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The National Center for Biotechnology Information shared clinical supplement guidance explaining how berberine interacts with various metabolic enzymes and transporters

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Measured: Severe hyperglycemia, BUN Unmeasured: ETOH, Toxic alcohols, iodinated contrast, sucrose Serum osmolality assessment prompts us to consider effective and ineffective osmoles at play: Effective osmoles (sodium, glucose, potassium) do not cross the plasma membrane, and therefore cause shifts in water movement (impact tonicity) Most of the clinical complications that arise as a result of hyponatremia (and its correction) are driven by the fact that sodium is an effective osmole it impacts tonicity, and therefore cell size