Although most many women with PCOS (polycystic ovarian syndrome) are routinely given drugs such as Metformin and clomiphene citrate (Clomid), a simple nutrient deficiency maybe be involved in PCOS and supplementation may restart ovulation naturally.
The nutrient which may be in short supply in PCOS women is d-chiro-inositol, a B-vitamin-like substance which is made within the body from other forms of dietary inositol. D-chiro-inositol is an essential nutrient for insulin regulation and is an integral part of the phosphoglycan which regulates insulin balance.
A number of studies have explored how women with PCOS respond to supplementation with d-chiro-inositol and most have found dramatic and surprising improvements in both the symptoms and bio-markers of PCOS in both lean and obese PCOS women.
One pioneering study (1) gave 1200 mg of d-chiro-inositol or a placebo to 44 obese women with PCOS once a day for 6 - 8 weeks. The women who took d-chiro-inositol experienced multiple improvements such as; positive changes in the plasma insulin curve after glucose challenge, lower circulating testosterone levels, lower blood pressure and nineteen of the twenty two women resumed ovulation compared to only six in the placebo group. The researchers of the study concluded that:
"d-Chiro-inositol increases the action of insulin in patients with the polycystic ovary syndrome, thereby improving ovulatory function and decreasing serum androgen concentrations, blood pressure, and plasma triglyceride concentrations."
A separate study evaluated the effects of d-chiro-inositol on lean PCOS women; in this study twenty lean PCOS (BMI 20 - 24.4) received either 600 mg of d-chiro-inositol or a placebo once a day for six to eight weeks. The women receiving the d-chiro-inositol showed significant changes in their insulin curve after glucose challenge compared to no change in the placebo group. Serum free testosterone decreased by 73% in the treatment group compared to no change in the placebo group, blood pressure and triglyceride levels dropped in the treated women and 60% of the treatment group ovulated compared to 20% of the placebo group. The study concluded that:
"We conclude that, in lean women with the polycystic ovary syndrome, D-chiro-inositol reduces circulating insulin, decreases serum androgens, and ameliorates some of the metabolic abnormalities (increased blood pressure and hypertriglyceridemia) of syndrome X."
A third study (3) evaluating the mechanisms behind these improvements in PCOS symptoms suggests that:
"...PCOS may be characterized by a defect in the conversion of myo-inositol to D-chiro-inositol, and that such a defect would contribute to both insulin resistance and hyperandrogenism in the syndrome."
Many women with PCOS have been helped by supplementing inositol; both myo-inositol and d-chiro-inositol have shown positive effects in studies and may restart ovulation naturally without the need for drugs. D-chiro-inositol is available as a nutritional supplement and as a food called farinetta, a specially processed form of buckwheat that contains 1371 mg of d-chiro-inositol per 100 g. Buckwheat is a gluten free and highly nutritious food but has a very distinctive taste that you either love or have a hard time disguising.
Inositols along with regular exercise, a whole food low glycemic diet and electro-acupuncture may help PCOS women to ovulate on their own and avoid costly IVF and gonadotropin injections by restoring their fertility naturally.
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This article is for informational and educational purposes only and is not a substitute for medical or dietetic advice for which you should consult a physician or dietitian.
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(1) Ovulatory and Metabolic Effects of d-Chiro-Inositol in the Polycystic Ovary SyndromeJohn E. Nestler, M.D., Daniela J. Jakubowicz, M.D., Paula Reamer, M.A., Ronald D. Gunn, M.S., and Geoffrey Allan, Ph.D. N Engl J Med 1999; 340:1314-1320April 29, 1999
(2) Endoc Pract. 2002 Nov-Dec;8(6):417-23. Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Iuorno MJ, et al.
(3) J Pediatr Endocrinol Metab. 2000;13 Suppl 5:1295-8. Role of inositolphosphoglycan mediators of insulin action in the polycystic ovary syndrome. Nestler JE. et al.