Promising research is proving there may be a natural way to support women with polycystic ovarian syndrome, or PCOS, in managing insulin levels. Myo-Inositol and D-chiro-inositol are worth learning more about!
Inositol is a member of the B-Complex family of vitamins important in maintaining cell structure and integrity. Inositol acts as a lipotropic agent within the body to help emulsify fats, for weight management and to redistribute body fat. The body produces its own inositol from glucose although researchers and doctors alike are unsure how exactly it does so. One theory is that it is produced by intestinal bacteria.*
What are Myo-Inositol and D-chiro-inositol?
Myo-Inositol and D-chiro-inositol (from here on referred to as MYO and DCI) are two of nine forms, or isomers, of inositol that have been studied for their potential to aid the bodies of women with PCOS in properly utilizing insulin. Insulin resistance can lead to overall hormonal imbalance and is a common symptom for women with PCOS. Every tissue in the body has its own ratio of MYO to DCI – MYO being higher and producing DCI when needed.
Myo-Inositol is found in human tissues and a variety of food sources, which include unprocessed grains (oats, wheat germ and bran), fresh citrus fruits (except lemons), cantaloupe, brewer’s yeast, unrefined molasses, liver, lima beans, raisins, peanuts, cabbage, and lecithin.
D-chiro-inositol is not known to be naturally abundant in most diets. The human body makes DCI from MYO via the action of an enzyme called epimerase.
The Study Shows:
A 2014 study published in Gynecological Endocrinology aimed to evaluate how MYO and DCI affected women with PCOS. Fifty women clinically diagnosed with PCOS participated in this study. They were broken into two groups: 25 women given 4 grams of myo-inositol plus 400 micrograms of folic acid per day for six months and another 25 women were given 1 gram of D-chiro-inositol plus 400 micrograms of folic acid per day.
The Results
The women in the MYO/folic acid group reported, “statistically significant reductions of diastolic and systolic blood pressure, lowering of luteinizing hormone (LH), lowering of the LH/FSH (follicle stimulating hormone) ratio lowering of total testosterone and free testosterone and androstenedione and prolactin and the HOMA Index (homeostasis model assessment)- to check for insulin resistance. These same patients also had a statistically significant increase of SHBG (sex hormone binding globulin) and of the glycemia/immunoreactive insulin ratio.”
The women in the DCI/folic acid group showed “a statistically significant reduction of systolic, but not diastolic blood pressure, a statistically significant reduction of the Gallwey-Ferriman Score (a measure of hirsutism), of LH, LH/FSH ratio, total testosterone, free testosterone, androstenedione, prolactin and the HOMA Index.”
The Conclusion
While MYO may impact metabolic profile, weight loss and testosterone levels, the DCI affected to a greater degree the circulating androgens, both MYO and DCI show support for being able to:
- improve the body’s ability to spontaneously ovulate
- lower
-
➞ systolic blood pressure and triglycerides
➞ luteinizing hormone
➞ the luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio
➞ circulating androgens
➞ prolactin levels
- help the body properly utilize insulin
Both MYO and DCI are known as insulin-sensitizing agents for women with PCOS. When insulin levels are balanced, the body is better able to regulate overall reproductive function, including hormone balance, ovarian function, egg quality, and the menstrual cycle.
Dr. Tori Hudson reminds us that “Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in reproductive aged women. The majority of women with PCOS (about 74%) do not ovulate, almost half (about 42%) have insulin-resistance, and almost half (48%) have hyperandrogenism.” These statistics alone signify the importance of this research. Researchers are learning that all of the activities of MYO and DCI are enhanced when MYO and DCI are combined. According to the PCOS Nutrition Center, “Women with PCOS who took a combination of MYO and DCI with a physiologic ratio of 40:1 (as seen in blood plasma), had better results than taking one supplement alone.”
What Additional Studies Show
- 1. A 2012 systematic review of randomized controlled trials published in Gynecological Endocrinology shared that researchers have studied the effects of MYO versus those of Metformin, a common prescription medication given to women with PCOS. They found that 18% more pregnancies occurred for the women who took MYO than those who took Metformin (11%). In this same study, one group of 60 women received 1,500 mg of metformin daily and another group of 60 women received 4 g of MYO plus 400 mcg of folic acid daily. The results showed that of the women taking MYO and folic acid, 65% experienced restored ovulation and only 50% in the metformin group experienced the same.
2. Another study published in the The Journal of Clinical Endocrinology and Metabolism showed that “After the 8-week myo-inositol treatment, there was a significant reduction in LH/FSH ratio, FSH, prolactin, androstenedione, testosterone, insulin, and BMI compared to baseline; there was also a significant increase in the glucose/insulin ratio (8.4±0.9 to 12.1±0.2, P<0.01).”
In Closing
No two cases of PCOS present the same in women diagnosed with this syndrome. We have learned that making dietary and lifestyle changes are first and foremost critical. It is only when these are in place that herbs, nutritional supplements, and natural therapies are able to be most effective. Caffeine depletes inositol stores, so part of this dietary change should be to limit or quit caffeine entirely. MYO and DCI are an important consideration as part of a PCOS natural health restoration program. Being that PCOS can greatly affect a woman’s fertility, any new research pointing to promoting proper function of the body through natural means, such as MYO and DCI supplementation, is exciting!
*Should this be the case, this is yet another reason to boost gut flora – think probiotics.
- Combination of Myo-inositol and D-chiro-inositol: A First Line Treatment for PCOS (2014, October 1). Retrieved from: http://www.pcosnutrition.com/combination-of-myo-inositol-and-d-chiro-inositol-for-pcos/
- Haas, E., & Levin, B. (2006). Vitamins. In Staying healthy with nutrition: The complete guide to diet and nutritional medicine (21st century ed., pp. 134-135). Berkeley, California: Celestial Arts.
- Hudson, T. (2015, April 29). Comparison of myo inositol and D’Chiro Inositol in PCOS women. Retrieved from: http://drtorihudson.com/general/nutrition/comparison-of-myo-inositol-and-d-chiro-inositol-in-pcos-women/
- Nestler, J., Jakubowicz, D., Reamer, P., Gunn, R., & Allan, G. (1999, April 29). Ovulatory and Metabolic Effects of d’Chiro Inositol in the Polycystic Ovary Syndrome — NEJM. Retrieved from: https://www.nejm.org/doi/full/10.1056/NEJM199904293401703
- Nordio, M., & Proietti, E. (2012, May 16). The combined therapy with myo inositol and D’Chiro Inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo inositol supplementation alone. European Review for Medical and Pharmacological Sciences, Retrieved from: https://www.europeanreview.org/wp/wp-content/uploads/1357.pdf
- Tais, S. (2013, August 1). Myo Inositol in Polycystic Ovarian Syndrome. Natural Medicine Journal, Retrieved from: https://www.naturalmedicinejournal.com/journal/2013-08/myo-inositol-polycystic-ovarian-syndrome
- Unfer, V., Carlomagno, G., Dante, G., & Facchinetti, F. (2012). Effects of myoinositol in women with PCOS: A systematic review of randomized controlled trials. Gynecological Endocrinology. Retrieved from: http://www.researchgate.net/profile/Gianfranco_Carlomagno/publication/221797391_Effects_of_myO-inositol_in_women_with_PCOS_a_systematic_review_of_randomized_controlled_trials/links/0c960515aa603d7727000000.pdf
Elizabeth Willett is the Senior Herbalist and Lead Educator at NaturalFertilityInfo.com. She holds a BS in Mass Communications (2000) from Minnesota State University, and a Master of Arts degree (MA, 2010) in Holistic Health Studies with a specialization is herbalism from St. Catherine University in St. Paul, MN. Liz has written over 200 articles on women’s fertility and brings a vast wealth of knowledge and expertise in holistic health and healing to Natural Fertility Info.com
Which is better for those new to Inositol:MYO or DCI?
Dear Amanda,
This will depend on each person’s situation, yet either may be fine. Our FerilicaTM line of supplements sells Myo-Inositol at the Natural Fertility Shop.
Hi,
Is it safe to take Inositol for fertility if you do not suffer from PCOS?
Thx
Dear Daniela,
Myo-inositol can be taken by women who do not have PCOS. What we know is that myo-inositol is part of the B vitamin family (B8), and is a building block used by the body for many cell functions. For fertility, myo-inositol is probably most researched for its ability to promote normal ovulation and hormone balance for women with PCOS. It may also be a great way to improve egg health for all women with egg health/quality concerns. It forms a critical component of follicular fluid, playing a role in healthy follicle development. Myo-inositol is believed to enhance insulin sensitivity of the ovary, which encourages better egg quality.