Inositol for PCOS: Why it should be part of your PCOS plan

fertility pcos

Manage PCOS with Inositol

Inositols (sometimes referred to as myo-inositol or D-chiro inositol) are one of the most researched supplements for PCOS, and one I use widely in my nutrition clinic to support my clients in reducing and resolving PCOS. Whilst there is never just one thing - one food or supplement - that manages PCOS, inositol has shown a lot of positive outcomes in research and I've found it to be effective as part of an overall treatment plan for all types of PCOS.

Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrine (hormone / metabolic) conditions that affects up to 20% of women of reproductive age worldwide. Whilst all women with PCOS experience it slightly differently, PCOS is characterised by high levels of androgen hormones (like testosterone and DHEA-S). High androgens cause symptoms including irregular or absent periods, anovulation (lack of ovulation), acne, hirsutism, weight gain or difficulty losing weight, and difficulty conceiving. Some PCOS women also experience fatigue, cravings, high fasting insulin and glucose, insulin resistance, low-grade chronic inflammation, and anxiety and depression are common.

What is Inositol?

Inositols are a sugar molecule that belong to the B vitamin group, and can be synthesised by the body. The most important inositol in PCOS is myo-inositol, the most abundant form in humans. D-chiro inositol has also been studied, and is used by the body is much lesser amounts.

Very small amounts of inositol are also found in some foods including:

legumes (beans, chickpeas, lentils)
grains (amaranth, oats, buckwheat, wild rice, popcorn)
seeds (part of why I love seed cycling for PCOS)
melon and citrus fruits

Whilst we can get some inositol in foods, and the body can synthesise it, studies have found a much higher therapeutic dose to be beneficial for PCOS, which wouldn't be possible to get through the diet alone.

Why is Inositol Important in PCOS?

Inositols play an important role in cell signalling and helps in regulating multiple pathways. For PCOS, inositol improves carbohydrate metabolism, acts as an insulin sensitiser (shown to be as effective as Metformin, without the side effects), and scavenges free radicals, thereby improving insulin sensitivity, menstrual cycle regularity, ovarian function. The benefits of inositol in PCOS include:

1. Inositol can restore ovulation

Myo-inositol supplementation has been shown to improve menstrual cycle regularity in PCOS, helping to bring back periods in amenorrhoea (no periods) and shorten menstrual cycle lengths in oligomenorrhoea (cycles >35 days). More regular menstrual cycles and ovulation means more health-benefiting progesterone production.

2. Inositol can improve insulin sensitivity and blood sugar regulation

Up to 70% of PCOS women have insulin resistance, which is associated with metabolic syndrome and several chronic diseases. Insulin resistance occurs when cells stop responding to the action of insulin, not enabling glucose from the blood to enter into cells. This can cause high blood sugar levels and high insulin. High insulin drives excess androgen production, the hormone that causes the symptoms of PCOS. Blood sugar dysregulation and high insulin can also occur in 'lean' PCOS women without insulin resistance.

Myo-inositol improves insulin sensitivity and lowers fasting insulin, thereby reducing excess androgen production and PCOS symptoms. Improving insulin sensitivity also helps to reduce fatigue, improve energy and reduce cravings.

3. Inositol can reduce testosterone

Studies show myo-inositol reduces total testosterone. High testosterone is common in PCOS and causes symptoms including irregular menstrual cycles, weight gain, acne, hirsutism and difficulty conceiving. Myo-inositol also increases Sex Hormone Binding Globulin (SHBG) which binds up excess hormones like testosterone, making them inactive, thereby reducing PCOS symptoms.

4. Inositol may enhance fertility

Studies have shown promising results in enhancing fertility in PCOS with myo-inositol by:

increasing egg quality
improving menstrual cycle regularity and ovulation
increasing the number of matured eggs during ovulation stimulation and IVF
increase pregnancy rates following ovarian stimulation, IUI and IVF

5. Inositol may prevent gestational diabetes

PCOS women have increased risks of Gestational Diabetes (GD) due to high blood sugar levels during pregnancy. GD can increase risks of complications in both the mother and baby. Preventing GD includes both nutrition and lifestyle treatment. Studies have shown myo-inositol supplementation during pregnancy can reduce the risk of GD by up to 60%.

What about D-Chiro Inositol?

A common question I get asked is, "I read about taking myo-inositol in combination with D-chiro inositol, should I take both?"

Taking myo-inositol alone is the cheapest and safest way to supplement with inositol for PCOS. Several studies showing the effectiveness of inositol is using myo-inositol alone. Some studies suggest a combination of a specific ratio of 40:1 myo-inositol and D-chiro inositol, as this is the ratio found in the body. However given, D-chiro inositol has negative effects on the ovaries and egg quality, therefore impacting fertility, I recommend using myo-inositol alone.

Safety of Inositol Supplementation

Inositol supplementation has been shown to be safe when taken as prescribed. No adverse effects have been found in studies where myo-inositol was taken during pregnancy. Caution should be used when taking alongside Metformin, as both reduce blood glucose levels. Caution should also be taken with D-chiro supplementation alone, as high doses have been found to have negative effects on the ovaries and egg quality.

The Key Takeaways

Myo-inositol is a safe an effective supplement to reduce and resolve PCOS symptoms, alongside a PCOS friendly nutrition and lifestyle plan. Myo-inositol can help to restore menstrual cycle regularity, ovarian function, lower testosterone, improve insulin sensitivity and enhance fertility. Always work with a qualified practitioner such as a Clinical Nutritionist for safe and effective supplementation. For further guidance with myo-inositol supplementation and PCOS treatment, book a complimentary wellness discovery call.