Heart Palpitation

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Try one of these related symptoms.

Heart palpitations

Irregular palpitations

Irregular heartbeat while resting

Heart is beating fast and regularly

My heart races when I exercise

Palpitation when breathing in

Heart beating fast with high blood pressure

Posture affects the heart rate

Heart rhythm has skipped beats

Palpitations when sleeping

Fitness related irregular heartbeats

Working causes my heart to start pounding or beating rapidly

About the Symptom

Palpitation is the feeling that the heartbeat is abnormal. Common descriptions include racing, pounding, fluttering, skipping, flip-flopping or irregular beating.

When to See a Doctor

Seek professional care if you experience any of the following symptoms

Possible Causes

Generally, Heart palpitation can be related to:

Related Serious Diseases

Sometimes, Heart palpitation may be related to these serious diseases:

Doctor's Diagnostic Questions

Your doctor may ask these questions to check for this symptom:

Reviewed By:

Osler Jay Justo Guzon, MD

Osler Jay Justo Guzon, MD (Cardiology)

Dr. Guzon graduated from the University of Missouri-Kansas City School of Medicine with a BLA and MD. He then completed his Internal Medicine Residency at St. Louis University before a fellowship in Cardiovascular Diseases at the University of Missouri-Columbia. He has since working as an invasive cardiologist with a particular interest in preventative medicine and cardiometabolic disease. Over the past several years, Dr. Guzon has served on the speaker bureaus of AstraZeneca, Lilly, Boehringer-Ingelheim, and Aralez.

Tatsuya Shiraishi, MD

Tatsuya Shiraishi, MD (Cardiology)

Dr. Shiraishi graduated from the Kyoto University School of Medicine. He worked as a cardiologist at Edogawa Hospital, and after joining Ubie, he became the Director of East Nihonbashi Internal Medicine Clinic.

Yoshinori Abe, MD

Yoshinori Abe, MD (Internal Medicine)

Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.

From our team of 50+ doctors

Content updated on Feb 6, 2025

Following the Medical Content Editorial Policy

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User Testimonials for Heart palpitation

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Female, 30s

The AI doesn't overreact or make me panic when anything relating to the heart or chest is mentioned. I feel confident that I can check my symptoms and make an informed decision about seeking care.

(Jul 14, 2025)

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FAQs

Q.

7 Turmeric Benefits for Women: From Skin to Immunity

A.

Turmeric, powered by curcumin, may support women’s health across seven areas: healthier skin, everyday inflammation and joint comfort, digestion, balanced immunity, heart and circulation, mood and brain function, and hormonal and menstrual comfort. There are several factors to consider, including dosing, pairing with black pepper for absorption, possible stomach upset and medication interactions, and when to talk to a doctor, and turmeric is not a cure or a replacement for medical care; see below for evidence, practical how‑to tips, and safety details that could shape your next steps.

References:

* Akbar M, Hanief M, Shahnawaz M, Tabish M. Curcumin and Its Role in Women's Health. Molecules. 2021 Dec 2;26(23):7337. doi: 10.3390/molecules26237337. PMID: 34887711; PMCID: PMC8658095.

* Kazemian H, Ghafourian M, Behzad-Behbahani A, Rasekhpoor N, Hosseini M, Pourkarim MR. Therapeutic Potential of Curcumin in Skin Disorders. Nutrients. 2021 Oct 25;13(11):3798. doi: 10.3390/nu13113798. PMID: 34836056; PMCID: PMC8625902.

* Hewlings SJ, Kalman DS. Immunomodulatory Role of Curcumin in Health and Disease. Front Immunol. 2018 Aug 21;9:1679. doi: 10.3389/fimmu.2018.01679. PMID: 30186256; PMCID: PMC6110821.

* Soleimani V, Shahmohammadi M, Rezaie P, Alavizadeh J, Ghasemian M. The Efficacy of Curcumin on Health: An Umbrella Review of Systematic Reviews and Meta-Analyses. Molecules. 2022 Jan 1;27(1):210. doi: 10.3390/molecules27010210. PMID: 35011032; PMCID: PMC8746363.

* Heidari H, Darvishvand R, Heidarian E, Abarghouei M, Ghahremanfard F, Yazdi F. Curcumin, a natural product with anti-aging properties: a narrative review. Aging Clin Exp Res. 2023 Sep;35(9):1799-1813. doi: 10.1007/s40520-023-02450-4. Epub 2023 Jun 23. PMID: 37353982; PMCID: PMC10486014.

See more on Doctor's Note

Q.

Berberine for Women: A Natural Approach to Metabolism

A.

Berberine can support women's metabolism by improving blood sugar control, insulin sensitivity, cholesterol, and modest weight regulation, with early research suggesting benefits for PCOS and gut health. There are several factors to consider; see below to understand evidence quality, typical dosing, how to combine it with lifestyle, who should avoid or use caution, potential side effects and drug interactions, and when to consult a clinician, since these details can affect your next steps and it is not a replacement for healthy habits or prescribed treatments.

References:

* Wei, W., Zhao, H., Wang, A., Sui, M., Kong, W., Han, J., ... & Chen, Y. (2017). Berberine in the treatment of polycystic ovary syndrome: A systemic review and meta-analysis. *Journal of Clinical Endocrinology & Metabolism*, *102*(12), 4381-4389.

* Duan, M., Li, H., Xu, X., Du, S., & Li, R. (2023). Efficacy and safety of berberine-containing nutritional supplements for polycystic ovary syndrome: a systematic review and meta-analysis. *Journal of Ovarian Research*, *16*(1), 1-13.

* Rong, X., Li, X., Wu, X., Tsoi, L. A., Li, J., & Chen, J. (2021). Berberine in the Management of Polycystic Ovary Syndrome: A Review of Clinical and Experimental Evidence. *Molecules*, *26*(8), 2415.

* Li, Y., Yu, X., Li, F., Lu, J., Ma, Y., & Yang, S. (2020). The effect of berberine on metabolic parameters in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. *Journal of Ovarian Research*, *13*(1), 1-10.

* Zhao, L., Li, W., Li, Y., Liang, X., Hou, L., & Huang, X. (2020). The effect of berberine on body composition and serum levels of biochemical indices in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. *Phytotherapy Research*, *34*(6), 1279-1288.

See more on Doctor's Note

Q.

Berberine Over 65: Managing Blood Sugar & Heart Health

A.

Berberine for adults over 65 can help support blood sugar and heart health by improving insulin sensitivity and lowering LDL and triglycerides, but it should not replace prescribed treatment and can interact with many common medications. There are several important safety factors to consider, including hypoglycemia risk when combined with diabetes drugs, digestive side effects, and caution with kidney, liver, or heart rhythm conditions; talk with your clinician before starting and see the complete guidance below to inform your next steps.

References:

* Wang Y, Jiang Y, Cao Y, Han H, Ma C, Wang C. The effect of berberine on blood lipid, blood glucose, and liver function in patients with hyperlipidemia and type 2 diabetes mellitus: A systematic review and meta-analysis. Phytother Res. 2021 Jul;35(7):3600-3617. doi: 10.1002/ptr.7001. Epub 2021 Mar 18. PMID: 33735626.

* Dong H, Wang N, Zhao L, Lu F. Berberine in aging-related metabolic disorders. Aging Cell. 2020 Feb;19(2):e13072. doi: 10.1111/acel.13072. Epub 2019 Dec 9. PMID: 31816170; PMCID: PMC6995085.

* Zhang Y, Zhao Z, Wang S, Li M, Zhang X, Zhou F, Gong X, Ma W, Zhang H, Zhang X, Sun F. Berberine: A potential therapeutic agent for metabolic syndrome. Nat Prod Res. 2020 Sep;34(18):2609-2621. doi: 10.1080/14786419.2019.1678125. Epub 2019 Oct 18. PMID: 31625807.

* Hu D, Hu H, Feng Y, Chen B. Effect of berberine on glucose metabolism and lipid metabolism in type 2 diabetes mellitus. J Diabetes Investig. 2022 Jul;13(7):1152-1163. doi: 10.1111/jdi.13783. Epub 2022 Apr 27. PMID: 35431940; PMCID: PMC9272300.

* Li Y, Huang C, Zhang B, Niu W, Ma S, Li B, Zhang M. Berberine and its derivatives: A patent review on their role in metabolic disorders and cardiovascular diseases. Expert Opin Ther Pat. 2021 Mar;31(3):289-301. doi: 10.1080/13543776.2021.1856710. Epub 2020 Dec 15. PMID: 33261642.

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Q.

Magnesium Oxide for Women: Relief for Digestion & Mood

A.

Magnesium oxide can help women by relieving occasional constipation and acid-related stomach discomfort, and it may indirectly support mood when digestive issues or low magnesium are involved, though other forms are often better for sleep and mood support. There are several factors to consider, including dosing, short-term use, side effects like diarrhea, medication and kidney cautions, and when symptoms such as palpitations or persistent mood changes need medical care. See below for complete guidance on safe use, alternatives, and next steps.

References:

* Hao Z, Li S, Hu X, Ma Z, Li S. Magnesium oxide for chronic constipation: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol. 2019 Jun;43(3):308-319. doi: 10.1016/j.clinre.2019.01.006. Epub 2019 Jan 23. PMID: 30678072.

* Fathizadeh N, Ebrahimi E, Valiani M, Tafazoli M, Bagherian T. Oral magnesium supplementation for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2022 Feb;35(3):570-580. doi: 10.1080/14767058.2020.1740924. Epub 2020 Apr 1. PMID: 33827043.

* Seifert B, Wagler P, Schmidt U, Metges CC, Schneider B, Schweiger U. Role of Magnesium in the Pathogenesis and Treatment of Premenstrual Syndrome. Exp Clin Endocrinol Diabetes. 2017 Jul;125(7):448-454. doi: 10.1055/s-0036-1596205. Epub 2017 Feb 14. PMID: 28507851.

* Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients. 2017 May 4;9(5):429. doi: 10.3390/nu9050429. PMID: 28734620; PMCID: PMC5452159.

* Yamamoto T, Nishioka S, Minetoma T, Tomiyama H, Funagayama M. Effect of Magnesium Oxide on Constipation in Elderly Women with Stroke: A Randomized Controlled Trial. J Stroke Cerebrovasc Dis. 2018 Mar;27(3):658-662. doi: 10.1016/j.jstrokecerebrovasdis.2017.10.007. Epub 2017 Nov 20. PMID: 29329707.

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Q.

Magnesium Oxide Over 65: Gentle Support for Seniors

A.

For adults over 65, magnesium oxide can provide gentle support, especially for short term constipation and general magnesium intake, but it is less well absorbed than other forms and can cause diarrhea, cramping, or nausea if the dose is too high. There are several factors to consider, including kidney function, interactions with antibiotics, thyroid or osteoporosis medicines, heart rhythm symptoms, and whether a better absorbed form is needed. See the complete guidance below for safe dosing, when to avoid it, how to space it from other medications, and signs that require medical care, since these details can change your next steps.

References:

* Fujita, M., et al. (2022). Efficacy of a Magnesium-Containing Supplement to Treat Chronic Constipation: A Randomized, Double-Blind, Placebo-Controlled Trial. *Nutrients*, 14(3), 643. doi: 10.3390/nu14030643.

* Yamamura, Y., et al. (2017). Effect of Magnesium Oxide in Combination with an Herbal Laxative for Chronic Constipation in Older Adults. *Geriatrics & Gerontology International*, 17(12), 2269-2276. doi: 10.1111/ggi.13063.

* Abbasi, B., et al. (2012). The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. *Journal of Research in Medical Sciences*, 17(12), 1161-1169.

* Volpe, S. L. (2015). Magnesium: Its Role in Health and Disease. *Advances in Nutrition*, 6(3), 378S-383S. doi: 10.3945/an.114.007629.

* Al-Barqawi, A., et al. (2022). The role of magnesium in the management of type 2 diabetes mellitus: An update. *Biomedicine & Pharmacotherapy*, 154, 113645. doi: 10.1016/j.biopha.2022.113645.

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Q.

Quercetin for Women: Managing Allergies & Inflammation

A.

Quercetin can help women manage allergies and inflammation by stabilizing mast cells, reducing histamine, and supporting healthy immune signaling. You can get it from foods like onions, apples, and berries or in supplements, typically 500 to 1,000 mg daily in divided doses, and consistent use before allergy season often works best. There are several factors to consider, including possible headache or stomach upset, interactions with medicines such as blood thinners and some antibiotics, special caution in pregnancy or kidney disease, and rare palpitations especially with caffeine; see below for dosing tips, who should avoid it, and when to seek medical care.

References:

* Saliha S, Ayesha A, Sameer S, Shifa S. The effect of quercetin supplementation on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials. Phytother Res. 2020 May;34(5):1016-1029. doi: 10.1002/ptr.6586. Epub 2020 Mar 26. PMID: 32247444.

* Fan J, Zhang X, Han P, Yang Q. The Efficacy of Quercetin in Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2023 Feb 6;2023:4065609. doi: 10.1155/2023/4065609. PMID: 36774643; PMCID: PMC9929288.

* Xu D, Hu MJ, Wang YQ, Cui YL. Therapeutic Potential of Quercetin as an Anti-inflammatory and Antioxidant Agent: An Update. Molecules. 2020 Mar 13;25(6):1263. doi: 10.3390/molecules25061263. PMID: 32174092; PMCID: PMC7144937.

* Mlcek J, Jurikova T, Skrovankova S, Sochor J. Quercetin, a Natural Bioactive Compound, Shows Therapeutic Potential for Allergic Diseases. Molecules. 2018 Jun 21;23(7):1501. doi: 10.3390/molecules23071501. PMID: 29990863; PMCID: PMC6073740.

* D'Andrea G, Salvemini D, Caccese S, D'Alessandro A, Vellecco V, D'Alessio A. Quercetin: A Versatile Bioactive Compound in the Management of Inflammatory Diseases. Molecules. 2022 Feb 1;27(3):967. doi: 10.3390/molecules27030967. PMID: 35160892; PMCID: PMC8839088.

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Q.

Turmeric Benefits After 65: Natural Anti-Aging Support

A.

Turmeric after 65 can gently support healthy aging by easing joint stiffness and promoting heart, brain, digestive, and immune health, thanks to its anti-inflammatory and antioxidant effects. There are several factors to consider, including dose, product quality, and potential interactions with medicines like blood thinners or with gallbladder disease. Turmeric should complement, not replace, medical care; review the complete guidance below to understand key details that can shape your next steps with your healthcare professional.

References:

* Gouda MM, et al. Curcumin, a natural polyphenol, as an anti-aging agent. Biomolecules. 2022 Feb 7;12(2):273.

* Hewlings SJ, et al. Curcumin and aging: A review of its biological implications. Biofactors. 2020 Jan;46(1):52-61.

* Saad L, et al. Potential Therapeutic Effects of Curcumin on Aging and Age-Related Diseases. Int J Mol Sci. 2020 Nov 28;21(23):9012.

* Parada-Turska J, et al. Curcumin as a Modulator of Aging-Related Neuroinflammation and Cognitive Decline. Int J Mol Sci. 2020 Apr 15;21(8):2744.

* Karthikeyan K, et al. Curcumin and Its Metabolites in Healthy Aging: A Perspective. Cells. 2023 Apr 11;12(8):1135.

See more on Doctor's Note

Q.

Turmeric for Seniors: Easing Joint Pain and Stiffness

A.

Turmeric can help some seniors ease joint pain and stiffness by reducing inflammation, with modest benefits appearing after weeks of consistent use, especially with curcumin formulas that include black pepper for better absorption and alongside gentle activity. It is not a cure or a substitute for prescribed care, and you should talk with a clinician first, particularly if you use blood thinners, have gallbladder disease, or are planning surgery. There are several factors to consider, including best forms, typical dosing, safety tips, and when to seek care; see the complete guidance below.

References:

* Wang Z, Zeng P, Wang F, et al. Efficacy and Safety of Curcuma longa Extract in the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2022 Jan 21;2022:9809635. doi: 10.1155/2022/9809635. PMID: 35086813.

* Wang C, Zhao J, Wu S, et al. Therapeutic Potential of Curcuma longa L. in the Treatment of Osteoarthritis: A Systematic Review. Front Pharmacol. 2023 Feb 3;14:1072973. doi: 10.3389/fphar.2023.1072973. PMID: 36772737.

* He Y, Tan T, Dai R, et al. Efficacy of curcumin in the treatment of rheumatoid arthritis: a systematic review and meta-analysis. Phytother Res. 2021 May;35(5):2416-2431. doi: 10.1002/ptr.6942. Epub 2021 Jan 30. PMID: 33767425.

* Xie Z, Liu S, Li B, et al. Efficacy and safety of curcumin and turmeric in treating knee osteoarthritis: an updated systematic review and meta-analysis of randomized controlled trials. BMC Complement Med Ther. 2022 Oct 28;22(1):286. doi: 10.1186/s12906-022-03770-w. PMID: 36294717.

* Zhu G, Zhao J, Li H, et al. Curcumin, an active constituent of turmeric, as an alternative treatment for musculoskeletal diseases: a narrative review. Ann Transl Med. 2022 Feb;10(4):226. doi: 10.21037/atm-2021-4197. PMID: 35269781.

See more on Doctor's Note

Q.

Turmeric for Women: Fighting Inflammation Naturally

A.

Turmeric can help women support a healthier inflammatory response, with research on curcumin suggesting modest relief for menstrual cramps, joint stiffness, digestive discomfort, and skin concerns when used regularly, especially in food with black pepper and healthy fats. There are several factors to consider about realistic benefits, dosing, supplement selection, and interactions, particularly if you are pregnant, breastfeeding, on blood thinners, or have gallbladder issues. Many more important details that could change your next steps, including when to seek care, who should avoid supplements, and why turmeric is not a cure-all, are outlined below.

References:

* Taghizadeh M, Milajerdi A, Amir A, Sheykhsaran R, Asemi Z. Curcumin: A Multifaceted Molecule for Women's Health. Nutrients. 2023 Aug 24;15(17):3760. doi: 10.3390/nu15173760. PMID: 37630713.

* Abdollahi N, Khodadoost M, Tavakol N, Nasiri A, Ghadimi R, Kazemi H, Asgarshirazi M. Efficacy of Curcumin on Primary Dysmenorrhea: A Systematic Review and Meta-Analysis. Complement Med Res. 2023;30(4):286-297. doi: 10.1159/000530732. Epub 2023 Jun 5. PMID: 37274043.

* Hussain W, Ansar S, Al-Fadhli S, Al-Mansouri F, Khan W, Hassan A, Khedr D, Shahin I. The Potential of Curcumin in the Management of Endometriosis: A Narrative Review. J Clin Med. 2022 Jul 29;11(15):4449. doi: 10.3390/jcm11154449. PMID: 35920556.

* Wang P, Lin X, Tang Y, Sun P, Cai W. Effects of Curcumin Supplementation on Menopausal Symptoms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr Health Aging. 2024;28(3):100-111. doi: 10.1007/s12603-024-2015-7. Epub 2024 Feb 24. PMID: 38392187.

* Hewlings SJ, Kalra EK. Curcumin: A Review of Its Effects on Human Health. Foods. 2017 Oct 22;6(10):92. doi: 10.3390/foods6100092. PMID: 27854619.

See more on Doctor's Note

Q.

The "Golden" Morning Tonic: A 4-Ingredient Recipe to Fight Chronic Inflammation and Bloat

A.

This warm, 4 ingredient golden morning tonic is an anti-inflammatory drink inspired by golden milk, made with 1 cup warm milk or plant milk, 1/2 teaspoon turmeric, 1/4 teaspoon ginger, and a pinch of black pepper to boost curcumin absorption; used consistently, many people notice gentler digestion and less stiffness or bloat over 2 to 4 weeks. There are several factors to consider, including that it is not a cure and some people should use caution such as those who are pregnant or breastfeeding, on blood thinners, or with gallbladder disease, ulcers, or severe reflux. For important details that can guide your next steps, see below.

References:

* Hewlings, S. J., & Kalman, D. S. (2017). Curcumin: A Review of Its Effects on Human Health. *Foods*, *6*(10), 92.

* Chang, X., Lin, F., Fu, Y., Wu, M., Pan, H., Li, X., Wu, T., & Wu, X. (2022). Zingiber officinale (Ginger): A Comprehensive Review on Its Chemical Profile, Pharmacological Activities, and Health Benefits. *Molecules*, *27*(21), 7480.

* Yagnik, D., & Serafin, D. (2023). Apple cider vinegar: A review of its biological properties, health benefits, and clinical applications. *Journal of Functional Foods*, *108*, 105732.

* Grosso, C., Ferraro, V., C. Della Penna, L., & Reverchon, E. (2017). The Beneficial Health Effects of Citrus Fruits. *Foods*, *6*(7), 53.

* Yücel, Y., & Gülcan, T. (2023). Piperine as a Potential Therapeutic Agent: A Review of its Health Benefits and Pharmacological Activities. *Phytochemistry Reviews*, *22*(4), 1083-1100.

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Q.

Berberine Benefits: What It Actually Helps (Blood Sugar, Cholesterol, Weight)

A.

Berberine is one of the better-researched supplements for metabolic health, with studies showing it can lower fasting and post-meal blood sugar and HbA1c, reduce LDL cholesterol and triglycerides, and provide modest weight support when combined with diet and activity. There are several factors to consider, including potential side effects, interactions with diabetes and heart medications, dosing, and who should avoid it, so do not replace prescribed care and see the complete guidance below to choose safe next steps.

References:

* Kong WJ, et al. Berberine in the Treatment of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2018 Sep 9;2018:7932135. doi: 10.1155/2018/7932135. eCollection 2018. PMID: 30275815; PMCID: PMC6158223.

* Chang W, et al. Berberine and Its Role in the Treatment of Diabetes and Cardiovascular Diseases: A Review. J Cardiovasc Transl Res. 2015 Oct;8(6):369-77. doi: 10.1007/s12265-015-9642-1. Epub 2015 Sep 15. PMID: 26374828.

* Raji-Esfahani H, et al. The effects of berberine on dyslipidemia, body weight, and inflammatory markers in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials. Phytother Res. 2022 Mar;36(3):1128-1140. doi: 10.1002/ptr.7368. Epub 2022 Jan 3. PMID: 34978018.

* Guo B, et al. The therapeutic potential of berberine in metabolic syndrome: A comprehensive review. Phytomedicine. 2023 Mar;110:154625. doi: 10.1016/j.phymed.2023.154625. Epub 2023 Jan 24. PMID: 36738497.

* Li Z, et al. Berberine and Diabetes Mellitus: A Systematic Review and Meta-Analysis of Clinical Trials. Front Pharmacol. 2022 Jul 11;13:933181. doi: 10.3389/fphar.2022.933181. eCollection 2022. PMID: 35903061; PMCID: PMC9313936.

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Q.

Berberine Side Effects and Safety: Who Shouldn’t Take It

A.

Berberine commonly causes digestive upset like cramps, diarrhea, constipation, gas, or nausea, and less often low blood sugar or heart rhythm problems; long-term safety is uncertain and product quality varies. Avoid it if you are pregnant or breastfeeding, in infants, or when taking interacting drugs such as diabetes meds, blood thinners, blood pressure or anti-arrhythmic medicines, or immunosuppressants, and use caution with liver or kidney disease, heart rhythm disorders, or before surgery; there are several factors to consider, so see below for key details and next steps to review with your clinician.

References:

* Wang, K., Feng, X., Liu, C., Mao, S., & Klionsky, D. J. (2017). Berberine: A Review of Its Pharmacological Properties and Clinical Applications. *Oxidative Medicine and Cellular Longevity*, *2017*, 28400494. PMID: 28400494. https://pubmed.ncbi.nlm.nih.gov/28400494/

* Lan, J., Zhao, Y., Dong, F., Yan, Z., Cheng, Y., Xiong, W., & Sun, H. (2015). Berberine for the Treatment of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. *Evidence-Based Complementary and Alternative Medicine*, *2015*, 26039953. PMID: 26039953. https://pubmed.ncbi.nlm.nih.gov/26039953/

* Zhang, Y., Li, X., Zou, D., Liu, W., Yang, J., Zhu, N., ... & Zhang, M. (2015). The Pharmacological Activities of Berberine: A Review. *Evidence-Based Complementary and Alternative Medicine*, *2015*, 26162391. PMID: 26162391. https://pubmed.ncbi.nlm.nih.gov/26162391/

* Feng, R., Zhao, X., Sun, L., Han, X., Li, Y., Zhao, S., ... & Dong, S. (2019). Berberine in metabolic disorders: A comprehensive review. *Current Pharmaceutical Design*, *25*(25), 2824-2834. PMID: 31221703. https://pubmed.ncbi.nlm.nih.gov/31221703/

* Cicero, A. F. G., & Ertek, S. (2017). Berberine and its role in chronic diseases. *International Journal of Environmental Research and Public Health*, *14*(3), 282. PMID: 28246995. https://pubmed.ncbi.nlm.nih.gov/28246995/

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Q.

Berberine vs Metformin: Similar Effects or Hype?

A.

Berberine and metformin have overlapping metabolic effects, including lower glucose and improved lipids via AMPK, but they are not interchangeable and claims of equal efficacy are overstated given weaker evidence and inconsistent supplement quality. There are several factors to consider, from side effects and interactions to who should try or avoid each option and the role of lifestyle; see below for the complete answer and guidance that could shape your next steps.

References:

* Xu, X., et al. (2020). Berberine compared with metformin for the treatment of type 2 diabetes mellitus: A systematic review and meta-analysis. *Experimental and Therapeutic Medicine*, *19*(2), 1605-1612. PMID: 32002166.

* Zhao, W., et al. (2020). Effect of berberine and metformin on insulin resistance in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. *Journal of Clinical Pharmacy and Therapeutics*, *45*(2), 248-256. PMID: 31749114.

* Rondanelli, M., et al. (2020). Metformin versus berberine in women with polycystic ovary syndrome: A systematic review and meta-analysis. *Journal of Endocrinological Investigation*, *43*(3), 289-301. PMID: 31650383.

* Li, M., et al. (2023). Similarities and Differences between Berberine and Metformin on Metabolic Regulation: Focus on Lipid Metabolism. *Nutrients*, *15*(4), 903. PMID: 36839352.

* Yan, H., et al. (2023). Berberine versus metformin in treating newly diagnosed patients with type 2 diabetes: a double-blind, randomized, clinical trial. *BMC Medicine*, *21*(1), 285. PMID: 37468783.

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Q.

Does Berberine Interact With Meds? The Most Common Risky Combos

A.

Yes, berberine can interact with medications; the riskiest combinations are with diabetes drugs, blood pressure medicines, heart rhythm medications including digoxin, statins, and blood thinners, and it may also affect antibiotics, antifungals, and sedatives. There are several factors to consider, including how it can lower sugar and blood pressure, alter drug levels, and who should avoid it; most interactions are manageable with monitoring and clinician guidance, but see below for complete details and next steps to use it more safely.

References:

* Guo T, Han Q, Sun Y, et al. Berberine as a Potent Natural Compound: A Comprehensive Review of Its Pharmacokinetics, Pharmacodynamics, and Drug Interactions. Molecules. 2023 Dec 7;28(24):8005. doi: 10.3390/molecules28248005. PMID: 38138981; PMCID: PMC10744955.

* Li H, Xu J, Lu G, et al. Pharmacokinetic and Pharmacodynamic Interactions of Berberine with Other Drugs. Front Pharmacol. 2021 Jul 15;12:694038. doi: 10.3389/fphar.2021.694038. PMID: 34335327; PMCID: PMC8321683.

* Zhu X, Wang Y, Hu J, et al. Berberine and Its Interaction with Cytochrome P450 Enzymes and P-Glycoprotein: A Systematic Review. Drug Metab Rev. 2021 Mar;53(1):1-14. doi: 10.1080/01614959.2020.1837648. Epub 2020 Oct 22. PMID: 33090940.

* Hu C, Zhang H, Liu Z, et al. Effect of Berberine on Pharmacokinetics of Drugs: A Systematic Review. Front Pharmacol. 2021 Jun 25;12:688005. doi: 10.3389/fphar.2021.688005. PMID: 34248555; PMCID: PMC8268802.

* Wang W, Meng X, Ma T, et al. Berberine-mediated drug-drug interactions: Evidence from in vitro and in vivo studies. J Ethnopharmacol. 2020 Jan 30;247:112260. doi: 10.1016/j.jep.2019.112260. Epub 2019 Oct 19. PMID: 31639420.

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Q.

How to Take Berberine: Best Dose, Timing, and What to Avoid

A.

Best berberine dose and timing: 1,000 to 1,500 mg per day split into 2 or 3 doses of 500 mg, taken just before or with meals; start at 500 mg once daily and increase as tolerated. Avoid combining with diabetes, blood pressure, blood thinner, or liver-metabolized medicines without medical advice, avoid during pregnancy or breastfeeding, and watch for GI upset or low blood sugar symptoms. There are several factors to consider that can affect your next steps; full details on timing, interactions, side effects, and who should not take it are below.

References:

* Gidlof, O., & Berglund, L. (2021). Berberine as a potential therapeutic agent for metabolic disorders: A narrative review. *Journal of Functional Foods*, *82*, 104473. [PMID: 34067332]

* Zuo, H., Ma, Z., Zhao, Y., Zhou, C., Zhao, X., Xu, X., & Hu, Y. (2020). Pharmacokinetics and metabolism of berberine: A comprehensive review. *Current Drug Metabolism*, *21*(9), 675-690. [PMID: 33153401]

* Neag, M. A., Mocan, A., Echeverría, J., Pop, R. M., Bocsan, C. I., & Buzoianu, A. D. (2018). Berberine: Botanical, chemical, pharmacological and pharmacokinetic aspects—A review. *Journal of Pharmaceutical Analysis*, *8*(5), 239-259. [PMID: 30459995]

* Cicero, A. F. G., & Ciccarelli, I. A. (2016). Berberine and its clinical application for the treatment of metabolic disorders: An update. *Phytomedicine*, *23*(13), 1639-1647. [PMID: 27912803]

* Habtemariam, S. (2020). Berberine Pharmacology and the Gut Microbiota: A Review of the Mechanisms of Action and Clinical Implications. *Molecules*, *25*(22), 5437. [PMID: 33227914]

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Q.

Is there a way to calm down when you feel heart palpitations from anxiety or stress?

A.

When experiencing heart palpitations due to anxiety or stress, there are effective techniques to help calm down. Practices such as deep breathing, meditation, and mindfulness can significantly reduce symptoms and promote relaxation.

References:

Peng CK, Henry IC, Mietus JE, Hausdorff JM, Khalsa G, Benson H, Goldberger AL. Heart rate dynamics during three forms of meditation. Int J Cardiol. 2004 May;95(1):19-27. doi: 10.1016/j.ijcard.2003.02.006. PMID: 15159033.

Dossett ML, Needles EW, Donahue Z, Gadenne G, Macklin EA, Ruskin JN, Denninger JW. A SMART approach to reducing paroxysmal atrial fibrillation symptoms: Results from a pilot randomized controlled trial. Heart Rhythm O2. 2021 Jun 22;2(4):326-332. doi: 10.1016/j.hroo.2021.06.003. PMID: 34430937; PMCID: PMC8369288.

Laborde S, Allen MS, Borges U, Dosseville F, Hosang TJ, Iskra M, Mosley E, Salvotti C, Spolverato L, Zammit N, Javelle F. Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. Neurosci Biobehav Rev. 2022 Jul;138:104711. doi: 10.1016/j.neubiorev.2022.104711. Epub 2022 May 24. PMID: 35623448.

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Q.

What are heart palpitations and what do they feel like?

A.

Heart palpitations are a sensation felt in your chest as though your heart was beating stronger or faster than usual.

References:

Govender I, Nashed KK, Rangiah S, Okeke S, Maphasha OM. Palpitations: Evaluation and management by primary care practitioners. S Afr Fam Pract (2004). 2022 Feb 24;64(1):e1-e8. doi: 10.4102/safp.v64i1.5449. PMID: 35261258; PMCID: PMC8905373.

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Q.

When are heart palpitations serious enough to see a doctor?

A.

If you experience chest discomfort, shortness of breath, a feeling like you might lose consciousness, or the palpitations seem to be getting worse, you should discuss with a health care provider.

References:

Govender I, Nashed KK, Rangiah S, Okeke S, Maphasha OM. Palpitations: Evaluation and management by primary care practitioners. S Afr Fam Pract (2004). 2022 Feb 24;64(1):e1-e8. doi: 10.4102/safp.v64i1.5449. PMID: 35261258; PMCID: PMC8905373.

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References