Polycystic ovarian syndrome is comprised of multiple signs and symptoms. PCOS metabolic syndrome is treated with multiple approaches, including diet, lifestyle changes, and most of the time with medication. Nevertheless, as this condition affects the patient in a hormonal and metabolic manner, numerous molecular dysfunctions are involved and should be treated. Supplement support in PCOS has shown to be an essential therapeutic part of this condition.
The endocrine factors affecting patients with PCOS can increase the risk of endometrial cancer. Indeed, the presence of irregular menses, unopposed estrogen exposure, reduced levels of progesterone combined with obesity, insulin resistance, and diabetes. Therefore, PCOS treatment, support, and healing process have been taken into many directions: weight loss and nutritional interventions the most favorable in metabolic outcomes.
Endocrine and metabolic factors can be easily traced back to a low-grade inflammation state. In fact, most of the nutritional interventions are supported by the supplementation of Omega-3 fatty acids. Furthermore, the beneficial role in immune regulation, cellular differentiation, promotion of insulin sensitivity, and ovulation that omega-3 fatty acids exert has been reported.
Omega -3 fatty acids benefits.
|Inhibits the synthesis of COX-2.|
|Competes with arachidonic acid as a substrate.|
|Reduces cholesterol absorption and LDL-C synthesis.|
|Improves the liver’s LDL receptor activity (less circulating LDL levels).|
|Promotes insulin sensitivity and adiponectin levels.|
|Reduces triglyceride levels.|
The use of inositol, a 6-carbon polyol, as an insulin sensitizer, has been reported with multiple beneficial effects on glucose metabolisms. Myo-inositol and D-chiro-inositol are 2 of the 9 stereoisomers produced in the epimerization of inositol, called inositolphosphoglycan.
(IPG). Furthermore, IPG application has an important contribution to enhancing the physiological insulin-receptor activity, reducing glucose levels in serum. Also, the IPG combination has recently resulted in promoting ovulation.
MI and DCI benefits on PCOS.
|Reduction of serum insulin levels.|
|Decreases serum testosterone.|
|Promotes follicular maturation.|
|Improves hormonal profile, regulates menses.|
The research application of Vitamin D supplementation is growing outstandingly. The intervention with Vit D in PCOS and its role on metabolic risk factors have been broadly reported. However, vitamin D deficiency is common in patients suffering from PCOS and is tightly linked with insulin resistance. Vitamin D’s underlying action relies on its capacity to reduce pro-inflammatory cytokines, increasing insulin receptor activity on the cellular membrane.
It has been reported that vitamin D leads to estrogen and progesterone production in cultured human ovary and placenta cells. However, research studies have not been able to reproduce this last finding in human studies. Nevertheless, vitamin D supplementation has been shown to improve glucose oral tolerance after 60 min of glucose intake. Most researchers also conclude that vitamin D supplementation might work in a dose-dependent manner since better metabolic outcomes in HOMA-IR, TT, serum insulin, antioxidant capacity, higher levels of SHBG, and plasma glucose have been reported with a 4000IU supplementation.
Insulin resistance is part of the pathology of PCOS. Therefore its treatment and reduction are imperative to prevent the development of further complications like cardiovascular disease. However, the treatments to lower glucose levels, like metformin, are linked to bloating and other gastrointestinal complications. Furthermore, the intervention of various biologically available folate forms has been used to improve metabolic risk factors.
The actions favoring the supplementation of vitamin B6 on PCOS patients relies on its capacity to reduce homocysteine. Overall, this lowering of cysteine can reduce stroke incidence, promotes glucose homeostasis, reduces fasting insulin levels, and lowers cardiovascular disease risk factors.
PCOS can affect multiple states; an inflammatory state accompanied with high oxidative stress are commonly found in these patients. Therefore, antioxidant supporting agents are recommended to prevent further complications and increased PCOS signs and symptoms. The culprit of insulin resistance actions over oxidative stress is believed to be the main factor reducing antioxidant functions of SOD, catalase, and GPX. N-acyl-cysteine is a promoter of the main antioxidant enzymes and promotes normal mucosal levels.
Most of the reported effects in supplementation confirm that the combination of multiple vitamins or active compounds may work better for PCOS’s treatment. PCOS, being a condition that combines multiple signs and symptoms has to treated with multiple approaches like dietary and lifestyle modification. In fact, supplementation plays an essential role when it comes to dietary support. Multiple studies show how the reduction of weight is beneficial for patients with PCOS. The most common way to reduce weight is to follow a moderately reduced-calorie diet, this is associated to reduce intake of certain vitamins. Therefore, the high doses of vitamins and active compounds are difficult to attain, making supplementation essential to the patient’s healing process. – Ana Paola Rodríguez Arciniega. Master in Clinical Nutrition.
Metabolism and hormonal clearance are tricky to understand. In fact, multiple metabolism products equal multiple enzymes and nutritional compounds that can help in the proper synthesis of hormones.
Khani, Behnaz, Farahnaz Mardanian, and Sajadeh Jafari Fesharaki. “Omega-3 supplementation effects on polycystic ovary syndrome symptoms and metabolic syndrome.” Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 22 (2017).
Nordio, M., & Proietti, E. (2012). The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci, 16(5), 575-581.
Trummer, C., Schwetz, V., Kollmann, M., Wölfler, M., Münzker, J., Pieber, T. R., … & Lerchbaum, E. (2019). Effects of vitamin D supplementation on metabolic and endocrine parameters in PCOS: A randomized-controlled trial. European journal of nutrition, 58(5).
Lind, M. V., Lauritzen, L., Kristensen, M., Ross, A. B., & Eriksen, J. N. (2019). Effect of folate supplementation on insulin sensitivity and type 2 diabetes: a meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition, 109(1), 29-42.
Panti, Abubakar A., et al. “Oxidative stress and outcome of antioxidant supplementation in patients with polycystic ovarian syndrome (PCOS).” Int J Reprod Contracept Obstet Gynecol 7 (2018): 1667-72.
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