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55 studies in the last 5 years · Latest meta-analysis: 2026
200120132026
1PCOS symptoms improvementMeta-AnalysisCited 2×n=5,501 · very large study2025
Chromium, inositol, and Omega-3 were found to be beneficial for improving lipid profile.
Zhao G et al. · Reproductive biology and endocrinology : RB&E (2025)
Inositol significantly decreased total cholesterol and triglyceride levels, while curcumin was most effective in improving low-density and high-density lipoprotein cholesterol levels.
Chromium, inositol, and Omega-3 were found to be beneficial for improving lipid profile.
For improving obesity, sex hormone levels, inflammatory factors and oxidative stress indicators of PCOS patients, carnitine, chromium, and soy isoflavones are effective options, respectively.
2Body weight reductionMeta-AnalysisCited 10×n=2,362 · very large study2023
Carnitine was relatively effective in reducing body mass, while chromium, Omega-3, and selenium were beneficial for improving glucose metabolism.
Hu X et al. · PeerJ (2023)
The network meta-analysis showed that carnitine, inositol, and probiotics reduced body weight and body mass index (BMI) compared to placebo, and carnitine outperformed the other supplements (SUCRAs: 96.04%, 97.73%, respectively).
Omega-3 lowered fasting blood glucose (FBG) (SUCRAs: 93.53%), and chromium reduced fasting insulin (FINS) (SUCRAs: 72.90%); both were superior to placebo in improving insulin resistance index (HOMA-IR), and chromium was more effective than Omega-3 (SUCRAs: 79.99%).
Selenium was potent in raising the quantitative insulin sensitivity index (QUICKI) (SUCRAs: 87.92%).
3Clinical pregnancy ratesMeta-AnalysisCited 25×n=2,617 · very large study2024
The results showed that use of antioxidants not only significantly increased the number of retrieved oocytes and high-quality embryo rates but also reduced the dose of gonadotropin, contributing to...
Shang Y et al. · Advances in nutrition (Bethesda, Md.) (2024)
The results showed that use of antioxidants not only significantly increased the number of retrieved oocytes and high-quality embryo rates but also reduced the dose of gonadotropin, contributing to higher clinical pregnancy rates.
Appropriate antioxidant treatment should be offered at a low dose according to the patient's age and ovarian reserve.
This study was registered at PROSPERO as CRD42022359529.
4Gestational diabetes preventionMeta-AnalysisCited 26×n=1,319 · large study2023
Evidence from seven studies shows that antenatal dietary supplementation with myo-inositol during pregnancy may reduce the incidence of gestational diabetes, hypertensive disorders of pregnancy and preterm birth.
Motuhifonua SK et al. · The Cochrane database of systematic reviews (2023)
Huge benefit
← WorseNo effectBetter →
For the primary neonatal outcomes, only one study measured the risk of a large-for-gestational-age infant and found myo-inositol was associated with both appreciable benefit and harm (RR 1.40, 95% CI 0.65 to 3.02; 1 study, 234 infants; low-certainty evidence).
Further, myo-inositol may result in little to no difference in caesarean section (RR 0.91, 95% CI 0.77 to 1.07; 4 studies, 829 women; low-certainty evidence).
For the secondary neonatal outcomes, meta-analysis showed no neonatal hypoglycaemia (RR 3.07, 95% CI 0.90 to 10.52; 4 studies; 671 infants; very low-certainty evidence).
5PCOS managementMeta-AnalysisCited 27×n=2,230 · very large study2024
The evidence supporting the use of inositol in the management of PCOS is limited and inconclusive.
Fitz V et al. · The Journal of clinical endocrinology and metabolism (2024)
The evidence supporting the use of inositol in the management of PCOS is limited and inconclusive.
Clinicians and their patients should consider the uncertainty of the evidence together with individual values and preferences when engaging in shared decision-making regarding the use of inositol for PCOS.
6IVF/ICSI outcomes and OHSS reductionMeta-AnalysisCited 4×n=1,827 · large study2024
Metformin and myoinositol may reduce OHSS risk in PCOS patients but did not significantly improve pregnancy outcomes.
Lin L et al. · Journal of ovarian research (2024)
Huge benefit
← WorseNo effectBetter →
Myoinositol was linked to a shorter gonadotropin duration (SMD = -1.21, 95% CI -2.03 to -0.38) and fewer side effects (OR = 0.23, 95% CI 0.06-0.83) compared to controls.
Metformin led to lower E2 levels, a higher number of mature oocytes, and increased side effects (SMD = -376.52, 95% CI -610.83 to -142.22; SMD = 2.23, 95% CI 0.36-4.10; OR = 6.85, 95% CI 4.32-10.86) than controls.
Metformin and myoinositol may reduce OHSS risk in PCOS patients but did not significantly improve pregnancy outcomes.
7Regular menstrual cycle in PCOSMeta-AnalysisCited 70×n=1,691 · large study2023
Inositol is an effective and safe treatment in PCOS.
Greff D et al. · Reproductive biology and endocrinology : RB&E (2023)
Huge harm
← WorseNo effectBetter →
In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo.
Ours is the first study to report that for women with PCOS, myo-inositol combined with D-chiro-inositol and metformin combined with thiazolidinediones appear superior to metformin alone in improving insulin resistance and decreasing total testosterone.
Zhao H et al. · Reproductive health (2021)
Compared with metformin, treatment with myo-inositol + D-chiro-inositol was associated with a greater improvement in menstrual frequency (odds ratio 14.70 [95% confidence interval (CI) 2.31-93.58]).
Ours is the first study to report that for women with PCOS, myo-inositol combined with D-chiro-inositol and metformin combined with thiazolidinediones appear superior to metformin alone in improving insulin resistance and decreasing total testosterone.
Myo-inositol combined with D-chiro-inositol is particularly efficacious in menstrual recovery.
9Gestational diabetes mellitus incidenceMeta-AnalysisCited 21×n=1,321 · large study2022
In conclusion, 4 g MI nutritional supplementation per day during early pregnancy may reduce GDM incidence and severity, therefore may be a practical and safe approach for the prevention of GDM.
Wei J et al. · Nutrients (2022)
Huge benefit
← WorseNo effectBetter →
Likely real
Pooled results were expressed as relative risk (RR) or mean difference (MD) with a 95% confidence interval (95% CI).
Compared with the control group, 4 g myo-inositol (MI) supplementation per day significantly decreased the incidence of GDM (RR = 0.30, 95% CI (0.18, 0.49), p < 0.00001).
It also decreased the need of insulin treatment, and reduced the incidence of preterm delivery and neonatal hypoglycemia.
10Clinical pregnancy rateMeta-AnalysisCited 64×n=6,510 · very large study2017
In this review, there was very low-quality evidence to show that taking an antioxidant may provide benefit for subfertile women, but insufficient evidence to draw any conclusions about adverse events.
Showell MG et al. · The Cochrane database of systematic reviews (2017)
This suggests that among subfertile women with an expected clinical pregnancy rate of 22%, the rate among women using antioxidants would be between 27% and 33%.
Heterogeneity was moderately high.There was insufficient evidence to determine whether there was a difference between the groups in rates of miscarriage (OR 0.79, 95% CI 0.58 to 1.08, P = 0.14, 18 RCTs, 2834 women, I2 = 23%, very low quality evidence).
This suggests that, among subfertile women with an expected miscarriage rate of 7%, use of antioxidants would be expected to result in a miscarriage rate of between 4% and 7%.
11Live birth ratesMeta-AnalysisCited 213×n=4,451 · very large study2017
Our updated review suggests that metformin alone may be beneficial over placebo for live birth, although the evidence quality was low.
Morley LC et al. · The Cochrane database of systematic reviews (2017)
No clear effect
← WorseNo effectBetter →
Metformin versus placebo or no treatmentThe evidence suggests that metformin may improve live birth rates compared with placebo (OR 1.59, 95% CI 1.00 to 2.51, 4 studies, 435 women, I2 = 0%, low-quality evidence).
There was no clear evidence of a difference in miscarriage rates (OR 1.08, 95% CI 0.50 to 2.35, 4 studies, 748 women, I2 = 0%, low-quality evidence).
However, the combined therapy group had higher rates of clinical pregnancy (OR 1.59, 95% CI 1.27 to 1.99, 16 studies, 1529 women, I2 = 33%, moderate-quality evidence) and ovulation (OR 1.57, 95% CI 1.28 to 1.92, 21 studies, 1624 women, I2 = 64%, moderate-quality evidence).
12Cycle regularization in PCOSMeta-Analysisn=388 · medium study2025
In this meta-analysis of RCTs, combination therapy was associated with cycle regularization and reduction in hirsutism and LH/FSH ratio compared to metformin monotherapy.
Kelly FA et al. · Endocrine (2025)
Differences in acne (p = 0.58), body mass index (p = 0.13), fasting blood glucose (p = 0.07) and HOMA-IR (p = 0.25) were not statistically significant.
In this meta-analysis of RCTs, combination therapy was associated with cycle regularization and reduction in hirsutism and LH/FSH ratio compared to metformin monotherapy.
Further studies are needed to clarify the true benefits of the use of inositol in PCOS treatment.
15Hormonal and metabolic parameters in PCOSMeta-AnalysisCited 14×n=460 · medium study2023
Our meta-analysis comparing hormonal and metabolic parameters between MET and MI did not show much significant difference, indicating both drugs are equally beneficial in improving metabolic and hormonal parameters in patients with PCOS.
Fatima K et al. · Irish journal of medical science (2023)
Our meta-analysis comparing hormonal and metabolic parameters between MET and MI did not show much significant difference, indicating both drugs are equally beneficial in improving metabolic and hormonal parameters in patients with PCOS.
16Treatment response in trichotillomaniaMeta-AnalysisCited 22×n=286 · medium study2021
There was insufficient evidence from meta-analysis to confirm or refute the efficacy of any agent or class of medication for the treatment of TTM in adults, children or adolescents.
Hoffman J et al. · The Cochrane database of systematic reviews (2021)
No clear effect
← WorseNo effectBetter →
Antioxidants versus placebo in adolescents There was little to no difference in treatment response between antioxidant (50%) and placebo groups (25%) after six weeks, based on a single trial of silymarin (RR 2.00, 95% CI 0.28 to 14.20; 8 participants; low-certainty evidence).
Antipsychotics versus placebo in adults There may be greater treatment response in the antipsychotic group (85%) compared to the placebo group (17%) after 12 weeks, based on a single trial of olanzapine (RR 5.08, 95% CI 1.4 to 18.37; 25 participants; low-certainty evidence).
Cell signal transducers versus placebo in adults There was little to no difference in treatment response between cell signal transducer (42.1%) and placebo groups (31.6%) after 10 weeks, based on a single trial of inositol (RR 1.33, 95% CI 0.57 to 3.11; 38 participants; low-certainty evidence).
The available evidence is insufficient to recommend nutrient supplementation to improve female infertility in women trying to conceive naturally and those utilising MAR.
Pandey C et al. · Nutrients (2024)
The available evidence is insufficient to recommend nutrient supplementation to improve female infertility in women trying to conceive naturally and those utilising MAR.
However, there is currently no indication that these nutrients pose any risk of significant harm.
19Treatment recommendations for nutraceuticals and phytoceuticals in psychiatric disordersMeta-AnalysisCited 117×2022
Based on the current data and clinician input, a range of nutraceuticals and phytoceuticals were given either a supportive recommendation or a provisional recommendation across a range of various psychiatric disorders.
Sarris J et al. · The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry (2022)
Based on the current data and clinician input, a range of nutraceuticals and phytoceuticals were given either a supportive recommendation or a provisional recommendation across a range of various psychiatric disorders.
However several had only a weak endorsement for potential use; for a few it was not possible to reach a clear recommendation direction, largely due to mixed study findings; while some other agents showed no obvious therapeutic benefit and were clearly not recommended for use.
It is the intention of these guidelines to inform psychiatric/medical, and health professional practice globally.
20Thyroid peroxidase autoantibodies reductionMeta-AnalysisCited 8×n=10 · very small study2024
Therefore, we recommend that patients with HT(Hashimoto's Thyroiditis) be given an appropriate amount of selenium as an auxiliary treatment during standard-of-care treatment.
Peng B et al. · Frontiers in endocrinology (2024)
Huge benefit
← WorseNo effectBetter →
These data were combined using standardised mean differences (SMDs) and assessed using a random effects model.
Compared to the placebo group, the use of selenium supplements was able to significantly reduce the levels of thyroid peroxidase autoantibodies (TPOAb) (SMD: -2.44, 95% CI: -4.19, -0.69) and thyroglobulin autoantibodies (TgAb) (SMD: -2.76, 95% CI: -4.50, -1.02).
A total of 10 quantitative meta-analyses of case-control studies were selected for this meta-analysis.