If you have pernicious anemia, any kind of digestive condition, or you've had gastric surgery, your gut may not absorb B12 the way it should
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J Toxicol Environ Health A
This group, which includes polyquinones, naphthoquinones, and anthraquinones, exhibits a wide range of biological activities such as antioxidant, anti-inflammatory, and immunomodulatory effects
One example in particular is if you are on TRT and use an Aromatase Inhibitor (AI) to keep your Estrogen levels in the sweet spot, having Berberine in your system may potentiate the effects of that AI (as the liver isn't breaking it down as efficiently as normal), which could potentially tank your Estrogen far below what it would normally be at on that same AI dosage without Berberine in your system