- AMPK
- AMP-activated protein kinase — the cell's fuel-sensor that switches on glucose uptake, fatty-acid oxidation, and mitochondrial biogenesis. Berberine activates it (same pathway as metformin).
- Bioavailability (~1%)
- The fraction of an oral berberine HCl dose that reaches systemic circulation. P-glycoprotein pumps most of it back into the gut — why clinical doses look large (1,500 mg/day split).
- Dihydroberberine (DHB)
- The partially reduced metabolite that actually crosses the intestinal wall. 3-5× higher bioavailability than HCl at lower doses, ~3× the price.
- Berberine HCl
- Berberine hydrochloride salt — the cheap, trial-validated form. ~1% bioavailable but the form 30+ RCTs measured. The volume play at $12-25/month.
- Phytosome formulation
- Berberine + phosphatidylcholine complex (e.g. Berberol/Indena) — middle-tier bioavailability between HCl and DHB, with published trial backing.
- CYP3A4 inhibition
- Berberine blocks the liver enzyme metabolising cyclosporine, tacrolimus, simvastatin, and some calcium-channel blockers — spiking their plasma levels. Coordinate with clinician if on these.
- P-glycoprotein
- The intestinal efflux pump that explains berberine's poor absorption. Also pumps digoxin and dabigatran — berberine raises plasma levels of these substrates.
- HbA1c
- 3-month average blood glucose marker. Yin 2008 showed berberine 1,500 mg/day cut HbA1c 0.7-1.0% — matching metformin 1,500 mg/day in type-2 diabetics.