Inositol: benefits, dosage, contraindications

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Inositols are cyclic polyols (C6H12O6) with a molecular weight of 180.16; they are present in all living organisms and participate in numerous metabolic pathways. Inositol was once considered part of the B-vitamin complex. However, it is now known that inositol is produced in the human body. Therefore, it is not considered an essential B vitamin but is rather called a pseudovitamin. Inositols exist in nine stereoisomeric forms, among which myo-inositol (MI) is the most important and most widely distributed in nature. In humans, inositols come mainly from dietary sources in the form of MI, such as cereals, corn, meat, citrus fruits, and legumes. MI can then be converted into D-chiro-inositol (DCI) under the stimulus of insulin. As a result, each organ and tissue can balance inositol levels and the MI/DCI ratio in a specific way, regulating metabolic processes. Endogenous inositol is an essential component of the phospholipids of the cell membrane. It has low lipotropic activity and can remove fat from liver and intestinal cells. Biological function varies according to the isomers. Myo-inositol is a source of second messengers such as diacylglycerol. It is necessary for the growth of human cells.

Other name(s) 

D-Myo-Inositol, D-chiro-inositol

Scientific name(s)

Hexahydroxycyclohexane

Family or group: 

Pseudovitamins


Indications

Scoring methodology

EFSA approval.

Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with consistently positive conclusions for the indication.
Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with positive conclusions for the indication.
One or more randomized studies, or several cohorts or epidemiological studies, with positive conclusions for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or conflicting.
No clinical studies to date that can demonstrate the indication.


Metabolic syndrome
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Certain clinical research in postmenopausal women with metabolic syndrome who follow a hypocaloric diet shows that taking myo-inositol at a dose of 2 grams twice a day for one year reduces total cholesterol by 29 mg/dL, triglycerides by 64 mg/dL, systolic and diastolic blood pressure by 9 mmHg and 6 mmHg, respectively, increases high-density lipoprotein (HDL) cholesterol by 6 mg/dL and improves insulin resistance compared with placebo. Furthermore, it did not reduce body mass index or waist circumference in these patients. Another clinical study shows that daily intake of a combination of inositol and alpha-lipoic acid for 6 months, in combination with a hypocaloric diet, reduces insulin resistance by at least 20% compared with hypocaloric diet alone. In addition, taking inositol and alpha-lipoic acid appears to increase HDL cholesterol by about 6% and reduce triglycerides by 5% compared with baseline.

Posologie

posologieOral

posologie4 g

duration1 - years

populationAdults

formulationmyo-inositol


Synergies


Polycystic ovary syndrome
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A meta-analysis of clinical research shows that taking inositol modestly reduces fasting blood glucose, fasting insulin, total cholesterol, triglycerides, and testosterone levels compared with control in women with polycystic ovary syndrome. Other clinical studies have shown that taking D-chiro-inositol 1–1.2 grams or myo-inositol 4 grams with 400 mcg folic acid per day for 6 months decreases serum triglyceride and testosterone levels, slightly lowers blood pressure, and improves ovarian function. Other research indicates that taking myo-inositol and D-chiro-inositol together may improve metabolic parameters more quickly than taking myo-inositol alone. A small clinical study shows that taking 4 grams of myo-inositol and 400 mcg folic acid per day for three spontaneous cycles induces ovulation in about 62% of women with anovulatory PCOS and insulin resistance. Another clinical study shows that taking a combination of 2 grams of inositol, 200 mcg folic acid, and 600 mg N-acetylcysteine twice daily for 12 months improves ovulation rates in women with PCOS and oligomenorrhea, regardless of baseline insulin sensitivity.

Posologie

posologieOral

posologie1 - 4 g

duration6 months

populationWomen

formulationD-chiro-inositol, myo-inositol


Synergies


Pregnancy
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A meta-analysis of five clinical trials in women at risk of gestational diabetes shows that daily intake of myo-inositol and folic acid, from the first trimester and throughout pregnancy, reduces the risk of preterm birth by 64% compared with folic acid alone. In most studies, the dose used is 2 grams of myo-inositol plus 200 mcg of folic acid twice a day.

Posologie

posologieOrally

posologie4 g

populationPregnant women

formulationmyo-inositol


Synergies


Gestational diabetes
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Most clinical research shows that taking 2 grams of myo-inositol plus 200 mcg of folic acid twice a day from the first trimester and throughout pregnancy decreases the incidence of gestational diabetes by 57% to 92% compared with folic acid alone in patients at risk of gestational diabetes. Myo-inositol appears to be more effective than D-chiro-inositol.

Posologie

posologieBy mouth

posologie4 g

populationPregnant women

formulationmyo-inositol


Synergies


Obsessive-compulsive disorder
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A preliminary clinical study in adults with obsessive-compulsive disorder (OCD) shows that taking 18 grams per day of inositol for 6 weeks improves scores on the Yale-Brown Obsessive Compulsive Scale (a scale that provides a measure of the severity of obsessive symptoms) compared with placebo. However, taking inositol does not appear to improve the severity or type of OCD symptoms in patients already taking a selective serotonin reuptake inhibitor. Both studies were small and the treatment was administered for only 6 weeks.

Posologie

posologieOral

posologie18 g

duration6 - weeks

populationAdults


Psoriasis
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A small clinical study suggests that taking 6 grams per day of inositol for 10 weeks may improve psoriasis associated with lithium therapy.

Posologie

posologieOral

posologie6 g

duration10 - weeks

populationAdults


Properties


Neurological

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Inositol is a simple isomer of glucose that is a key metabolic precursor in the phosphatidylinositol (PI) cycle. Unlike L-DOPA and tryptophan, which are amino acid precursors for monoamine neurotransmitters and which may have antidepressant properties, inositol is a precursor of a second intracellular messenger system. The PI cycle is a second messenger system for many neurotransmitters. Decreased brain levels of inositol have been observed in patients suffering from depression, anxiety, and compulsive disorders. In addition, limited clinical evidence suggests that exogenous inositol may have benefits similar to selective serotonin reuptake inhibitors (SSRIs) in conditions such as panic disorder, depression, and obsessive-compulsive disorder.

Usages associés

Obsessive-compulsive disorder

Metabolic

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In vitro and animal studies have shown that insulin resistance is directly linked to a deficiency in D-chiro-inositol and to an imbalance with myo-inositol (two stereoisomers of inositol). D-chiro-inositol acts as a second messenger in insulin signaling and is an insulin sensitizer. In vitro research suggests that it has activity similar to insulin. Inositol is also a precursor of phosphoinositides, which play a role in cell signaling and are also secondary messengers involved in glucose metabolism and have insulin-like effects. In addition, inositol can increase levels of adipocytokines, particularly adiponectin, which are negatively correlated with glucose and insulin concentrations. Finally, myo-inositol can activate lipogenesis via stimulation of acetyl-CoA carboxylase.

Usages associés

Metabolic syndrome, gestational diabetes

Effect on fertility

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Clinical research shows that taking myo-inositol, D-chiro-inositol, or the combination of these two forms appears to improve ovulation and pregnancy rates in women with polycystic ovary syndrome.nnClinical research also shows that treating sperm with myo-inositol in vitro increases sperm motility in men with oligoasthenospermia. This increased motility leads to an 18% increase in pregnancy rate during intrauterine insemination compared with controls. nn


Hormonal metabolism

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Researchers believe that inositol induces ovulation in women with polycystic ovary syndrome (PCOS) by improving insulin sensitivity. It also produces the second messenger inositol triphosphate, which is involved in the regulation of certain hormones such as thyroid-stimulating hormone and follicle-stimulating hormone. The reduction in insulin resistance is also thought to be responsible for the improvement of other symptoms associated with PCOS, including hypertension, hyperlipidemia, hyperglycemia, obesity, and increased serum testosterone concentrations. nn

Usages associés

Polycystic ovary syndrome, Pregnancy

Dermatologic effect

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Supplemental inositol appears to improve psoriasis that is worsened or triggered by lithium use. The mechanism is unknown, but lithium appears to cause a reduction of inositol both in the brain and in other tissues. Furthermore, inositol supplementation does not appear to reduce the effectiveness of lithium in the treatment of bipolar disorder. nn

Usages associés

Psoriasis


Safe dosage

Adults 18 years and older: 1 g - 18 g (D-chiro-inositol, myo-inositol)

Inositol is generally used at doses of 1 to 4 grams per day, often in combination with folic acid 200 to 400 mcg per day. Inositol has been used with apparent safety at doses up to 18 grams per day for 6 weeks or 6 grams per day for 10 weeks.

Pregnant women: 4 g (myo-inositol)

Myo-inositol has been used with apparent safety at doses up to 4 g per day during pregnancy.


Interactions

Médicaments

Antidiabetic: interaction undefined

Clinical research shows that inositol lowers blood glucose and glycated hemoglobin (HbA1c) levels in diabetic patients. Theoretically, taking inositol with antidiabetic medications may increase the risk of hypoglycemia.


Precautions

Type 2 diabetes: use with caution

Clinical research shows that inositol lowers blood glucose and glycated hemoglobin (HbA1c) levels in diabetic patients. Theoretically, taking inositol with antidiabetic medications may increase the risk of hypoglycemia.

Breastfeeding woman: avoid

Breast milk is rich in endogenous inositol. However, the effects of exogenous inositol are not known. Avoid use due to lack of reliable and sufficient information.