Comparative Effects of Gymnema sylvestre and Berberine on Adipokines, Body Composition, and Metabolic Parameters in Obese Patients: A Randomized Study
Open accessAbstract
Gymnema sylvestre (GS) and berberine (BBR) are natural products that have demonstrated therapeutic potential for the management of obesity and its comorbidities, as effective and safe alternatives to synthetic drugs. Although their anti-obesogenic and antidiabetic properties have been widely studied, comparative research on their impact on the gene expression of adipokines, such as resistin (Res), omentin (Ome), visfatin (Vis) and apelin (Ap), has not been reported. Methodology: We performed a comparative study in 50 adult Mexican patients with obesity treated with GS or BBR for 3 months. The baseline and final biochemical parameters, body composition, blood pressure, gene expression of Res, Ome, Vis, and Ap, and safety parameters were evaluated. Results: BBR significantly decreased (p < 0.05) body weight, blood pressure and Vis and Ap gene expression and increased Ome, while GS decreased fasting glucose and Res gene expression (p < 0.05). A comparative analysis of the final measurements revealed a lower gene expression of Ap and Vis (p < 0.05) in patients treated with BBR than in those treated with GS. The most frequent adverse effects in both groups were gastrointestinal symptoms, which attenuated during the first month of treatment. Conclusion: In patients with obesity, BBR has a better effect on body composition, blood pressure, and the gene expression of adipokines related to metabolic risk, while GS has a better effect on fasting glucose and adipokines related to insulin resistance, with minimal side effects.
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Less effective drugs for weight loss, such as sympathomimetics and lipase inhibitors, were associated with more subtle AEs including oily stools and fecal urgency.
“Less effective drugs for weight loss, such as sympathomimetics and lipase inhibitors, were associated with more subtle AEs including oily stools and fecal urgency [3,14].”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
Natural or complementary products such as berberine, silibnin, and Lipigo have been studied for weight loss, with reported side effects ranging from bloating and flatulence to more clinically significant GI disturbances.
“Additionally, some natural or complementary products, such as berberine, silibnin, and Lipigo, have been studied for weight loss, with reported side effects ranging from bloating and flatulence to more clinically significant GI disturbances [14,17].”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
Berberine caused hemorrhoidal bleeding (28%), nausea (20%), and constipation (16%); all symptoms were mild and self-limited.
“Berberine caused hemorrhoidal bleeding (28%), nausea (20%), constipation (16%); however, all symptoms were mild and self-limited [14].”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
In Bandala et al., Gymnema sylvestre caused loose stools (52%), dysgeusia (40%), diarrhea (28%), reflux (28%), and nausea (20%).
“In Bandala et al., Gymnema sylvestre caused loose stools (52%), dysgeusia (40%), diarrhea (28%), reflux (28%), nausea (20%).”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
Lipigo, Gymnema sylvestre, berberine, obex, and vutiglabridin demonstrated favorable short-term tolerability with only mild, transient GI events.
“Agents such as Lipigo, Gymnema sylvestre, berberine, obex, and vutiglabridin demonstrated favorable short-term tolerability with only mild, transient GI events [14,15,17,19].”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
Natural and emerging compounds such as silibinin, Lipigo, Gymnema sylvestre, berberine, and vutiglabridin appear well tolerated in early studies.
“Natural and emerging compounds such as silibinin, Lipigo, Gymnema sylvestre, berberine, and vutiglabridin appear well tolerated in early studies, but their small sample sizes and short follow-up preclude strong conclusions [14,15,17,22].”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
Natural and investigational products such as Gymnema sylvestre and berberine likely act through local modulation of gut microbiota and bile acid metabolism, producing mild, transient discomfort.
“Natural and investigational products such as Gymnema sylvestre and berberine likely act through local modulation of gut microbiota and bile acid metabolism, producing mild, transient discomfort [14,22].”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
The small sample sizes and short follow-up of studies of natural and emerging compounds preclude strong conclusions.
“Natural and emerging compounds such as silibinin, Lipigo, Gymnema sylvestre, berberine, and vutiglabridin appear well tolerated in early studies, but their small sample sizes and short follow-up preclude strong conclusions [14,15,17,22].”
From Gastrointestinal Adverse Effects of Anti-Obesity Medications in Non-Diabetic Adults: A Systematic Review (2025) · cites this paper as [14]
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Ghosh, A. R., Alsayari, A., Habib, A. H., Wahab, S., Nadig, A. P. R., Rafeeq, M. M., Binothman, N., Aljadani, M., Al-Dhuayan, I. S., ALaqeel, N. K., et al. (2023) · Antioxidants · doi:10.3390/antiox12010134 · Cited by 16 · see citing works
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Berberine attenuates olanzapine induced-metabolic syndrome.
Al-Naimi, M. S., Rasheed, H. A., Al-Kuraishy, H. M., & Al-Gareeb, A. I. (2019) · PubMed · Cited by 13 · see citing works
Basciani, S., Nordio, M., Dinicola, S., Unfer, V., & Gnessi, L. (2023) · Nutrients · doi:10.3390/nu15143142 · Cited by 12 · see citing works
Congenital disorders of intestinal digestion and absorption (sugars, proteins, lipids, ions)
Peretti, N., & Mas, E. (2022) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2022.101785 · Cited by 9 · see citing works
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Serum apelin-12 and obesity-related markers in Egyptian children with Down syndrome
Yahia, S., Salem, N. A., El-Hawary, A. K., Salem, M., El-Farahaty, R. M., El‐Gilany, A., Shoaib, R. M. S., & Noureldin, M. A. (2023) · European Journal of Pediatrics · doi:10.1007/s00431-023-05315-3 · Cited by 4 · see citing works
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Younus, I., Iqbal, S., Shahid, M., & Hassan, H. (2023) · The Professional Medical Journal · doi:10.29309/tpmj/2023.30.01.7169 · Cited by 2 · see citing works
Flagged first, then by citations
3 of the 93 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Obesity: pathophysiology and therapeutic interventions
Kong, Y., Yang, H., Nie, R., Zhang, X., Zuo, F., Zhang, H., & Nian, X. (2025) · Molecular Biomedicine · doi:10.1186/s43556-025-00264-9 · Cited by 89 · see citing works
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The effect of berberine on obesity indices: a systematic review and meta-analysis
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Potential Health Effects of the Natural Alkaloid Berberine: A Narrative Review
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Self-citationAntioxidants as a Link Between Diabetes and Potential Plant-Based Therapies
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- Authors
- Bandala, C., Carro-Rodríguez, J., Cárdenas-Rodríguez, N., Peña-Montero, I., Gómez-López, M., Hernández-Roldán, A. P., Huerta-Cruz, J. C., Muñoz-González, F., Ignacio-Mejía, I., Domínguez, B., & Lara-Padilla, E.
- Affiliations
- Instituto Politécnico Nacional (MX)
- Laboratorio de Neurociencias, Instituto Nacional de Pediatría, Mexico City 04530, Mexico
- Laboratorio de Obesidad, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico
- Unidad de Investigación en Farmacología, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosio Villegas, Secretaria de Salud, Mexico City 14080, Mexico
- Laboratorio de Medicina Traslacional, Escuela Militar de Graduados en Sanidad, Universidad del Ejército y Fuerza Aérea, Mexico City 11200, Mexico
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2024-07-16
- Volume
- 16
- Issue
- 14
- Pages
- 2284
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC11280467
- OpenAlex
- W4400683279
- Cited by
- 18
- References
- 93
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 2
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Instituto Politecnico Nacional (2170253, 221826)
- Consejo Nacional de Ciencia y Tecnología (2170253, 221826)
- Topics
- Health Sciences › Medicine › Pharmacology › Berberine and alkaloids research
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- Gymnema sylvestre, berberine, obesity, adipokines, resistin, omentin, visfatin, apelin, body composition, blood pressure, fasting blood glucose, insulin resistance, gene expression, herbal medicine, antidiabetic drugs, adverse effects
- MeSH terms
- Apelin, Adult, Berberine, Blood Glucose, Blood Pressure, Body Composition, Female, Humans, Male, Middle Aged, Obesity, Plant Extracts, Cytokines, Anti-Obesity Agents, Gymnema sylvestre, Lectins, Resistin, Adipokines, Nicotinamide Phosphoribosyltransferase, GPI-Linked Proteins
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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