Nutrient Support for PCOS

A systematic review and network analysis was recently published in PeerJ, evaluating the randomized clinical trials of various nutritional therapies for women with polycystic ovarian syndrome (PCOS). A total of 41 studies and over 2300 patients were included in the review, with network analysis providing a comparison of the impact of 8 therapies on specific outcomes related to endocrine function and glucolipid metabolism, such as BMI and fasting plasma glucose. The nutritional supplements reviewed and compared included selenium, chromium, carnitine, inositol, CoQ10, omega-3 fatty acids, probiotics, and vitamin D.

Overall, carnitine supplementation was associated with the largest reduction in weight and BMI, though inositol and probiotics both performed better than placebo. Omega-3 fatty acids were found to be the most effective for reducing fasting glucose levels; probiotics and CoQ10 were also more effective than placebo. Chromium had the largest effect on fasting insulin levels as well as insulin sensitivity per HOMA-IR, though selenium was associated with the largest improvement in the QUICKI measure of insulin sensitivity. Regarding serum lipids, CoQ10 appeared to be the most effective for women with PCOS, significantly lowering triglycerides, and both total and LDL cholesterol. Chromium and probiotics also lowered triglycerides, while chromium and vitamin D lowered total cholesterol. No significant differences between any supplements and placebo were observed for HDL-C, sex hormone binding globulin, total testosterone, or C-reactive protein.

This review noted a number of limitations, such as inconsistent dosing or duration between studies, as well as an imbalance in the number of studies included. For example, 12 studies utilized vitamin D, whereas only one study related to carnitine and inositol was included. Nonetheless, this may help to provide some guidance, and perhaps lead to more targeted approaches for women with PCOS.