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While generally considered safe, berberine may interact with certain medications, so consulting with a healthcare provider before starting is recommended

But I think it has been overlooked in discussions about GLP-1 drugs

In adults, single doses above 10 grams or 150 mg/kg have a reasonable likelihood of causing toxicity.[34] Toxicity can also occur when multiple smaller doses within 24 hours exceeds these levels, or even with chronic ingestion of doses as low as 4 g/day, and death with as little as 6 g/day

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Nocturnal hypoglycaemia can cause sleep disruption, night sweats, and vivid dreams

And if you have been infected with the Epstein-Barr virus, which causes mononucleosis and some other illnesses, you could be at higher risk