Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties. Researchers compared the effects of lifestyle changes alone or with placebo to lifestyle combined with metformin. They found that lifestyle modification combined with taking metformin resulted in increased weight loss. As a result, there was a lower body mass index (BMI), and improved menstruation.

In a new review published earlier month in the Journal of Clinical Medicine, researchers investigated the physiopathology in PCOS and vitamin D deficiency.

Pharmaceutical interventions provide some improvements but they do not correct many of the underlying factors and have side effects that may not be tolerated by patients. Many PCOS patients are overweight and have dietary habits that exacerbate the condition.

Previous research has demonstrated the importance of vitamin D in patients with PCOS. Women with PCOS are often vitamin D deficient, specifically those with a higher weight.

In addition, a vitamin D deficiency is a risk factor for glucose intolerance and insulin resistance, which may lead to diabetes. Since women with PCOS and hirsutism tend to have lower levels of vitamin D than those without hirsutism, a correlation between vitamin D deficiency and hyperandrogenism can be suggested.

Vitamin D is also essential to mitigate inflammation and oxidative stress. Furthermore, vitamin D has been shown to play a role in egg quality and fertility. In general text, women with PCOS have lower vitamin D levels compared to healthy individuals.

This review demonstrates the relationship between vitamin D and the hormonal and metabolic profile of PCOS patients as well as its role in fertility. Vitamin D should have broad significance to increase natural conception in women with PCOS with a goal to decrease costs related to in vitro fertilization procedures. Vitamin D supplementation women with PCOS is a safe strategy to improve their symptoms without adverse effects.

Other nutrients to consider to support PCOS:

Studies have shown that an inositol deficiency is common in women with PCOS. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods which is a distinctive characteristic feature of PCOS. As a result, the nutritional requirements of PCOS patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these women.

Myo-inositol and D-chiro-inositol are both essential for patients with PCOS. The conversion of myo-inositol to D-chiro-inositol is of interest because errors here have been strongly involved in PCOS patients. Strong evidence supports that the body makes D-chiro-inositol from myo-inositol and more evidence suggests that some people are less able to make this conversion than others.  Along this spectrum, people who are completely unable to convert myo-inositol to D-chiro-inositol are only going to benefit from supplementation with D-chiro-inositol. Other people who make the conversion, but with less than optimal efficiency, may benefit from large doses of myo-inositol. And, other individuals in between, might see the best results from a blend of the two. Since this conversion is impaired in individuals with PCOS, it is important to always include D-chiro-inositol with myo-inositol supplementation. D-chiro-inositol is the more potent form of inositol for supporting insulin resistance, however, myo-inositol is need for oocyte quality and maturation. Therefore, supplementing with D-chiro-inositol alone cannot not fulfill myo-inositol’s roles that are specific and different from D-chiro-inositol, since it does not convert to myo-inositol.

Also, essential fatty acids should be consumed in our diets for overall health, but most individuals with insulin resistance are deficient. Fish oils improve insulin sensitivity and reduce inflammation. 

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Morgante G, Darino I, et al. PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment. J Clin Med. 2022 Aug 2;11(15):4509.

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