PCOS SUPPORT Metabolic Balance, uses a unique group of herbal and mineral ingredients. Gynostemma pentaphyllum also known by its traditional name Jiaogulan or Southern Ginseng is indigenous to South East Asia. It has been drunk as a tea for centuries and is known as the Herb of Immortality as it is reputed to prolong life.
Gynostemma has been found to sensitise the insulin receptor, lower insulin resistance through raising AMPK which lowers glucose secretion from the liver. It lowers blood glucose and lowers the long term marker of blood glucose HbA1C better than Metformin. In a 2012 research article by Hirst et al, maximum HbA1C reduction with Metformin was 1.1% units. However, a study on Gynostemma found a 2% unit drop in HbA1C (Vu Thi Thanh Huyen 2011).
Chromium has similar insulin sensitizing properties lowering blood insulin and glucose levels.
Chromium facilitates insulin signaling at many points of the insulin signaling cascade. When insulin ‘docks with the insulin receptor, it binds to a part called the alpha subunit. For signal transduction to occur, the beta subunit needs to be activated. Chromium activates the beta sub-unit which in turn phosphorylates (activates) the insulin receptor substrate (IRS) molecules. At this stage chromium stops the breakdown (ubiquination) of IRS-1. Chromium also blocks a molecule which inhibits insulin signally called PTP 1B (protein tyrosine phosphatase 1B). Chromium also promotes other ‘downstream’ signaling molecules like P-I-3-kinase(PI3K) and the Akt. (Hua 2012).
Chromium supports AMPK (5’adenosine monophosphate activated protein kinase) which helps GLUT4 vesicles translocate from inside the cell to the cell surface.
Chromium is a very’ talented’ team player in combatting insulin resistance (IR) and the consequences of IR being glucose intolerance and a higher risk of type 2 diabetes. High blood sugar results in the oxidative damage of proteins (glycosylation or glycation). Chromium is also has antioxidant functions lowering glycosylation of proteins and lowering oxidation of fats (lipid peroxidation).
Chromium boosts glutathione and glutathione peroxidase (premium antioxidants in the body’s antioxidant armory.
Furthermore, chromium is effective in reducing food cravings which of itself could increase weight.
Inositol is a member of the B group of vitamins There are 9 stereoisomers (forms) of inositol. The molecular formula of inositol is identical to that of sugar (C6H12O6) however the 3 dimensional arrangement of the atoms and attachments are different to sugar. It is a sugar alcohol and when taken as a supplement lowers blood sugar levels. Myo-Inositol (MI) is most abundant of all inositols and high amounts are required for oocyte maturation. A German study of 3602 PCOS patients given MI for 3 months restored ovulation in 70% of patients and had a fertility rate equivalent to or better than reported for Metformin. How can Myo-inositol be so effective?
Approximately 99% of all inositols is MI and is used interchangeably with inositol. Small amounts of MI are metabolized to D-chiro-Inositol (DCI) by the enzyme epimerase. DCI maintains insulin sensitivity. In PCOS urinary DCI levels are very low. The worse the insulin resistance the lower the DCI in urine of PCOS patients.
Studies have reported improved oocyte function, the start of regular periods after just 34 days treatment with 2grams MI daily. In one study 10 out of 22 women fell achieved biochemical pregnant within 6 months. Another study of 50 PCOS with 2g MI reported lowered LH, lowered LH/FSH ratio, prolactin, androstenedione and insulin. MI resulted in larger quality oocytes and higher pregnancy rates, with 10/50 women falling pregnant and 8 successful deliveries compared to 3 deliveries in non MI treated patients
It has been suggested that MI and DCI reduce insulin resistance, improve ovarian function and reduce androgen levels in women with PCOS.
DCI as a sole agent has also been used. 600mg DCI daily decreased insulin and testosterone levels. Even a higher dose of DCI 500mg bd improved the quality of oocytes.
Supplemental DCI bypasses defective epimerase activity and achieves downstream metabolic effects of insulin in DCI deficient tissues. However in nature epimerase is unidirectional meaning giving DCI cannot fulfil any of the functions of MI. Hence a physiological combination of both Mi is able to enhance oocyte maturation and small amounts of DCI are available with needing epimerase for insulin sensitivity and hormone regulation. Research suggests that lower doses of MI may suffice if co-administered with DCI.In arandomised controlled study of MI/DI versus Mi alone showed a better ovulation, endocrine, metabolic with better insulin sensitivity and lipid profiles than MI alone (Minozzi 2013)