Can Berberine Be Used As A Natural Remedy For PCOS?

Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects about 5–10% of premenopausal women, including adolescents. Not only can premenopausal women have PCOS, but postmenopausal women can also have this disorder.¹

Women can be affected by PCOS during their reproductive years. Additionally, as women age, this disorder can cause more serious conditions. Research shows that women with PCOS are highly likely to develop cardiovascular disease, and more than half of them may develop type 2 diabetes by age 40.² ³

The treatment of PCOS can vary depending on the range of symptoms experienced. For example, a woman may have severe symptoms, ranging from irregular to absent periods to high insulin and blood sugar levels, while another may have only one symptom. 

In addition, each symptom will have its own treatment protocol, such as taking specific medications for a particular symptom or incorporating lifestyle changes.

Researchers have recently begun studying the effects of berberine, an herbal supplement derived from plants, on PCOS.⁴

This article will focus on PCOS and how berberine can help with PCOS symptoms.

What is PCOS?

The causes of PCOS are unknown, although there may be chemical, socioeconomic, and lifestyle indications of the causes of PCOS symptoms. 

Chemical indicators (e.g., insulin resistance) and lifestyle indicators (e.g., obesity) can explain possible causes of PCOS symptoms. Premenopausal women with PCOS may start as having difficulty ovulating or having ovaries that have problems producing eggs. When the ovaries do not produce eggs, this can cause ovarian cysts to form. 

These cysts create an excess of male hormones or androgens, which include testosterone, androstenedione, and dehydroepiandrosterone sulfate. Multiple cysts producing these excess male hormones may cause premature degeneration of the ovarian follicles. 

Symptoms of PCOS may include:

• Irregular or no periods

• Excess hair growth on the chest, stomach, and back

• Male-pattern baldness or thinning hair

• Obesity, especially around the abdomen

• Acne

• Swelling ovaries that can interfere with egg production

• Infertility

As women age, PCOS, which at some point only affects reproductive functions, can transform into a metabolic disorder that can affect other organ functions and contribute to more severe conditions, such as type 2 diabetes or cardiovascular disease. 

A metabolic disorder or metabolic syndrome results when abnormal chemical reactions interfere with your digestive system's ability to break down food into sugars and acids for energy to be used instantly or stored away in the liver, muscles, or body fat. Metabolic syndrome is closely related to insulin resistance, one of the chemical indications that causes PCOS symptoms.

Some of the symptoms that a metabolic disorder or a metabolic syndrome can display include the following:

• Abdominal obesity

• High blood pressure

• High fat or triglyceride levels

• Low HDL cholesterol (the good cholesterol)

• Type 2 diabetes 

Although there is no cure for PCOS, various treatments, such as medications or herbal supplements, are available. One herbal supplement that researchers have recently studied as a viable treatment for PCOS is berberine.

What is berberine?

Berberine is a compound found in different plants, including goldthread, Oregon grape, barberry, and various other plants worldwide. Berberine was a traditional medicine extracted from Huang Lian plants and barberry and used in China, India, Iran, and other countries.

How does berberine work?

Berberine is an isoquinoline alkaloid that helps with digestive stimulation, immune stimulation, and the regulation of hypoglycemia and cholesterol. When taken, berberine is transported through the bloodstream to cells throughout the body. 

As medications do, berberine can bind to molecular targets inside the cells and change their function. Berberine's goal is to activate an enzyme in the cells called AMP-activated protein kinase (AMPK), which helps reduce the energy stored and increase energy production.  

This enzyme is found in the brain, heart, muscles, kidney, and liver cells and controls metabolism. When berberine activates the enzyme, studies have shown that it can produce results like:⁵

• Enabling the body to break down sugar inside the cells

• Lowering insulin resistance

• Causing a significant reduction in blood sugar levels

Researchers have studied whether berberine can overcome insulin resistance compared to prescription thiazolidinediones (TZDs) and metformin medications. One study indicated that berberine improved blood glucose control by significantly normalizing or reducing blood glucose.⁶

However, taking berberine alone for the treatment of type 2 diabetes is not recommended until researchers can conduct more clinical trials with larger sample sizes to validate the findings.

Benefits of berberine for PCOS

Treatments for PCOS usually include taking synthetic hormones, such as birth control pills, to help control menstrual cycles and lower male hormone levels. However, if a woman wants to become pregnant, this treatment is contraindicated.

Taking berberine for PCOS, which has been shown to lower insulin resistance, may help the ovaries produce more eggs, reduce the amount of cyst growth, and lower male hormone levels.

Does berberine help with weight loss PCOS?

To understand how berberine can help with weight loss, it might be helpful to know how insulin resistance can play a role in obesity. 

Insulin is released from the pancreas when blood sugar enters the bloodstream. Insulin helps your body's cells collect blood sugar and turn it into energy. Once the cells collect all of the blood sugar, this is an indication for the pancreas to stop releasing insulin.

 With insulin resistance, the cells need more and more insulin to collect the blood sugar and lower the blood sugar levels in the bloodstream. As a result, your body's cells start to disregard the amount of insulin released, becoming insulin resistant. After a while, the pancreas cannot release enough insulin to make the cells respond, and the blood sugar in the bloodstream continues to rise. 

When the cells cannot receive more blood sugar, the liver, and muscles take on the extra blood sugar. But, eventually, with insulin still flooding the bloodstream, the liver and muscles will come to a point when they cannot accept any more blood sugar either, and the excess blood sugar is distributed to fat cells. The fat cells store the blood sugar as body fat, which accumulates around the organs, contributing to weight gain and obesity.

So when you take berberine to reduce insulin resistance, berberine's activation of the enzymes in the body tissue cells allows these cells, rather than the fat cells, to receive the blood sugar and turn it into energy. As a result, berberine can help with weight loss by reducing the need for fat cells to rid the blood of sugar, contributing to weight loss and assisting in shrinking belly fat.

How long does berberine take effect for weight loss?

Research has been conducted to determine the effectiveness of berberine for weight loss purposes with promising results. 

One study had 37 men and women with metabolic syndrome take 300mg of berberine three times a day for three months.⁷

After three months, researchers discovered that their body mass indexes (BMIs) had decreased from an obesity range to an overweight range, and they had lost an average of two inches around their waists. Although these results seem promising, researchers need to conduct more studies with larger groups to see if these findings can be duplicated and validated.

Another study conducted among type 2 diabetes patients also saw a significant decrease in waist and waist/hip measurements. Over 13 weeks of taking both metformin and berberine, their blood sugar decreased significantly, their waist measurements decreased by two inches, and their waist/hip measurements decreased by three inches.⁸

Where can I find berberine?

Berberine herbal supplements can be found in any pharmacy or vitamin store, in any pharmacy aisle in supermarkets, or online.

Side effects of taking berberine

Adverse effects that are known to occur when taking berberine in high doses are:

• Nausea

• Abdominal distension

• Diarrhea

• Constipation

• Headaches

• Slow heart rate

• Flatulence

Taking berberine after meals may relieve side effects, such as nausea, abdominal distention, and diarrhea. If you experience constipation while taking berberine, try reducing the dosage.

Does berberine affect hormones?

Berberine does have an effect on hormones but in a positive way. Berberine is instrumental in decreasing androgen or male hormone levels for women with PCOS. Berberine is also known to reduce leptin levels. Because leptin is an appetite-stimulating hormone, decreasing the levels of this hormone can assist in weight loss.

Can berberine damage the liver?

Researchers studied patients with type 2 diabetes treated with 500 mg three times daily for 13 weeks. Although 34.5% of the patients participating in the study were observed at this dosage to exhibit side effects, no changes in liver enzymes were evident, indicating no inflammation or damage to cells in the liver.⁹

However, in animal studies, it was found that high doses of berberine administered over days led to altered liver function and generated liver tissue damage. But because animal studies are not always indicative of human anatomical responses, and researchers have not done enough studies on humans, it is inconclusive if berberine causes damage to human livers.¹⁰

Dosage

How much berberine should I take for PCOS?

Berberine is commonly used between 900 and 1500 mg per day based on several of the studies cited above. However, it is common to take 500mg thrice daily. As always, consult your doctor about whether berberine is safe for you and how much you should use.

Is berberine better than metformin for PCOS?

Berberine may help with many more symptoms of PCOS than metformin. Metformin can help with insulin resistance issues, but not much more than that. Berberine can help with insulin resistance issues, but it can also reduce the risk of cardiovascular disease by lowering your cholesterol, assisting in weight loss, and lowering androgen hormone levels. 

Can you take berberine and metformin together for PCOS?

One study had a group of people with type 2 diabetes take both metformin and berberine together for 13 weeks.¹¹

Researchers observed that the group taking metformin and berberine together decreased glucose significantly more in the plasma before eating and drinking for eight hours and the amount of glucose in the plasma after eating than by taking metformin or berberine alone. In addition, HbA₁c was reduced from 8.1% to 7.3%.

Taking berberine and metformin together can add other benefits to your treatment that taking metformin alone will not offer. In addition to lowering your blood sugar, berberine can help decrease triglyceride, total cholesterol, and LDL-C. Berberine, taken with metformin, can also help with weight loss.

However, if you choose to treat your insulin resistance by taking metformin and berberine, you must carefully monitor your blood sugar levels. If blood sugar levels drop too significantly, this can cause problems rather than provide benefits.

Can you replace metformin with berberine?

Although berberine has provided promising results when studied, it is not extensively used in treating insulin resistance, and researchers should conduct more clinical observation of the use of berberine for insulin resistance.

However, if you are resistant or intolerant to metformin, you can consider adding to or replacing your metformin treatment with berberine. Taking berberine in addition to or in place of metformin will help increase your tolerance and minimize your side effects.

Note that you should not change or add any medications to your regimen without a full discussion with your physician. Abrupt changes to your insulin medications can potentially be life-threatening.

The lowdown

PCOS symptoms are serious, and having PCOS can lead to even more severe conditions. Having a natural remedy, like berberine, may not only relieve one symptom, insulin resistance, but several symptoms, such as high androgen levels, high cholesterol, and obesity. Not only may berberine assist in relieving symptoms, but it could also help reduce the progression into more severe conditions, such as cardiovascular diseases and type 2 diabetes.

You should be aware that berberine is not FDA-approved for the above conditions, and no clinical trials have definitively proven that berberine is effective. You should not make changes to your medical regimen without consulting your doctor first. 

Berberine should not also be used in pregnant or nursing women or in children without the full discussion and agreement of your doctor.