Research
Ashwagandha vs. Berberine: Best for PCOS Weight Loss
Explore how Ashwagandha and Berberine can aid weight loss for women with PCOS by addressing stress and insulin resistance.
July 6, 2025
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Explore how Ashwagandha and Berberine can aid weight loss for women with PCOS by addressing stress and insulin resistance.
When managing weight with PCOS, Ashwagandha and Berberine are two supplements often considered. Here's the key difference:
Both supplements can aid PCOS weight management but address different root causes. Always consult a healthcare provider before starting any supplement.
PCOS, or polycystic ovary syndrome, has a significant impact on metabolism. In fact, 50% to 90% of women with PCOS experience insulin resistance. This condition forces the pancreas to produce excess insulin, which in turn triggers higher levels of androgens and leads to central weight gain. On top of that, elevated insulin levels can disrupt appetite regulation, causing stronger cravings and making it harder to feel full. Studies show that between 38% and 88% of women with PCOS are either overweight or obese.
Chronic inflammation is another hurdle, as it interferes with the body's ability to lose weight through diet and exercise.
"Insulin resistance can also lead to weight gain, which can make PCOS symptoms worse, as having excess fat causes the body to produce even more insulin." – NHS
In the U.S., PCOS affects 6% to 18% of women of reproductive age. While medications play a role in managing this condition, lifestyle changes - like improving diet and increasing physical activity - are equally important. Supplements such as Ashwagandha and Berberine can also provide targeted support for the metabolic challenges associated with PCOS.
"PCOS is a combination of hormonal and metabolic imbalances, in addition to insulin resistance. Regular use of berberine individually may help those measures, which may result in a better overall management of PCOS." – Layth Tumah, MD, Functional Medicine Specialist
These supplements address the root causes of PCOS rather than just masking symptoms. For example, Berberine has been shown to improve blood sugar levels and reduce cholesterol, with effects comparable to metformin in patients with type 2 diabetes. Even modest weight loss - around 5% to 10% of total body weight over six months - can significantly improve PCOS symptoms.
The real benefit of supplements lies in their ability to break through the metabolic barriers that make weight loss so difficult for women with PCOS. By enhancing insulin sensitivity and reducing inflammation, they can amplify the results of dietary and exercise efforts.
However, it’s essential to note that supplements aren't regulated by the FDA. Consulting a healthcare provider before starting any supplement is crucial. A multidisciplinary approach - including guidance from nutritionists and mental health professionals - often yields the best results in managing PCOS.
"Managing weight is crucial in improving PCOS symptoms and reducing long-term risks of diabetes, cardiovascular disease, certain cancers, and infertility." – Jocelyn A. Carlo, M.D., Director of Gynecology at Hackensack Meridian Jersey Shore University Medical Center
These benefits pave the way for exploring how Ashwagandha and Berberine can specifically aid in weight management for women with PCOS.
Ashwagandha is considered an adaptogen, which means it helps regulate cortisol levels in the body. This is particularly important for women with PCOS, as high cortisol levels can lead to increased blood sugar, insulin resistance, and ultimately, weight gain. Additionally, ashwagandha supports thyroid function, which is crucial since women with PCOS are three times more likely to develop Hashimoto's thyroid disease compared to those without the condition. A well-functioning thyroid is key to maintaining a healthy metabolism, which plays a significant role in weight management. In one randomized controlled trial, participants who took 600 mg of ashwagandha root extract experienced normalized thyroid hormone levels, including TSH, T3, and T4. By supporting thyroid health, ashwagandha lays the groundwork for better metabolic function and weight control.
Ashwagandha helps with weight loss in multiple ways. By reducing cortisol, it minimizes stress-related fat storage, particularly around the abdomen. It also improves blood sugar regulation, which is critical since insulin resistance affects up to 70% of women with PCOS. A review study highlighted that ashwagandha significantly reduced blood sugar, hemoglobin A1c, and insulin levels. Stress relief is another benefit - lower stress levels can reduce overeating, making it easier to stick to a healthy diet and lifestyle. In a 2019 study, participants who took 240 mg of ashwagandha daily saw a significant drop in cortisol levels compared to those on a placebo. Better sleep, another effect of ashwagandha, also plays a role in managing hunger hormones and improving insulin sensitivity.
Beyond its impact on weight, ashwagandha offers other benefits for managing PCOS symptoms. It has been shown to reduce anxiety significantly, which is noteworthy since women with PCOS are three times more likely to experience anxiety. Some studies even suggest its effects are comparable to lorazepam (Ativan) but without the side effects. Ashwagandha may also help regulate menstrual cycles and improve fertility by supporting ovarian function. Its anti-inflammatory properties add another layer of benefit, as research shows it can lower cholesterol by up to 53% and triglycerides by up to 45% in animal studies.
For optimal results, a daily dose of about 600 mg - up to 1,250 mg is considered safe - should be taken with food consistently over 8–12 weeks.
Berberine, a natural compound found in plants like tree turmeric, Oregon grape, and goldenseal, is gaining attention for its potential to combat insulin resistance - a condition that affects 35% to 80% of people with PCOS. Alarmingly, over half of individuals with PCOS may develop type 2 diabetes by age 40.
This compound helps prevent weight gain through several mechanisms. It enhances how cells absorb glucose and reduces leptin levels, a hormone that stimulates appetite and can lead to overeating. Berberine also blocks lipoprotein lipase, an enzyme that promotes fat storage, making it harder for the body to convert excess calories into fat. Angela Grassi, MS, RDN, LDN, and founder of the PCOS Nutrition Center, highlights its effectiveness:
"Berberine is a potent insulin sensitizer that rivals that of metformin".
Additionally, berberine supports liver health by reducing fat accumulation and encouraging the breakdown of fatty acids. These combined effects contribute to its reputation as a natural aid for weight loss.
Studies back up berberine's ability to promote weight loss in women with PCOS. Research published in the European Journal of Endocrinology observed 89 participants with PCOS who were divided into three groups: one receiving berberine (500 mg three times daily), another taking metformin (500 mg three times daily), and a placebo group. After three months, those taking berberine saw greater reductions in body fat, waist circumference, and waist-to-hip ratio compared to the other groups.
A 2022 study further suggested that berberine could reduce the risk of cardiovascular disease in PCOS patients due to its positive effects on body composition. Dr. Layth Tumah, a Functional Medicine Specialist, explains:
"PCOS is a combination of hormonal and metabolic imbalances, in addition to insulin resistance. Regular use of berberine individually may help those measures, which may result in a better overall management of PCOS."
Because of its weight loss and blood sugar benefits, often compared to metformin, berberine has earned the nickname "Nature's Ozempic". But its benefits extend beyond weight loss, making it a valuable tool in managing PCOS.
Berberine doesn't just help with weight management - it also addresses other symptoms of PCOS. The same European Journal of Endocrinology study found that berberine significantly improved cholesterol levels. Participants experienced reductions in total cholesterol, LDL ("bad" cholesterol), and triglycerides, alongside an increase in HDL ("good" cholesterol), with results surpassing those seen with metformin.
It may also support hormonal balance and fertility by lowering androgen levels and improving ovulation and menstrual regularity - key concerns for women with PCOS, who are 15 times more likely to experience infertility and three times more likely to suffer early pregnancy loss.
Moreover, berberine has anti-inflammatory properties and may enhance gut health, both of which play a role in metabolic regulation. Another advantage is that it tends to cause fewer side effects than metformin, with most users reporting only mild gastrointestinal discomfort.
To minimize stomach upset, healthcare providers often recommend starting with a low dose of berberine and gradually increasing it. Always consult a healthcare professional before adding berberine to your routine, especially if you're taking other medications.
Both ashwagandha and berberine can help with weight management in PCOS, but they tackle the issue from different angles. Ashwagandha primarily focuses on reducing stress by lowering cortisol levels, addressing one of the key contributors to weight gain. Its active compounds, called withanolides, help the body cope with stress while maintaining steady energy levels.
On the other hand, berberine targets insulin sensitivity. It enhances how cells absorb glucose by activating the AMPK enzyme, which essentially acts as a metabolic switch, improving how the body burns energy. This makes berberine especially effective for managing metabolic dysfunction often linked to PCOS.
In short, ashwagandha works to counteract stress-related weight gain, while berberine improves metabolism and insulin regulation. If your weight challenges are tied to stress, poor sleep, or elevated cortisol, ashwagandha might be the better option. However, if insulin resistance and metabolic issues are your primary concerns, berberine could be more effective.
Here’s a quick comparison to highlight their differences:
| Attribute | Ashwagandha | Berberine |
|---|---|---|
| Main Action | Reduces stress and balances cortisol | Boosts insulin sensitivity and glucose metabolism |
| Weight Loss Impact | Indirect (through stress and appetite control) | Direct (affects body fat, BMI, and metabolic markers) |
| PCOS Benefits | Improves mood, sleep, energy, and blood sugar regulation | Supports weight control, insulin function, and hormonal balance |
| Key Considerations | Best for stress-driven symptoms | Best for metabolic and insulin-related issues |
Research backs up these distinctions. For instance, a study involving 52 adults found that taking ashwagandha root extract (300 mg twice daily) resulted in better stress management, appetite control, happiness, weight, and BMI after eight weeks. Meanwhile, another small study showed that participants who took berberine daily for three months experienced noticeable weight loss, emphasizing its role in improving body composition.
Given the metabolic complexities of PCOS, choosing a supplement that aligns with your main challenges - whether stress or insulin resistance - can make a significant difference.
Each supplement comes with its own safety considerations. Berberine may cause digestive issues like nausea or constipation, especially at high doses. It can also interact with certain medications such as antidepressants, MAOIs, blood thinners, and beta blockers, so monitoring liver function is recommended.
Ashwagandha, while generally safe for most people, can affect liver and thyroid function. This means those with hyperthyroidism or liver conditions should proceed with caution. Additionally, it may interact with sedatives, thyroid medications, immunosuppressants, blood thinners, and anxiety medications.
Both supplements should be avoided during pregnancy or breastfeeding. Berberine, in particular, poses risks, as there’s limited safety data for young women or early pregnancy.
If you’re considering berberine, start with a low dose and gradually increase it to reduce digestive discomfort. It’s also important to choose products that have been independently tested for quality and purity. Unlike ashwagandha, which can be taken long-term under medical guidance, berberine is generally not recommended for extended use.
When selecting a supplement for managing PCOS symptoms, it's important to focus on your specific challenges. Registered dietitian Madison Lawrie, B.Sc., RD, emphasizes:
"Supplements can complement your PCOS management plan. But they work best when they're supportive – not central".
This advice ties back to how each supplement addresses unique aspects of PCOS.
Pinpoint your main symptoms. If stress, poor sleep, anxiety, or elevated cortisol levels are significant factors, ashwagandha might be a good choice. It may also help if thyroid dysfunction is part of your PCOS profile. However, be cautious - ashwagandha can sometimes raise testosterone levels, which might worsen issues like acne, hair thinning, or excessive hair growth.
Address metabolic concerns with berberine. For those dealing with insulin resistance, weight gain, or high cholesterol, berberine is known for its ability to improve insulin sensitivity and help manage cholesterol levels.
Always consult a healthcare provider. Before starting any supplement, ask yourself: What symptom am I targeting? Does evidence support its use? Am I already addressing this issue through diet and lifestyle changes? Could it interact with my medications? For example, ashwagandha may interfere with medications for insulin resistance, thyroid issues, or high blood pressure. Similarly, berberine can interact with certain drugs, and prolonged use might require monitoring of liver function.
Monitor your body's response. Introduce one supplement at a time to track its effects. Keep a symptom journal to note changes in mood, energy, weight, or any side effects. This personalized tracking helps you fine-tune your approach, as individual responses can vary.
Pair supplements with lifestyle changes. Supplements are most effective when combined with a balanced diet, regular exercise, stress management, and good sleep habits. Since PCOS affects so many people, finding the right mix of strategies can make a real difference in symptom management.
Finally, consult your healthcare provider to determine the right dosage for your needs. A targeted, thoughtful approach can enhance the metabolic benefits discussed earlier.
Understanding whether stress or insulin resistance is behind your PCOS-related weight gain requires a closer look at symptoms and specific tests. Chronic stress often leads to high cortisol levels, which can promote abdominal fat accumulation and worsen insulin resistance. Meanwhile, insulin resistance directly impacts fat storage, appetite, and the body's ability to break down fat - key contributors to weight gain in PCOS.
To pinpoint the cause, a healthcare provider can test for insulin resistance by checking blood markers like fasting insulin and glucose levels. Stress and cortisol levels can also be evaluated through clinical assessments. It’s worth noting that these factors often overlap, so addressing both stress management and metabolic health may be essential for managing weight effectively.
Yes, you can typically take Ashwagandha and Berberine together, as they may work well in supporting weight management for individuals with PCOS. Research so far hasn’t shown any major negative interactions between the two. That said, both supplements can affect blood sugar levels, so taking them together might intensify this impact.
Keep in mind that Ashwagandha and Berberine can also interact with certain medications, like blood thinners, sedatives, or thyroid treatments. If you’re on any medication or dealing with specific health issues, it’s best to check with your healthcare provider before adding these supplements to your routine. This ensures both safety and effectiveness.
To get the most out of Ashwagandha or Berberine for managing PCOS symptoms, pairing them with a few lifestyle adjustments can make a big difference:
When combined with Ashwagandha or Berberine, these habits can help restore hormonal balance, increase energy, and support your overall well-being.
