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Common gastrointestinal effects are the most frequently reported adverse reactions, with studies reporting variable rates of digestive symptoms: Diarrhoea and loose stools Abdominal cramping and discomfort Constipation (less common) Nausea and bloating These effects are typically dose-dependent and may improve with gradual dose escalation or taking berberine with meals

This article unpacks the mixed evidence and offers practical guidance for clinicians

To assess the association between exposure and the overall risk of pregnancy loss, cause-specific Cox proportional hazard models were used, considering any variation in gestational age at enrolment across the three groups

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