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Berberine inhibits CYP3A4, CYP2D6, CYP2C9 and P-glycoprotein, raising levels of many co-administered drugs including digoxin, and it adds to the hypoglycemia risk of metformin and sulfonylureas
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If weight loss occurs too rapidly without adequate protein intake or physical stimulus, the resulting muscle loss can leave joints like the knees and hips feeling less stable
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