Talk:Berberine

Enzyme inhibition

You did a revert claiming "Not WP:MEDRS sources, but you didn't justify exactly why you think they are not WP:MEDRS. These sources are secondary (reviews) that are fully WP:MEDRS compliant, and the described effects have been in fact. Could you please specify why you think that they are not WP:MEDRS? Also, you mentioned WP:CRYSTAL (speculation). Can you please specify why you think it is a speculation? These claims are present in the article cited. Maybe you didn't like the explanation of CYP3A4. Let me remove the explanation. Please review that version. (unsigned by Maxim Masiutin)

Removal of this content was justified because the sources are about primary research and do not represent sufficient clinical evidence for use of berberine in any disease condition. The Pharmazie source does not review advanced clinical trials (there are none) and the Planta Med source states that evidence for effects of berberine is "limited" and "weak", i.e., not worth mentioning in an encyclopedia.

See WP:MEDASSESS - there are 1) no MEDRS reviews of using berberine for treating any disease, 2) no clinical organization recommending its use, and 3) no national regulatory agency approving its use in humans. The sources you added are primary, unfiltered information (left and right pyramids, respectively).

I removed mention of berberine as a traditional medicine because it came from a non-reputable, unusable source describing mouse experiments. Zefr (talk) 01:41, 29 December 2023 (UTC)

My objection was about the following text that you reverted: Berberine inhibits the activity of CYP3A4, an enzyme involved in drug metabolism. I agree that you removed many improper statements, but I do not agree that you removed a statement about CYP3A4 inhibition. It was not me who wrote about "Culture and society" and I agree that you removed it. But the statement about CYP3A4 which I added after resolved your objections each time you reverted 3 times which is against the 3-revert rule. I will ask administrators whether such actions were appropriate. Also, you reverted that without proper explanation on the talk page, and you didn't explain until I created that section. The statement about CYP3A4 was confirmed by two medline-indexed reviews: PMID 34620272, PMID 22855269, which I cited. Therefore, please consider restoring the claim about CYP3A4 inhibition. Maxim Masiutin (talk) 10:44, 29 December 2023 (UTC)

@Bon courage - can you please help us here too? I made a claim that Berberine inhibits the activity of CYP3A4, also backed up by two sources that I found reliable (reviews indexed in MEDLINE). Still, the user Zefr disagreed. I tried various style: first a style that gives more information on what CYP3A4 is, and explains how it was established (on measuring medicine levels in human subjects), then I made a plain simple statement, but we still disagreed. The point of disagreement is the following. I am convienced that it should be mentined that Berberine inhibits the activity of CYP3A4, whereas Zefr considers it should not be mentioned as the sources are not enough to support this claims. Maybe you can help us get into consensus and we would not be needed to ask for a formal resolution process. Thank you again! Maxim Masiutin (talk) 16:36, 29 December 2023 (UTC)

@Bon courage - can you also please help with this one if you have time? Maxim Masiutin (talk) 19:08, 29 December 2023 (UTC)

I don't see any particular problem with the sources, so inclusion will boil down to a question of what is WP:DUE. In general if mentioning lab work I think it is best to be clear by saying laboratory experiments have found, or somesuch. Bon courage (talk) 09:06, 30 December 2023 (UTC)

These where not laboratory experiments. PMID 34620272 mentions several studies which demonstrated that berberine can increase the concentrations of cyclosporine in renal transplant patients and midazolam in healthy adult volunteers, confirming its inhibitory effect on CYP3A4. These were studies on human subjects, measuring levels of plasma cyclosporine and midazolam. Measurements of substances metabolized by an enzyme and taking inhibitor (or inducer) in one group and placebo in another group is a way to confirm that particular substance is an inhibitor (or inducer). Why did you mention laboratory experiments (lab work)? Zefr mentioned that this source "does not review advanced clinical trials (there are none)". However, current state of the art allows even using invitro studies and/or simpler trials (not necessarily advanced clinical trials) to be able to state that a particular substance is an inhibitor/inducer. The second study PMID 22855269 which is an earlier one states that evidence for effects of berberine is "limited" and "weak". Zefr considers such kind of evidence is not worth mentioning in an encyclopedia. Still, the evidence was "limited" and "weak" at the date of publication. Later studies mentioned in PMID 34620272 confirmed the findings described in PMID 22855269. Maxim Masiutin (talk) 09:47, 30 December 2023 (UTC)

I assumed it was lab work from the text in the article here - I only assessed the sources' types and didn't delve into their content. If evidence is weak that should be stated, and there may be a case for omitting it. Another consideration is that Pharmazie is rather a low impact[1] journal. Bon courage (talk) 09:52, 30 December 2023 (UTC)

Thank you! What is your conclusion then? Should we mention that berberine inhibits the activity of CYP3A4? If yes, how should we mention it, addressing the issues you've raised? Maxim Masiutin (talk) 10:09, 30 December 2023 (UTC)

I think either (a) mention this material with appropriate caveats, or (b) omit it. I have no preference. Bon courage (talk) 11:49, 30 December 2023 (UTC)

OK, let us omit it until we collect better evidence in the future (to reach the consensus with Zefr).

As about my complaint about the edit warring, the administrators concluded that there was No violation – there must be four or more reverts within a 24 hour period for the 3-Revert Rule to apply; the links you have provided do not meet these criteria. Which does not absolve Zefr of their responsibility to take it up on talk.

I will watch future publications and will add information if it will be solid. Maxim Masiutin (talk) 13:54, 30 December 2023 (UTC)

@Zefr: I am happy that we reached consensus on the talk page. You were right on substance. Sorry that I was wrong. The only think that I didn't like about our consensus-building is edit warring. It would have been productive to explain on the talk page after the first revert or even before reverting, as I did in Talk:Hydroxyzine#Remove_information_baked_by_primary_sources_only. I first raised the issue, inserted inline templates, and then, after 12 days passed, deleted the improper claims. Maxim Masiutin (talk) 14:54, 30 December 2023 (UTC)

Not all edits or reverts require a talk page discussion. Clear edit summaries, WP:ES, should be sufficient unless a topic has genuine controversy. In my edit summaries on the berberine article, I used descriptions of the sources like "weak", "conjecture", "primary", non-MEDRS, etc., which are usually sufficient to show the content and sources are disputable and too vague for the encyclopedia. "The burden to demonstrate verifiability lies with the editor who adds or restores material - burden was not met for your sources.

You provided a correct revert and edit summary today on the hydroxyzine article. Well done. Zefr (talk) 15:31, 30 December 2023 (UTC)

Thank you very much for the appraisal for hydroxyzine. If I see vandalism or addition of unsourced information about a living person or when an edit is the only addition of square bracket around a word to a make disambiguation page link, I revert immediately. I am also a pending changes reviewer, but I try to be a cooperative collegue editor, not a policeman who follows the rules strictly.

But if I notice inappropriate health claim which stayed for months, I prefer to discuss on a talk page. It would not harm to keep questionable statements for yet few days if it already stayed a few months, and people are less enraged if you talk first, compared to when you revert first. When I write on a talk page, people can think a few days, calm down or find arguments or find better sources. So I try to behave friendly and not in a hurry. Maxim Masiutin (talk) 19:15, 30 December 2023 (UTC)