Berberine has poor solubility and poor oral bioavailability, which is why so much of an oral dose stays in the gut (Feng 2015, PMID: 26174047; Moon 2021, PMID: 35010998). Gut microbial nitroreductases reduce berberine to dihydroberberine, the intestine-absorbable form, which is then re-oxidized back to berberine in intestinal tissue by a non-enzymatic reaction before entering the blood. Supplemental DHB is intended to supply that absorbable form directly. Once berberine reaches circulation it is understood to act largely through AMPK activation, which is the mechanism generally proposed for its metabolic effects. Read that last step as background pharmacology: the studies cited on this page measured plasma levels, glycemic endpoints and toxicology, not AMPK signaling from DHB.
Avelor applies every berberine interaction to DHB, since DHB re-oxidizes to berberine. See `berberine.md` for the complete interaction table.
Independently graded against 173,636 indexed supplements with 177 published clinical interactions, sourced from PubMed, FDA CAERS, openFDA, and NIH DSLD | Last updated:
Not medical advice. Based on published clinical research and systematic reviews.