Inositol is one of the supplements I regularly recommend to patients; due it is effectiveness at helping the body utilize insulin.
What is Inositol?
Inositol is from the B vitamin family and has the molecular form of sugar, though the body does not metabolize it like sugar. For individuals familiar with Chinese medicine, Inositol would support spleen qi energy. Inositol is classified as a B vitamin, but the body can manufactured it from fruits and veggies. Researchers believe some individuals (especially PCOS cases) are deficient in inositol or are unable to manufactory it from food sources.
What does Inositol do?
Inositol helps the liver metabolize fat, reduces high blood sugar and enhances calming brain hormones.
Don’t have insulin resistance or PCOS but have experienced ovarian cyst formation?
Well you might have problems utilizing sugar and insulin in your body.
What are the signs?
There are several symptoms but I find two common signs – 1) drops in blood sugars before a meal. You could be experiencing mild hunger but not really hungry enough to eat. Yet 20 to 30 minutes later you are ravenous possibly accompanied by anger and irritability. The hunger will manifest as strong cravings for sugary foods and carbohydrates. 2) A bad case of the blahs, sleepiness/fatigue and foggy thinking after eating a meal. These symptoms indicate either a diet high in sugar, carbohydrates and processed food or your body system unable to metabolize sugar and insulin correctly. Of course diet modification is the biggest part in helping our bodies to function strongly, but Inositol with a meal will lessen these symptoms. Plus if you have anxiety or interrupted sleep patterns with the above signs, then inositol’s calming capacity could help.
Why are blood sugar levels important to fertility?
Insulin interacts with the ovary at the level of the follicle. Too much circulating insulin can encourage cyst formation, such as in severe presentations this would be PCOS. In lesser presentations, some women experience a monthly cyst or cyst formation with IUI/IVF cycles. Insulin encourages receptors on the follicle to be overly reactive to LH, this increasing the production of testesterone and fluid in the follicle to form a cyst.
In my experience women taking inositol and manage their diets have decreased cyst formation and improved drug cycles. Recently the following study was released indicating Inositol was effective at lowering cyst formation and improving egg quality in PCOS clients who completed an IUI cycle. The article continued to state that mouse and human studies found inositol in follicular fluid, which correlated with good egg quality. Even though there is no test for the deficiency of inositol, it could provide a solution for women experiencing cyst formation and subfertility. On top of this, staying calm and obtaining satisfying deep sleep could lessen some of the overwhelming emotions around conceiving.
Myo-insoitol may improve oocyte quality in intracytoplasmis sperm injection cycles. A prospective controlled randomized trial. By Enrico Papaleo, MD and et all. Fertility and Sterility Volume 91 Issue 5
A number of small randomized and nonrandomized cohort studies have shown that women with PCOS respond to D-chiro-inositol (DCI) therapy, increasing ovarian activity and menstrual frequency. In fact, an inositol phosphoglycan (IPG) molecule containing DCI is known to have a role in activating enzymes that control glucose metabolism, acting as postreceptor mediator or as a second messenger of insulin signal.
Myo-inositol (MI) and DCI are isoforms of inositol and belong to the vitamin B complex. Myo-inositol is widely distributed in nature, whereas DCI, the product of epimerization of C1 hydroxyl group of MI, is relatively rare.
In IVF techniques, it was demonstrated that supplementation with myo-inositol is positively related to meiotic progression of mouse germinal vesicle oocytes, enhancing intracellular Ca2+ oscillation. Indeed, in human follicular fluids, higher concentrations of MI provide a marker of good-quality oocytes.
The aim of the present study was to investigate the effects of myo-inositol on ovarian function in women with PCOS undergoing ovulation induction for intracytoplasmic sperm injection (ICSI), treated within a randomized placebo-controlled trial.
During the study period, 60 patients conforming to the inclusion criteria were randomized into two groups as described. Group A (myo-inositol plus folic acid) consisted of 30 patients and group B (folic acid alone) consisted of 30 control subjects.
Total r-FSH units and number of days of stimulation were significantly reduced in myo -inositol group. Furthermore, peak E2 levels at hCG administration were significantly lower in the myo-inositol–treated group.
The mean number of oocytes retrieved did not differ between the two groups, whereas in the myo-inositol group the number of immature oocytes and degenerated oocytes was significantly reduced.
Polycystic ovary syndrome is one of the most common endocrine disorders affecting women. A defect in insulin action has been suspected, possibly as a consequence of a deficiency of DCI, which is a component of inositol phosphoglycans.
Insulin-lowering medications, particularly different isoforms of inositol, represent novel therapies for restoring spontaneous ovulation, with a potential positive effect also on human oocyte meiotic maturation. These therapies appear to influence steroidogenesis directly, reducing the androgen production in theca cells. In fact, it was demonstrated that DCI administration increases the action of insulin in patients with PCOS, thereby improving ovulatory function and decreasing testesterone concentration.
However myo-inositol is an important constituent of follicular microenvironment, playing a determinant role in both nuclear and cytoplasmic oocyte development. In fact, in IVF techniques supplementation by myo-inositol is positively related to meiotic progression of mouse germinal vesicle oocytes, enhancing intracellular Ca2+ oscillation. Indeed, in human follicular fluids, higher concentrations of MI provide a marker of good-quality oocytes.
The present study is the first trial focusing on this molecule, belonging to the vitamin B complex, and its effects on patients with PCOS undergoing ovulation induction. The preliminary data show that in patients with PCOS the treatment with myo-inositol and folic acid, compared with folic acid alone, reduced germinal vesicles and degenerated oocytes at ovum pick-up without compromising total number of retrieved oocytes. These results are in line with other studies, suggesting the positive effect that myo-inositol plays on developmental competence of maturing oocytes.
In fact, in gonadotropin– plus myo-inositol–treated patients, a significant reduction in E2 levels at hGC administration was found, and as a consequence we suppose this approach could be adopted to decrease the risk of hyperstimulation in such patients.
In conclusion, these observations suggest that MI may prove useful in the treatment of PCOS patients undergoing ovulation induction, both for its insulin-lowering activity and its intracellular role in oocyte maturation.