PCOS is a common endocrine disorder that affects 6% to 10% of women of reproductive age, and is characterised by polycystic ovaries, menstrual dysfunction, hyperandrogenism and impaired fertility.
It is also linked to risk factors for metabolic syndrome, type 2 diabetes, and heart diseases, including dyslipidaemia, inflammation, insulin resistance, oxidative stress, and hypertension, and raises the risk of mental illnesses such as anxiety and depression.
Moreover, it has been said to be associated with vitamin D, as genes involved in vitamin D level regulation are related to blood pressure control, as well as lipid and glucose metabolism. Vitamin D may affect inflammation and oxidative stress by helping to prevent damaged cellular DNA propagation.
Based on previous studies, researchers in Iran hypothesised that a combination of different nutrients may benefit PCOS patients, such as the co-administration of vitamin D and omega-3, which had been shown to have anti-inflammatory and immunomodulatory effects.
This could improve the hormonal profile, metabolic abnormalities, mental illness, and endothelial dysfunction on PCOS patients.
An efficient combination?
They therefore conducted an RCT to determine the impact of the co-administration of omega-3 and vitamin D on clinical, metabolic and genetic parameters of women with PCOS.
They recruited 60 PCOS patients between 18 and 40 years of age and randomly assigned 30 of them to receive 50,000 IU of vitamin D every fortnight and 2,000mg of omega-3 from fish oil daily for 12 weeks, with the other 30 receiving a placebo for 12 weeks.
Afterwards, the researchers observed that co-supplementation of vitamin D and omega-3 markedly lowered total serum testosterone levels in the treatment group, compared with the placebo group.
The patients in the treatment group also saw a significant improvement in depression, general health, anxiety, and stress, unlike those in the placebo group.
In addition, their serum high-sensitivity C-reactive protein and malondialdehyde levels dropped considerably, and their total plasma antioxidant capacity rose significantly in comparison to the placebo group.
The researchers also wrote: "Vitamin D and omega-3 fatty acid co-supplementation significantly down-regulated gene expression of interleukin-1 (IL-1), and up-regulated vascular endothelial growth factor in (the) peripheral blood mononuclear cells of subjects with PCOS, when compared with placebo."
Other considerations for co-administration
They added that the RCT's main limitation was that they did not measure the subjects' circulating levels of free fatty acids, or assess the impact of the co-supplementation of vitamin D and omega-3 on gene expression related to metabolic profiles and oxidative stress.
At the same time, the study's small sample size, short duration, small supplement doses and serum vitamin status at the start of the intervention could have affected its results.
They concluded: "Overall, the co-administration of vitamin D and omega-3 fatty acid for 12 weeks had beneficial effects on mental health status, total testosterone level, serum high-sensitivity C-reactive protein, plasma total antioxidant capacity and malondialdehyde levels, and gene expression of IL-1 and vascular endothelial growth factor among women suffering from PCOS.
"Our findings support the anti-inflammatory and immunomodulatory roles of combined vitamin D and omega-3 supplementation."
Source: Journal of Affective Disorders
"The influences of vitamin D and omega-3 co-supplementation on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome"
Authors: Mehri Jamilian, et al.