Positive PCOS Research – Inositol
There are many dedicated doctors and researchers working on behalf of women with PCOS. Dr. Antonio Simone Laganà is one of these dedicated researchers. He works in the Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences at the University of Messina in Italy.
Dr. Laganà has been conducting some very helpful studies around the supplement inositol. If you haven’t yet heard about inositol, then you’ll want to know that inositol is NOT a pharmaceutical drug. It is a naturally occurring substance produced in the human body that belongs to the vitamin B complex group. There are nine different types of inositol and can be found naturally in many foods such as fruits, nuts and beans. It is a precursor to a number of ”signaling molecules” that essentially tell cells how to behave. Of the nine different types of inositol, two have insulin-sensitizing capabilities: myo-inositol and d-chiro-inositol. Dr. Laganà is proactively trying to get the word out about his study findings and has been posting his research studies on my Facebook page. I thought I would summarize his findings for you. Please spread the word and pass this info on to fellow Divas. If you want to discuss these finding with your doctor, be sure to point them to the actual research references provided below. You might also read my post about myo-inositol here.
Here is a summary of Dr. Laganà’s recent studies:
On March 9th, Dr. Laganà published some preliminary data proceeding the 16th World Congress of Gynecological Endocrinology on ovarian function and metabolic factors in women affected by PCOS after treatment with D-chiro-inositol. (1) The study looked at 25 patients affected by PCOS and menstrual irregularities. The patients underwent treatment with 1 g of D-Chiro-Inositol plus 400 mcg of Folic Acid orally for 6 months. After the 6 months there was a statistically significant reduction of the Systolic blood pressure, Gallwey-Ferriman Score, LH, LH/FSH ratio, total Testosterone, free Testosterone, ∆-4-Androstenedione, Prolactin and HOMA Index; in the same patients there was a statistically significant increase of SHBG and Glycemia/IRI ratio. Moreover, there was a statistically significant (64%; p<0.05) post-treatment menstrual cycle regularization.
The study conclusion is d-chiro-inositol is effective in improving ovarian function and metabolism of patients affected by PCOS.
Comparison study between of myo-inositol and D-chiro-inositol
Published on December 19th, 2013, the aim of this work was to compare the effects of myo-inositol and d-chiro-inositol in PCOS. 50 patients, with homogeneous bio-physical features, affected by PCOS and menstrual irregularities participated and were randomly divided into two groups: 25 were treated with 4 g of myo-inositol plus 400 mcg of folic acid orally for six months, 25 with 1 g of d-chiro-inositol plus 400 mcg of folic acid orally for six months. Both groups were analyzed pre-treatment and post-treatment BMI, systolic and diastolic blood pressure, Ferriman–Gallwey score, Cremoncini score, serum LH, LH/FSH ratio, total and free testosterone, dehydroepiandrosterone sulfate (DHEA-S), Δ-4-androstenedione, SHBG, prolactin, glucose/immunoreactive insulin (IRI) ratio, homeostatic model assessment (HOMA) index, and the resumption of regular menstrual cycles.
The study conclusion was that both the isoforms of inositol were effective in improving ovarian function and metabolism in patients with PCOS, although myo-inositol showed the most marked effect on the metabolic profile, whereas d-chiro-inositol reduced hyperandrogenism better.
Summary of Findings
Dr. Laganà has given me permission to post his editorial Know your Enemy: The Rationale of Using Inositol in the Treatment of Polycystic Ovary Syndrome. This article is a nice summary of all the the research findings on myo-inositol and d-chiro inositol.
Just to be sure, I emailed the following questions to Dr. Laganà-
Amy: “There is much confusion among women with PCOS as to what type of inositol to use for PCOS. It seems that myo is best for egg quality and trying to conceive and d-chiro is best for lowering androgens. Do you have any recommendations on what type to use?” Here was his response,
Dr. Lagana: “According to our recent data analysis, both the isoforms of inositol are effective in improving ovarian function and metabolism in patients with PCOS, although myo-inositol showed the most marked effect on the metabolic profile, whereas D-chiro-inositol reduced hyperandrogenism better.”
Amy: “Can and should a woman with PCOS take both forms of inositol – myo and d-chiro?”
Dr. Laganà: “Despite currently there is no clear evidence to support the treatment with a combination of myo- and d-chiro-inositol, there is a paper published by Nordio & Proietti in 2012 (http://www.ncbi.nlm.nih.gov/pubmed/22774396), which found that the combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Neverthless, further data are needed to clarify better the situation. In my opinion it will be mandatory in future to use a “tailored treatment” basing on different bio-hormonal parameters of each patient.”
Amy: “Can myo-inositol and d-chiro-inositol be taken if a women is pregnant or nursing?”
Dr. Laganà: To date, there are no reports about side effects of Inositol administration during pregnancy and breastfeeding. Accumulating evidence seems to suggest that Inositol supplementation during pregnancy may:
Thanks Dr. Lagana for all your efforts in helping women with PCOS!
Antonio Simone Laganà was born in Reggio Calabria (Italy) on 8th May 1986. During his university career he was trained in particular in histology and embryology (supervisor Prof. Domenico Puzzolo), Clinical Pharmacology (supervisor Prof. Edoardo Spina), Immunology and General Pathology (supervisors Prof. Vincenza Sofo, Dr. Francesca Maria Salmeri) and finally in Obstetrics and Gynecology. He attended also the Department of Interventional Radiology of the Virginia Commonwealth University (Richmond, Virginia – USA), where he studied technique of uterine fibroids chemioembolization (supervisor Prof. Uma Prasad), and the Department of Obstetrics and Gynecology of the “Klinicky Centar” (Belgrade – Serbia. Supervisor Prof. Milan Terzic). He earned his graduation at University of Messina (Italy) and became Resident Medical Doctor in Obstetrics and Gynecology. He is of Member of the “Italian Association of Endometriosis” Expert Panel , In-Training Member of the “Society for Gynecologic Investigation”, Regular Member of the “European Society of Human Reproduction and Embryology”, of the “International Society of Gynecological Endocrinology” and of Giorgio Pardi Foundation’s professional research team. He got a Master of “gynaecological minimally invasive and robotic surgery” (supervisor Prof. Vito Cela, University of Pisa). His research interests are: Endometriosis, Reproductive Immunology, T cell subsets, Chronic Pelvic Pain, Organogenesis and Genetic of Mullerian-Derived Structures, Gynecological Endocrinology, Polycystic Ovarian Syndrome (PCOS), Laparoscopy, Hysteroscopy, Minimally invasive surgery in ob/gyn. He is author of many papers published in national and international peer-reviewed journals, and his presence is often requested as Invited Speaker in international congresses.
Where can we find these forms of inositol? I saw where my local vitamin shop has inositol, but I don’t think it shows different forms. Would you have to have this presribed by a doctor?
Can/should you take both forms?
Dr. Lagana’s reply – “Despite currently there is no clear evidence to support the treatment with a combination of myo- and d-chiro-inositol, there is a paper published by Nordio & Proietti in 2012 (http://www.ncbi.nlm.nih.gov/pubmed/22774396), which found that the combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone.
Neverthless, further data are needed to clarify better the situation. In my opinion it will be mandatory in future to use a “tailored treatment” basing on different bio-hormonal parameters of each patient.”
Finally someone who is making the effort to help this disabiling syndrome. Will definitely be trying inositol! Thank you so much for your time in doing this research Dr. Lagana.
My biggest questions here would be could you take both at the same time? We want both great quality eggs and lower androgen fueled side effects!
Wow. This is huge. Thank you so much, Amy, for posting these articles. I will definitely try it. Currently, I am 7 1/2 months pregnant with my first child. Can I use it while pregnant or should I wait until I deliver? Also, and this just might be coincidence, but when the doctors found out that I was pregnant, they did the Counsyl test which tests for a bunch of diseases that I could be a carrier of (fragile X syndrome, cystic fibrosis, etc) and they found that I had a recessive disorder that inhibited folic acid production and now, I take a supplement. I just find it interesting that Dr. Lagana had his patients take a folic acid supplement in both clinical trials as well. It could just be a coincidence but I wonder if other PCOS women are low in folic acid production absorption.
I’m curious about taking inositol and Metformin. My doctor has me on Metformin and my acupuncturist on myo- inositol. Are the 2 together ok??
Since I was a kid, 16 years old I was diagnosed with PCOS. No doctor ever treated me for the cause, they all treated the sideaffects (no monthly period), I was put on all kind of drugs with progesterone to help me bleed regulary, afterwards I was on birth control and it helped, but as soon as I’d stop using them it got the same, or even worse. Once I havent had my period in 8 months! If I was pregnant I could deliver a baby by then… Now, aged 31 I am married and my husband and I want a family, I found a very good doctor, endocrinologist and she helped me, finally! She had sent me to do some tests and among others I already knew what to expect (my hormones to be a mess), I found out I was insulin resistant. The doctor had prescribed metformin, I started taking it on 16th of June, in one month I ovulated and concieved, but unfortunately it was blighted ovum and I had to have it taken out. I’ve continued taking metformin, and now I got my first period – almost naturaly…for me it is a miracle, and I hope in few months I will be with child again. I haven’t tried these other, herbal medicines, although I would if I had an opportunity, but for now I feel blessed metformin had helped me being a ‘real woman’ again.
Has there been any more research and data or conclusions made since this article first came out? I am in particular curious about the last section in regards to its safety during pregnancy and breastfeeding. It said to date (as of 2014 Im guessing) there have been no reports about side effects…now it’s 2016 and wondering if there have been any actual studies done on this, especially the possible effects on children through breastfeeding, thank you!