PCOS Treatment
Reducing calorie intake improves symptoms of PCOS
Short-term treatment of obese PCOS women on a very low calorie diet (350-450 kcal per day) leads to a two-fold increase in serum SHBG levels and an accompanying fall in serum insulin.
http://www.makainaturopathic.com/articles/PCOS.pdf
1000 mcg of chromium picolinate improved insulin sensitivity by 35% in 2 months
Women with PCOS took 1000 mcg of chromium picolinate for two months, at which time their glucose disposal (insulin sensitivity) had improved by an average of 35%, and their baseline insulin levels fell by 22%.
http://www.ovarian-cysts-pcos.com/chromium.html
200 mcg of chromium picolinate improved glucose tolerance but not ovulatory frequency
In women with polycystic ovary syndrome, chromium picolinate (200 microg/d) improves glucose tolerance compared with placebo but does not improve ovulatory frequency or hormonal parameters.
http://www.ncbi.nlm.nih.gov/pubmed/16359984
High fiber and omega-3, low carbohydrate and saturated fat diet improves testosterone profile
Women with PCOS should also consider maintaining a diet that is patterned after the type 2 diabetes diet. This diet includes an increase in fiber and a decrease in refined carbohydrates, as well as a decrease in trans and saturated fats and an increase in omega-3 and omega-9 fatty acids. Foods that contain anti-inflammatory compounds (fiber, omega-3 fatty acids, vitamin E, and red wine) should also be emphasized. Evidence is provided for the impact of these dietary changes on improvements in the testosterone profile of PCOS patients.
http://www.ncbi.nlm.nih.gov/pubmed/18203965
Lower omega-6:omega-3 fatty acid ratio lowers testosterone
We selected a cross-sectional PCOS cohort and conducted a principal component analysis on plasma fatty acid profiles. Effects of long chain omega 3 polyunsaturated fatty acid supplementation on fasting and postprandial metabolic and hormonal markers were determined in PCOS subjects by a randomized, crossover, placebo-controlled intervention. RESULTS: Cross-sectional data showed that a greater plasma omega-6 concentration and omega-6:omega-3 ratio were associated with higher circulating androgens and that plasma omega-3 status was associated with a less atherogenic lipid profile. Omega-3 supplementation reduced plasma bioavailable testosterone concentrations, with the greatest reductions in subjects who exhibited greater reductions in plasma omega-6:omega-3 ratios. CONCLUSIONS: Cross-sectional data suggest that polyunsaturated fatty acids modulated hormonal and lipid profiles and that supplementation with omega-3 improves androgenic profiles in PCOS. In bovine theca cells, arachidonic acid modulated androstenedione secretion, which suggests an indirect effect of omega-3 through the displacement of or increased competition with omega-6.
http://www.ncbi.nlm.nih.gov/pubmed?term=arachidonic%20acid%20pcos
N-acetylcysteine + L-arginine lowers insulin resistance by 39% and restores ovulation in PCOS
Eight patients with PCOS displaying oligo-amenorrhea from at least 1 yr underwent a combined treatment with N-acetylcysteine (1200 mg/day) plus L-arginine (1600 mg/day) for 6 months. Menstrual function, glucose and insulin levels, and, in turn, homeostasis model assessment index of insulin resistance were monitored. Menstrual function was at some extent restored as indicated by the number of uterine bleedings under treatment (3.00 vs 0.00). Also, a well-defined biphasic pattern in the basal body temperature suggested ovulatory cycles. Insulin resistance decreased under treatment (2.12 vs 3.48). In conclusion, this preliminary, open study suggests that prolonged treatment with N-acetylcysteine+L-arginine might restore gonadal function in PCOS. This effect seems associated to an improvement in insulin sensitivity.
http://www.ncbi.nlm.nih.gov/pubmed/19494711
N-Acetylcysteine lowers insulin resistance, testosterone and free androgens
Patients were treated for 5-6 weeks with N-acetylcysteine at a dose of 1.8 g/day orally. A dose of 3 g/day was arbitrarily chosen for massively obese subjects. Six of 31 obese patients with PCOS were treated with placebo and served as controls. Fasting glucose, fasting insulin, and glucose area under curve were unchanged after treatment. Insulin area under curve after oral glucose tolerance test was significantly reduced, and the peripheral insulin sensitivity increased after N-acetylcysteine administration, whereas the hepatic insulin extraction was unaffected. The N-acetylcysteine treatment induced a significant fall in testosterone levels and in free androgen index values. In analyzing patients according to their insulinemic response to oral glucose tolerance test, normoinsulinemic subjects and placebo-treated patients did not show any modification of the above parameters, whereas a significant improvement was observed in hyperinsulinemic subjects. CONCLUSION(S): N-acetylcysteine may be a new treatment for the improvement of insulin circulating levels and insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome.
http://www.ncbi.nlm.nih.gov/pubmed/12057717
D-chiro-inositol improves insulin sensitivity by 36% and lowers free testosterone by 73%
In the 10 women given D-chiro-inositol (600 mg/day for 6 to 8 weeks), the mean area under the plasma insulin curve after oral administration of glucose decreased significantly from 8,343 mU/mL/min to 5,335 mU/mL/min. Concomitantly, the serum free testosterone concentration decreased significantly from 0.83 ng/dL to 0.22 ng/dL. Six of the 10 women (60%) in the D-chiro- inositol group ovulated in comparison with 2 of the 10 women (20%) in the placebo group. Systolic and diastolic blood pressures, as well as plasma triglyceride concentrations, decreased significantly in the D-chiro- inositol group . We conclude that, in lean women with PCOS, D-chiro-inositol reduces circulating insulin, decreases serum testosterone, and ameliorates some of the metabolic abnormalities (increased blood pressure and hypertriglyceridemia) of syndrome X.
http://www.ncbi.nlm.nih.gov/pubmed/15251831
Myo-inositol lowers testosterone, increases SHBG and progesterone, and improves insulin sensitivity
In 23 women treated with myo-inositol (4g for 12 to 16 weeks), the area under the plasma insulin curve after oral administration of glucose decreased from 8.54 to 5.535 μU/ml/min. The serum total testosterone decreased from 99.5 to 34.8 ng/dl, and serum free testosterone from 0.85 to 0.24 ng/dl. SHBG increased from 144 to 198. The progesterone peak value was higher in the myo-inositol group (15.1 ng/ml). Plasma triglycerides decreased from 195 to 95 mg/dl. Systolic blood pressure decreased from 131 to 127 mmHg. Diastolic blood pressure decreased from 88 to 82 mmHg. The index of composite whole body insulin sensitivity increased from 2.80 to 5.05 mg-2/dl-2 . Also, 16 out of 23 women of myo-inositol group ovulated (4 out of 19 in placebo group).
http://www.europeanreview.org/pdf/604.pdf
Myo-inositol restores normal ovulatory activity and fertility
Myo-inositol combined with folic acid (Inofolic) 4 g a day was administered continuously for 6 months. RESULTS: Twenty-two out of the 25 (88%) patients restored at least one spontaneous menstrual cycle during treatment, of whom 18 (72%) maintained normal ovulatory activity during the follow-up period. A total of 10 singleton pregnancies (40% of patients) were obtained. Nine clinical pregnancies were assessed with fetal heart beat at ultrasound scan. Two pregnancies evolved in miscarriage. CONCLUSION: Myo-inositol is a simple and safe treatment that is capable of restoring spontaneous ovarian activity and consequently fertility in most patients with PCOS.
http://pubget.com/profile/author/Guido%20Marelli
Hypothyroidism causes PCOS; treating hypothyroidism treats PCOS
Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and DHEA-S, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone. CONCLUSION: Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102473/?tool=pubmed
Adding calcium to metformin treatment improves outcome in PCOS
In this pilot study, infertile PCOS patients were enrolled in a randomized clinical trial and divided into three equal groups. Group 1 received 1,000 mg of calcium and 400 IU of vitamin D per day, orally. Group 2 received the same as Group 1, plus 1,500 mg/day of metformin. Group 3 received 1,500 mg/day of metformin. RESULTS: Generalized estimating equation tests showed that the number of dominant follicles (> or = 14 mm) during the 2-3 months of follow-up was higher in the calcium-vitamin D plus metformin group than in either of the other two groups.CONCLUSION: The effects of metformin and calcium-vitamin D in regulating the menstrual cycle suggest that they could also be effective for the treatment of anovulation and oligomenorrhea, with possible consequences for pregnancy rates in PCOS patients
http://www.ncbi.nlm.nih.gov/pubmed/19574176