Sensible Supplementation for PCOS
By Hillary Wright, MEd, RDN, author The PCOS Diet Plan
If you have PCOS, basic supplementation may help. To enhance absorption and tolerance, take with food, including some fat to increase absorption of fat-soluble nutrients like vitamin D.
A Basic Multivitamin
- Most women don’t eat perfect diets every day, so a multi gives you a little added assurance that you’ve covered all the bases
- Multis will ensure you’re getting the government-recommended minimum 400 micrograms of folic acid daily to help prevent neural tube defects in women who could become pregnant
- Very few women get enough vitamin D, so some basic supplementation is warranted
- Metformin, a commonly used medication to treat PCOS, may interfere with vitamin B12 absorption over time so extra supplement is recommended
- Research suggests that up to 75 percent of Americans may have inadequate blood levels of vitamin D—that is, less than 30 nanograms per milliliter (ng/ml)
- Research suggests vitamin D may improve insulin resistance; accumulating research has linked low levels of vitamin D with both PCOS and diabetes (as well as other diseases like heart disease and cancer)
- Many vitamin D experts recommend at least 1,000-2000 IUs of vitamin D3 per day for everyone not exposed to the sun year-round; very low levels require higher amounts of D3 or a prescription of 50,000 IU of vitamin D3 followed by a maintenance daily dose to avoid becoming deficient again. Most multivitamins contain 600 IUs of vitamin D; women’s multi’s often contain 800-1000 IU
- Women with PCOS are at higher risk of cardiovascular disease and omega-3s from either fatty fish or supplements have been found to lower blood triglyceride levels and blood pressure, and may slow the accumulation of cholesterol plaques in the arteries.
- Omega 3’s may also help improve insulin resistance and counter the chronic inflammation that may be present in PCOS.
- Don’t eat at least 8 ounces of fatty fish like salmon, herring, mackerel or sardines per week? A daily fish oil supplement containing at least 650 – 1000 mg of combined DHA and EPA maybe be helpful.
- Research shows a deficiency of a natural substance in the body called inositol may contribute to the insulin resistance and high testosterone seen in women with PCOS
- Inositol may also help nurture healthy egg quality in those trying to conceive
- Large amounts of inositol are not widely available in the food supply, so supplementing with inositol may help improve insulin resistance and ovulation
- Inositol in the body occurs in a ratio of 40-to-1 myo-inositol to d-chiro-inositol so supplementing with a product with that ratio (such as Ovasitol by Therologix, LLC) is ideal
NAC (N-acetyl cysteine)
- NAC is both an anti-inflammatory and an anti-oxidant
- NAC may improve insulin resistance and lower testosterone levels
- One study of women with PCOS added either metformin or NAC to Clomid for ovulation induction and found the NAC/Clomid combination more effective at improving ovulation and pregnancy rates though more research is needed as findings in studies are somewhat mixed)
- Doses used in studies range form 1-3 grams per day (higher doses in heavier women), and is generally considered safe
- Berberine is an herb that acts as an insulin sensitizer in a manner similar to metformin
- Some research suggests berberine may be good for “gut” health by increasing production of short chain fatty acids in the intestine, which helps maintain a healthy intestinal lining barrier.
- Berberine may also nurture the growth of “good bacteria” in the gut, which in turn improves insulin resistance, and may lower the risk of heart disease and cancer.
- A commonly used dose of berberine is 500 mg three times daily
Coenzyme Q 10
- CoQ10 is a vitamin-like substance that acts as an anti-oxidant
- CoQ10 has been studied widely and found good for cardiovascular health, including high blood pressure
- For women with PCOS who are trying to conceive, some studies suggest coQ10 may help improve egg quality and blood sugar metabolism
- In one study, when paired with Clomid, CoQ10 was associated with higher ovulation and pregnancy rates
- Research studies have used between 200 and 600 mg per day
** The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding dietary supplementation.
 Gyn Endo 31, no 8 (2015):635-638
 Reprod BioMed Online. 29, no.1 (July 2014): 119-124