Pinitol, D-Chiro-Inositol & Inositol
Three natural substances have recently made a name for themselves in the PCOS community: pinitol, d-chiro-inositol & inositol.
Their use has been linked to lowered cholesterol, moderate weight loss and increased ovulation in women with PCOS, which in turn aids in the increased chance for becoming pregnant. In fact, it is believed that a deficiency in d-chiro-inositol is partially to blame for the insulin resistance in women with PCOS. So, if this deficiency can be addressed, the condition itself could be addressed as well.
Travis Johnson, with an MA in Biochemistry and VP of Chiral Balance LLC, a company devoted to providing unbiased information and access to purchasing various amounts of d-chiro-inositol supplements, said recently, "If you can address the insulin resistance ... then you can address all of the symptoms of the syndrome not least of which is compromised fertility. In my opinion, there is a small but incontrovertible body of evidence that women with PCOS have some defect in inositol metabolism such that they don't make DCI (d-chiro-inositol)." (5)
The term "inositol" is associated with a family of related substances known as B-vitamins. Pinitol and d-chiro-inositol are within this family and are similar in chemical structure and biochemical action. Myo-inositol is also a member of this family of B-vitamins and is often referred to as simply inositol. Myo-inositol can be found in many human tissues as well as various foods, including fruits, beans, grains, and nuts. (6)
Pinitol can be purchased as a supplement, but it also exists in some foods such as legumes and citrus fruits. An inositol supplement is also available and in one study its use has been linked to a 23% increase in ovulation. (2) This effect has also been documented in women taking supplements of d-chiro-inositol with a noted increase in ovulation of 86%. (1)
It is important to understand that pinitol can be made into d-chiro-inositol within the body - pinitol converts to myo-inositol, which then converts to d-chiro-inositol. "DCI, for most people, can be made from pinitol or even sugar, but it has to pass through myo-inositol along the way and therein lies the problem," according to Travis Johnson. (5)
Pinitol, inositol and d-chiro-inositol are all available for purchase as supplements. Pinitol is the most expensive, followed by d-chiro-inositol and inositol but all three supplements can be beneficial. Some women may benefit from a supplement of pinitol, which could then aid in the conversion ultimately to d-chiro-inositol.
The same can be said for an inositol supplement. For those women who are unable to make the conversion, a d-chiro-inositol supplement may be the best course of action.
The New England Journal of Medicine completed a study regarding the ovulatory and metabolic effects of d-chiro-inositol on PCOS and concluded that the substance increased the action of insulin in women with PCOS, which improved the ovulatory function and decreased blood pressure, androgen and plasma triglyceride concentrations. (4)
Additionally, pinitol appears to be converted, at least in part, to d-chiro-inositol in the body as evidenced by "a 14-fold increase in the levels of d-chiro-inositol after administration of pinitol to diabetic patients." (1) So, a pinitol supplement may also be beneficial for women with PCOS.
It has been said that women with PCOS are incapable of making the conversion necessary for the effectiveness of these substances. This statement is not entirely true. While some women with PCOS lack the natural capacity to convert pinitol or myo-inositol into d-chiro-inositol, there is evidence that "women with PCOS can still utilize DCI, they just have to have a source other than their own body," explains Johnson. (5)
With all of the emerging research and studies on the effectiveness of these natural supplements, the possible benefits certainly make taking one of these supplements worth the effort.
(4) Nestler, J.E., Jakubowicz, D.J., Reamer, P., et al. Ovulatory and Metabolic Effects of d-Chiro-Inositol in the Polycystic Ovary Syndrome. New England Journal of Medicine
340(17), 1999, pages 1314-1320