What is PCOS?
Polycystic ovarian syndrome or PCOS is the most common metabolic and hormonal condition in women and affects around 10% of adult women with ovaries.
In PCOS, women have high levels of male hormones (called androgens), such as testosterone and androstenedione. These are the two main androgens elevated in PCOS. High androgen levels can cause PCOS symptoms such as infrequent or no ovulation, missed or minimal periods, acne, excess hair growth on unwanted areas (face and back), hair thinning on the top of the head and more.
Women with PCOS are also at high risk of additional health conditions. PCOS can lead to insulin resistance. Insulin is a hormone required to control blood sugar in the body, those who are insulin resistant do not use insulin effectively and the body’s cells cannot respond to the insulin and take in glucose, which causes blood sugars to increase. Insulin resistance can lead to diabetes, cause weight gain, and affect the function of the ovaries.
Do PCOS supplements help?
Before we dive into the role of supplements for PCOS management it is important to know that not all nutritional supplements are created the same. Some supplements may actually be harmful. It is always best to talk with a registered healthcare professional before implementing any supplements into your routine.
At this time there is no cure for PCOS and therefore PCOS must be managed by a combination of medications, lifestyle changes, and PCOS supplements. Certain supplements can support you in addressing insulin resistance and correcting high androgen levels.
As a PCOS dietitian, I wanted this article to provide you with an outline of the best evidence-based PCOS supplements to help you cut through marketing and avoid unnecessarily expensive products.
What are the best supplements for PCOS?
Here are the current best supplements that support insulin levels, hormone balance, and metabolism in women with PCOS.
Inositol
Inositol is a sugar that is naturally occurring in the body and found in many foods such as cantaloupe, grapefruit, lima beans, brown rice, whole wheat products, almonds, and walnuts. Inositol is usually found in powdered forms for supplements. Actually, inositol can be found in 9 different forms (!!) but Myo-inositol (MI) and D-chiro-inositol (DCI) have the biggest impact on PCOS.
Myo-inositol and D-chiro-inositol Supplements
Women with PCOS tend to have much higher DCI levels and lower MI levels which leads to a low ratio. When combined with other diet and lifestyle changes research shows that a 40:1 MI/DCI relationship is best for restarting ovulation in women with PCOS.
Research has strongly shown that inositol enhances insulin sensitivity, decreases unwanted symptoms, and improves period regularity in PCOS which in return helps with fertility for women with PCOS. Some studies say that inositol may even be more effective than metformin for increased ovulation and pregnancy rates.
Since it helps to control blood sugars, Myo-inositol can also assist with weight loss. In fact, when used appropriately, inositol is one of the best supplements for PCOS weight loss.
To learn more about using inositol in PCOS, book a consultation with a PCOS dietitian.
Vitamin D
Vitamin D is essential for many bodily functions such as maintaining bone health, regulating renal function, dental health and reducing obesity. Unfortunately, vitamin D deficiency is a common diagnosis in women with PCOS and it is shown to have a correlation to insulin resistance.
That is why vitamin D is one of the most important vitamins in the management of PCOS. Supplementing vitamin D has been shown to have beneficial effects on menstrual regularity, ovulation, decreasing risk of diabetes and decreasing testosterone levels. Plus it has been shown to improve mood and mental health.
As a PCOS nutritionist, I suggest taking a 1,000-2,000 IU of vitamin D3 supplement daily for the management of PCOS as sunlight exposure alone is enough to meet vitamin D needs in Canada. On beautiful sunny days, I would encourage you to get outside by gardening, walking with a friend, or going for a bike ride with a family member as a way to get additional vitamin D, spend time with a loved one and move your body!
Omega 3
Omega 3 fatty acids are essential nutrients to the human body. Essential nutrient means that our bodies require them but are unable to produce or create them and therefore these nutrients must be obtained from the foods in our diet.
Omega 3 fatty acids play important roles throughout the body. Some of these roles include the protection of heart health, brain function and development, development of healthy eyes, and fetal development.
Research has shown that in PCOS, omega 3 fatty acids can help to improve insulin sensitivity, reduce inflammation, and lower androgen levels. Omega 3 fatty acids are also a healthy fat that can help to improve cholesterol and reduce the risk of heart disease, which is elevated in women with PCOS.
Food sources of Omega 3 fatty acids are cold-water fatty fish like salmon, mackerel, tuna, herring and sardines along with other seafood. Omega 3 can also be found in nuts and seeds such as flax seeds, chia seeds and walnuts. Along with plant oils such as flaxseed oil, soybean oil and canola oil.
Probiotics
Many of the common symptoms of PCOS may negatively affect the diversity and composition of the trillion bacteria that live in our gut.
Probiotics are live microorganisms that can help to restore and improve microbiome gut health. Gut health plays an important role in controlling inflammation. As alluded to above, chronic inflammation is a common manifestation of PCOS and a key contributor to insulin resistance and weight gain.
The best probiotics for PCOS are found in foods, like probiotic yogurt, kefir, kombucha, kimchi, sauerkraut, and miso. If you do not eat these foods regularly, I suggest you find a high-quality probiotic supplement.
If you want to learn more about the link between your gut health and managing your PCOS read this!
N-Acetyl Cysteine (NAC)
NAC is believed to be a helpful PCOS supplement due to its antioxidant properties, and its ability to improve insulin sensitivity and reduce chronic inflammation. These effects of NAC may help improve symptoms of PCOS, including irregular periods, acne, hormone balance, reduced inflammation, increased fertility and excess hair growth.
However, it is important to know that while NAC has shown promise in research, it is not as well studied when compared to inositol in PCOS. More research is needed to understand its effects on PCOS fully and determine the optimal NAC supplementation dosages.
If you are interested in trying NAC to see if it can assist you in getting pregnant or reduce symptoms caused by PCOS then it is best to talk with your care provider to make sure it is right for you.
Want to learn more about PCOS supplements?
Good PCOS management is crucial for controlling symptoms, improving fertility, and regulating menstrual periods. Supplementation with inositol, NAC, vitamin D, omega 3, and probiotics have been shown to be beneficial in managing PCOS symptoms.
The best way to ensure you are maximizing your nutrition is to consult an expert PCOS dietitian who can recommend foods and supplements to help you reach your PCOS goals. I’ve got your back!
If you want to work together, contact me to book a session with a PCOS dietitian.