Nutrients And Herbal Interventions

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Several herbal and nutrient interventions are recommended because of the complexity of this condition. Some therapies can improve ovulation and insulin sensitivity and reduce hyper-androgenism. (See Table 29-1 below.)

Table 29-1. Nutrient and Herbal Interventions for Polycystic Ovary Syndrome



Research strongly supports these interventions Vitamin C

Chromium picolinate



Some research supports these interventions

Stinging nettle (Urtica dioica)


Momordica (bitter melon; Momordica charantia) a-lipoic acid

Clinical or historical use supports these interventions

Soy (Glycine spp.) protein extract

Gymnema (Gymnema sylvestre)

Essential fatty acids

Saw palmetto (Serenoa repens)

400-2,000 mg per day 400 mcg per day 600 mg per day 1.2 g per day

300-900 mg per day 25-50 mg per day 900-1,800 mg per day 600 mg per day

20- 40 g per day 400 mg per day 1-3 g per day 320 mg per day


Chromium is a trace element commonly used for blood-sugar balancing. Chromium in the trivalent form is found in many foods such as whole-grain products, egg yolks, coffee, nuts, brewer's yeast, meat, green beans, and broccoli. Chromium deficiency often presents with impaired glucose, insulin, and lipid metabolism. Research has demonstrated that chromium supplementation reduces glucose intolerance and relieves symptoms of type 1 and type 2 diabetes, as well as those of gestational diabetes.47 The proposed mechanism of action for the insulin response to chromium is focused on the insulin receptor. Chromium activates the insulin receptor tyrosine kinase and inhibits the insulin receptor phosphotyrosine phosphatase enzyme. This causes increased phosphorylation of the insulin receptor and increased insulin sensitivity and may facilitate glucose transport into cells.48 In addition, chromium may augment insulin binding, insulin receptor number, and beta-cell sensitivity.49 A study performed on women with PCOS showed that chromium supplementation improved glucose tolerance in this population.50

Vitamin C

Vitamin C has multiple functions including antioxidant and collagen-stimulating properties. A study performed on anovulatory women for whom clomiphene failed showed that oral supplementation with vitamin C (400 mg per day) increased ovulation both with and without clomiphene citrate.51 In addition, a study indicated that vitamin C supplementation for infertile women with luteal-phase defects may increase progesterone levels.52 Vitamin C has also been shown to improve endothelial-dependent vasodilation, which has been shown to be abnormal in women with PCOS.53


N-acetyl-cysteine (NAC) is a derivative of the amino acid L-cysteine. NAC is the precursor to glutathione and is commonly used for its antioxidant, anti-inflammatory, and mucolytic actions. A study performed on women with PCOS whose conditions are resistant to clomiphene showed that NAC supplementation of 1.2 g per day plus clomiphene significantly increased ovulation and pregnancy rates.54


Zinc is an essential trace mineral and is a required cofactor for numerous biochemical reactions. Zinc has been shown to affect glucose transport and insulin levels. Evidence suggests that zinc supplementation can improve glucose tolerance and increase insulin-induced glucose transport into cells.55 In addition, some research indicates that zinc may be deficient in individuals with type 2 diabetes.56

Alpha-Lipoic Acid

Alpha-lipoic acid (ALA) is a coenzyme used in carbohydrate metabolism and adenosine triphosphate (ATP) production, and is a potent free-radical scavenger. ALA has been shown to improve insulin sensitivity, and several studies on patients with type 2 diabetes have demonstrated that ALA supplementation increases metabolic clearance of glucose by as much as 50%.57

ALA supplementation can also increase glucose uptake into skeletal muscle by 40%-300%.58 Research has demonstrated that ALA stimulates adenosine monophosphate-activated protein kinase in skeletal muscle, which causes a decrease in triglyceride accumulation. Studies have suggested that triglyceride accumulation in skeletal muscle contributes to insulin resistance.59

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