Berberine and PCOS: Is this a promising supplement?

How Can Berberine Be Used As A Natural Treatment for Insulin Resistance 

What do nutraceuticals have to do with insulin resistance?

In modern culture we turn to doctors for support for our medical problems like polycystic ovary syndrome. However, most doctors are only taught to treat disease with medication and surgery. They receive very little training in the realm of nutriceuticals, botanicals and supplements.

Often medications like metformin are prescribed to help patients manage insulin resistance. Sometimes these medications have uncomfortable side effects. This is where Berberine comes in. Berberine typically doesn’t include the same uncomfortable gastrointestinal side effects of metformin.

Berberine Improves Insulin Sensitivity

Berberine makes your body more sensitive to insulin’s messages(that’s why we call it an insulin sensitizer) which helps keep our blood glucose in check. It helps your cells offer more receptors (aka doorbells) for insulin to utilize.

A greater number of insulin receptors increases the volume of the doorbells alerting your cells that it’s time to pull in glucose from the bloodstream.(3) This is great because it keeps our bodies from storing fat in places it shouldn’t, like our liver. 

Improving insulin and glucose levels has the potential to improve many different areas of PCOS health.

Berberine Can Lower Risk of Fatty Liver Disease

When fat starts building up in the liver, it’s referred to as Non-alcoholic fatty liver disease–but for now we will just call it fatty liver. Fatty liver is an important topic for those of us learning to manage PCOS because many of us have an increased risk of developing fatty liver.

Fatty liver can be a rather silent condition at first and doctors often look for it in your annual appointment when they order AST and ALT – which are just liver enzymes.

If elevated, that is a sign you may have Fatty Liver disease. Other than diet and lifestyle changes, scientists have found that berberine may help our body combat both insulin resistance and fatty liver disease.(7)

Berberine Helps Your Body Activate Metabolic Pathways

Berberine is helpful for these conditions because it kick-starts a metabolic pathway called AMPK. AMPK ramps up when the body thinks it’s starving or fasting. It tells our cells to be more sensitive to insulin which makes them gobble up glucose at a quicker rate leading to less fat storage in organs like the liver.

When we take berberine we trick our cells into activating AMPK which gives us some of the benefits of fasting (like increased insulin sensitivity) without actually starving ourselves, or fasting. 

Berberine Improves PCOS Hormone Imbalances

Berberine Lowers Testosterone Levels

Studies have shown that the administration of berberine can improve testosterone levels. Testosterone is responsible for a number of frustrating PCOS symptoms. It can also increase insulin resistance and result in poor-quality oocytes.

Improving testosterone levels is something that will not only provide relief from frustrating PCOS symptoms, but it also has promise for improving ovulation and fertility.

Berberine Can Improve Fertility With PCOS

Berberine is not a supplement recommended in pregnancy. Often this makes women with polycystic ovary syndrome avoid it in the pre-conception period.

This is not something to be afraid of while trying to conceive. In fact, evidence shows it is a promising treatment to improve fertility. (8)

How Berberine Can Improve Fertility

Berberine improves insulin sensitivity which has a downstream effect of lowering testosterone production in the ovary. This can improve ovulation rates, egg quality, and progesterone production.

Berberine has also been shown to increase sex hormone binding globulin. Sex hormone binding globulin grabs hold of testosterone and essentially turns it off.

Berberine has multiple avenues of lowering androgens and improving cycle regularity. It can lower the production of testosterone and “turn off” the testosterone that has already been created.

Berberine and IVF Treatment

One study considering the benefits of metformin or berberine prior to IVF looked at 150 PCOS patients. Taking berberine or metformin for 3 months prior to IVF showed lower total testosterone, fasting glucose, fasting insulin, and increases in sex hormone binding globulin.

Berberine and metformin resulted in increased pregnancy rates and reduced incidence of ovarian hyperstimulation when compared with a placebo group.

Berberine had a higher rate of live birth rates than metformin. It also had better decreases in BMI, lipids, and total FSH.

The study also noted lower GI side effects when compared to the metformin group.

Berberine Promotes Sex Hormone Binding Globulin(SHBG)

We saw above how berberine can support the liver and improve fatty liver disease. This is done in part because of it’s impact on insulin sensitivity.

Yet the liver has many more functions when it comes to hormones. It is responsible for breaking down estrogen and getting it out of the body. It converts most of your inactive thyroid hormone T4 into the active form T3.

The liver also makes the protein SHBG. The main purpose of SHBG is to turn off sex hormones. Supporting the liver, means we see all of these benefits: estrogen detox, thyroid hormone function, and SHBG levels increasing meaning that testosterone will be less potent in your body.

Are you convinced this is a supplement worth trying yet?

Acne, PCOS, and Berberine

Acne in PCOS often has a hormonal source – usually androgenic(testosterone or DHEA-S)in nature. We have already established how berberine can lower testosterone, but it can improve acne via another pathway as well.

Berberine has powerful antimicrobial properties, which make it great for acne clearance. Sometimes acne is fueled by hormones but can also be exacerbated by bacterial infections.

Our gut and our skin are reflections of one another. If our skin is angry in any way, we always should “pop the hood” in a sense – and see what’s going on inside the engine.

Berberine and the Gut

When we think about our guts we often think dysfunction should be treated with acid-lowering medications or laxatives. No matter which end of your gastrointestinal tract you may be suffering symptoms, berberine has a history of treating it.

Struggle with gas? Feel bloated all the time? Have diarrhea or constipation? Berberine can help with some of these symptoms and is certainly worth a try if you experience any of these AND you have PCOS.

Berberine increases the gut microbial communities’ production of short-chain fatty acids. This is an important fuel for the gut.

Berberine Has Anti-Microbial Properties

Berberine has the ability to kill off certain gut microbes. Because of this, I have heard many practitioners in the functional medicine world discuss the need to limit use of berberine.

The rationale for this suggestion is that we don’t know what long-term administration of berberine will do to gut microbiota.

When you look at the research with a critical lens, I don’t see the need to be so concerned. Evidence shows that berberine can kill opportunistic (or bad) bacteria and promotes the proliferation of good bacteria.