PCOS Management
Berberine for PCOS: Benefits and side effects

Berberine for PCOS: Benefits and side effects

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PCOS is difficult to manage, but berberine may help. Current research shows that berberine provides benefits for PCOS and little risk of side effects

Basma Faris, MD, CCMS, OB-GYN & Nutritionist

Managing PCOS can be challenging, and it’s natural to want to explore options beyond traditional treatments. Lately, many have been talking about berberine as a natural remedy for PCOS, but is it really as effective as it sounds? Let’s dive into what makes this herbal supplement so popular—and whether it might be worth considering for your PCOS journey.

What is PCOS?

Before we dive into berberine, it's important to have a general understanding of PCOS, or Polycystic Ovary Syndrome, and the specific symptoms that berberine may help with. The exact cause of PCOS isn't known, but we do know that it can affect both the endocrine and metabolic systems. 

Women with PCOS commonly experience:

  • Menstrual irregularities
  • Infertility
  • Increased body hair growth 
  • Acne that doesn't respond to standard treatments
  • Obesity or weight gain
  • Insulin sensitivity
  • Oily skin
  • Higher risk of pregnancy complications 
  • Increased risk of heart disease

What is berberine? 

Berberine is an organic alkaloid. In simple terms, this means it's a substance found in certain plants. These plants include golden seal, barberry, and Oregon grape, which has the scientific name berberis aquifolium. This is likely how the compound got its name. It's also found in Rhizoma coptidis, which has a long history of use in Traditional Chinese Medicine. 

Is berberine good for PCOS? 

Berberine is thought to help various conditions, including PCOS. It's important to note that berberine will not cure PCOS. According to FDA regulations, it can't be used to "treat" PCOS, either. However, berberine may help relieve some of the symptoms associated with PCOS.

Research suggests that Berberine may be helpful for some PCOS related issues, including: 

  • Infertility
  • Pregnancy-related complications
  • Weight gain
  • Increased risk of heart disease
  • Insulin resistance

Berberine for insulin resistance

PCOS is related to infertility, and a higher risk of complications if you do become pregnant. Women with PCOS have a 15 times higher risk of infertility, and a 3 times higher risk of early pregnancy loss or miscarriage. 

Pregnancy related complications include miscarriage, gestational diabetes, preeclampsia (pregnancy-related high blood pressure), and a higher risk of death before or after birth. 

It's believed that insulin, which is the hormone that the body uses to process sugar within the body, is thought to have a major impact on reproduction. 85% of women with PCOS have insulin resistance, which makes it harder for their bodies to process sugar. 

Current research suggests that berberine has a hypoglycaemic effect, which means it can lower insulin resistance and help your body process sugar effectively. In fact, it interacts with the body in various ways to combat insulin resistance, including increasing glucose metabolism and reducing the amount of glucose absorbed into the body. 

Unfortunately, there have been few studies on the effects of Berberine for PCOS. However, the studies that have been conducted are promising. 

One study compared berberine to Metformin, a drug commonly prescribed to diabetic individuals to treat insulin resistance. The study found berberine to be as effective as metformin at improving the rates of pregnancy through IVF, lowering blood sugar, and lowering insulin resistance. Surprisingly, it was more effective than metformin at increasing live birth rates. 

Berberine PCOS increased fertility 

One small study found that berberine can increase menstrual regularity and ovulation. This is important, because it is fairly common for women with PCOS to have a menstrual period without ovulation, which means that an egg is not released into the uterus. Without ovulation, pregnancy can not occur.  

PCOS berberine weight loss results 

Women with PCOS often struggle to lose weight due to several factors. One of these is insulin resistance, which is associated with weight gain. However, PCOS can also trigger the body to release more leptin, an appetite-stimulating hormone. 

Berberine has been shown to reduce leptin in addition to insulin resistance. It also inhibits lipoprotein lipase, which tells the body to store fat. 

One study, published in the European Journal of Endocrinology, compared berberine, metformin, and placebo for weight loss. The study included 89 women with PCOS. Some were given berberine, some metformin, and the final group was given a placebo. 

Participants were told to reduce the amount of carbohydrates and fat in their diet, and exercise up to 30 minutes each day. The study followed the participants for three months. 

The group that took berberine had greater weight loss than those taking metformin or placebo. In addition, they had lower levels of total cholesterol. More importantly, they had lower levels of LDL (bad) cholesterol and higher levels of HDL (good) cholesterol. 

Berberine dosage for PCOS

If you are considering taking berberine for PCOS, it's important to know how much berberine for PCOS. Since berberine is a supplement rather than a medication, there's no concrete amount to take. However, there are some recommendations. 

Most of the studies conducted with berberine have a dosage of 500 mg two or three times a day, with a maximum recommended dosage of 1.5 grams per day. The long-term effects haven't been well studied, but some sources suggest it can be taken for up to 2 years. 

Verywell Health recommends taking 500 mg of berberine three times a day. Since berberine can cause stomach upset, you may want to begin with a lower dose and work your way up. The simplest way to do this is to take 500 mg once a day for a week, then increase it to 500 mg twice a day the second week, and 500 mg three times a day the third week. 

Types of berberine supplements

The most common type of berberine supplement is capsule form. However, you can also take berberine in a powder or liquid form. There are a few things to consider when selecting a berberine supplement. 

First, it's a good idea to choose a supplement made by a reputable company. The FDA doesn't have authority over supplements, so some products may be of lower quality or contaminated. 

Next, you will need to pay attention to the strength and dosage of the supplement you choose. 500 mg capsules are the standard, but there are also stronger formulations, up to 12000 mcg, or 1.2 grams per serving. 

Next, there are a few different formulations. Most berberine supplements contain berberine HCI. A few supplements are made with full spectrum Oregon grape extract, rather than isolated berberine. 

Some supplements contain a slightly modified type of berberine, known as dihydroberberine. Berberine has low bioavailability, which accounts for most of its side effects. It's thought that dihydroberberine has greater bioavailability, and a lower risk of side effects. One very small study found that dihydroberberine resulted in higher berberine levels in the body with lower doses than berberine, but it's unclear if this has an effect on the effectiveness or side effects.

Potential side effects of berberine 

The most commonly reported side effects of berberine are gastrointestinal, particularly constipation, flatulence, and nausea. One study found that three people in the berberine group had a bitter taste in their mouth, compared to 9 in the metformin group. Another study had one person in the berberine group and two in the metformin group report diarrhea. No fetal abnormalities in participants taking berberine were reported in any of the studies. 

These studies are small, but suggest that berberine has a lower risk of side effects than metformin. When side effects were reported, they resolved quickly. 

Does berberine cause Hair Loss? 

Interestingly, berberine can cause hair loss in some individuals. However, it can also help reduce certain types of hair loss. It's thought that berberine's effect on hormones can trigger hair loss in some people. It also affects cell growth and inflammation, which can impact hair growth. 

There's no research specifically addressing hair loss and growth while taking berberine. However, there are anecdotal reports of women who are taking berberine for PCOS having significant hair loss. However, there are also many anecdotal reports of women having increased hair growth.   

Should I take berberine for PCOS? 

Berberine is promising for PCOS management, and has many health benefits. It also has a low risk of side effects. However, there are some people who should not take berberine. 

Health benefits of berberine 

Berberine has many benefits, aside from managing PCOS. Despite rare instances of gastrointestinal side effects, berberine is beneficial for gut health. It reduces inflammation in the gut, kills bad bacteria, and encourages the growth of healthy gut bacteria. 

It's also excellent for reducing inflammation in all areas of the body, which may have a positive effect on your overall health. 

Current research suggests that berberine may help prevent dementia by preventing brain damage, and could play a role in the future treatment for Alzheimer's disease.  

Berberine interactions and contraindications 

Berberine is not recommended for women who are pregnant or breastfeeding. If you have low blood sugar or low blood sugar, you may want to avoid this supplement, because berberine lowers blood pressure and sugar levels. If you currently take medication for high blood pressure, diabetes, or insulin resistance, you should discuss it with your doctor before trying berberine. 

You should avoid berberine if you are taking Cyclosporine. If you are taking an over the counter cough medicine containing DXM, sedatives, or medication broken down by the liver, you should use caution when taking berberine.

Final Verdict

While berberine shows promise as a natural option for managing some symptoms of PCOS, it's not a cure, and it may not work the same for everyone. Research supports its potential benefits in areas like insulin resistance, weight management, and possibly even fertility, but it’s essential to approach it as a supplement, not a primary treatment.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461078/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864590/#B12-life-13-00125

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864590/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672885/

https://www.verywellhealth.com/pcos-and-berberine-4136324#:~:text=After%20three%20months%20of%20treatment,about%20as%20well%20as%20metformin.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028834/

https://medlineplus.gov/druginfo/natural/1126.html#DrugInteractions

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