Co-Supplementation of Vitamin D and Probiotics Significantly Improved Hormonal, Inflammatory & Oxidative Stress Markers in Women with Polycystic Ovary Syndrome

by | Feb 22, 2024 | 2019, Probiotics, Vitamin D - General, Women's Health

Written by Taylor Woosley, Science Writer. 12-week intervention of 50,000 IU vitamin D every 2 weeks plus 8 x 109 CFU/day probiotic significantly reduced total testosterone (p<0.001), hirsutism (p<0.001), hs-CRP (p<0.001) and MDA levels (p=0.001) and significantly increased TAC (p<0.001) and GSH levels (p=0.02) compared to placebo. 

woman with long hairPolycystic ovary syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age1. Although one of the underlying causes of PCOS is the high ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH) and increased frequency of gonadotropin-releasing hormone (GnRH), the exact etiology and pathology have not been comprehensively well-known2. PCOS significantly impacts women’s quality of life, often increasing the risk of long-term health complications such as infertility, type 2 diabetes, metabolic syndrome, and endometrial cancer3.

A growing body of evidence indicates that vitamin D is essential to reproductive health and that menstrual imbalance and fertility dysfunction is linked to vitamin D deficiency4. Vitamin D plays a role in glucose metabolism through enhancing insulin synthesis and release, increasing expression of insulin receptors, and suppressing pro-inflammatory cytokines5. Furthermore, research on probiotics has shown its potential to influence weight loss, biomarkers of insulin resistance, and lipid profiles in PCOS subjects6.

Ostadmohammadi et al. conducted a randomized, double-blinded, placebo-controlled trial to assess the effects of co-supplementation with probiotics and vitamin D on mental health status, hirsutism, hormonal profiles, and biomarkers of inflammation and oxidative damage in subjects with PCOS. Subject inclusion consisted of women aged 18-40 years, with PCOS diagnosed based on the Rotterdam criteria, with a body mass index (BMI) in the range of 1.4-4. Participants were randomized to either the vitamin D and probiotic group or placebo (corn oil and starch) for 12 weeks. The vitamin D and probiotic group took 50,000 IU vitamin D every 2 weeks plus 8 x 109 CFU/day probiotic (containing four strains: Lactobacillus acidophilus, Bifidobacterium bifidum, Lactobacillus reuteri and Lactobacillus fermentum).

All participants completed a 3-day diet recall to access daily macro- and micro-nutrient intakes at weeks 0, 4, 9, and 12. Primary study outcomes were hormonal profiles. Secondary study outcomes were mental health parameters and biomarkers of inflammation and oxidative stress. Fasted blood samples were collected at baseline and end of intervention to measure serum total testosterone and sex hormone-binding globulin (SHBG), serum 25-hydroxyvitamin D concentrations, serum high sensitivity C-reactive protein (hs-CRP) levels, plasma NO levels, total antioxidant capacity (TAC) concentrations, total glutathione (GS), and malondiadehyde (MDA) concentrations. Hirsutism was assessed using a modified Ferriman-Gallwey (mFG) scoring systems of 9 body areas. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI). Mental health was investigated using the beck depression inventory (BDI), general health questionnaire-28 (GHQ-28), and depression anxiety and stress scale (DASS) at baseline and after the 12-weeks.

60 women [vitamin D plus probiotics (n=30) and placebo (n=30)] were included in the final analysis. Independent sample t-tests were used to determine differences in anthropometric measurements and dietary intakes between groups. Multiple linear regression models were utilized to analyze the treatment effects on study outcomes, after adjusting for confounding factors, such as age and BMI. Significant findings of the study are as follows:

  • At 12 weeks, the intervention group experienced significantly improved BDI (p=0.04), GHQ (p=0.03), and DASS (p=0.02) compared to placebo.
  • Vitamin D and probiotic supplementation was associated with a significant reduction in total testosterone (p<0.001), hirsutism (p<0.001), hs-CRP (p<0.001) and MDA levels (p=0.001). Furthermore, the intervention group had a significant increase in TAC (p<0.001) and GSH levels (p=0.02) compared to placebo.

Results of the 12-week randomized, double-blinded, placebo-controlled trial show that co-supplementation of vitamin D and probiotics significantly improved inflammatory and oxidative stress markers, along with hormonal and mental health parameters in women with PCOS. Further research should continue to explore the use of anti-inflammatory and gut microbiome modulatory agents on PCOS severity. Study limitations include the lack of data on fecal bacteria and microbiome characterization of participants, along with not analyzing further markers of oxidative stress and inflammation.

Source: Ostadmohammadi, Vahidreza, Mehri Jamilian, Fereshteh Bahmani, and Zatollah Asemi. “Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome.” Journal of ovarian research 12 (2019): 1-8.

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Posted February 22, 2024.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

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