, either. Can berberine really help you lose weight? The compound affects enzymes involved in energy regulation, which promotes healthy blood glucose levels and insulin resistance, making it potentially useful in diabetes treatment. It's been shown to possibly inhibit fat-forming and lipogenic genes of fat, reducing fat-production. But the studies that show this "are not well designed, and they're mostly animal studies. They just have marginal results, which may be due to a placebo effect, or concurrent lifestyle changes," says Halperin.Berberine also has a laxative effect, which could be attributed to weight loss effects, but not long-term.Should you take a berberine supplement? Generally, berberine is considered a safe supplement. It's well tolerated—very few adverse reactions have been reported. Side effects include nausea, vomiting, and muscle weakness, but they're not common.That being said, you should always consult with your doctor or primary care provider before starting a new supplement. This is especially true for those with pre-existing conditions or who are taking medications. "Berberine can interact with certain medications, particularly those metabolized by the liver," Kenney says. It also "may interact with medications such as blood thinners, anti-diabetic drugs, and medications that undergo liver metabolism." It's important to note, too, that berberine is currently listed as a supplement under the FDA. Supplements are not well regulated, so it's important to select one that has been tested by a third party, Halperin says.