The 10 Best Supplements for PCOS

While no pill or drink can replace a healthy way of eating and lifestyle, emerging research has shown that taking the right dietary supplements can help to improve PCOS. That’s because people with PCOS have been shown to be deficient in some key vitamins and minerals, many of which affect fertility and insulin resistance. Certain medications are also known to affect the absorption of specific nutrients. Here’s our list of the Top 10 nutrition supplements for people with PCOS.

Vitamin D

Vitamin D is the first pick on our top 10 list of best supplements for PCOS because it plays an important role in the health and fertility for people with PCOS. Despite the importance, research shows that 67-85% of women with PCOS are deficient in vitamin D.

Recognized as a vitamin and a hormone, Vitamin D receptors have now been identified in almost every tissue and cell in the human body. This Vitamin has also been found to be involved in follicle egg maturation and development, making it a key vitamin women who are trying to conceive should consider supplementing with.

Vitamin D has been associated with reducing androgen levels in women with PCOS. A review of six clinical trials with 183 women with PCOS revealed that vitamin D supplementation significantly reduced total testosterone levels.

Another study also found significant reduction in androgens in PCOS women. Both total testosterone and androgens levels were reduced (by 12% and 17%) after three months of supplementing with vitamin D 50,000 IU each month.

READ: 3 MAJOR ROLES OF VITAMIN D FOR PCOS

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Fish Oil

Omega-3 fats are essential for people with PCOS, as they provide numerous health benefits. Omega-3 fats are linked to improving triglycerides and insulin levels, lowering inflammation and blood pressure, and even providing better hair and skin quality and improving your mood. DHA is particularly important during pregnancy, as it aids in the baby’s brain development. New research shows omega-3 fats can even boost fertility in those with PCOS.

There are three different types of omega-3 fats: Alpha-linolenic acid (ALA) are plant based omega-3s found in avocados; nuts like walnuts and almonds; seeds like hemp, chia, and flax, and oils like olive and avocado oil. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are omega-3 fats found in egg yolks and fatty or “oily” cold water fish such as salmon, tuna, trout, and halibut. Few other fish are rich in omega-3s.

Fish and fish oil are the best ways to get in omega-3 fats. This is because only a small percentage of plant-based omega-3 foods like nuts and seeds, are converted into DHA and EPA in the body.

Nutrition guidelines recommend we consume cold-water or fatty fish two times per week to reap the benefits of omega-3 fatty acids. Salmon, halibut, tuna, and trout are the best sources of omega-3s. Even if you eat these types of fish twice a week or more, you may consider taking a fish oil supplement.

READ: 7 BENEFITS OF OMEGA-3 FATS FOR PCOS

READ: FISH OIL IMPROVES MOOD

 

Myo and d-chiro inositol

Inositols top our list of best supplements for PCOS. Inositols are relatives of B-vitamins. MYO and d-chiro inositol (DCI), are the two most common types that work differently in the body.

It’s believed that people with PCOS may have a defect in “secondary messengers” which relay signals of insulin, contributing to insulin resistance. MYO and DCI work as these secondary messengers.

Simply put: when we eat foods (mostly carbohydrates), they get converted into glucose in our blood stream. We need the glucose to enter our cells to be used for energy. When blood glucose levels rise, a signal (imagine a doorbell is rung) is sent from the cell door to the nucleus telling it to open up. However, with PCOS, the doorbell on the cell door may be defective. This means that it takes longer for the cells to open its doors to glucose resulting in higher amounts of insulin needing to be secreted. Secondary messengers acts to repair the doorbell so that the cell doors open in response to glucose, resulting in less insulin needing to be secreted.

Benefits of inositols include improved menstrual regulation and better egg quality. Inositols have also been found to improve insulin and cholesterol levels, help with acne, and even mood.

Supplementing with MYO and DCI in a 40:1 ratio is ideal to mimic this unique ratio in the body. This combination has been shown to work better than either MYO or DCI alone in PCOS. Ovasitol has this unique 40:1 ratio.

READ: I TOOK OVASITOL. HERE’S WHAT HAPPENED

READ: 10 Surprising Benefits of Ovasitol for PCOS

N-Acetylcysteine

N-acetylcystine (NAC) is helpful for improving fertility and many of the metabolic aspects related to PCOS such as fatty liver, high cholesterol and insulin resistance. NAC is also great for keeping the immune system healthy.

NAC is an antioxidant and amino acid. Specifically, it’s a derivative of the amino acid L-cysteine, an essential precursor used by the body to produce glutathione, an antioxidant that protects against free radical damage and oxidative stress and is a critical factor in supporting a healthy immune system.

A study published in the European Journal of Obstetrics, Gynecology, and Reproductive Biology compared the effects of NAC and metformin in women with PCOS. In this prospective trial, 100 women were divided to receive either metformin (500 mg three times daily) or NAC (600 mg three times daily) for 24 weeks. Both treatments resulted in significant and equal decreases in BMI, hirsutism, fasting insulin, free testosterone, and menstrual irregularity

Three randomized studies compared NAC or metformin with Clomid in women with PCOS. In two of the studies, Clomid plus NAC resulted in improved ovulation and pregnancy rates compared with placebo.

READ N-ACETYL CYSTEINE (NAC): A NATURAL INSULIN-SENSITIZER FOR PCOS?

 

Berberine

Like NAC, berberine works as an insulin-sensitizer and its potency has been compared with that of metformin. This herb is also an aggressive way to reduce high cholesterol levels and fatty liver.

Berberine slows the release of free fatty acids while boosting fat burning in the mitochondria to lower cholesterol levels. Berberine also inhibits the enzyme lipoprotein lipase which is responsible for producing cholesterol and triglycerides. Berberine has also been shown to promote cholesterol excretion from the liver to bile.

READ: 10 BENEFITS OF BERBERINE FOR PCOS

 

Magnesium

Magnesium is an important mineral that people with PCOS are significantly lacking in. Women with PCOS are 19 times more likely to have a magnesium deficiency, according to a study in Gynecology Endocrinology. This is concerning as magnesium has been shown to play a role in glucose, insulin, and blood pressure regulation.

Magnesium can also help prevent migraines and improve PMS symptoms as well as mood. A review of 18 studies published in Nutrients, showed that magnesium does have a beneficial effect for people with anxiety. Many symptoms of anxiety such as apathy, anxious behavior, anger, nervousness, insomnia, rapid pulse, or heart palpitations may be reduced by supplementing with magnesium.

Added bonus: Higher levels of magnesium can also help with sleep, which women with PCOS have difficulty with.

READ: BENEFITS OF MAGNESIUM FOR PCOS

 

Zinc

Zinc isn’t typically on the radar for most people with PCOS but it should be! Studies are showing that women with PCOS have low levels of zinc. The good news is that increasing levels of zinc can improve many of the frustrating symptoms those with PCOS experience every day like acne, hair loss, and excessive hair growth. That’s because zinc works to inhibit the enzyme that converts testosterone into its non-aromatizable form, dihydrotestosterone (DHT).

Our PCOS MULTI® has been specifically formulated with higher amounts of zinc for this reason.

READ: WHAT DOES ZINC HAVE TO DO WITH PCOS? A LOT!

PCOS Multi

Co Enzyme Q10

Coenzyme Q10 or CoQ10, plays a role in energy production in muscle cells. Emerging research is showing that CoQ10, may offer numerous benefits to people with PCOS.  Coenzyme Q10 has been shown to be involved in improving fertility and pregnancy in women with PCOS by improving egg quality. Newer research is showing the potential of Q10 to lower cholesterol and insulin levels as well. Supplementing with CoQ10 is important if you take a statin as it affects the absorption of Q10.

READ: HEALTH BENEFITS OF COENZYME Q10 FOR PCOS

 

Vitamin B12

Research is strongly showing that long-term use of metformin and at high doses (1.5mg or higher daily) can deplete levels of vitamin B12. A deficiency of vitamin B12 can cause permanent neurological and nerve damage as well as mood changes and decreased energy. There is evidence that a deficiency can occur just after 3 months of use.

Individuals who take metformin get B12 levels checked annually. A simple blood test can assess vitamin B12 status. Elevated serum homocysteine and methylmalonic acid levels (the best indicator) may also indicate a B12 deficiency.

Mandatory supplementation with B12 has now been proposed for those taking metformin. Taking a daily multivitamin containing 100% of the daily value (DV) for vitamin B12 may do the trick although many of our patients who take a mulitivitamin with B12 and are on high doses of metformin are still deficient in vitamin B12, requiring extra supplementation.

The best absorbable form of Vitamin B12 is methlycobalimum. Taking vitamin B12 sublingual (under the tongue) is recommended for over the counter B12 supplements.

READ: NEW METFORMIN WARNING: MANDATORY SUPPLEMENTATION WITH VITAMIN B12

 

Melatonin

Last on our top 10 list of best supplements for PCOS is melatonin. Melatonin has always been known for being a helpful sleep aid, but did you know it’s also involved in fertility? And helping with inflammation and insulin resistance?

Women with PCOS have been found to have abnormally low levels of melatonin in follicular fluid according to research published in the Journal of Human Reproductive Science. Since melatonin is an antioxidant that improves egg quality, low follicular levels may contribute to infertility seen in PCOS women.

Melatonin is a hormone as well as an antioxidant secreted by the pineal gland that controls the wake and sleep cycle associated with the circadian rhythm.

The therapeutic dosage of melatonin in these studies is 2 mg to 10 mg daily. Women who are trying to conceive may benefit from 2 mg per day. Melatonin should be taken at night because it does promote sleepiness.

READ: Melatonin Improves Fertility

In addition to a healthy lifestyle, taking supplements may help to improve PCOS symptoms and increase fertility. Taking them consistently is key for best results. Monitoring lab values as well as physical symptoms is also helpful to see if a supplement is beneficial. As always, please consult with your doctor before taking any dietary supplement.

Sources:

  1. Thomson RL, Spedding S, Buckley JDVitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2012 Sep; 77(3):343-50.
  2. Azadi-Yazdi M1, Nadjarzadeh A1, Khosravi-Boroujeni H. The Effect of Vitamin D Supplementation on the Androgenic Profile in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials. Horm Metab Res. 2017 Mar;49(3):174-179.
  3. Pal L, Berry A, Coraluzzi L, Kustan E, Danton C, Shaw J, Taylor H Therapeutic Implications of vitamin D and calcium in overweight women with polycystic ovary syndrome.. Gynecol Endocrinol. 2012;28:965–968.
  4. Oner G, Muderris II. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2011 Aug 8.
  5. Salehpour S, Akbari Sene A, Saharkhiz N, Sohrabi MR, Moghimian F. N-acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome. J Obstet Gynaecol Res. 2012;38(9):1182-1186.
  6. Abu Hashim H, Anwar K, El-Fatah RA. N-acetyl cysteine plus clomiphene citrate versus metformin and clomiphene citrate in treatment of clomiphene-resistant polycystic ovary syndrome: a randomized controlled trial. J Women’s Health (2002). 2010;19(11):2043-2048.
  7. Berberine improves insulin resistance in granulosa cells in similar way to metformin. Fertility and sterility.2006; supplement S459-S460.
  8. Li MF1, Zhou XM1,2, Li XL1,2The Effect of Berberine on Polycystic Ovary Syndrome Patients with Insulin Resistance (PCOS-IR): A Meta-Analysis and Systematic Review Fertility and ster Evid Based Complement Alternat Med. 2018 Nov 14;2018:2532935.
  9. Sharifi F, Mazloomi S, Hajihosseini R et al. Serum magnesium concentrations in polycystic ovary syndrome and its association with insulin resistance. Gynecol Endocrinol. 2012;28(1):7-11.
  10. Boyle NB, Lawton C, Dye L. The effects of magnesium supplementation on subjective anxiety and stress-A systematic review. Nutrients. 2017;9(5).
  11. Jamilian M, Foroozanfard F, Bahmani F, Talaee R, Monavari M, Asemi Z. Effects of Zinc Supplementation on Endocrine Outcomes in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res. 2016 Apr;170(2):271-8.
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