Herbal medicine has a long history of traditional use, throughout the world, for menstrual irregularities and fertility. More recently, scientific research has been showing positive results for herbal and nutritional treatments for polycystic ovarian syndrome, and deepening our understanding of the underlying causes. We now know that herbs and nutrients can be used to adjust levels of specific hormones and encourage the normal, healthy function of organs. Teamed with modifying our diet and forming good habits in our daily lives, these therapies can form the basis of long-lasting hormonal change.
Whilst there are some effective natural medicines available over the counter, herbs and nutrients are best prescribed by a trained Herbalist, Nutritionist or Naturopath (both Herbalist & Nutritionist). When choosing a natural medicine practitioner look for someone with a sound education in Science and who is a member of a government-recognised Professional Association. This means that the practitioner is bound by a duty of care that ensures that they do no harm. Ask to see their qualifications. There are a range of treatments that your practitioner may select for you. Here are my 10 favourite:
Herbal medicine
*Please note: herbal medicines may interact with medications and should not be taken concurrently without supervision of a trained practitioner. If you become pregnant, cease taking herbal medicines and consult your practitioner. Only take herbal preparations in the dose recommended on the label. If in doubt consult your Naturopath or Herbalist.
1. Licorice & Peony
This herbal combination has a long history of use in Traditional Chinese Medicine and some evidence from small clinical trials. I have seen great results in clinic with this combination but it isn’t for everyone so it’s important to have a proper assessment by your naturopath before taking it.
How it works: it is thought that licorice and peony reduce testosterone (an androgen) by the blocking of enzymes involved in its production. This may be why this combination can regulate the menstrual cycle.
Cautions: whilst this is a generally safe treatment, there are many situations in which this herbal medicine combination should not be taken. It is best prescribed by your Naturopath/Herbalist so that they can assess it's suitability and determine the right dose. Definitely do not take if: you have high blood pressure, you are under 18, you are on fertility drugs, digoxin, corticosteroid drugs or blood pressure medication. Be monitored by you Naturopath if you want to use it long-term.
2. Goat's rue
This is the blood sugar-lowering herb that the diabetes drug Metformin was based on. It is excellent for sugar cravings. It contains guanidine, which dimethylbiguanide was modelled off, to make Metformin. Metformin is commonly prescribed as a treatment for PCOS.
How it works: it increases insulin sensitivity, thereby decreasing insulin resistance and androgen production. In turn, this decreases PCOS symptoms.
Cautions: not to be taken with insulin or blood sugar-lowering drugs.
3. Cinnamon
Most of us have this common household spice in our kitchen. So throw it into cooking wherever possible. I often use it in chia pudding, porridge or muesli. However, it can also be delightful in savoury cooking! For example, Yotam Ottolenghi uses loads of it in delicious savoury recipes. Cinnamon can also be taken in liquid extract or capsule form, as prescribed by your Naturopath.
How it works: cinnamon enhances blood sugar control by reducing blood glucose levels and improving insulin sensitivity. This decreases insulin levels, thereby reducing androgen secretion and PCOS symptoms.
Cautions: some people are allergic to cinnamon. If you experience an allergy to cinnamon seek medical advice immediately. Not for long term use unless supervised by a naturopath.
4. Phellodendron
Phellodendron has a long history of use in Traditional Chinese Medicine. It contains berberine, which has been studied for it's effects on blood glucose, PCOS, acne and diabetes.
How it works: berberine helps PCOS by lowering blood sugar, increasing insulin sensitivity and healing the gut. In the clinic, I have found that Phellodendron is particularly great for acne.
Cautions: Not to be taken for longer than 3 months at a time. This herb may interact with many medications so if you are taking any prescriptions please consult your Naturopath/Herbalist before taking Phellodendron. Also please note that the berberine content of Phellodendron products may vary, and this will change the effective dosage. So if you aren't getting the best results, contact your naturopath.
5. Rhodiola
Rhodiola has a history of traditional use in Eastern Europe and Asia and has long been a popular herb due to it's ability to help the body to cope with stress, improve mood, increase mental alertness (student's love it!), decrease fatigue and heighten endurance. It is a wonderful herb and I use it all the time in clinic.
How it works: this herb decreases the stress hormone cortisol, thereby reducing insulin. So you can see that stress is bad for PCOS. I'll be explaining this further in my next post.
Cautions: NOT to be taken with antidepressant medications.
Nutrients
*Please note: if you become pregnant, all nutrient supplementation should be ceased and you should consult your naturopath about what to take during your pregnancy. Only take nutrient supplements at the dose recommended on the label of that particular product. If in doubt consult your Naturopath or Doctor.
1. Inositol
There are 2 forms of inositol available as a supplement: Myo-inositol and D-chiro-inositol. Both have shown great results in reducing symptoms of PCOS clinical trials. These include reduction in acne & hirsutism, regulating the menstrual cycle and improving ovulation.
How does it work? Inositol reduces insulin and thereby reduces androgens.
Cautions: for best results this supplement should be taken 1/2hr before food and 2hrs away from caffeine. Dosage is important. Myo-inositol is effective at a dosage of 2g/day over 6 months. D-chiro-inositol can be taken at a dose of 1000-1500mg. However, always follow the directions on the label of your supplement and if in doubt consult your Naturopath or Doctor.
2. Chromium
Chromium is an essential trace nutrient that has been found to be crucial for blood sugar control. There is evidence from clinical trials that chromium supplementation reduces blood sugar and insulin resistance in women with PCOS and Type 2 Diabetes. Important: Chromium Picolinate is the type of chromium that has been shown to work in the clinical trials. Not all chromium supplements are the same.
How it works: it is thought that chromium increases insulin sensitivity by binding to insulin receptors, thereby helping the body to use sugar from the blood, whilst reducing excess insulin in the blood. If you are not sure why excess insulin is bad for PCOS, check out this post.
Cautions: chromium may reduce the need for blood sugar-lowering medications so consult your doctor before taking chromium if you are on these.
3. Magnesium
Not just any old magnesium. Magnesium bisglycinate (also called magnesium amino acid chelate) is the most likely to give you a therapeutic effect because it is the most well absorbed in the gastrointestinal tract. Magnesium is an important mineral for wellbeing, performing at least 300 different functions in the body including muscle relaxation and blood sugar regulation. It is depleted by stress, caffeine and alcohol.
How it works: once again, magnesium combats insulin resistance.
Caution: poor forms of magnesium, whilst not harmful, may give you loose or watery bowel movements because your body can't absorb them. This can however, be useful as a short-term treatment for constipation.
4. Vitamin D
Around one third of Australians are vitamin D deficient. Have your vitamin D levels checked once per year. If you are deficient you should supplement until your levels are corrected.
How it works: noticed a pattern here? You guessed it. Vitamin D also works on insulin resistance. As most of these treatments work on the same pathway, you can see why you don't need to be on all of them. However, if you are vitamin D deficient this needs to be in your regime because vitamin D plays a myriad of other important roles in the body, including maintaining bone density and immune system function.
Cautions: vitamin D is a fat soluble vitamin which means that it gets stored in fat in the body. If you take too much, you can end up with toxicity. Make sure you get your blood levels tested before you start supplementing and see your Naturopath or Doctor to determine which dose and duration of treatment is right for you.
5. Alpha-lipoic acid
Alpha-lipoic acid is an antioxidant that helps cells use glucose for energy. It has had positive results in small clinical trials in both diabetic patients and patients with PCOS.
How it works: Alpha-lipoic acid assists the insulin signalling pathway, improving insulin sensitivity and reducing symptoms of PCOS.
Cautions: like chromium, alpha-lipoic acid may have an additive effect with blood sugar-lowering medications and decrease the need for them. See your practitioner before beginning if you are on medication.
There are many more herbs and nutrients to choose from but these are some of the most commonly used and most effective. They can help you get better results but they cannot replace the right diet. Without a low sugar, low carbohydrate, anti-inflammatory diet, they are merely band-aids and when you stop taking them, your symptoms may return. These natural medicines can help you get better results faster and with the support of the right diet, exercise and stress reduction they can help you keep PCOS in check, permanently.
All the best on your health journey,
Josephine
Josephine Cabrall is a Melbourne-based online naturopath with a special interest in PCOS. See Josephine for a consult.
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