Berberine For PCOS: Benefits, Risks & Practical Tips

Written by Martina S. in Nutrition

Berberine is a popular herbal remedy associated with some powerful metabolic benefits that may also play an important role in the management of PCOS (Polycystic Ovary Syndrome). But how exactly can women with PCOS benefit from taking a berberine supplement? And are there any risks or side effects?

That’s what I’ll discuss in this article supported by the latest research as well as my own experience with this herbal supplement. You’ll also find some practical tips on how to best choose and use berberine for PCOS to gain the most benefits. 

If you’d like to learn more about how to fully reverse PCOS through lifestyle modifications, make sure to check out my previous article ‘How To Treat PCOS Naturally (Science-Based Guidelines)’.

What is berberine?

Berberine is an organic chemical compound (alkaloid) extracted from the roots and barks of various plant species such as Rhizoma coptidis, Berberis vulgaris (Berberry) and other herbs belonging to the Berberis family. It has a vibrant yellow color and can also be used as a dye.

In traditional Chinese medicine, berberine has been used for centuries to treat a variety of health conditions in particular those associated with metabolic dysfunctions and gastrointestinal issues.

Due to the increasing amounts of evidence on the strong beneficial effects of this compound, berberine is now frequently used as an alternative to treat several health conditions, including metabolic syndrome, diabetes and PCOS. 

The existing research supports the beneficial properties of berberine for women with PCOS and here’s all you need to know.

Benefits of berberine for PCOS:

  • Improved insulin resistance
  • Weight loss
  • Improved fertility
  • Cardiovascular health support
  • Liver support

✓ Improved insulin resistance

Insulin resistance (your body’s inability to process insulin effectively) is a metabolic condition closely related to the development and progression of PCOS. In fact, it is now considered to be the root cause of PCOS in most women with this condition (up to 70%).

That’s because once your body stops responding to insulin effectively you’re likely to develop hyperinsulinemia (high levels of insulin). Increased insulin levels in the blood can, in turn, signal to your ovaries to produce excessive amounts of androgens (the ‘male’ hormones) responsible for many of the common PCOS symptoms.

You can find more information about this process in my previous article ‘PCOS Insulin Resistance Explained & How To Reverse It’.

Improving blood sugar regulation and reversing insulin resistance is therefore the key focus of most PCOS management strategies. While there are many different lifestyle factors that can have an impact on insulin resistance, your diet is amongst the most significant ones. This also includes the use of dietary supplements and herbal remedies such as berberine.

One of the greatest benefits of berberine for PCOS is its ability to drastically lower blood sugar levels and improve insulin sensitivity as it’s been shown in a large number of studies. Those effects appear to be as powerful as some blood glucose-lowering drugs such as Metformin which is the most common medication prescribed to patients with diabetes and PCOS. 

Several studies involving women with PCOS have also confirmed those beneficial properties of berberine and it is now widely used to help normalize high blood sugar levels and decrease insulin resistance as a part of an effective PCOS treatment strategy.

✓ Weight loss

It’s been shown that berberine is able to affect our bodies on a molecular level as it’s able to bind to certain molecules inside the cells and change their function (similarly to drugs). One of those functions is activating an enzyme AMPK which is responsible for regulating metabolism.

Since berberine is able to help regulate metabolism it also appears to play an important role in weight management. Several studies have shown improvements in body composition (greater fat loss, improved waist-to-hip ratio, lower BMI) after taking a berberine supplement. 

It is believed that berberine affects several hormones involved in the regulation of hunger, appetite and fat storage (such as insulin, leptin and adiponectin). It may also inhibit the growth of fat cells, stimulate redistribution of fatty tissues and inhibit the enzyme lipoprotein lipase (responsible for storing fat).

Because weight gain and increased visceral fat (in the abdominal area) are typical features of PCOS, berberine could be particularly beneficial for women with this condition. This has been demonstrated in a few studies where women with PCOS taking berberine supplements were able to lose weight and reduce their waist-to-hip ratio.

Please note that dietary and lifestyle changes are the most important factors when it comes to weight loss and nutritional supplements (such as berberine) should be used only as additional support.

Read more: ‘PCOS Belly Fat Explained & How To Reduce It’

✓ Improved fertility

Irregular periods and anovulation are typical symptoms of PCOS caused by erratic fluctuations in hormones. Unfortunately, this also puts women with PCOS at increased risk of infertility and they’re more likely to experience difficulties getting pregnant.

The good news is that once the underlying cause of PCOS is addressed and hormonal balance restored, most women with PCOS can fall pregnant and experience a healthy pregnancy. Several herbal remedies also appear to have beneficial effects on female fertility and berberine may be one of them.

Studies have shown that berberine supplements were able to significantly improve ovulation rates in women with PCOS and increase their pregnancy rates. In fact, those effects were even greater in comparison to taking Metformin. Berberine was also associated with fewer side effects.

While the exact mechanism isn’t clear, it may be related to improved insulin resistance and increased expression of GLUT-4 (glucose transporter 4) in the ovaries resulting in improved ovulation cycles. However, those effects still need to be confirmed by further research..

✓ Cardiovascular health support

PCOS is now considered a risk factor for developing heart disease due to the metabolic and hormonal dysfunctions associated with this condition. Women with PCOS are therefore encouraged to support their cardiovascular health as they tend to have abnormal lipid profiles (high triglycerides and cholesterol).

Fortunately, lifestyle and dietary modifications are an effective strategy for doing so and some nutritional supplements can also help decrease the risk of cardiovascular complications, including berberine.

Berberine has been shown to improve several different factors involved in cardiovascular health by lowering the levels of triglycerides and cholesterol (total and LDL) and by raising the levels of HDL (the ‘good’) cholesterol. 

The good news is that even studies involving women with PCOS have shown improvements in those biomarkers suggesting that berberine may be effective in reducing heart disease risk factors in women with PCOS.

✓ Liver support

The liver is an organ responsible for more than 500 functions in your body including hormone regulation, detoxification and elimination of excess hormones. It is, therefore, not surprising that this organ plays a key role in the management of PCOS and hormonal balance.

Unfortunately, women with PCOS are likely to develop NAFLD (non-alcoholic liver disease) as a result of their metabolic abnormalities. This condition is closely related to insulin resistance and in most cases can be successfully reversed through diet and other lifestyle changes.

Interestingly, some studies suggest that supplementing with berberine may also be an effective strategy for reducing fatty liver and protecting against liver fat buildup. This has been demonstrated even in participants diagnosed with PCOS who suffered from NAFLD.

The liver-protecting properties of berberine are primarily accredited to its ability to improve insulin resistance, reduce blood triglyceride levels and promote fat oxidation (fatty acids breakdown). Additionally, there is also some evidence suggesting that berberine may have strong antioxidant and anti-inflammatory effects.

Disadvantages of berberine for PCOS:

  • Side effects
  • Medication interaction
  • Pregnancy

✕ Side effects

While berberine appears to be well-tolerated by most people and is generally considered safe, some people may experience some mild side effects mostly related to digestion problems (such as diarrhea, nausea, gas and stomach ache).

To minimize the risk of negative side effects it is recommended to choose a high-quality product ideally third-party tested to ensure the purity of its content. You should also avoid taking berberine in excessive amounts.

✕ Medication interaction

Another thing to consider is that berberine supplements may interfere with several medications (including diabetes drugs, blood thinners, antidepressants) due to its strong metabolic effects. You should always consult with your doctor before taking berberine supplements, especially if you suffer from any medical condition.

Women with PCOS should be particularly conscious if they also take other blood sugar-lowering drugs and supplements such as metformin or inositol.

✕ Pregnancy

Despite the beneficial effects of berberine on fertility, women who are already pregnant or breastfeeding are not recommended to take berberine supplements as it may have a negative impact on the fetus or newborn.

Best types of berberine for PCOS:

  • Berberine capsules
  • Berberine liquid
  • Berberine powder

There are several different forms in which you can take a berberine supplement including capsules, liquid or powder. Since the form doesn’t affect the supplement’s effectiveness, this choice will be mostly dependent on your personal preferences. 

However, keep in mind that berberine has a very strong bitter flavor (difficult to mask) which makes using the liquid and powder form quite inconvenient. I personally find berberine capsules to be the most practical, especially when taking the supplement several times a day.

Regardless of the form you should, however, pay close attention to the overall quality of the product. That’s because dietary and herbal supplements are generally very poorly regulated and their content oftentimes doesn’t match their label.

Choosing a high-quality product from a reliable brand is, therefore, crucial to ensure its safety as well as its effectiveness. This is especially true if you’re planning to take berberine for its medicinal properties on a regular basis. Always choose products that are third-party tested from a legitimate organization (I share some of my favorites later in this post).

Since berberine is known to have very low bioavailability (it’s poorly absorbed), you also want to look at the supplement’s concentration and choose one with at least 500mg of berberine per capsule. Be aware that the front labels are often misleading as they claim to provide high doses of berberine per serving but 1 serving usually means 2 capsules or more (always check the back).

Is berberine good for PCOS?

In general, berberine is a good dietary supplement for PCOS as it’s been shown to relieve several symptoms associated with this condition. Berberine is particularly effective in improving insulin resistance but it may also help manage weight, improve fertility and support cardiovascular health.

Is berberine the same as turmeric?

Turmeric and berberine are not the same as they both come from different plants. Berberine is a chemical compound naturally occurring in several different plants including the Turmeric tree. However, regular turmeric comes from the roots of the plant Curcuma longa and does not contain berberine.

If you’d like to know more about the benefits of turmeric root for PCOS, you can find more information here: ‘Turmeric For PCOS: Benefits, Risks & Practical Tips‘.

What is the best form of berberine?

Berberine capsules appear to be the best form of this supplement as it’s highly convenient and sufficiently mask the strong bitter taste of berberine. However, other forms of this supplement including berberine powder and berberine liquid are just as effective and provide the same health benefits.

Best berberine supplements for PCOS:

These are some of my favorite brands of berberine products that I’ve used in the past and found great in terms of their quality and effectiveness. I personally prefer using berberine capsules as it’s much easier to take in the right doses. I don’t really recommend buying pure berberine powder as it doesn’t taste good and it’s very difficult to mask even in meals.

How to use berberine for PCOS:

Berberine can be easily incorporated into a diet in many different ways and forms. Depending on the type and brand of berberine products, the effects on PCOS may vary. However, there are some general recommendations based on the research findings that may be followed to maximize the positive effects.

How much berberine should I take for PCOS?

As a general rule, women with PCOS should consume between 500-1500 mg of berberine per day (in 2-3 servings) to achieve the most health benefits. However, the optimal dosage of berberine for PCOS may differ between individuals depending on their personal circumstances and the type of berberine used.

When is the best time to take berberine for PCOS?

The best time to take berberine for PCOS appears to be with meals, ideally about half an hour before eating. This strategy works best to help stabilize blood sugar levels after meals and prevent rapid insulin spikes. Berberine also appears to be better tolerated when taken with meals.

How long does it take for berberine to work for PCOS?

In general, most women with PCOS start noticing significant improvements in their symptoms and health biomarkers after around 3 months of regular berberine supplementation. However, the length of this period may be affected by the severity of hormone imbalances and other important factors.

How do you use berberine for PCOS?

Berberine can be used for PCOS on a daily basis when consumed in the recommended amounts (500-1500 mg per day). Since berberine has a half-life of several hours, it is best to spread the doses into several servings per day. It is generally recommended to take 500g of berberine 3x a day with meals.

Pro tips:

  • Track your progress – get tested and keep a track of your progress, with enough data you’re more likely to see what strategies and supplements work for you best and it also helps you stay motivated, you can find some useful tools here ‘TOP 5 Smart Devices To Monitor & Manage PCOS‘
  • Create a routine – consistency is key for taking supplements so creating a solid daily routine can make it easy for you to stick to your plan and get better results, try to take it at the same time of the day (eg. with lunch, breakfast or dinner) every day
  • Use a supplement container – if you take multiple supplements a day I highly suggest using one of those practical containers where you can pre-arrange your tablets for each day, it makes taking supplements way more effortless
  • Eat a healthy diet – don’t forget that berberine supplements are not a replacement for a healthy diet and making the right dietary choices should remain your priority, here’s an easy to follow plan to get the most benefits ‘The Best PCOS Diet (Ultimate Guide)‘
  • Drink a lot of water – make sure you drink a lot of fluids with your supplements so it’s easier for your body to digest and absorb those nutrients
  • Be patient – don’t expect any overnight results, keep in mind that your body is a complex system that doesn’t like rapid changes – it usually takes several weeks before you start seeing results

Resources:

  • An, Y., Sun, Z., Zhang, Y., Liu, B., Guan, Y., & Lu, M. (2014). The use of berberine for women with polycystic ovary syndrome undergoing IVF treatment. Clinical endocrinology, 80(3), 425–431. https://doi.org/10.1111/cen.12294
  • Chang, X., Wang, Z., Zhang, J., Yan, H., Bian, H., Xia, M., Lin, H., Jiang, J., & Gao, X. (2016). Lipid profiling of the therapeutic effects of berberine in patients with nonalcoholic fatty liver disease. Journal of translational medicine, 14, 266. https://doi.org/10.1186/s12967-016-0982-x
  • Dong, H., Zhao, Y., Zhao, L., & Lu, F. (2013). The effects of berberine on blood lipids: a systemic review and meta-analysis of randomized controlled trials. Planta medica, 79(6), 437–446. https://doi.org/10.1055/s-0032-1328321
  • Feng, X., Sureda, A., Jafari, S., Memariani, Z., Tewari, D., Annunziata, G., Barrea, L., Hassan, S., Šmejkal, K., Malaník, M., Sychrová, A., Barreca, D., Ziberna, L., Mahomoodally, M. F., Zengin, G., Xu, S., Nabavi, S. M., & Shen, A. Z. (2019). Berberine in Cardiovascular and Metabolic Diseases: From Mechanisms to Therapeutics. Theranostics, 9(7), 1923–1951. https://doi.org/10.7150/thno.30787
  • Lan, J., Zhao, Y., Dong, F., Yan, Z., Zheng, W., Fan, J., & Sun, G. (2015). Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. Journal of ethnopharmacology, 161, 69–81. https://doi.org/10.1016/j.jep.2014.09.049
  • Lee, Y. S., Kim, W. S., Kim, K. H., Yoon, M. J., Cho, H. J., Shen, Y., Ye, J. M., Lee, C. H., Oh, W. K., Kim, C. T., Hohnen-Behrens, C., Gosby, A., Kraegen, E. W., James, D. E., & Kim, J. B. (2006). Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes, 55(8), 2256–2264. https://doi.org/10.2337/db06-0006
  • Li, L., Li, C., Pan, P., Chen, X., Wu, X., Ng, E. H., & Yang, D. (2015). A Single Arm Pilot Study of Effects of Berberine on the Menstrual Pattern, Ovulation Rate, Hormonal and Metabolic Profiles in Anovulatory Chinese Women with Polycystic Ovary Syndrome. PloS one, 10(12), e0144072. https://doi.org/10.1371/journal.pone.0144072
  • Li, M. F., Zhou, X. M., & Li, X. L. (2018). The Effect of Berberine on Polycystic Ovary Syndrome Patients with Insulin Resistance (PCOS-IR): A Meta-Analysis and Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 2532935. https://doi.org/10.1155/2018/2532935
  • Li, Y., Ma, H., Zhang, Y., Kuang, H., Ng, E. H., Hou, L., & Wu, X. (2013). Effect of berberine on insulin resistance in women with polycystic ovary syndrome: study protocol for a randomized multicenter controlled trial. Trials, 14, 226. https://doi.org/10.1186/1745-6215-14-226
  • Pang, B., Zhao, L. H., Zhou, Q., Zhao, T. Y., Wang, H., Gu, C. J., & Tong, X. L. (2015). Application of berberine on treating type 2 diabetes mellitus. International journal of endocrinology, 2015, 905749. https://doi.org/10.1155/2015/905749
  • Rondanelli, M., Infantino, V., Riva, A., Petrangolini, G., Faliva, M. A., Peroni, G., Naso, M., Nichetti, M., Spadaccini, D., Gasparri, C., & Perna, S. (2020). Polycystic ovary syndrome management: a review of the possible amazing role of berberine. Archives of gynecology and obstetrics, 301(1), 53–60. https://doi.org/10.1007/s00404-020-05450-4
  • Shen, H. R., Xu, X., Ye, D., & Li, X. L. (2021). Berberine Improves the Symptoms of DHEA-Induced PCOS Rats by Regulating Gut Microbiotas and Metabolites. Gynecologic and obstetric investigation, 86(4), 388–397. https://doi.org/10.1159/000518040
  • Tabassum, R., Imtiaz, F., Sharafat, S., Shukar-Ud-Din, S., & Nusrat, U. (2013). Prevalence and clinical profile of insulin resistance in young women of poly cystic ovary syndrome: A study from Pakistan. Pakistan journal of medical sciences, 29(2), 593–596. https://doi.org/10.12669/pjms.292.3180
  • Wang, H., Zhu, C., Ying, Y., Luo, L., Huang, D., & Luo, Z. (2017). Metformin and berberine, two versatile drugs in treatment of common metabolic diseases. Oncotarget, 9(11), 10135–10146. https://doi.org/10.18632/oncotarget.20807
  • Wei, W., Zhao, H., Wang, A., Sui, M., Liang, K., Deng, H., Ma, Y., Zhang, Y., Zhang, H., & Guan, Y. (2012). A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. European journal of endocrinology, 166(1), 99–105. https://doi.org/10.1530/EJE-11-0616
  • Yan, H. M., Xia, M. F., Wang, Y., Chang, X. X., Yao, X. Z., Rao, S. X., Zeng, M. S., Tu, Y. F., Feng, R., Jia, W. P., Liu, J., Deng, W., Jiang, J. D., & Gao, X. (2015). Efficacy of Berberine in Patients with Non-Alcoholic Fatty Liver Disease. PloS one, 10(8), e0134172. https://doi.org/10.1371/journal.pone.0134172
  • Yang, J., Yin, J., Gao, H., Xu, L., Wang, Y., Xu, L., & Li, M. (2012). Berberine improves insulin sensitivity by inhibiting fat store and adjusting adipokines profile in human preadipocytes and metabolic syndrome patients. Evidence-based complementary and alternative medicine : eCAM, 2012, 363845. https://doi.org/10.1155/2012/363845
  • Yao, J., Kong, W., & Jiang, J. (2015). Learning from berberine: Treating chronic diseases through multiple targets. Science China. Life sciences, 58(9), 854–859. https://doi.org/10.1007/s11427-013-4568-z
  • Zhang, N., Liu, X., Zhuang, L., Liu, X., Zhao, H., Shan, Y., Liu, Z., Li, F., Wang, Y., & Fang, J. (2020). Berberine decreases insulin resistance in a PCOS rats by improving GLUT4: Dual regulation of the PI3K/AKT and MAPK pathways. Regulatory toxicology and pharmacology : RTP, 110, 104544. https://doi.org/10.1016/j.yrtph.2019.104544
  • Zhao, H., Xing, C., Zhang, J., & He, B. (2021). Comparative efficacy of oral insulin sensitizers metformin, thiazolidinediones, inositol, and berberine in improving endocrine and metabolic profiles in women with PCOS: a network meta-analysis. Reproductive health, 18(1), 171. https://doi.org/10.1186/s12978-021-01207-7

Recent Posts