Metabolic and hormonal effects of a combined Myo-inositol and d-chiro-inositol therapy on patients with polycystic ovary syndrome (PCOS)

Januszewski, Marcin; Issat, Tadeusz; Jakimiuk, Alicja; Santor-Zaczynska, Malgorzata; Jakimiuk, Artur

doi:10.5603/gp.2019.0002

Cited by 30 publications

(28 citation statements)

References 19 publications

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“… 55 Also when given in combination, myo-inositol and D-chiro-inositol treatments were associated with a decrease in free testosterone, LH, FSH, an increase of serum SHBG, and an improvement in skin conditions. 56 …”

Section: Inositols In Polycystic Ovary Syndrome and Fertilitymentioning

confidence: 99%

Inositols and metabolic disorders: From farm to bedside

Caputo

Bona

Leone

et al. 2020

Journal of Traditional and Complementary Medicine

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Inositol and its derivates are catching interest in metabolism since taking part in several physiological processes, including endocrine modulation. Through several mechanisms mostly mediated by insulin signaling, these compounds regulate the activities of several hormones and are essential in oocytes maturation. It is interesting to point out the contribution of an inositol deficiency in the development of several diseases, mainly in the metabolic and endocrine setting. Inositols derive from both diet and endogenous production; among causes of inositol deficiency reduced dietary intake, increased catabolism and/or excretion, decreased biosynthesis, inhibition of gut and cellular uptake and altered microbiota could be considered. Mounting direct and indirect evidence suggests that the two main isoforms (Myo-inositol-inositol, D-chiro-inositol) are implied in glycemic and lipidic metabolism and supplementation yield a beneficial effect on these parameters without hazards for health. Moreover, they have a role in polycystic ovary syndrome, acting as insulin-sensitizing agents and free radical scavengers, helping to regulate metabolism and promoting ovulation. The aim of this narrative review is to discuss the role of inositols in metabolic function disorders paying attention to whether these compounds could be efficacious and safe as a therapeutic agent with a focus on dietary intake and the role of gut microbiota.

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Section: Inositols In Polycystic Ovary Syndrome and Fertilitymentioning

confidence: 99%

Inositols and metabolic disorders: From farm to bedside

Caputo

Bona

Leone

et al. 2020

Journal of Traditional and Complementary Medicine

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“…Added Compounds e other MI : DCI ratios analyzed in some other clinical studies were 3.6 : 1, 5 : 1, and 10 : 1. Mendoza carried out two studies with the 3.6 : 1 ratio [52,53] and Brusco studied only one at 5 : 1 [54], while Januszewski looked at 10 : 1 [55]. All of these ratios were without scientific justification and were derived from an outdated vision in connection with the initial use of DCI in PCOS (and later abandoned).…”

Section: Comments On Studies With Other Ratios Andmentioning

confidence: 99%

Inositol Treatment for PCOS Should Be Science-Based and Not Arbitrary

Roseff

Montenegro

2020

International Journal of Endocrinology

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e aim of this paper is to critically analyze the composition of many inositol-based products currently used to treat Polycystic Ovary Syndrome (PCOS). Several different combinations of myo-inositol and D-chiro-inositol, with and without additional compounds such as micro-and macroelements, vitamins, and alpha-lipoic acid, have been formulated over the years. Such therapeutic proposals do not take various features of inositol stereoisomers into consideration. As an example, it is important to know that D-chiro-inositol treatment may be beneficial when administered in low doses, yet the progressive increase of its dosage results in the loss of its advantageous effects on the reproductive performance of women and a deterioration in the quality of blastocysts created via in vitro fertilization (IVF). In addition, we have to consider that the intestinal absorption of myo-inositol is reduced by the simultaneous administration of D-chiro-inositol since the two stereoisomers compete with each other for the same transporter that has similar affinity for each of them. A decrease in myo-inositol absorption is also found when it is coadministered with inhibitors of sugar intestinal absorption and/or types of sugars such as sorbitol, maltodextrin, and sucralose. e combination of these may require higher amounts of myo-inositol in order to reach a therapeutic dosage compared to inositol administration alone, a particularly important fact when physicians strive to obtain a specific plasma level of the stereoisomer. Finally, we must point out that D-chiro-inositol was found to be an aromatase inhibitor which increases androgens and may have harmful consequences for women. erefore, the inositol supplements used in PCOS treatment must be carefully defined. Clinical evidence has demonstrated that the 40 : 1 ratio between myo-inositol and D-chiro-inositol is the optimal combination to restore ovulation in PCOS women. erefore, it is quite surprising to find that inositol-based treatments for PCOS seem to be randomly chosen and are often combined with useless or even counterproductive molecules, all of which can weaken myo-inositol's efficacy. Such treatments clearly lack therapeutic rationale.

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“…Зважаючи на дані попередньо проведених досліджень стосовно диференційованих функцій МІ і DХI в яєчнику, можна стверджувати, що зареєстроване в нашій роботі відновлення овуляторних циклів відбулося завдяки оптимальному співвідношенню цих форм інозитолу в застосовуваному комплексному препараті. Схожі результати були отримані закордонними колегами [29,30].…”

Section: результати дослідження та їх обговоренняunclassified

Optimization of ovarian function and metabolic status in syndrome of polycystic ovaries

Татарчук

Косей

Тутченко

et al. 2020

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Objective: to evaluate the effect of the Quinofolic complex (myo-inositol 500 mg, D-chiro-inositol 12.5 mg, methyltetrahydrofolate 250 mcg) on ovarian function, metabolic status and biochemical hyperandrogenism in women with classic phenotypic phenotype of polycystic ovary syndrome (PCOS) and insulin resistance.Materials and methods. An open comparative study was conducted in 60 women of early/active reproductive age diagnosed with PCOS (classic phenotypic form) and laboratory confirmed insulin resistance, divided into 2 groups: study group received recommendations for lifestyle modification in accordance with clinical guidelines 2018, as well as Quinofolic in a dose of 2 capsules per day; control group received similar recommendations for lifestyle modification and folic acid, similar to the one in Quinofolic for 6 months. End points of the study were: duration of intermenstrual intervals and ultrasonographic signs of ovulation; dynamics of HOMA index, waist/hip ratio, free testosterone index.Results. At the end of the third month of treatment statistically significant reduction of intermenstrual intervals was recorded in the study group: 45.6 ± 3.2 vs 68.9 ± 8.2 days before treatment. At the end of the sixth month of treatment, the average duration of intermenstrual intervals in the study group was 32.6 ± 2.8 days. Also, the average duration of intermenstrual intervals in the study group differed statistically significantly from the control group: 45.6 ± 3.2 vs 68.2 ± 5.6 days at the end of the 3rd month and 32.6 ± 2.8 vs 56.6 ± 4 8 days at the end of the sixth month. Average duration of intermenstrual intervals in the control group at the end of the third month did not show statistically significant dynamics. The dynamics of waist/hip ratio decrease in the study and control groups was comparable, but these changes were not statistically significant compares to values before the intervention in both groups. At the same time in the study group, a statistically significant decrease of HOMA index and free testosterone index were recorded synchronously with a decrease in waist/hip ratio. Despite the significant effect of lifestyle modification in individual participants in the control group, the average HOMA index and level of free testosterone index did not show statistically significant changes.Conclusions. Results of the study combined with data on the effectiveness of the combined use of inositol isomers myo-inositol/D-chiro-inositol ratio = 40:1 confirm the feasibility of their use to improve folliculogenesis, reduce hyperandrogenism and insulin resistance in women with PCOS.

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Metabolic and hormonal effects of a combined Myo-inositol and d-chiro-inositol therapy on patients with polycystic ovary syndrome (PCOS)

Cited by 30 publications

References 19 publications

Inositols and metabolic disorders: From farm to bedside

Inositols and metabolic disorders: From farm to bedside

Inositol Treatment for PCOS Should Be Science-Based and Not Arbitrary

Optimization of ovarian function and metabolic status in syndrome of polycystic ovaries

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