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Copper defense mechanisms by bacteria within the bacterial community, such as the production of extracellular vesicles to secrete copper out of cells, could also benefit other bacterial species due to a lower toxic copper concentration in the environment (Lima et al., 2022)

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Theoretical or documented interactions include: Immunosuppressants (particularly ciclosporin, where clinical interaction has been documented) Medications metabolised by CYP3A4 or CYP2D6 enzymes Medications that are P-glycoprotein substrates Consult your pharmacist or GP before taking berberine alongside any regular medications, particularly those with a narrow therapeutic window