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Eur J Pharmacol 2021, 911

9 These clinical findings are consistent with preclinical data that berberine activates AMPK and favorably alters lipid metabolism, but the trial did not directly measure GLP-1 or gut microbiota composition

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Additionally, patients should promptly report symptoms of pancreatitis (severe abdominal pain, sometimes radiating to the back, with or without vomiting) or gallbladder problems (pain in the right upper abdomen, fever, yellowing of skin/eyes)