Do I Need to Take Supplements for PCOS?

Although supplements will not replace a nutrient-dense diet, for people with PCOS certain supplements may help with symptom management and to help replace low levels of certain nutrients.

PCOS is a common endocrine (hormonal) disorder which affects 1 in 10 people in the UK (1). The symptoms of PCOS include oily skin, acne, excessive hair growth, male pattern hair loss, lack of/irregular periods and trouble getting pregnant although symptoms vary from person to person so everyone’s PCOS can look different (2).

Common Supplements Used in PCOS

Everyone in the UK should be taking Vitamin D from October to March due to the lack of sunlight during the winter months. But people with PCOS have an increased risk of vitamin D deficiency which may be linked to some of the metabolic effects of PCOS (3). Vitamin D plays an important role in reproduction including ovarian follicular development and can help improve insulin resistance, hyperandrogenism and lipid metabolism in people with PCOS (4). Therefore, it may be beneficial to take a 10mg vitamin D supplement year-round for people with PCOS. 

If you are on metformin, a common drug used to help manage insulin resistance in people with PCOS, you may need to supplement with Vitamin B12. This is because metformin may cause alterations of the B12 intrinsic factor complex in the ileum, resulting in a B12 deficiency (5). If you are on a plant-based diet and are taking metformin then speak to your doctor about B12 supplementation as it may be even more necessary. It is useful to aim for a blood test to see if you are deficient in B12 annually.

Omega-3 has been seen to be beneficial for PCOS, especially in relation to the chronic inflammation associated with PCOS (6). Omega-3 has been seen to improve triglycerides, maintain cardiovascular health and reduce androgens in people with PCOS (7). If you are having a couple of portions of oily fish in your diet every week then you should be getting enough omega-3 in your diet but for those on a plant-based diet or if you know you aren’t consuming enough omega-3 then supplementing omega-3 may be beneficial.

Another popular supplement for PCOS is inositol, a vitamin-like substance found in food and produced in the body. Inositol has been seen in people with PCOS to have benefits in regards to regulating testosterone production, lowering high blood pressure and blood lipid levels, improving egg quality and chances of conception (8). Studies suggest that the 40:1 ratio of myo- to d-chiro-inositol is the most beneficial as it most closely resembles the ratio in the body, but it is important to note that more research is required on inositol supplementation (9).

If you are trying to conceive then folic acid is key to your future babies’ health but folic acid is also linked to higher conception rates, increased chance of ovulation, higher quality oocytes and a shorter conception period (10). The NHS recommends taking 400mcg of folic acid before conception and up to 12 weeks gestation (11). Some people may need a higher dose, depending on their health, medical history and circumstances, so always discuss this with a fertility dietitian or doctor for personalised advice.

Before taking any supplements, remember to speak to your doctor, healthcare team, a Registered Dietitian or a Registered Nutritionist to ensure there are no counter-indications with other medications.

For other supplements you may want to consider if you have PCOS, check out the blog posts on NAC, melatonin, magnesium, zinc and chromium picolinate.

References

1. BDA, 2016. Polycystic Ovary Syndrome – the fundamentals[online]. Available from: https://www.bda.uk.com/resource/polycystic-ovary-syndrome-the-fundamentals.html

2. NHS, 2019. Symptoms Polycystic ovary syndrome[online]. Available from: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/

3. Krul-Poel, Y., Koenders, P., Steegers-Theunissen, R., ten Boekel, E., Wee, M., Louwers, Y., Lips, P., Laven, J. and Simsek, S., 2018. Vitamin D and metabolic disturbances in polycystic ovary syndrome (PCOS): A cross-sectional study. PLOS ONE, 13(12), p.e0204748.

4. Miao, C., Fang, X., Chen, Y. and Zhang, Q., 2020. Effect of vitamin D supplementation on polycystic ovary syndrome: A meta‑analysis. Experimental and Therapeutic Medicine,.

5. Aroda VR, Edelstein SL, Goldberg RB, Knowler WC, Marcovina SM, Orchard TJ, Bray GA, Schade DS, Temprosa MG, White NH, Crandall JP; Diabetes Prevention Program Research Group. Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab. 2016 Apr;101(4):1754-61.

6. Mohammadi E. Effects of omega-3 fatty acids supplementation on serum adiponectin levels and some metabolic risk factors in women with polycystic ovary syndrome. Asia Pac J Clin Nutr. 2012;21(4):511-8

7. Nadjarzadeh A. The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial. Iran J Reprod Med. 2013 Aug;11(8):665-72.

8. Kalra, B., Kalra, S., & Sharma, J. B. (2016). The inositols and polycystic ovary syndrome. Indian journal of endocrinology and metabolism, 20(5), 720–724. doi:10.4103/2230-8210.189231

9. Sortino, M. A., Salomone, S., Carruba, M. O., & Drago, F. (2017). Polycystic Ovary Syndrome: Insights into the Therapeutic Approach with Inositols. Fron- tiers in pharmacology, 8, 341. doi:10.3389/fphar.2017.00341

10. Gaskins AJ, Afeiche MC, Wright DL, et al. Dietary folate and reproductive success among women undergoing assisted reproduction. Obstet Gynecol. 2014;124(4):801-809.

11. NHS, 2019. Folic acid[online]. Available from: https://www.nhs.uk/medicines/folic-acid/