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Hi, I’m Alyssa! AKA, The PCOS Nutritionist Alyssa!

I’m a Registered Dietitian dedicated to helping you eliminate your PCOS symptoms with sustainable and realistic nutrition changes.

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Can I Take Berberine and Inositol Together For PCOS?

Wondering which one you should take for PCOS? Or whether you can take berberine and inositol together for PCOS? You’re in the right place. 

Hi, I’m Alyssa, a registered dietitian living with PCOS too. I’m here to make your life easier by giving you the research-based facts to help you manage this condition. 

This blog will dive into the benefits of inositol and berberine for PCOS, which one is better, and whether it’s safe to take both of them together. Let’s go!

supplement capsules and green herbal leaves on a white background with text overlay stating berberine or inositol for pcos? or both?

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Why Take Supplements For PCOS?

Polycystic ovarian syndrome (PCOS) is a common hormonal condition that affects approximately 8-13% of women of reproductive age worldwide, with an even larger amount of the population going undiagnosed (1). Despite how prevalent it is, there have not been many advances in terms of mainstream medical options outside of prescription medications, such as Metformin or oral contraceptives (aka birth control pills).

Some common symptoms of PCOS include:

  • Irregular periods
  • Anovulation and infertility
  • Weight gain (particularly in the abdominal area, something that’s commonly referred to as PCOS belly
  • Hirsutism (aka excess hair growth on the face and body)
  • Hair loss
  • Acne and other skin conditions such as hidradenitis suppurativa 
  • Fatigue

While the exact cause of PCOS isn’t well understood, insulin resistance, chronic inflammation, and high androgen levels (aka male hormones like testosterone) seem to be common driving forces in this condition. Left unmanaged, these can lead to an increased risk of developing other chronic diseases such as type 2 diabetes, cardiovascular disease, high blood pressure, and fatty liver disease. 

Given the limited medical options that those with PCOS are offered, many are interested in exploring natural supplements or more holistic approaches to naturally manage PCOS symptoms.

Let’s jump into the benefits of berberine for PCOS and what the research actually says. 

Berberine for PCOS

Berberine is an ancient herb that has been used for centuries in traditional Chinese medicine. It was commonly used for fertility and diabetes.

Berberine has become popular in recent years through social media, being coined as “nature’s Ozempic” for its ability to help with weight loss. While this may have put berberine on more people’s radar, it’s actually not a new supplement in the PCOS world. 

Berberine Benefits For PCOS

Weight Loss

There have been several clinical studies that have examined the benefits of berberine for PCOS. Berberine is most commonly known for its ability to reduce body weight, which it can do pretty effectively. A systematic review found that berberine supplementation had a moderate but significant effect on decreasing body weight, body mass index (BMI), and waist circumference. 

Insulin Resistance

Berberine is also highly regarded for its ability to improve insulin sensitivity (2). In other words, it can make your body more sensitive to the hormone insulin, and reduce insulin resistance. Considering insulin resistance is present in up to 80% of those with PCOS, this can be pretty significant for controlling symptoms like carb cravings and decreasing the risk of type 2 diabetes.

Androgens

High androgen levels are one of the key characteristics of PCOS. If you struggle with hair loss, hirsutism (aka excess hair growth), or acne, high levels of androgens are likely the problem.

One clinical trial looked at 50 PCOS women who took 500 mg of berberine twice per day for 6 months. It found that there were reductions in total testosterone levels, free androgen index, androstenedione, and sex hormone binding globulin (SHBG) levels. Other studies have found similar results.

Inflammation

Chronic, low-grade inflammation has emerged as a key factor in the development of PCOS. Berberine may help to reduce inflammation and lower oxidative stress. A systematic review found that berberine reduced C-reactive protein (CRP) levels, which are often used to indicate whether inflammation is present. 

Cholesterol Levels

Dyslipidemia, or abnormal cholesterol levels, are common in PCOS regardless of body size. Total cholesterol, LDL (aka “bad”) cholesterol, and triglycerides tend to be high, while HDL (aka “good”) cholesterol tends to be low. Studies have found that berberine can favorably alter cholesterol levels in those with PCOS.

Gut Health

Berberine does appear to have the potential to alter the gut microbiome, which tends to be less diverse in those with PCOS. Research is still emerging on how this may affect PCOS, and the results are conflicting and inconclusive. Some research finds benefits, but, one clinical trial done in animals found that berberine negatively altered the gut intestinal flora: decreasing the amount of gut bacteria and the diversity, which may negatively impact overall health (3).

infographic listing the benefits of berberine for pcos.

Berberine Compared To Metformin

Metformin is one of the most common prescription medications used in the treatment of PCOS. There have been a few clinical trials that have compared how well berberine performs compared to metformin in those with PCOS. Additionally, there have been a couple of studies that have looked at berberine in addition to metformin. 

One small clinical trial found that berberine led to greater reductions in waist circumference and cholesterol levels compared to metformin (4). Another recent clinical trial found that berberine performed similarly to Metformin in terms of reducing insulin resistance, and that it may have a greater potential to reduce cardiovascular disease risk (5). 

Although this wasn’t done in those with PCOS, another study examined the combination of metformin and berberine in those with type 2 diabetes. It found that the combination of metformin plus berberine led to less inflammation and improved insulin sensitivity better than metformin alone (6).

Overall, it appears that berberine performs equally as well as metformin for PCOS. In some categories, such as weight loss and lipid profiles, it may actually perform better. This is exciting news, especially for those who cannot handle the side effects of metformin. 

Typical Dosage

Berberine appears to be safe for short-term use, although researchers acknowledge that more research is needed to determine safe doses for long-term use.

For short term use, most research studies used 500 to 1500 mg daily. It’s generally recommended to spread these doses out throughout the day in 500 to 600 mg increments. 

For berberine supplements, I recommend this one.

Side Effects and Safety Concerns 

Common side effects of berberine are gastrointestinal symptoms such as nausea, upset stomach, diarrhea, and constipation.

While berberine has become pretty popular, there’s one thing that I don’t see being discussed nearly as often as it should be: the long-term safety of berberine. Researchers have not yet established the amount of time that berberine is safe to take. Doses up to 1500mg (or 1.5g) per day for up to 6 months appear to be safe, but beyond that is unknown.

Berberine also is not recognized as safe for pregnancy or breastfeeding. 

Always talk to your healthcare provider before starting any new dietary supplements to discuss whether it’s a good option for your unique medical needs.

Inositol for PCOS

This is one of the most well-studied supplements for PCOS. Inositol is a type of sugar that’s naturally found in certain foods like nuts, beans, and citrus fruits. It’s similar to a B vitamin and used to be commonly referred to as vitamin B8.

You can actually read my full review of my favorite inositol supplement here: 8 Ovasitol Benefits For PCOS (A Dietitian’s Thoughts).

Let’s jump into the highlights of this supplement for PCOS though.

Inositol Benefits For PCOS

Insulin Resistance

We’ve already established that insulin resistance is prevalent in PCOS. Research studies show that inositol can significantly lower glucose levels and insulin levels, which can ultimately reduce insulin resistance and the risk of type 2 diabetes. 

Weight Loss

Inositol seems to have a positive impact on BMI, perhaps because of its ability to significantly lower insulin resistance. One randomized controlled trial in particular found that those who combined myo-inositol plus d-chiro inositol lost more weight than those who took myo-inositol alone. The group with the combo inositol supplement lost 13.9% of their body weight in 6 months. 

infographic listing the benefits of inositol for pcos.

Testosterone Levels

High androgens, particularly high testosterone, are common in PCOS and can be contributing to those pesky chin hairs you’re dealing with. Inositol can significantly lower testosterone levels, particularly free testosterone levels. One clinical study found that inositol lowered free testosterone levels by 73% (7).

Cholesterol Levels

Similar to berberine, inositol can lower total cholesterol, LDL (“bad”) cholesterol, and triglyceride levels, while also raising HDL (“good”) cholesterol levels.

Carb Cravings

Many people report a significant decrease in carb cravings when they start taking inositol supplements. This is likely because of a decrease in glucose and insulin levels.

To learn more about taming your PCOS cravings, check out this one: 7 Tips To Stop Your PCOS Cravings.

Regulate Menstrual Cycle and Ovulation

Irregular menstrual cycles are one of the hallmark symptoms of PCOS, with anovulation (or lack of ovulation) being a key culprit. Inositol can help to regulate periods and restore ovulation. One study found that 61% of participants had restored ovulation after 12 weeks of using an inositol supplement (8).

Egg Quality & IVF Outcomes

Many women with PCOS experience poor egg quality because of the underlying hormonal imbalances. This can make it more difficult to achieve a healthy pregnancy. Inositol supplementation, particularly a combination of myo-inositol and d-chiro inositol, can improve egg quality, pregnancy rates, and fertility outcomes in those with PCOS. It can also improve outcomes for those undergoing IVF treatment.

If fertility is your goal, you’ll also probably want to consider a Prenatal Vitamin Supplement for PCOS.

Gestational Diabetes Risk

Since insulin resistance is so prevalent in PCOS, the risk of gestational diabetes in pregnancy is also higher unfortunately. Inositol is considered to be safe for pregnancy and can lower the risk of gestational diabetes and may also reduce pre-term birth. 

Thyroid Function

Up to 25% of those with PCOS also have an autoimmune thyroid condition called Hashimoto’s hypothyroidism. Inositol supplementation can reduce thyroid stimulating hormone (TSH) levels and thyroid antibodies. 

Inositol Compared To Metformin

Overall, inositol appears to perform similarly to metformin in terms of lowering body weight and reducing insulin resistance according to past research. A recent clinical trial compared the use of metformin, inositol, or berberine in PCOS. This trial found that myo-inositol reduced insulin resistance significantly better than metformin or berberine.

There has also been some research that combined inositol (myo-inositol + d-chiro inositol) and metformin. One study found significantly better outcomes for insulin resistance, total testosterone, and menstrual regularity with this combination rather than either one alone (9).

Typical Dosage

The typical dosage of inositol is a combination of two types of inositol: myo-inositol and d-chiro inositol. The recommended dosage is 2,000 to 4,000 mg of myo-inositol daily, along with 50 to 100 mg d-chiro inositol daily.

For the recommended myo-inositol and d-chiro combination supplements, I recommend Ovasitol by the brand Theralogix. It’s one of my absolute favorite supplements to recommend for PCOS. You can use PRC code: 202702 for a discount, and this can usually be combined with a discount code found online to make it more affordable.

Side Effects and Safety Concerns

Side effects of inositol are rare but may include gastrointestinal upset such as nausea, upset stomach, and diarrhea.

Inositol supplements appear to be safe for long-term use. They’re also safe for pregnancy and breastfeeding.

Inositol or Berberine: Which Is Better? 

I wish I had a good answer for you here, but unfortunately, it’s going to depend on you and your unique situation. Your healthcare provider can help guide you through whether either of these options are a good fit for you. 

They both have the potential to improve a lot of negative symptoms you may be experiencing with PCOS, such as insulin resistance, irregular periods, inflammation, high cholesterol levels, and high androgens.

When we get down to it though, research supports a wider variety of uses for inositol that haven’t been proven with berberine yet, such as thyroid benefits and fertility outcomes. Inositol is also recognized as safe for long-term use, pregnancy and breastfeeding…so there’s really no need to stop taking this supplement if you notice benefits.

On the other hand, berberine seems to have a bigger impact on weight loss. But the long term safety of berberine isn’t established yet. It’s likely safe to take up to 1500 mg daily for up to 6 months. It’s also not safe for pregnancy or breastfeeding. So if you’re planning to become pregnant, this may not be a great choice for you. 

infographic chart comparing berberine to inositol for pcos.

Can I Take Berberine and Inositol Together? 

There are not any known interactions between these two popular supplements. However, since they both work similarly, the effects of these supplements may be magnified if they’re combined together…which may lead to symptoms like hypoglycemia (low blood sugar). 

One clinical trial examined the effect of a combination of supplements on glucose levels (blood sugar levels). It combined low doses of berberine (200 mg) and inositol (300 mg), along with other nutrients like chromium picolinate and curcumin, and measured its effects. It found that the supplement combination lowered glucose levels, insulin levels, insulin resistance, cholesterol levels, and inflammation (10). However, it’s important to note that this study was not done on those with PCOS. The amounts of inositol and berberine were also very low compared to many commercially available products.

Always talk to your healthcare provider as to whether these two supplements can be taken together safely.

The Bottom Line

Berberine and inositol are two popular supplements for PCOS. They both have favorable research for their abilities to lower insulin resistance, inflammation, body weight, cholesterol levels, and androgen levels. 

Berberine appears to be more effective for those looking to lose weight, although it’s not well understood if berberine is safe to take beyond a 6 month period. It’s also not safe for pregnancy or breastfeeding.

Inositol appears to be more effective for those looking to lower insulin resistance. Inositol also has additional known benefits for fertility and its ability to regulate menstrual cycles. It’s considered safe for long term use and while pregnant or breastfeeding. This potentially makes it a good choice for those looking for fertility support.

There aren’t any known interactions between these two supplements, and they appear to be safe to take together. However, since they both can have similar benefits for those with PCOS, the combination of the two may magnify the effects and cause negative side effects such as low blood sugar levels. 

It’s always best to discuss your health concerns and supplement regimen with your healthcare provider. They will be able to guide you on whether these are safe options for you.

More PCOS Supplement Posts You’ll Love

Ashwagandha for PCOS: What You Should Know

Maca Root for PCOS: Is It Worth The Hype?

Best Supplements for PCOS Weight Loss

Happy Hormones PCOS Multivitamin Review

Best Magnesium for PCOS

Disclaimer: this is for informational purposes only. It is not intended to substitute for or replace professional medical advice. It is not intended to diagnose, treat, or cure any medical conditions including polycystic ovary syndrome (PCOS). Always consult with your medical doctor before making changes to your health routine.

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