Diet and lifestyle make a huge difference in treating the root cause of PCOS. However, we also use targeted supplementation with our PCOS members
based on their clinical history and individualized labs.
In this article, we’ll review the best supplements for PCOS, how they help treat hormonal imbalance, and which dosage to consider for best results.
Inositol is one of the best supplements for PCOS
due to its benefits in controlling blood sugar.
Up to 70 percent of women with PCOS have some degree of insulin resistance (1
This occurs when your cells become resistant to insulin, a hormone responsible for controlling blood sugar levels. Fortunately, inositol may lower high insulin levels and improve blood sugar control in women with PCOS (2
). Read more about PCOS and insulin resistance.
By improving insulin resistance with inositol, you may experience more regular ovulatory cycles and improved fertility. In fact, one study found that myo-inositol was more effective in restoring ovulation than metformin, a drug commonly used to treat insulin resistance in PCOS (3
). Another smaller study found that taking myo-inositol reduced testosterone levels and symptoms of hirsutism (excessive hair growth) in women with PCOS (4
Dosing of Inositol
The two main types of inositol effective for PCOS are called myo-inositol and D-chiro-inositol. We recommend taking a 40:1 combination of myo- and D-chiro-inositol to mimic the ratio of these molecules naturally found in the body (5
). Typical doses of myo-inositol in this ratio range from 2 – 4 grams per day.
N-Acetyl Cysteine (NAC)
NAC is a powerful antioxidant that reduces inflammation and oxidative stress in the body. Oxidative stress occurs when you have too many free radicals and/or too little antioxidants. Women with PCOS tend to have higher levels of inflammation and oxidative stress, which is why NAC may be one of the best supplements for this condition.
Other benefits of NAC include:
- Lowering testosterone levels (7).
- Improving insulin resistance; NAC may reduce fasting insulin effectively more than metformin (8).
- Boosting fertility by optimizing ovulation and improving cervical mucus quality (9).
Dosing of NAC
NAC is safe and well-tolerated. We may recommend between 600 – 1,200 mg of NAC per day.
Fish oil is the healthy omega-3 fat derived from oily fish like salmon, herring, and anchovies.
Fish oil is one of the best supplements for PCOS because of its powerful anti-inflammatory benefits. For example, taking a fish oil supplement may improve insulin resistance and lower cholesterol numbers in women with PCOS (10
Dosing of Fish Oil
Fish oil, or omega-3 supplements, should contain the two key omega-3 fats derived from fish: EPA and DHA. In addition to eating fish at least twice per week, we may recommend taking about 1,000 mg of total fish oil (EPA + DHA) per day.
is involved in over 300 reactions in the body, many of which affect hormone balance and signaling. Unfortunately, over half of Americans fail to meet the daily magnesium requirements with their diet (11
Taking a magnesium supplement for PCOS may improve insulin resistance, reduce inflammation, and ease PMS symptoms (12
Magnesium can also be calming and helpful for restful sleep.
Dosing of Magnesium
Magnesium supplements are available in a variety of forms, including magnesium oxide, citrate, or glycinate. Magnesium oxide is not well absorbed and may cause diarrhea or GI upset. Magnesium citrate, however, is much better tolerated and has a very gentle laxative effect which may help if you also suffer from constipation. Magnesium glycinate is the most universal form that is well absorbed and tolerated with minimal GI effects.
Appropriate dosing of magnesium supplements ranges from 200 – 350 mg per day.
Women with PCOS tend to have lower zinc
levels than women without this condition.
Some researchers suggest that zinc deficiency may be partly to blame for the insulin resistance and abnormal cholesterol levels often seen in PCOS (13
). Fortunately, taking a zinc supplement may help to treat these underlying conditions (14
What’s more, a zinc supplement may reduce unwanted symptoms of PCOS like hair loss, unwanted hair growth, and acne (15
Dosing of Zinc
You can safely take between 10 – 30 mg of zinc per day in the form of zinc picolinate, glycinate, or citrate. Make sure you also take a multivitamin that contains copper, as taking too much zinc for longer periods may cause a copper deficiency.
A general B-complex vitamin is one of the best supplements for PCOS because of the wide range of benefits these nutrients provide. Plus, some medications often prescribed for PCOS (like birth control and metformin) can actually deplete your body of many of these B vitamins (16
Vitamin B6, folate, and vitamin B12 are particularly important in optimizing hormonal balance in PCOS. These three B-vitamins help to lower inflammation by breaking down an amino acid, called homocysteine, which is commonly elevated in women with PCOS (13
). Lowering homocysteine may reduce your risk factors for heart disease and other reproductive symptoms.
Dosing of B-Complex
Choose a B-complex vitamin that contains the methylated forms of folate and vitamin B12. These methylated forms (named methylfolate and methylcobalamin, respectively) are the active version of these vitamins and more effectively used by the body, especially in women with MTHFR genetic mutations.
plays an important role in controlling inflammation, balancing hormones, and promoting overall health.
Inflammation is a key driver of insulin resistance seen in PCOS. Likewise, insulin resistance worsens inflammation. A probiotic supplement is one tool we may use to optimize gut health in our PCOS patients to lower inflammation and disrupt this vicious cycle.
Taking a probiotic supplement may also normalize your menstrual cycle, lower androgen levels (like testosterone), and improve insulin resistance (18
Dosing of Probiotics
There is a wide range of probiotic dosing used in research and on the market today. For example, most probiotic supplements contain between 10-30 billion colony forming units (CFU) per capsule. Other probiotics, like spore-based probiotics
, may only need to contain a few billion CFU because of how they function in the gut. A good rule of thumb is to look for a probiotic supplement that contains multiple (5-10) probiotic strains for the most benefit.
Up to 85 percent of women with PCOS have a vitamin D deficiency (19
). Unfortunately, lower vitamin D levels are significantly associated with worsening insulin resistance in PCOS, independent of your weight, ethnicity, or season of the year.
Since vitamin D is not commonly found in the foods we eat, we must rely on adequate sunshine or supplementation. Supplementing with vitamin D may improve insulin resistance, lower inflammation, and help to normalize your menstrual cycle (20
Dosing of Vitamin D
Vitamin D dosing should be personalized based on your own lab results. For example, if your vitamin D levels are adequate (50-70 ng/mL), a maintenance dose of about 2,000 units per day may be most appropriate. However, you may require higher doses (5,000 units per day) if your blood levels indicate a vitamin D inadequacy or deficiency. If you are severely deficient, you may require a short term prescription for a megadose of vitamin D. We check vitamin D levels and provide personalized recommendations for all of our clinical program members here at Root.
Ideally, your vitamin D supplement should also contain vitamin K2, which helps direct calcium and vitamin D to your bones where it can be used and stored.
Individualizing Your PCOS Supplements
Feeling overwhelmed? We’re here to help. Here are a couple of options for working with us:
1. Our Root functional medicine membership
, a doctor and dietitian one on one program, which includes testing for several core nutrients and PCOS as well as other important labs.