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SupplementModerate evidenceImmunity

Myo-inositol

Sugar alcohol with RCT signal for PCOS, comparable to metformin for ovulation restoration and metabolic markers.

Why

Myo-inositol is a sugar alcohol that functions as a second messenger in insulin and FSH signalling. Multiple RCTs in polycystic ovary syndrome (PCOS) report improvements in menstrual regularity, ovulation rate, hyperandrogenism markers, and insulin resistance, effects comparable to metformin in head-to-head trials. The 40:1 myo-inositol to D-chiro-inositol ratio (physiological ratio) is the most-studied formulation.

How it works

Component of inositol phosphoglycan second messengers that mediate insulin action at the post-receptor level. In ovarian theca cells, supports FSH signalling and oestrogen synthesis. In skeletal muscle, supports GLUT4 translocation. Restores the disrupted myo:D-chiro inositol balance documented in PCOS.

Expected onset · Cycle regularity changes over 3–6 months; metabolic markers over 8–12 weeks

How to take

Dosage

PCOS: 2 g twice daily (4 g/day total), often in a 40:1 myo:D-chiro-inositol ratio. Trials run 3–6 months.

Timing

Twice daily with food

On the label

'Myo-inositol' with stated milligrams, or '40:1 myo-inositol : D-chiro-inositol' for the physiological-ratio formulation. Avoid pure D-chiro-inositol products (different effect, not equivalent).

Ideal for

Women with PCOS, menstrual irregularity, hirsutism, fertility complaints; women undergoing IVF with PCOS phenotype.

Safety

Generally very well tolerated. Mild GI upset (nausea, flatulence) at high doses. Pregnancy: small RCTs in gestational diabetes prevention; otherwise data limited. Coordinate with the prescribing clinician. No significant drug interactions documented at supplement doses.

Evidence

At a glance

Unfer 2017 Endocr Connect meta-analysis (9 RCTs): myo-inositol improved insulin sensitivity, ovulation rate and total testosterone in PCOS vs placebo, with effects comparable to metformin in head-to-head trials. Costantino 2009 RCT: 4 g/day improved menstrual regularity and insulin sensitivity over 12 weeks. Strong direction of effect with very favourable tolerability profile.

Where to get it

Shop Myo-inositol on Amazon

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