I’m a supplement junkie. If you refer to my ttc cv, you can see that I tried for over a year, long before we even started trying to have a baby, to regulate my cycles naturally. I’ve tried everything that I am aware of that is advocated for as a natural solution to PCOS. I’ve tried all of the following, alone and in combination, including both high intensity and low intensity and somewhere in-between exercise, herbal tinctures, supplements, acupuncture, Chinese herbs, a low Glycemic Index diet, a stricter diet from the PCOS diet e-book, and bioidentical hormones.
As I have discussed before, prior to starting Metformin, none of these worked. In fact, I believe they may have exacerbated the problem. However, I have a strong sense of distrust for Western medicine, so I can’t help but combine some natural remedies while moving forward with more intense infertility treatments. As a result, I continue to do stick to a low GI diet, exercise regularly, do acupuncture, and take a whole slew of supplements.
I’ve found it frustrating and confusing to track down an appropriate list of supplements for someone with PCOS. In an attempt to help others, I wanted to provide the supplements I take linked to the research that convinced me it was an important supplement to include in my regimen.
In order to ensure I am taking my supplements, I purchased a pill container. It appears as if I have a terminal illness. I do not. Just PCOS.
Caveat: I am not an Eastern or Western medical practitioner, nor do I have a degree in pharmacology. The information provided below is simply a review of medical literature, and is not to be construed as medical advice. Thanks!
N-Acetyl-Cysteine (NAC): NAC is an antioxidant that is most commonly used as an antidote to acetaminophen overdose and as a anti-mucolytic for the treatment of chronic bronchitis. Since 2002, medical research has explored the efficacy in treating PCOS with NAC. The earliest study that I’ve found explores NAC’s ability to increase insulin sensitivity in women with PCOS (Fulghesu et al, 2002). The trial found that NAC has a statistically significant effect in increasing insulin sensitivity and decreasing androgens. The study used women with varying BMI’s including overweight women and women with a BMI within the normal range.
It appears as if the aforementioned article was the starting point for a slew of additional articles exploring the efficacy of NAC in treating PCOS and inducing ovulation in women with PCOS. Studies found that NAC assists in inducing ovulation in clomid-resistant women with PCOS (Rizk et al, 2005), as well as PCOS women not previously diagnosed as clomid-resistant (Badawy et al, 2010). Research also reveals that NAC is just as effective as Metformin in reducing androgens, BMI, and hirsutism, in addition to having a positive effect on menstrual irregularity and fasting insulin levels (Oner & Muderris, 2011).
Additionally, NAC has been found to reduce oxidative stress which results in inflammation and increases the risk of miscarriage (Amin et al, 2008). Researchers hypothesize that women with PCOS have an increased level of oxidative stress (Zhang et al, 2008). They also have determined that the oxidative stress is the reason why women with PCOS are at increased risk for cardiovascular disease (Sabuncu et al, 2001).
This is just a small summary of the literature regarding NAC and PCOS. While most of the literature I’ve reviewed shows a positive and statistically significant effect, not all studies reported significant results ( e.g. Elnashar et al, 2005). Most of the research utilized a dose of 1200 to 1800 mg/day. I’m currently taking 1200 mg a day. I’ve never had an RE suggest supplementation with NAC.
Personally, I think NAC is a miracle supplement for women with PCOS. NAC is found to be as effective as metformin in some trials, but it does not come with the nasty, pernicious side effects. I find it really interesting that NAC is a known anti-mucolytic and PCOS, as an Eastern diagnosis, is phlegm-damp, which results in excessive mucus.
Vitamin D: If any of you tuned in to the Fertility Focus Telesummit, you probably heard many of the speakers discuss the value of Vitamin D in regards to infertility treatments. Warning: One speaker was incredibly insensitive in suggesting that couples on the verge of IVF simply take a holiday to absorb some sun. You know, just relax.
Studies reveal that Vitamin D is involved in the production of sex hormones, assisting in the fertility of both men and women (Lerchbaum & Obermayer-Pietsch, 2012). In regards to PCOS, research reveals that a Vitamin D deficiency is negatively related to insulin resistance and glucose intolerance in Type II diabetics (Song and Manson, 2010). As we all know, PCOS is related to insulin resistance. Further, PCOS women are at increased risk for Vitamin D deficiency, resulting in increased risk of metabolic disorders (Raymond et al, 2011 & Wehr et al, 2009). Research does not provide as strong of an effect as NAC, but still provides evidence that Vitamin D is effective in improving insulin sensitivity and menstrual regularity(Selimoglu H. et al, 2010, & Wehr E. et al, 2011).
I tested borderline deficient when I first started trying to conceive. My naturopathic doctor suggested the test; my RE’s have never mentioned Vitamin D testing, but are on board with supplementation. I currently supplement with 2000 IUs daily, but started off with 4000 IUs daily for four months. I plan on retesting my levels in the next month to check the dosage.
L-Arginine: L-Arginine is an amino acid best know for its vasodilatory properties. LAG also produces Nitric Oxide (NO), which is thought to reduce inflammation due to free radicals and assist in the regulation of ovulation, including follicular development, and implantation (Westphal et al, 2004). Supplementation with LAG was found to increase blood flow to the organs, in addition to aiding the response to gonadotrophin in poor responder women (Battaglia et al, 1999). LAG in combination with NAC has been found to increase the amount of Nitric Oxide, which decreases the number of free radicals, typical in women with PCOS. Combined supplementation of NAC and LAG was found to increase insulin sensitivity and menstrual regularity in women with PCOS (Masha et al, 2009).
Returning to the Eastern diagnosis of phlegm-damp, circulation to the reproductive organs is not optimal due to excess production of mucus. Supplements and acupuncture, as well as castor oil packs, are helpful in increasing blood flow to the uterus and ovaries, reducing inflammation, and assisting in ovulation.
I currently supplement with 1000 mg/day. The research I’ve read utilized 1200 mg/day. I’ve never had a Western practitioner suggest LAG supplemenation.
Wow! What a slog. I’m not even done. I had originally planned to place this information in one blog post, but clearly it would be too much. As a result, I hope to include two more blog posts with additional supplements including inositol, CoQ10, EFA, Maca and more. I will also create a tab at the top, titled Supplements, so others can easily access the information.