Inositol is considered a safe and effective treatment for polycystic ovary syndrome (PCOS). [35] It works by increasing insulin sensitivity, which helps to improve ovarian function and reduce hyperandrogenism. [36] It is also shown to reduce the risk of metabolic disease in women with PCOS. [37] In addition, thanks to its role as FSH second messenger, myo-inositol is effective in restoring FSH/LH ratio and menstrual cycle regularization. [38] myo-Inositol's role as FSH second messenger leads to a correct ovarian follicle maturation and consequently to a higher oocyte quality. Improving the oocyte quality in both women with or without PCOS, myo-inositol can be considered as a possible approach for increasing the chance of success in assisted reproductive technologies. [39] [40] In contrast, D- chiro-inositol can impair oocyte quality in a dose-dependent manner. [41] The high level of DCI seems to be related to elevated insulin levels retrieved in about 70% of PCOS women. [42] In this regard, insulin stimulates the irreversible conversion of myo-inositol to D- chiro-inositol causing a drastic reduction of myo-inositol. myo-Inositol depletion is particularly damaging to ovarian follicles because it is involved in FSH signaling, which is impaired due to myo-inositol depletion. [11] Recent evidence reports a faster improvement of the metabolic and hormonal parameters when these two isomers are administered in their physiological ratio. The plasmatic ratio of myo-inositol and D- chiro-inositol in healthy subjects is 40:1 of myo- and D- chiro-inositol respectively. [43] The use of the 40:1 ratio shows the same efficacy of myo-inositol alone but in a shorter time. In addition, the physiological ratio does not impair oocyte quality. [44]

Exogenous administration of MYO in daily dosages of 4-30g up to 12 months is generally well tolerated. Mild side effects, such as nausea and diarrhea, may appear only for daily dosages greater than 12g ( 55).Gerasimenko, J. V.; Flowerdew, S. E.; Voronina, S. G.; Sukhomlin, T. K.; Tepikin, A. V.; Petersen, O. H.; Gerasimenko, O. V. (December 2006). "Bile acids induce Ca 2+ release from both the endoplasmic reticulum and acidic intracellular calcium stores through activation of inositol trisphosphate receptors and ryanodine receptors". The Journal of Biological Chemistry. 281 (52): 40154–40163. doi: 10.1074/jbc.M606402200. PMID 17074764. Reynolds, J. E. F. (1993). Martindale: The Extra Pharmacopoeia. Vol.30. Pennsylvania: Rittenhouse Book Distributors. p.1379. ISBN 978-0-85369-300-0. An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin has not been identified in man Inositol, primarily the isomer myo-inositol, is a carbocyclic sugar that is abundant in the brain and other mammalian tissues; it mediates cell signal transduction in response to a variety of hormones, neurotransmitters, and growth factors and participates in osmoregulation. [2] Concerning regulation of osmosis, in most mammalian cells the intracellular concentrations of myo-inositol are 5 to 500times greater than the extracellular concentrations. [3] Sijens, P. E., Oudkerk, M., van Dijk, P., Levendag, P. C., and Vecht, C. J. 1H MR spectroscopy monitoring of changes in choline peak area and line shape after Gd-contrast administration. Magn Reson.Imaging 1998;16(10):1273-1280. View abstract. Ciotta, L.; etal. (2011). "Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial". European Review for Medical and Pharmacological Sciences. 15 (5): 509–14. PMID 21744744.

Fovall, P., Dysken, M. W., Lazarus, L. W., Davis, J. M., Kahn, R. L., Jope, R., Finkel, S., and Rattan, P. Choline bitartrate treatment of Alzheimer-type dementias. Commun.Psychopharmacol. 1980;4(2):141-145. View abstract.No. Taking a choline supplement at the recommended dose poses no known side effects or risks to the development of your unborn baby. Do I need to worry about any interactions while taking choline supplements? Colazingari, S.; etal. (2013). "The combined therapy myo-inositol plus D- chiro-inositol, rather than D- chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial". Archives of Gynecology and Obstetrics. 288 (6): 1405–11. doi: 10.1007/s00404-013-2855-3. PMID 23708322. S2CID 45611717. One six-month study in 80 postmenopausal women with metabolic syndrome found that 4 grams per day of inositol improved insulin sensitivity, blood pressure and cholesterol levels more than a placebo ( 10). Inositol can be used to produce molecules that are involved in insulin’s action in your cells ( 9). Boeke CE, Gillman MW, Hughes MD, et al. Choline intake during pregnancy and child cognition at age 7 years. Am J Epidemiol 2013;177(12):1338-47. View abstract.

Chatterjee, J.; Majumder, A. L. (September 2010). "Salt-induced abnormalities on root tip mitotic cells of Allium cepa: prevention by inositol pretreatment". Protoplasma. 245 (1–4): 165–172. doi: 10.1007/s00709-010-0170-4. PMID 20559853. S2CID 9128286.Many people get all the vitamin B they need from their diet. If you also take a multivitamin or regularly consume fortified foods, there’s a good chance you’re getting enough and possibly more B vitamins than you need. Saito, T. [Choline antagonists and antacids for the treatment of peptic ulcer]. Nippon Rinsho 1984;42(1):158-162. View abstract.

There are also not enough studies to determine the safety of the supplements while breastfeeding. However, breast milk seems to be naturally rich in inositol ( 39). Studies have found that inositol may be beneficial for improving the function of the ovaries and fertility in women with PCOS ( 16, 17, 18). Sil A, et al. (2018). A randomized, open labeled study comparing the serum levels of cobalamin after three doses of 500 mcg vs. a single dose methylcobalamin of 1500 mcg in patients with peripheral neuropathy.Ehlers, Anke; Marakis, Georgios; Lampen, Alfonso; Hirsch-Ernst, Karen Ildico (2019-08-01). "Risk assessment of energy drinks with focus on cardiovascular parameters and energy drink consumption in Europe". Food and Chemical Toxicology. 130: 109–121. doi: 10.1016/j.fct.2019.05.028. ISSN 0278-6915. PMID 31112702. Buchman AL, Dubin MD, Moukarzel AA, et al. Choline deficiency: a cause of hepatic steatosis during parenteral nutrition that can be reversed with intravenous choline supplementation. Hepatology 1995;22:1399-403. View abstract. The thyroid gland is responsible for the synthesis and the secretion of thyroid hormones (TH), triiodothyronine (T3) and thyroxine (T4), which is made up by the thyrocytes (epithelial cells that are also named thyroid follicular cells). Of the two hormones, T4 constitutes approximately 90% of the entire TH pool, while T3 makes up the remainder 10%. A peripheral conversion of the prohormone T4 into the biologically more active hormone T3 is made up by enzymes known as deiodinases, which produce around 80% of the total T3 ( 1). The deiodinases are homodimeric selenoproteins containing a thioredoxin fold, and classified in three types: type 1 (D1) and type 2 (D2) activate T4 into T3; type 3 (D3) inactivates both hormones ( 2). Specifically, among the activating enzymes, D2 has better catalytic efficiency than D1. TH circulate in the plasma bound mainly to three proteins: thyroxine-binding globulin (TBG), transthyretin (TTR) and albumin ( 3). Approximately 5% of TH circulate bound to lipoproteins (HDL> LDL> VLDL). Only approximately 0.03% of circulating T4 and approximately 0.3% of circulating T3 is free, nonprotein-bound ( 4). For example, an early study demonstrated that taking a 12-gram inositol supplement every day for 4 weeks improved symptoms in people with depression ( 10). While some evidence suggests these injections might work with other weight loss methods, it’s important to implement these methods from the very start. Your doctor is your first source of expert advice on your weight loss goals, since everyone’s situation is different.