Myo-Inositol & PCOS

This supplement has been a game changer for my PCOS and I swear by it. It has helped regulate my menstrual cycle, balanced my blood sugar levels and provides me with a sense of satiety throughout the day.
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What is Myo-Inositol (MI)?
MI is one of nine different types of inositol. It is a naturally occurring carbohydrate produced in the human body from glucose, although it is not a sugar. Better described as a ‘vitamin-like’ substance, MI is often considered to be a member of the B complex group of vitamins. However, because it is produced by the body in amounts considered sufficient to support health, it is not officially termed an essential nutrient. In addition to the body’s own production from glucose, MI is also found naturally in many foods such as organ meats, fruit, grains, nuts and beans.
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How is MI beneficial for PCOS?
Inositols play an important role in many metabolic processes within our body. The two types of inositol of particular interest to women with PCOS however are MI and d-chiro-inositol (DCI). MI has been proven to restore ovulation and improve egg quality in women with PCOS (Unfer et al. 2012). MI can help address associated PCOS infertility by improving insulin resistance, androgen levels as well as many of the features of this metabolic disorder. Inositols act as second messengers for insulin, and their deficiency contributes to the various features of PCOS. Women with PCOS are 4x more likely to develop diabetes than women who do not have the disorder. They also have an increased risk of gestational diabetes, (GDM) which occurs during pregnancy. One study estimated that the risk is nearly 20% greater.
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Researchers have shown that taking MI supplements can lower blood sugar levels and the risk of GDM in women with PCOS. A study in Gynaecology Endocrinology showed the number of cases of GDM among pregnant women with PCOS who took MI was 17.4% vs. 54% in those who didn’t supplement. PCOS is marked in 30 - 40% by insulin resistance and hyperandrogenism
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Research has found MI to be an effective support in PCOS, in part due to its ability to improve insulin sensitivity, restore hormonal balance, improve menstrual regularity, reduce hyperandrogenism and influence ovarian function.
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The reason MI is predominantly the focus?
Meta-analysis of 9 random controlled trials revealed that MI alone or combined with DCI improves the metabolic profile of women with PCOS. DCI alone, at high dosage, can negatively affects oocyte (egg) quality. DCI is an important molecule for glycogen synthesis, MI is linked to an increase in glucose cellular uptake. It has been seen that organs with a high rate of glucose consumption such as your brain and heart need high levels of DCI, unlike the ovaries, which do not require high concentrations of DCI for proper functioning.
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The Research MI and folate combined:
In a randomised study involving PCOS patients, 2g of MI in combination with 200 μg folic acid, administered 2x daily for 3 months, led to a significant increase in the counts of follicles larger than 15 mm, which were identifiable by transvaginal ultrasound, and of oocytes recovered during collection, compared with the use of folic acid alone and placebo. There was also a significant reduction in the mean count of immature eggs related to the MI treatment in the same trial.
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In a double blind clinical trial, 42 women with PCOS received 4 g MI and 400 mcg folic acid daily or the placebo which was just folic acid. Results showed that MI increased insulin sensitivity, improved glucose tolerance and decreased glucose stimulated insulin release. The researchers, in addition observed a positive effect on ovulation. 16 out of 23 women in the MI group, ovulated, compared to 4 out of 19 women in the placebo group. In these women, there was also a 66% reduction of serum total testosterone and a 73% reduction of serum free testosterone concentrations. Cardiovascular markers, blood pressure and total cholesterol concentrations also decreased in the MI group.
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Another study was conducted with the administration of 400 μg of folic acid and 4g MI per day in a larger group of 92 women with PCOS. Frequency of ovulation and time to first ovulation improved significantly in the MI group, with a better/ early effect on follicular maturation, which coincided with the increase in circulating levels of estradiol observed in the first week of treatment. The authors also reported positive metabolic changes in patients treated with MI, including  significant weight loss. 
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Studies on IVF:
In a double blind trial, researchers compared the effects of supplementation with a combination of 2g MI and 200 mcg folic acid compared to just 200 mcg folic acid. This was taken twice daily for 3 months in women with PCOS undergoing IVF and ovulation induction. At the end of the treatment, both the number and quality of oocytes (immature egg cells) was greatly improved in the group taking MI.
Researchers concluded, that MI may be useful in the treatment of PCOS patients undergoing ovulation induction, both for its insulin sensitising activity, and its role in oocyte maturation. Additional research has found MI to be useful for improving oocyte quality, ovulation and pregnancy outcomes.
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In further studies:
A study in 20 women with PCOS carrying excess weight found that 12 weeks of MI supplementation led to improved insulin sensitivity, reproductive hormone balance and completely restored the menstrual cycle in all patients with either no menstrual cycle or with irregularities.  Now you all know probably know how much I disliked the contraceptive pill but this is interesting to note: Studies show that a combination of the contraceptive pill and 4g of MI daily for a year is more effective in controlling the endocrine, metabolic and clinical profile in patients with PCOS than the contraceptive pill alone; the same study also found MI reduced insulin levels and insulin resistance.
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What about unwanted facial hair?
Researchers investigated the effects of MI on 2 of the most common features of PCOS, hirsutism (unwanted facial hair) and hyperandrogenism (excessive circulating male sex hormone). In the study, 46 women were evaluated at baseline and then again, following treatment with MI for 6 months. Results showed that those supplemented with MI significantly reduced hirsutism, hyperandrogenism and insulin resistance.
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Studies with metformin:
Researchers compared the effects of 12 weeks of intervention with either MI or metformin on mental health parameters and biomarkers of oxidative stress in 60 patients with PCOS. Results showed that following the 12-week intervention, changes in general health, depression, anxiety, stress concentrations in the MI group were significantly different from the changes in the metformin group. The researchers concluded that their data supported that MI supplementation for 12 weeks among patients with PCOS has favourable effects on parameters of mental health in comparison to metformin. 
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A randomised controlled trial compared the effects of metformin and MI on the clinical and metabolic features in PCOS. Research revealed that both metformin and MI have been demonstrated to be useful in women with PCOS for lowering BMI, improving insulin sensitivity, and improving menstrual cycle, without significant differences between the two treatments.
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Mental health:
Research shows that MI also has an integral role in the activation of serotonin receptors (the ‘feel-good’ neurotransmitter), thus supporting its use for mood balance in the premenstrual phase of the menstrual cycle and also potential uses in depression and panic disorder.
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There are research studies demonstrating dosages of 18g of inositol per day was effective in OCD treatment.