I am constantly getting asked questions on how to manage PCOS, in fact, it is the most popular reason I am featured on podcasts! So, ladies, I thought it would be appropriate to address this matter as its own blog post, I have talked about before in eating for PCOS part 2.

Whilst the first port of call for PCOS is lifestyle management, supplements such as inositol, hailed as the new and more natural metformin, are becoming a popular way to try and manage symptoms.

What is Inositol?

Inositol is a chemical compound and B vitamin-like nutrient. It has a number of functions in the body, such as:

  • Influencing the action of insulin, and helping control blood sugars (Larner, 2002).
  • Affecting chemical messengers in our body, such as our happy hormones – dopamine and serotonin (Levine, 1997)

There are two main forms of inositol: myo-inositol (MI) and D-Chiro inositol (DCI). It is known that the ratio of these two forms can vary in different tissues of the body. In women with PCOS, the inositol ratios are reported to be higher than normal in other tissues, and lower than normal in fluid surrounding the eggs in the ovaries (Unfer et al., 2014).

How can Inositol Help?

Inositol can help manage PCOS due to its ability to enhance insulin function, by improving the body’s ability to move glucose into the cells. This helps manage insulin resistance, keep blood sugars more stable and many women report less sugar and carbohydrate cravings which are common in women living with PCOS (Pizzo et al., 2014). Additionally, a recent study found that inositol may promote ovulation and menstrual regularity in women experiencing fertility issues with PCOS (Kamenov et al., 2015).

 In fact, in one study of 25 women with PCOS who were given a combination of MI and folic acid, 40% of them fell pregnant! Whilst 22 of the 25 women got at least one spontaneous period during the 6 months follow-up and 18 of them were able to maintain the normal ovulation patterns (Papaleo et al., 2007).

There is also some evidence around it helping to reduce certain lipids in the blood including triglycerides and also blood pressure in women with PCOS (Tabrizi et al., 2018; Iuorno et al., 2002 ).

There is also some suggestion that the inositols may help with egg and embryo quality too (Pizzo et al., 2014).

Triple win: Inositol may help with improving hormone profiles, improving metabolic profiles and egg quality in women with PCOS all in one swoop!

How does Inositol help with PCOS?

The concept is restoring the balance of inositols in the ovaries in women with PCOS to reflect the ratio of those women without PCOS, plus its help with improving insulin sensitivity of the cells, can aid in reducing those high androgen levels that are causing lots of follicles to be stimulated and grow just a little but not enough to be released (Unfer et al., 2017; Kalra et al., 2016).

Where can I find inositol?

Of course, prioritizing food sources if important, so inositol can be found naturally in beans, fruit, wholegrains and nuts.

However, specific ratios of MI and DCI have been studied and compared in supplemental form, and so to get this exact controlled dosage, it is much more simple to achieve through supplementation.

Please speak to your doctor, dietitian or health care professional before commencing any supplement regime to ensure it is right for you and does not interact with any other medications or supplements that you are taking.

Is Inositol Safe?

It appears so for the most part, there has only been mild side effects such as nausea, gas and diarrhoea, occur at daily doses of up to 12 grams per day, most studies look at 2-4 g of inositol daily (Carlomagno & Unfer, 2011).

Should I take Inositol?

There is research to support the use of inositol in women with PCOS, and particularly when trying to conceive.

BUT there are a few circumstances where we need to be mindful and cautious before taking this supplement:

  1. When taking Metformin: you need to talk to your GP if you are taking metformin already because combined, the two (inositol and metformin) may increase your risk of blood sugars dropping a bit too low.
  2. Ratio of MI to DCI: Recent studies demonstrate that a balanced ratio of the two types of inositol is most effective in managing PCOS. The ratio we are aiming for is 40:1, MI to DCI (Nordio et al., 2019).
  3. More research is needed: A 2018 Cochrane review looking at MI for increasing fertility rates in women with PCOS found little benefit, and suggested that more research is needed in this area – particularly in determining whether there is any harm of taking inositol in women with PCOS.

Bottom line, if you’re not keen on supplementing it probably isn’t essential but rather a “nice-to-have”. If you’re willing to experiment alongside dietary and lifestyle changes, then speak to your health care professional before starting anything different to ensure it is right for you.

Read my two blogs on Eating for PCOS and Eating for PCOS Part 2.

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This blog was co-written by Kaylee Slater, graduate dietitian. You can find Kaylee on Instagram and connect with her on LinkedIn.

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