Polycystic ovarian syndrome (PCOS) is associated with irregular menstrual periods, infertility, obesity, diabetes, excess hair growth, acne, and other hormonal difficulties.

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

In a new review published earlier month in Frontiers in Endocrinology, researchers evaluated the effect of vitamin D supplementation in pregnancy and ovulation in patients with polycystic ovarian syndrome.

This review consisted of 20 randomized controlled studies with 1961 participants. The dosing of vitamin D supplementation ranged from a daily dose of 200 IU to 10,000 IU. In addition, one study had a one-time dose of 200,000 IU and two studies had a weekly dose of 6,000 IU and 10,000 IU. The duration of these studies ranged between 4 to 16 weeks. The meta-analysis demonstrated that pregnancy rate, ovulation rate, and matured oocytes rate of vitamin D supplementation group were significantly higher than those in the control group. In addition, early miscarriage rate, androgen level, luteinizing hormone (LH), follicle stimulating hormone (FSH), and premature delivery rate were reduced compared to the controls.

Previous research demonstrates that an optimal vitamin D 25-OH level is between 50-70 ng/ml. Most individuals will need a vitamin D dose between 5,000 and 10,000 IU daily to maintain this level.

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.

As a result, this review demonstrates that vitamin D supplementation contributes to higher pregnancy and ovulation rates as well as lower androgen, LH, FSH, and early miscarriage rates in women with PCOS regardless of the use of ovulation induction medications or assisted reproductive technologies.

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: Yang M, Shen X, et al. Effects of vitamin D supplementation on ovulation and pregnancy in women with polycystic ovary syndrome: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2023 Aug 1;12:1148556.

Sharing is caring!