Berberine is a medicinal herb that’s been used in both Eastern and Western herbal medicine for centuries. It’s a compound that can be found in many plants, including Oregon grape, goldenseal, goldthread, and European barberry. In its pure form, it is bitter-tasting and yellow.
Lately, the commercial supplement form of berberine gained attention among the TSW (topical steroid withdrawal) community after a research study showed that after 3-5 months of use, subjective overall improvement between 5% and 80% was reported by 9 subjects taking berberine.
This one small study led to many TSW sufferers self-prescribing doses of berberine in an effort to treat their own symptoms. However, the old adage still applies: If a little is good, more is not always better.
Self-prescribing a berberine supplement may seem like a simple and cheap fix, however, its efficacy will completely depend upon the state of your condition. Berberine on its own is not a cure-all for TSW, and too much can actually cause problems. Because of this, the best way to deliver better and more reliable results for Berberine is to include it as part of a comprehensive TCM treatment plan.
Berberine in Traditional Chinese Medicine
Berberine has been part of traditional Chinese medicine for centuries. The herbs most commonly seen in TCM dermatology formulas are the “three huangs:” That’s why these three are the focus of this article.
Huang Lian – (Chinese Goldthread)
Huang Bai – (Amur Cork Tree)
Huang Qin – (Baikal Skullcap)
One or more of these herbs are almost always a part of traditional TCM herbal formulas for eczema, TSW, and other inflammatory skin conditions, and are normally included in varying ratios from the beginning through the end of treatment. This means that when you choose TCM herbal medicine for your skin condition, you are already getting berberine and all of its benefits if your case calls for it. And the key is “if your case calls for it” — because it won’t always.
Since traditional Chinese practitioners have known and used the healing properties of herbs containing berberine for hundreds of years, they also know when berberine will work and when it won’t, the correct herb and correct amount for each individual patient, as well as the best and safest way to use berberine in treating various skin conditions, including TSW. They also know how to balance berberine with other herbs to make it even more effective and to reduce berberine’s side effects.
Also, berberine is just one of many chemical components of each of these herbal ingredients. Each herbal ingredient brings 100s of chemical components that, when combined, do so much more. Plus, when all these herbal ingredients are cooked and mixed together, they form bonds that bring about new chemical compounds. It is this alchemy that provides the right mix and delivery system to target your specific expression of your condition.
What Centuries of TCM Expertise Shows About Berberine
Each of the three huang herbs that contain berberine in TCM has a slightly different function. A trained TCM physician will know how to choose which ones to fine-tune your formula for your specific symptoms:
Huang Lian – clears heat, dispels dampness, and relieves toxicity. It is also used for gastrointestinal issues, bacterial infections, and inflammation. It is a very cold and bitter herb.
Huang Bai – eliminates dampness, reduces heat, and alleviates pain. It is also used to treat urinary tract infections, skin disorders, and rheumatoid arthritis.
Huang Qin – clears heat, dries dampness, and is helpful to detoxify. It is also used for respiratory and gastrointestinal issues, reducing inflammation and treating bacterial infections. It can also quell allergies.
As you can see, each of these herbs is not only used for skin conditions but for other illnesses as well. It’s a good demonstration that all Chinese herbs that are used internally affect your entire body – that’s how they heal. The fact that it affects your entire body, not just your skin, is very important to know. A trained TCM doctor can tell by your other body functions whether the addition of berberine will help or turn things for the worse in your individual health profile.
Using too much of any one of these herbs in a formula, or using them at the wrong time in your condition’s evolution, can throw your body off balance, causing more problems in both your skin and overall health.
That is why in TCM dermatology, herbs with berberine, along with other herbal formula ingredients, are individually prescribed only at the correct time and in the correct dose according to your specific symptoms. Your TCM practitioner will also change the percentage of herbs in your formula during the course of your treatment if your symptoms worsen or improve.
TCM Formulas Target the Root Cause of TSW – Not Just Symptoms
TCM formulas are greater than the sum of their parts. While each herb in your formula has a distinct and specific action, when all of the herbs in your formula are combined together, they complement each other and become a complex and powerful healing tool.
For example, you and another patient might both have oozing and burning lesions with your TSW. But your TSW might affect your lower limbs, while the other person’s TSW affects only their upper chest. In TCM, we can use different herbs in a formula – in addition to Huang Lian, or Huang Bai, or Huang Qin – to direct healing to each specific problem area. Some herbs direct healing to the head, some to the feet, some to your back, and some to your internal organs. Some herbs are better for moist, hot, and oozing lesions, while other herbs work better for itching, dry, and flaking lesions or scabs.
Additionally, a TCM formula is designed to eliminate the cause of your problem – not just treat the outer symptoms. We don’t want you to be dependent on herbs forever. We want you to reach a permanent resolution that allows you to enjoy your natural and healthy skin without any assistance. That’s why a TCM doctor takes the time to investigate your whole health history and your full range of symptoms to create a formula to correct your specific internal imbalance – not just temporarily manage an itch or a rash.
Limited “One Tool” Thinking
Trying to fix your skin by throwing berberine at the problem is like trying to fix your diet by eating only broccoli. Sure, broccoli is great, but for good and lasting health, you need a diet with a variety of healthy foods with other helpful nutrients in order to see any benefit from the broccoli.
Often, our approach to conventional medicine is to seek out a ‘one-fix’ solution to problems: There is a belief that one drug, one cream, or one chemical can solve a complex skin condition. Or, that one solution will work for everyone. Unfortunately, this just isn’t true. This way of thinking often leaves patients going from fix to fix, or trend to trend, and finding only minimal or temporary relief at best.
Ironically, we often fall victim to thinking the same way when new research shows the benefits of a single herb or plant-based medicine, especially when we are desperate for a cure. But just like conventional medicines, it’s rare that one herb or plant medicine is a true fix for an entire condition, or works the same way for everyone.
Conclusion
It’s exciting when new research papers or case studies support the health applications of medicinal herbs. However, self-diagnosing, self-prescribing, or over-ingesting herbal medicine in your excitement about such studies can sabotage your successful recovery. It’s always best to discuss herbs or supplements you’d like to try with a credentialed health professional first.
And indeed, if you are excited by new research on berberine, you owe it to yourself to consult with a TCM dermatology expert to see if and how TCM herbal medicine can bring the benefits of herbs containing berberine to your treatment plan safely and effectively for more lasting results.
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About the Author
Olivia Hsu Friedman, LAc, Dipl.OM, DACM, Cert. TCMDerm, is the owner of Amethyst Holistic Skin Solutions and treats Acne, Eczema, Psoriasis, and TSW. Olivia treats patients via video conferencing using only herbal medicine. Olivia is Chair of the Board of Directors of the American Society of Acupuncturists, serves on the Advisory Board of LearnSkin, and is a faculty member of the Chicago Integrative Eczema Group sponsored by the National Eczema Association.