Berberine vs Urolithin A

Mechanism

Berberine activates AMP-activated protein kinase (AMPK), the master metabolic sensor, mimicking many effects of caloric restriction and exercise. It inhibits mitochondrial Complex I, increasing the AMP:ATP ratio which triggers AMPK. Downstream effects include enhanced GLUT4 translocation (glucose uptake), inhibition of HMG-CoA reductase (cholesterol synthesis), upregulation of LDL receptor expression, and suppression of PCSK9. It also modulates gut microbiome composition, increasing short-chain fatty acid-producing bacteria.

Standard Dosing

500mg 2-3x daily (1000-1500mg total)

Timing

With meals or immediately before meals (reduces postprandial glucose spike). Must be taken with food.

Cycle Duration

Cycle 8-12 weeks on, 4 weeks off (or continuous under practitioner supervision)

Side Effects

• GI cramping/diarrhea (dose-dependent)
• Constipation in some
• Abdominal distension
• Potential for hypoglycemia

Contraindications

• Pregnancy (uterotonic — may induce contractions)
• Lactation
• Concurrent use of multiple CYP3A4 metabolized drugs
• Severe liver disease
• Children under 12

Best Stacking Partners

Mechanism

Gut metabolite of ellagitannins that activates mitophagy — selective clearance of damaged mitochondria. Improves mitochondrial function, muscle endurance, and cellular energy production. Only ~40% of population can produce it endogenously.

Contraindications

• Limited long-term safety data beyond 4 months