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The evidence for berberine's effects on blood glucose and cholesterol levels is of variable quality and not currently recommended in UK clinical guidelines

Although rare, alpha-lipoic acid may cause insulin autoimmunity (see Concerns and Cautions)

Talebali H, Farzinpour A (2006) Effect of different levels of perlite on performance of broiler chicks International journal of poultry science 5:432-435 Tomas FM, Pym RA, McMurtry JP, Francis GL (1998) Insulin-like growth factor (IGF)-I but not IGF-II promotes lean growth and feed efficiency in broiler chickens General and comparative endocrinology 110:262275 Valceschini E Poultry meat trends and consumer attitudes

Managing side effects requires attention to diet and lifestyle

A 10-year, randomized, population-based trial of 38,597 healthy women reported that supplementing with 600 IU of vitamin E reduced the risk of chronic lung disease by 10% (Agler 2011)

This process prevents homocysteine from becoming dangerously elevated