The best supplements for PCOS: vitamins and more
Vitamins and Minerals are micronutrients, or nutrients required by the body in very small amounts for normal function. Recent research is showing that many women with PCOS are deficient in essential vitamins and minerals which can cause, or worsen, the effects of PCOS. It has been shown that increasing dietary intake of certain vitamins and minerals can improve many symptoms of PCOS, such as testosterone levels, insulin resistance, fertility, and hair growth. The root cause of PCOS is linked to a combination of chronic inflammation and insulin resistance. Vitamins and minerals are heavily involved in allowing the body to reduce stress and inflammation, as well as normal and healthy insulin signalling. By restoring normal vitamin and mineral levels through supplementation, it is hoped that we can reduce the severity of PCOS and improve the symptoms. The most commonly suggested supplements for PCOS are multi-vitamins, myo-inositol, NAC, and melatonin.
In this article we have gathered together all the available information on vitamins and minerals for PCOS in one place. This one-stop guide will tell you everything you need to know about each micronutrient for PCOS, and tell you how you can start incorporating these into your diet. As always, check with your doctor before starting a new supplement regime to treat PCOS.
Contents
Vitamin A
Vitamin A, commonly referred to as Retinol, is converted in the body into many derivatives, such as retinoids and retinoic acid. Vitamin A and its derivatives are heavily involved in antioxidant activity, steroid metabolism and egg maturation [source]. It has been shown that for women with PCOS, certain cells in the ovaries activate genes related to retinoic acid production differently from healthy women [source]. Additionally, high levels of a protein that removes retinoic acid have been linked to obesity and reduced insulin signalling in women with PCOS [source], which may lead to altered hormone production in the brain and ovaries [source]. Vitamin A is commonly found as part of multivitamin pills and can be taken as a daily dietary supplement.
Vitamin B
Vitamin B is a very large family of vitamins, but 4 in particular have been identified as being important for PCOS: B6, B12, Folic Acid and Inositol. Inositol is so important that it is discussed separately below. Vitamin B6, B12 and Folic Acid have all been studied because of their ability to regulate levels of an amino acid called homocysteine [source]. Homocysteine is closely related to cardiovascular and reproductive symptoms of PCOS [source], and high levels have been linked to insulin resistance [source]. An important study has shown that in PCOS, low levels of vitamin B12 have been linked to insulin resistance, obesity and high homocysteine levels. This study showed that supplementation with folic acid for 3 months was enough to effectively reduce homocysteine levels and improve PCOS symptoms. This effect was particularly strong in women with PCOS who did not have insulin resistance! [source].
Several studies have looked at the B group of vitamins for PCOS and have shown that they can be effective for managing the long term risks of PCOS, in particular the cardiovascular risks [source]. Vitamin B complexes can easily be supplemented on their own or as part of a daily multivitamin pill.
Inositol
Inositol is another vitamin in the B family. Two types of Inositol are found within the body: myo-inositol and d-chiro-inositol. Inositol is involved in many processes in the body but most noticeably it is heavily involved in insulin activity and in ovary activity. Many studies have shown that supplementation with myo-inositol causes a significant improvement in PCOS, in particular the menstrual cycle and fertility, due to decreased insulin and testosterone levels. [source]. Myo-inositol is considered completely safe with no side effects at the standard doses. Myo-inositol is commonly found in powder form together with folic acid and is recommended for everyone with PCOS to trial for at least 6 months due to its strong benefits and low cost.
To learn more about inositol, check out: Inositol for PCOS: the complete guide.
Vitamin C
Vitamin C, also called ascorbic acid, is a micronutrient used by cells and tissues for healthy growth. Constant dietary intake of vitamin C is required as it is constantly excreted in urine. Vitamin C removes free radicals, making it a powerful antioxidant. Researchers have shown that vitamin C levels go up and down as part of the normal menstrual cycle, and have proven that vitamin C is essential for regulating the menstrual cycle and normal ovary function. [source].
It is thought that vitamin c is absorbed by the ovaries before ovulation to stimulate hormone production and collagen creation which is required for growth and repair during and after ovulation. Researchers believe that low levels of vitamin C may lead to the development of ovarian cysts seen in PCOS, but almost no research has been done to assess if vitamin C can be used to treat PCOS [source]. Sufficient vitamin C should be part of a balanced diet but it can easily be supplemented on its own or as part of a multivitamin pill.
Vitamin D
Vitamin D is essential for many functions in the body, including skeleton health, serotonin production, calcium regulation and more. Recently, studies have shown that vitamin D levels may be closely linked to insulin resistance, and that vitamin D levels are much lower in women with PCOS, compared to their healthy counterparts [source]. Studies have looked at the effect of vitamin D supplementation on PCOS and found that daily supplementation has positive effects on insulin resistance and cholesterol levels, as well as menstruation frequency [source]. It is thought that vitamin D helps to reduce inflammation and allow healthy follicle maturation, but the exact mechanism of this is not known yet! Vitamin D can be supplemented on its own (as a pill or serum) or as part of a multivitamin pill.
Vitamin E
Vitamin E is heavily involved in regulating antioxidants and reducing inflammation. Recently, studies have shown that vitamin E can improve fertility and uterus health in infertile women [source], and that in PCOS it may be beneficial for improving insulin resistance and testosterone levels [source]. Much more research is required before vitamin E can really be recommended for PCOS. Vitamin E is found in most daily multivitamin pills.
Vitamin-like nutrients
A few nutrients that are similar to vitamins but not classed in any of the vitamin families have been found to be very beneficial for PCOS. In particular, alpha-Lipoic Acid (aLA), flavonoids, and carnitine have all been shown to significantly improve insulin resistance, menstrual regulation, and healthy ovulation [source]. All 3 can be found as supplements, usually in pill or capsule form.
Calcium
Calcium is heavily involved in many processes in the body, in particular it is essential to egg maturation and follicle development as part of healthy ovulation. Insulin signalling, an essential component of PCOS, is dependent on calcium levels and calcium deficiency has been suggested to be associated with insulin resistance in PCOS. In fact, low levels of calcium are present in most women with PCOS and it has been shown that some calcium related genes are mutated in women with PCOS, which leads to higher testosterone and insulin resistance [source]. Supplementation with calcium has been shown to reduce body mass, improve menstruation, follicle maturation and pregnancy rates [source].
Magnesium
Magnesium supplementation has not been proven to have any positive effects for PCOS and magnesium levels are not currently linked to PCOS in any way [source].
Chromium
Some studies have shown that supplementation with chromium may be effective at reducing testosterone levels and improving menstrual regulation [source]. Some research has shown that chromium supplementation can help insulin resistance [source] but other studies have shown that it has no effects [source]. Much more research is needed to show if chromium is actually beneficial for PCOS.
Selenium
Selenium is used by the body to reduce oxidative stress and is involved in embryo development and healthy reproductive tissue function [source]. Researchers have found the selenium levels are abnormally low in women with PCOS [source] which may lead to accumulation of free radicals, which can cause increased testosterone levels. Studies have shown that selenium supplementation can improve insulin sensitivity as well as possibly improving fertility and the success of in vitro fertilisation (IVF). Selenium can be taken on its own as a pill or as part of a daily multivitamin pill.
Zinc
Zinc is essential throughout the body as it is used by many enzymes, hormones and receptors to function properly. In fact, zinc is extremely important for healthy insulin signalling, and zinc deficiency has been closely related to glucose intolerance, diabetes, and obesity [source]. Studies have shown that women with PCOS have abnormally low zinc levels [source] and that this may strongly affect insulin resistance as zinc is required for insulin to pass its signals into cells properly [source]. Research suggests that zinc supplementation may be beneficial for PCOS insulin resistance, and several studies have shown positive effects for type II diabetes, which can be very similar to PCOS in its treatment [source]. Zinc can be taken on its own in pill form or is found as part of a daily multivitamin pill.
Melatonin
Melatonin is closely related to the way our bodies control the day/night cycle but it is also found in very high levels in the fluid of newly developing eggs during ovulation. Melatonin has a very beneficial effect on ovulation due to its very strong anti-free radical properties [source]. Research has shown that supplementing with melatonin may help to support egg development and improve pregnancy rates [source]. It is known that follicle melatonin levels are lower than normal in women with PCOS. Melatonin can be taken in pill or capsule form and is also beneficial for improved sleep (which can help PCOS too!).
NAC
NAC, more properly called N-acetyl-L-cysteine, is a modified amino acid that is produced by the body. Research has shown that NAC supplements can significantly improve egg quality [source] as well as the production and sensitivity of insulin [source]. NAC has been proven to reduce testosterone and improve insulin sensitivity in both obese and lean women with PCOS [source], making it a useful supplement. In fact, NAC has been shown to have effects comparable to metformin for reducing body weight, reducing testosterone, improving insulin sensitivity, restoring menstruation and reducing unwanted hair growth [source]. NAC can be easily taken daily as a capsule or powder stirred into water. Current research suggests that taking 1500mg of NAC, spread over 2 or 3 doses per day has strong benefits.
For more information on Metformin, check out: PCOS and Metformin: everything you need to know.
Omega 3
Omega 3 is closely linked to the body's ability to reduce oxidative stress due to its anti-inflammatory properties. Whilst Omega 3 is linked to many general health benefits it has been studied many times in relation to PCOS and no link has been found between the two [source]. Regardless, many doctors and scientists recommend Omega 3 supplementation for general health and it is cheaply available as either capsules or liquid oil.
Probiotics
Probiotics are living microbial dietary supplements, often found in live dairy products like yoghurt. Probiotics help to improve the gut microbiome [source]. Recent studies have shown that probiotic supplementation is linked to improved glucose levels and antioxidant levels in diabetic patients [source]. Other researchers have shown that similar benefits for blood sugar levels and insulin levels may be seen for women with PCOS [source]. Chronic inflammation and insulin resistance are closely related to imbalances in the gut microbiome which has been shown to effect PCOS associated pathways, and as these two factors are at the core of PCOS some researchers are recommending probiotic supplements for women with PCOS [source]. Probiotic supplements are widely available in capsule form.
Which supplement should I take for PCOS?
There’s so much information around about supplements for PCOS, and much of it is conflicting or contradictory. One common theme that you will have seen above is that most women with PCOS are deficient in many of the essential vitamins and minerals discussed. For that reason, a daily multivitamin pill is a very cheap, safe, and easy way to try and increase your daily intake and restore healthy levels. Just double check the label on the multivitamin to make sure it includes all the vitamins and minerals discussed above.
To take this to the next level, you could ask your doctor for a blood test to check for nutrient deficiencies, and specifically supplement with higher levels of vitamins and minerals that are a problem for you.
On top of a daily multivitamin, daily supplementation with myo-inositol should be a standard for all women with PCOS due to its very convincing scientific evidence, low cost, and zero-risk. You may also want to consider additional daily supplementation with NAC and Melatonin as both of these are backed by quite convincing research showing benefits for women with PCOS.
For more information on Inositol, check out: Inositol for PCOS: the complete guide.
Other supplements, like probiotics, are beginning to show some promise but much more research is needed before they can really be recommended for PCOS. However, they may still be beneficial for other factors outside of PCOS, so go ahead and consider them as part of your regular dietary supplement routine if you find them interesting.
Finally, as with all PCOS treatments, it’s absolutely essential to remember that there is no magic pill for PCOS. The best way to treat PCOS is to combine lots of little benefits from different aspects of your life. Vitamin and mineral supplements may be beneficial, but they will be most beneficial when combined with a healthy diet, regular exercise, and other PCOS management techniques.
Always remember that dietary supplements cannot replace the benefits of a healthy, balanced diet that provides macronutrients and micronutrients that your body needs, so make sure that your diet is up to scratch before adding in daily supplementation.
For more information on diet for PCOS, check out: The best diets for PCOS.
