Berberine in metabolic and neurodegenerative disease: Functional food potential and therapeutic implications

Background: Alzheimer’s disease (AD) and metabolic issues such as type 2 diabetes mellitus (T2DM) represent growing public health burdens, with current treatments often providing only symptomatic relief or carrying significant side effects. Berberine, a plant-derived isoquinoline alkaloid, has been investigated for its dual roles in metabolic regulation and neuroprotection. Its antioxidant, anti-inflammatory, and metabolic effects suggest promise in addressing both disease classes simultaneously. Objective: This review synthesizes the evidence for berberine in both AD and T2DM therapy, evaluates its drug performance using 15 key parameters, and examines its practical advantages and limitations. The aim is to assess its therapeutic potential through the Functional Food Center’s 17-parameter framework. Methods: A literature review was conducted using PubMed, Scopus, and FFHDJ.com databases using combinations of keywords: “berberine,” “Alzheimer’s,” “dementia,” “type 2 diabetes mellitus,” “dyslipidemia,” “metabolic disease,” and “clinical trials.” Priority was given to recent (2000–2025) systematic reviews, meta-analyses, and randomized controlled trials. Results: Preclinical studies consistently demonstrate that berberine improves cognitive function, reduces amyloid-beta and tau pathology, and attenuates oxidative stress and neuroinflammation. Clinical trials in type 2 diabetes patients report significant improvements in glycemic control, HbA1c levels, and lipid profiles. Despite its low oral bioavailability, advances in delivery formulations show promise for enhancing clinical translation. Conclusion: Berberine demonstrates broad potential as a functional food with applications in both metabolic and neurodegenerative care. Its dual effects suggest it may bridge preventive and therapeutic domains, although robust clinical trials, particularly in dementia, remain lacking. Future research should address bioavailability challenges and evaluate berberine in larger, diverse patient populations. Keywords: berberine, Alzheimer’s disease, type 2 diabetes mellitus, functional foods, nutraceuticals