N-acetylcysteine 300mg + Myo-inositol 1000mg + Folic Acid 1.5mg
IN-ACETYL CYSTEINE (NAC)
N-acetyl-cysteine (NAC) is a stable derivative of the sulfur-containing amino acid cysteine and an antioxidant
that is needed for the production of glutathione, one of the body’s most important natural antioxidants and
detoxifiers. While cysteine is found in high protein foods, n-acetyl cysteine is not. A large body of evidence
supports the use of NAC in women with PCOS.
1.) Improving Insulin Sensitivity
Women with PCOS frequently have an abnormally high insulin response to sugars and refined starches. A
2002 study evaluated the effect of NAC on insulin secretion and peripheral insulin resistance in women with
PCOS (Fulghesu 2002). The study subjects who had an exaggerated insulin response to a glucose challenge
and were treated with NAC showed an improvement in insulin function in their peripheral tissues. The NAC
treatment also produced a significant decline in testosterone levels and in free androgen index values. The
researchers concluded, “NAC may be a new treatment for the improvement of circulating insulin levels and
insulin sensitivity in hyperinsulinemic patients with polycystic ovary syndrome.” (Abu 2010)
2.) Restoring Fertility
NAC may also be useful for improving fertility in women with PCOS. In one study, NAC appeared to improve
the effects of clomiphene, the widely used fertility drug. clomiphene plus NAC significantly improved
ovulation rates in a study of 573 women with PCOS. According to the researchers, 52% of the study
participants who took clomiphene plus NAC ovulated, whereas only 18% ovulated in the clomiphene alone
group. The authors concluded: “N-Acetyl cysteine is proved effective in inducing or augmenting ovulation in
polycystic ovary patients.” (Badawy 2007).
Myo-inositol is a stereoisomer of DCI. Like DCI, it is a key factor in insulin signaling, and serves also as a
precursor to DCI in endogenous inositol metabolism. It should then come as no surprise that studies using
myoinositol in women with PCOS produced results as promising as those obtained with DCI.
Double-blind, placebo-controlled investigations were carried out in 42 women with PCOS, subjects receiving
myo-inositol fared much better when compared to the placebo group, displaying decreases in testosterone,
triglycerides, and blood pressure; a significant improvement in insulin sensitivity; and a greatly increased
frequency of ovulation (Costantino 2009).
In another study, 20 women with PCOS were given either 2 grams of myo-inositol plus 200 mcg folic acid, or a
placebo of 200 mcg folic acid daily. After 12 weeks, the women taking myo-inositol showed improved insulin
sensitivity and androgen levels. Strikingly, all the subjects receiving myo-inositol returned to normal
menstrual cycles (Genazzani 2008).
In an Italian study of 92 PCOS patients, almost 50% showed significant weight loss and reduced leptin levels
after receiving myo-inositol plus folic acid (4 g myo-inositol plus 400 mcg folic acid). After a 14-wk treatment,
the myo-inositol plus folic acid group lost weight, whereas the placebo group gained weight (Gerli 2007).
A six-month study involving 50 PCOS women yielded similar results and gave researchers the time to evaluate
the effects of myo-inositol on hirsutism. Along with decreases in testosterone and insulin levels, the
participants who supplemented with myo-inositol experienced a reduction in hirsutism, and improvements
in skin appearance, leading researches to conclude, “Myoinositol administration is a simple and safe
treatment that ameliorates the metabolic profile of patients with PCOS, reducing hirsutism and acne.”(Zacche
In other well-designed clinical trials for follicular maturity and ovulation induction, myoinositol has produced
promising results, cementing its position as a novel therapy for PCOS management (Papaleo 2007, Papaleo
The preconceptional & periconceptional use of folic acid-containing supplements reduces the first
occurrence, as well as the recurrence, of neural tube defects. Women of populations in which adverse
pregnancy outcomes are prevalent often consume diets that contain a low density of vitamins and minerals,
including folate. Folate intake may need to be sustained after complete closure of the neural tube to decrease
the risk of other poor pregnancy outcomes. A central feature of embryonic and fetal development is
widespread cell division; folate is central because of its role in nucleic acid synthesis. During gestation,
marginal folate nutriture can impair cellular growth and replication in the fetus or placenta. Folate deficiency
can occur because dietary folate intake is low or because the metabolic requirement for folate is increased by
a particular genetic defect or defects. During pregnancy, low concentrations of dietary and circulating folate
are associated with increased risks of preterm delivery, infant low birth weight, and fetal growth retardation.
A metabolic effect of folate deficiency is an elevation of blood homocysteine. Likewise, the presence of
maternal homocysteine concentrations have been associated both with increased habitual spontaneous
abortion and pregnancy complications (eg, placental abruption and preeclampsia), which increase the risk of
poor pregnancy outcome and of decreased birth weight and gestation duration.
i.) Management of Polycystic Ovary Syndrome
ii.) Female Infertility
1 tablet 2-3 times a day