Read on as we break down the what, why, and how of this impressive herb and who can benefit from it.

What is Berberine?

Berberine is a plant alkaloid with a long history of medicinal use in both Ayurvedic and Chinese medicine. It is present in Hydrastis canadensis (goldenseal), Coptis chinensis (Coptis or goldenthread), Berberis aquifolium (Oregon grape), Berberis vulgaris (barberry), and Berberis aristata (tree turmeric). The berberine alkaloid can be found in the roots, rhizomes, and stem bark of these plants.

When was it discovered and what has been going on since?

 The earliest record of Rhizoma Coptidis as a medicinal herb was in A.D. 200 in The Herbal Classic of the Divine Plowman (Shen Nong Ben Cao Jing). In about A.D. 500, the anti-diabetes activity of Rhizoma Coptidis was recorded for the first time in a book titled “Note of Elite Physicians.”

Most berberine used in medical practice is not extracted from this herb because of its high cost. Usually, it is prepared from other herbs such as Berberis amurense Rupr. and Phellodendron amurense Rupr. Among many chemical forms of berberine, i.e., berberine hydrochloride, berberine sulfate, berberine citrate or phosphate, berberine hydrochloride is the most common form.

A literature search of Berberine, its uses, mechanism of action, new developments, and delivery systems revealed over 10,000 results. I will try to narrow down the most relevant and easily digestible fragments to inform you of its uses, side effects, and much more.

What are some proven benefits of Berberine?

Recently, basic research has proven that berberine can be used to lower the blood glucose level (Liang et al., 2019), improve insulin resistance (Lou et al., 2011), improve hyperlipidemia (Li et al., 2016), and prevent mild cognitive impairment (Kumar et al., 2016). This feature improves the shortcomings of the combination of statins and metformin and shows potential as a new first-line treatment drug.

Here is a brief list of the purported and proven benefits of Berberine. In the following section, I will elaborate on the mechanisms that lead to these benefits.

1. Lower blood sugar – improve glycemic control in diabetics.
2. Improve metabolic syndrome parameters (weight, waist circumference, blood pressure and lipid profile).
3. Improve Polycystic Ovarian Syndrome (PCOS).
4. Antimicrobial properties that assists in fighting bacterial and other microbial gut and skin infections.
5. Improve lipid profile, especially LDL, HDL and Triglycerides.
6. Improvement in NAFLD (nonalcoholic fatty liver disease).
7. Reduce cognitive impairment in diabetics.

How does Berberine do the magic?

Glycemic control:

Several animal and human studies have shown Berberine’s unequivocal effects on glucose control. Here is how it helps:

1. Berberine activates AMP-activated protein kinase (AMPK).

AMPK is a key energy-sensing/signaling system in the cells and acts as a fuel gauge by monitoring cellular energy levels.

2) It has an insulin-independent hypoglycemic effect that is related to inhibition of mitochondrial function, stimulation of glycolysis and activation of AMPK pathway. In the newly-diagnosed type 2 diabetic patients, berberine is able to lower blood insulin level via enhancing insulin sensitivity. However, berberine may improve insulin secretion in patients with poor β-cell function by resuscitating exhausted islets.

This study confirmed that administration of berberine (0.5 g three times daily) at the beginning of each meal was able to reduce fasting blood glucose (FBG) and postprandial blood glucose (PBG) in patients with newly-diagnosed type 2 diabetes. Hemoglobin A1c (HbA1c) levels were dropped by 2.0%, comparable to the effect of metformin. In poorly-controlled diabetic patients with insulin injection, berberine reduced HbA1c by 0.8%.

In the first in vitro study using hepatocytes (HepG2 cell line), berberine was shown to stimulate glucose consumption in an insulin-independent manner, and the activity was similar to that of metformin. Several studies have confirmed the insulin-independent activity of berberine in other cell models e.g., muscle cells (L6 and C2C12 cell lines) and adipocytes (3T3-L1 cell line). In the presence of insulin, berberine exhibited a synergetic effect on insulin-induced glucose consumption and glucose uptake. It is unclear if Berberine acts through the GLUT receptors.

3) The antioxidant and aldose reductase inhibitory activities of berberine may be useful in alleviating diabetic nephropathy.

Oxidative stress and aldose reductase activities are closely related to diabetic complications. Several groups have explored the obvious beneficial effect of berberine in this field. In STZ and high-carbohydrate/high-fat diet induced diabetic rats with hyperlipidemia, berberine markedly decreased malondialdehyde level and increased catalase, superoxide dismutase, glutathione peroxidase, and glutathione activities. Berberine also improved cognitive performance, lowered hyperglycemia, oxidative stress, and choline esterase activity in diabetic rats.

4) Berberine was shown to protect against endothelial injury, enhance the endothelium-dependent vasodilatation, and downregulate proinflammatory responses through activation of the AMPK signaling cascade.

5) Berberine also acts as an α-glucosidase inhibitor. α-Glucosidase is an intestinal enzyme that breaks down carbohydrates into monosaccharides. Inhibition of the enzyme will lead to diminished absorption of dietary carbohydrates.

6) Berberine may have extra beneficial effects on diabetic cardiovascular complications due to its cholesterol-lowering, anti-arrhythmias and nitric oxide (NO) inducing properties.

Cholesterol-lowering effects

Berberine (BBR) was reported to improve lipid metabolism in both animals and human subjects. Two clinical trials showed that berberine decreased triglycerides by 35% and 22%, serum cholesterol by 29% and 16%, and LDL-C by 25% and 20% in patients with dyslipidemia.

Reduction of cholesterol with berberine is related to the induction of LDL receptor (LDLR) expression in liver, which may be due to extended half-life of LDLR mRNA via activation of extracellular signal-regulated kinases (ERK) by berberine.

The results in this study showed that Berberine (BBR) supplementation can significantly lower TC, TG, LDL, Fasting blood glucose (FBG), insulin, HbA1c, HOMA-IR, SBP, weight, BMI, and waist circumference (WC) and can elevate HDL. According to the subgroup analysis, Berberine supplementation in participants with normal BMIs (18.5–24.9) was ineffective for changing TG, TC, LDL, HDL, insulin, SBP, weight, BMI, and WC. The significant effects of Berberine on HDL and WC were only seen in doses of more than 1 g/day, on FBG and HOMA-IR in the durations of more than 8 weeks, and on HbA1c and weight in both mentioned higher subgroups of dose (>1 g/d) and duration (>8 weeks). Moreover, BBR was significantly effective in alleviating cardiovascular risk factors, mainly in subgroups with impaired metabolic health such as NAFLD, type 2 diabetes, and metabolic syndrome. In addition, BBR was effective for the improvement of LDL, HDL, and FBG only in subgroups with abnormal ranges (HDL ≤ 40, LDL > 100 mg/dl, and FBG > 100 mg/dl). The optimum dose for BBR was 1 g/day for TG, TC, and weight, 1.8 g/day for insulin and HOMA-IR, and 5 g/day for HDL. The most effective duration was 40 weeks for FBG and 50 weeks from the beginning of BBR supplementation for DBP and WC.

BBR is suggested to upregulate the expression of LDL receptors in the human hepatoma cell line (HepG2) and to inhibit both cholesterol and TG synthesis in the liver, dose-dependently. This effect of BBR on lipid synthesis is mediated by the mitogen-activated protein kinase (MAPK/ERK) pathway, and can also be owing to the decrease in proprotein convertase subtilisin/kexin type 9 (PCSK9) mRNA. PCSK9 downregulates the LDL receptor (LDLR) and BBR acts against it. Another mechanism of action for BBR could be that it is an agonist for AMPK, a fuel gauge. This activation leads to the inhibition of cholesterol and TG synthesis by inactivating two enzymes, β-Hydroxy β-methylglutaryl-CoA (HMG-CoA) and ACC (acetyl-coenzyme A carboxylase). AMPK activation also increases energy production hence normalizing the imbalance between glucose, lipid, and energy. This activation can also impose anti-inflammatory effects and can speed up the transport of glucose in the serum by promoting glucose transporter type 4 (GLUT4) translocation, although GLUT4 involvement is still unclear.

Antimicrobial and antioxidant activities of Berberine

 The antimicrobial activity of berberine is well-established in treatment of infection caused by bacteria, viruses, fungi, protozoans and helminthes.

This study showed a significant effect of Berberine against Staph Aureus. In this study, Berberine showed antimicrobial activity against all tested strains of MRSA. Minimum inhibition concentrations (MICs) of berberine against MRSA ranged from 32 to 128 µg/mL. Ninety percent inhibition of MRSA was obtained with 64 µg/mL or less of berberine.

The authors concluded that BBR reduced the antioxidant capacity of S. aureus. Accumulation of the precursors (UDP-GlcNAc, CDP-ribitol, and CDP-glycerol) and downregulation of the key metabolite D-Ala-D-Ala suggest the inhibition of cell wall synthesis, especially the peptidoglycan synthesis. Metabolites involved in the shikimate pathway (such as 3-dehydroshikimate) and downstream aromatic amino acid synthesis were disturbed.

Improvement in NAFLD (Non Alcoholic Fatty Liver Disease)

Since liver plays a central role in glucose metabolism, numerous studies focused on effects of berberine, especially in fatty liver disease. In newly diagnosed type 2 diabetics with nonalcoholic fatty liver disease as comorbidity, berberine obviously ameliorated liver steatosis in ultrasonic images, decreased AST and ALT, reduced hemorheology indicators, and improved lipids profile. Similar results were obtained in another study. Berberine lowered FBG effectively in chronic hepatitis B and hepatitis C patients with T2DM or impaired fasting glucose. Liver function was improved greatly in these patients as indicated by the reduction of liver enzymes. This data showed that hepatic steatosis was alleviated by berberine through inhibition of fatty acid synthase (FAS) expression. Berberine decreased fasting blood glucose by direct inhibition of gluconeogenic genes, phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase) in liver.

Complex I of the electron transport chain is the major place of superoxide production, and is the target of berberine.  The antioxidant activity of berberine may directly result from complex I inhibition.

Mitochondrial inhibition may play a key role in the activities of berberine such as preventing fatty liver, reducing blood glucose and decreasing blood lipids. The details of the regulation remain to be explored.

Evidence for effects on inflammatory markers and liver enzymes has been conflicting.

Improvement in Metabolic Syndrome

 The metabolic disorder includes a spectrum of conditions such as nonalcoholic fatty liver disease (NAFLD), type 2 diabetes, impaired glucose tolerance (prediabetes), polycystic ovarian syndrome (PCOS), and hyperlipidemia. Previous studies have demonstrated that metabolic disorders are prone to diabetic encephalopathy and atherosclerosis (Barenbrock et al., 1995), which will generate Alzheimer’s disease and coronary heart disease (Razay et al., 2007). NAFLD is closely related to type 2 diabetes and dyslipidemia (Marchesini and Babini, 2006). Characteristic changes in patients with metabolic disorders include a decrease in serum high-density lipoprotein (HDL) or an increase in serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), fasting plasma glucose (FPG), and homeostasis model assessment-insulin resistance (HOMA-IR).

In this study, the authors showed that berberine significantly reduced waist circumference and waist/hip ratio significantly in the absence of weight change. Similar results were also reported by other groups. It was indicated berberine may inhibit visceral fat accumulation. In diabetic rats, adipocyte size and the ratio of white adipose tissue to body weight were decreased, and adipocyte number was increased with berberine treatment.

Although berberine was shown to suppress fat accumulation, the current evidence on mechanisms is controversial.

Berberine may also reduce the risk of developing metabolic syndrome through its beneficial effects on the gut microbiota. In the last decade, many studies have indicated that the composition of gut microbiota is associated with the regulation of the host’s health and metabolism. Dysbiosis, defined as an alteration in the quality and/or quantity of the intestinal microbiota, can affect the host’s physiology and may be a factor that leads to the onset of various diseases, including obesity and T2DM, as well as cardiovascular diseases, Crohn’s disease, and cancer

 Berberine and cancer treatment

 Berberine has exhibited ability to suppress tumor metastasis (Lin et al., 2006; Serafim et al., 2008; Cai et al., 2014). Matrix metalloproteinases (MMPs) degrade the tissue matrix, allowing tumor cells to break through the normal tissue barrier and invade the surrounding normal tissue and distant organs. Berberine inhibits the release of MMP-2 from tumor cells and thus inhibits tumor cell destruction of the tissue matrix.

In vitro studies have demonstrated that the inhibition of FAK, IKK, NF-kB, u-PA, MMP-2, and MMP-9 significantly reduced metastasis.

How is Berberine absorbed in the human body?

Berberine exhibits poor absorption, efflux and extensive metabolism in the human gut.  The absolute bioavailability of berberine is far less than 1%. Accordingly, one of the approaches for improving berberine’s efficacy is through studying the a variety of formulations to improve its bioavailability from the gut.

Which formulations of Berberine are the best?

Honestly, we don’t know. Berberine HCL is the most commonly available preparation. There is explosive research in progress to figure out the best way to increase the bioavailability of Berberine.

One groundbreaking area is of nanoparticles. Nanoparticles are fat-loving particles that help in protecting a drug from the breakdown of gastric enzymes and transport the drug to the bloodstream. Various nanoparticle formulations are being used in cancer treatments.

Nanoparticle formulations that encapsulate berberine for sustained release and improved bioavailability include the use of polymeric natural (e.g., chitosan) and synthetic (PLGA, PLGA-PEG, etc.) agents. Others include a self-micro emulsifying berberine-phospholipid complex of polyethylene glycol 1000 succinate (TPGS 1000) and SiO₂, phytosomes loaded with berberine-phospholipid complex, solid lipid nanoparticles, micelles, liposomes of various nature, etc.

Berberine NPs produced by both APSP and EPN methods have shown promising activities against Gram-positive and Gram-negative bacteria, and yeasts, with NPs prepared through the EPN method showing superior results compared to those made with the APSP method and the unprocessed drug.

So, now we know that Berberine is a magical herbal supplement. What are the negatives or side effects?

Berberine is clinically safe and well-tolerated by the human body. Few adverse reactions are reported, and no negative effect is observed on participants’ diet.

In this study, none of the patients suffered from severe gastrointestinal adverse events when berberine was used alone. In combination-therapy (Metformin + Berberine) the adverse events disappeared in one week after reduction in berberine dosage. The data suggest that berberine at dosage of 30mmg three times daily is well tolerated in combination therapy. Liver and kidney functions were monitored in this study. No significant changes in plasma ALT, γ-GT and creatinine were observed during the 13 weeks of berberine treatment.

It is recommended that Berberine be taken with food and if possible use gastroprotective coated formulations.

As always, please consult your health care practitioner who has knowledge about the mechanism of action of such herbal preparations and their possible interactions with any medications that you might be on. The quality of the preparation that you decide to take also matters.
Feel free to orders yours through this link to take advantage of our patient discount codes.

If you need a functional (holistic) approach to your PCOS, weight or any related or unrelated issues, feel free to schedule a functional consult here.

As always..

Be safe, be prepared and be ready,

Dr. Adeeti Gupta

References:

Yin, J., Ye, J., & Jia, W. (2012). Effects and mechanisms of berberine in diabetes treatment. Acta Pharmaceutica Sinica B, 2(4), 327-334. https://doi.org/10.1016/j.apsb.2012.06.003

Yin, J., Ye, J., & Jia, W. (2012). Effects and mechanisms of berberine in diabetes treatment. Acta Pharmaceutica Sinica B, 2(4), 327-334. https://doi.org/10.1016/j.apsb.2012.06.003

Zamani M, Zarei M, Nikbaf-Shandiz M, Hosseini S, Shiraseb F, Asbaghi O. The effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis. Front Nutr. 2022 Oct 14;9:1013055. doi: 10.3389/fnut.2022.1013055. PMID: 36313096; PMCID: PMC9614282.

Ye Y, Liu X, Wu N, Han Y, Wang J, Yu Y, Chen Q. Efficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Pharmacol. 2021 Apr 26;12:653887. doi: 10.3389/fphar.2021.653887. PMID: 33981233; PMCID: PMC8107691.

Front. Pharmacol., 15 January 2020
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Comincini S, Manai F, Sorrenti M, Perteghella S, D’Amato C, Miele D, Catenacci L, Bonferoni MC. Development of Berberine-Loaded Nanoparticles for Astrocytoma Cells Administration and Photodynamic Therapy Stimulation. Pharmaceutics. 2023; 15(4):1078.

Wu S, Yang K, Hong Y, Gong Y, Ni J, Yang N, Ding W. A New Perspective on the Antimicrobial Mechanism of Berberine Hydrochloride Against Staphylococcus aureus Revealed by Untargeted Metabolomic Studies. Front Microbiol. 2022 Jul 13;13:917414. doi: 10.3389/fmicb.2022.917414. PMID: 35910599; PMCID: PMC9328669.

Och A, Och M, Nowak R, Podgórska D, Podgórski R. Berberine, a Herbal Metabolite in the Metabolic Syndrome: The Risk Factors, Course, and Consequences of the Disease. Molecules. 2022 Feb 17;27(4):1351. doi: 10.3390/molecules27041351. PMID: 35209140; PMCID: PMC8874997.

Jun Yin, Jianping Ye, Weiping Jia: Effects and mechanisms of berberine in diabetes treatment, Acta Pharmaceutica Sinica B, Volume 2, Issue 4, 2012.

Zhao, J., Wang, Z., Karrar, E., Xu, D., & Sun, X. (2022). Inhibition Mechanism of Berberine on α-Amylase and α-Glucosidase in Vitro. Starch – Stärke, 74(3-4), 2100231. https://doi.org/10.1002/star.202100231

Xing, L., Zhou, X., Li, A., Li, H., He, C., Qin, W., Zhao, D., Li, P., Zhu, L., & Cao, H. (2021). Atheroprotective Effects and Molecular Mechanism of Berberine. Frontiers in Molecular Biosciences, 8, 762673. https://doi.org/10.3389/fmolb.2021.762673

Ma, X., Chen, Z., Wang, L., Wang, G., Wang, Z., Dong, X., Wen, B., & Zhang, Z. (2017). The Pathogenesis of Diabetes Mellitus by Oxidative Stress and Inflammation: Its Inhibition by Berberine. Frontiers in Pharmacology, 9. https://doi.org/10.3389/fphar.2018.00782

Koppen, L. M., Whitaker, A., Rosene, A., & Beckett, R. D. (2017). Efficacy of Berberine Alone and in Combination for the Treatment of Hyperlipidemia: A Systematic Review. Journal of Evidence-based Complementary & Alternative Medicine, 22(4), 956-968. https://doi.org/10.1177/2156587216687695

Yu HH, Kim KJ, Cha JD, Kim HK, Lee YE, Choi NY, You YO. Antimicrobial activity of berberine alone and in combination with ampicillin or oxacillin against methicillin-resistant Staphylococcus aureus. J Med Food. 2005 Winter;8(4):454-61. doi: 10.1089/jmf.2005.8.454. PMID: 16379555.

Koperska, A., Wesołek, A., Moszak, M., & Szulińska, M. (2022). Berberine in Non-Alcoholic Fatty Liver Disease—A Review. Nutrients, 14(17). https://doi.org/10.3390/nu14173459

Ye Y, Liu X, Wu N, Han Y, Wang J, Yu Y, Chen Q. Efficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Pharmacol. 2021 Apr 26;12:653887. doi: 10.3389/fphar.2021.653887. PMID: 33981233; PMCID: PMC8107691.

Lou T, Zhang Z, Xi Z, Liu K, Li L, Liu B, Huang F. Berberine inhibits inflammatory response and ameliorates insulin resistance in hepatocytes. Inflammation. 2011 Dec;34(6):659-67. doi: 10.1007/s10753-010-9276-2. PMID: 21110076.

Petrangolini, G., Corti, F., Ronchi, M., Arnoldi, L., Allegrini, P., & Riva, A. (2020). Development of an Innovative Berberine Food-Grade Formulation with an Ameliorated Absorption: In Vitro Evidence Confirmed by Healthy Human Volunteers Pharmacokinetic Study. Evidence-based Complementary and Alternative Medicine : ECAM, 2021. https://doi.org/10.1155/2021/7563889

Javed Iqbal, M., Quispe, C., Javed, Z., Sadia, H., Qadri, Q. R., Raza, S., Salehi, B., Abdulwanis Mohamed, Z., Sani Jaafaru, M., & Abdull Razis, A. F. (2021). Nanotechnology-Based Strategies for Berberine Delivery System in Cancer Treatment: Pulling Strings to Keep Berberine in Power. Frontiers in Molecular Biosciences, 7, 624494. https://doi.org/10.3389/fmolb.2020.624494

Yin, J., Xing, H., & Ye, J. (2008). Efficacy of Berberine in Patients with Type 2 Diabetes. Metabolism: Clinical and experimental, 57(5), 712. https://doi.org/10.1016/j.metabol.2008.01.013

Zhang, C., Sheng, J., Li, G., Zhao, L., Wang, Y., Yang, W., Yao, X., Sun, L., Zhang, Z., & Cui, R. (2020). Effects of Berberine and Its Derivatives on Cancer: A Systems Pharmacology Review. Frontiers in Pharmacology, 10, 481416. https://doi.org/10.3389/fphar.2019.01461

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WHAT

The symptoms of PCOS vary from zero to a hundred. PCOS is a spectrum and the pendulum swing can be controlled by the correct combination of natural, lifestyle and pharmaceutical approaches.

Various national and American educational societies have several classification criteria for PCOS diagnosis. The most commonly used criteria used are the Rotterdam Criteria. If any two of the three symptoms or signs are present then a diagnosis of PCOS can be made. The three criteria are hirsutism (excessive hair growth in unwanted areas), irregular periods, and polycystic ovaries on ultrasound.

That being said, PCOS is a syndrome and is always on a pendulum. The pendulum can swing from no symptoms to all the symptoms.

The picture can range from irregular periods, weight gain, excessive hair growth in unwanted areas, trouble losing weight, infertility, depression, low libido, pelvic pain, bloating, and much more.

WHY

 An imbalance between estrogen and progesterone with or without high testosterone levels can occur during PCOS. This, in combination with insulin resistance puts you at a higher risk of diabetes, causes difficulty in losing weight, and makes you lose your body shape.

What comes first? We still don’t know.

New research shows that these imbalances can be caused by some inherent changes in our genome. On top of that several environmental toxins called Xenoestrogens may either trigger PCOS or make things way worse. Xenoestrogens are chemicals that are commonly found in plastics, detergents, pesticides, perfumes, and even food. They go into our body and cause symptoms of excessive estrogen which in turn worsens PCOS.

WHO

Any female can be affected by PCOS. Some ethnicities or populations may have a higher incidence than others.

WHEN

Many females may start having symptoms as they go through puberty while many others develop symptoms later on in life at any age.

HOW

How can we fix it?

There are several strategies. It can be controlled or reversed but needs a multi-pronged approach. The superstar of this approach has to be a lifestyle and diet change.

In addition, there are several alternative herbal therapies and branded medications that can help.

What is Metabolic Syndrome and how do I know I have it?

Metabolic syndrome is a group of clinical findings. You do not need to have all of the characteristics to have it. However, a person with one clinical sign is more likely to have others. Most expert groups define metabolic syndrome as the presence of three or more of the following characteristics in a person:

• Obesity, especially in the abdominal area (defined by some groups as a waist size greater than 94 to 102 cm (38 to 41 in) in men or greater than 80 cm (32 in) in women)
• Impaired fasting glucose (fasting blood sugar of 100 to 125mg/dLor 5.6 to 7 mmol/L)
• Increased blood pressure(130/85or higher) or if you take medicine for high blood pressure
• Increased fasting levels of triglycerides (bad cholesterol).

What increases my risk of developing Metabolic syndrome? Can I avoid it?

The following factors are thought to increase the risk of developing metabolic syndrome:

• Being overweight (body mass index of 25kg/m²or more)
• Menopause (in women)
• Increasing age
• Smoking
• Eating a high carbohydrate diet
• Lack of physical activity
• Family history of diabetes or metabolic syndrome.

Yes, by carefully monitoring your diet and having an active exercise regimen, you may be able to avoid the florid clinical manifestation of metabolic syndrome.

What are the long-term health risks of metabolic syndrome?

Diabetes — Type 2 diabetes is much more likely to develop among people with the metabolic syndrome. Healthy lifestyle changes, such as weight loss and exercise, can help to reduce the risk of developing type 2 diabetes.

Heart disease— People with metabolic syndrome are at increased risk for developing cardiovascular disease. Cardiovascular disease includes coronary artery disease (collections of fatty plaques inside the heart’s blood vessels), cerebrovascular disease (collections of fatty plaques inside the blood vessels leading to the brain), and high blood pressure. Cardiovascular disease can lead to heart attack, stroke, or angina (chest pain).

Can I get tested for PCOS or metabolic syndrome? How do I know I have it?

The metabolic syndrome is diagnosed based upon a physical exam and a blood test of your fasting (before breakfast) blood sugar, cholesterol, and triglyceride levels.

Your doctor will check your weight, blood pressure and perform a full physical exam

Your doctor will also run some blood tests to check your fasting cholesterol, blood glucose, liver function and HbA1c. Checking fasting Thyroid hormone levels is also helpful because sometimes-slow thyroid (hypothyroidism) can look clinically like metabolic syndrome. Slow thyroid can be easily fixed by thyroid hormone supplementation. We may also check other hormones such as estrogen, progesterone, cortisol, DHEA and 17 hydroxy progesterone.

Remember that many times, especially if you are in the early stages of PCOS your blood work may be completely normal. In that case, you still need to proceed with the full-service approach to avoid progression into full-blown PCOS with advancing age.

Is one exercise regimen better than another?

Endurance exercise is an effective strategy to prevent muscular insulin resistance. A new study published in the Journal of Physiology demonstrates that exercising in the fasting state is more effective than exercising after eating a meal. Again, it’s all about balance. Several strategies can be used to assist with endurance and aerobic exercise that can increase longevity and improve insulin sensitivity.

I have a very busy schedule and I don’t have time to exercise, can I just get liposuction?

Removal of abdominal adipose tissue with liposuction does not improve insulin sensitivity or risk factors for coronary heart disease, suggesting that the negative energy balance induced by diet and exercise is necessary for achieving the metabolic benefits of weight loss.

PHYSICAL, SOCIAL AND MENTAL WELLNESS PLAY KEY ROLES IN HELPING WOMEN GAIN VICTORY OVER PCOS

We and designed a comprehensive approach called the ‘LAMPS” approach.

L- Lifestyle: Diet/ exercise and routine

Studies have shown that even 10-15 lbs. of weight loss can help regulate the periods. Lifestyle changes such as diet, exercise and weight loss will help regulate periods even without medical therapy.

A-Alternative medicine: Herbal and natural supplements

A customized plan incorporating natural herbal remedies can help you in swinging the pendulum to the left. The process can seem daunting and slow at first. We specialize in a comprehensive functional approach to PCOS and we have seen amazing results without the use of medication while avoiding the side effects of traditional pharmaceutical drugs.

M- Mental wellness:

Reducing stress, increasing mindfulness, and focusing on self-care go a long way. Remember, our brains are connected intricately with the ovaries and adrenals. Stress and elevated cortisol can affect the delicate hormonal balance and influence the estrogen/ progesterone balance.

P-Pharmacological approach:

Medications such as oral contraceptive pills, metformin and spironolactone are the traditional medical approaches to managing PCOS.

S-Social wellness:

You are not alone. Surrounding yourself with friends and family who bring positivity into your life is key. Get out of negative situations if it is safely possible. And if it is not possible then at least start planning and taking baby steps towards a better situation. Feel free to utilize our framework tool kit to assist you with your journey.

WHERE SHOULD I START?

• Get your regular GYN check up and talk to your provider.
• Functional approach: If you are suffering from multiple symptoms and can’t figure out why, feel free to reach out to us for a holistic consult here.
• Support group: If you are already getting care and are in need of a support group, we host monthly sessions where we get a cohort together to try and assist you with the complexities of PCOS.
• Custom packages: Because PCOS has multiple causes, it cannot be fixed by one approach. Hence, we have designed customized packages that include a multipronged approach so you can achieve good outcomes with a guided journey.

As always, we are here to help. Here is a quick video where I explain the basics of PCOS.

Be safe, be strong and be prepared.

Dr. Adeeti Gupta

The post PCOS Explained! appeared first on Walk In GYN Care.