This post was updated on September 8th, 2019

The biggest problem with most blogs about PCOS supplements is that they’re only written by people trying to sell them. Even if you have the best of intentions, you simply can’t be unbiased if it affects your pockets.

This blog is different.

I have no affiliates to any supplement suppliers and I have no intention of ever selling them.

But I do have a lot to say on the topic. Especially after having recently reviewed over 900 scientific papers that studied PCOS related supplements when creating my Beat PCOS Supplement Guide.

When you take a proper look at the supplements that really have good scientific data in their corner, the list of contenders looks vastly different to what you’d expect. For a start, the list is pretty short and for many of the symptoms we’d like to treat, there just aren’t good supplements that provide a meaningful effect.

For supplement promoters this can be an inconvenient truth, but for the women that take them this can make all the difference between finding a genuine treatment or wasting your money.

As the creator of the free 30 Day PCOS Diet Challenge, my priorities lie in service to the inspiring women who want to take back control of their health using evidence based lifestyle interventions. So my interest is in providing the best information possible to help you beat this highly treatable disorder based on quality science.

Determining Your Personal Nutrient Status

After having met literally tens of thousands of women with PCOS it’s become clear to me that supplements are of interest for two reasons. You either want a natural alternative to pharmacological drugs, or you’re concerned about a potential nutrient deficiency.

In the list below you’ll find the small number of PCOS supplements where high quality scientific studies have found a notable or strong effect. These PCOS supplements don’t just have one or two animal trials showing a “statistically significant result” (the hurdle rate for publication). They actually have multiple, randomized controlled human studies showing the sort of effect you could really notice if you take them.

To help you understand your potential nutrient deficiencies I’ve also created a free PCOS Nutrient Inadequacies Download to go along with this article.

In this comprehensive free guide, I share the most common PCOS related nutrient inadequacies and have identified those that result from the drugs we’re usually prescribed. Birth control, metformin, antidepressants, and many more all cause nutrient depletions that even most doctors don’t know to look for.

The Beat PCOS Nutrient Inadequacies Guide by Smart Fertility ChoicesI’ve also included a recommended resource that describes a step by step process to determining your own personal nutrient status. This includes the exact name of all the tests you need, links to the labs, and 70 pages of detailed notes explaining how to interpret the findings.

 
Get The Guide >
 

While I always recommend maximizing your nutrient status by consuming healthy wholefoods like those included in my free 3 Day PCOS Meal Plan and my free 30 Day PCOS Diet Challenge, supplements can also play an important role too.

So here’s a list of the 11 most proven PCOS supplements according to the evidence.

1. Inositol

If you haven’t heard of inositol before, they’re a group of nine naturally occurring vitamin-like compounds that are present to varying degrees in many foods. Myo-inositol, D-chiro-inositol, or a combination of the two are the most commonly used types of inositol when it comes to taking supplements.

Structurally speaking, they’re somewhat similar to glucose, and the various things they do at a cellular level means they can have a significant effect on several PCOS related symptoms.

When researching for my Beat PCOS Supplements Guide, I looked at nearly 30 scientific studies that specifically looked at the effects of inositol supplements on various PCOS related symptoms. The take home from this analysis was that while the marketing hype can seem a bit overzealous, inositol supplements really can hold their own when it comes to certain PCOS symptoms.

11 Proven Supplements For PCOS

If you really want the lowdown on this highly popular PCOS supplement, then my full blog post on inositol for PCOS is well worth a read. Here are the key points I think everyone needs to know though.

Myo-inositol is clearly a pretty good idea for anyone with PCOS that’s trying to conceive as this supplement has been shown to reduce AMH levels and the size of polycystic ovaries better than birth control (Ozay et al. 20161). It’s also been shown to increase egg quality and reduce the risk of ovarian hyperstimulation in women undergoing fertility treatment (Papaleo et al. 20092; Ciotta et al. 20113).

If your doctor prescribes metformin to help you get pregnant, you’re actually better off taking myo-inositol instead. In a carefully controlled trial, researchers demonstrated this point when women with PCOS who took myo-inositol supplements achieved a natural pregnancy rate of 30% during a six month period, compared to just 18% of women that were prescribed metformin (Raffone et al. 20104).

This is something I really wish I had known during my four and a half year struggle with infertility

11 Proven Supplements For PCOSInositol supplements can also be great for anxiety with several studies showing they can reduce panic attacks, sometimes even better than medication (Palatnik et al. 20015). Inositol can help with unwanted hair and acne too, but don’t expect amazing results. The best research to date shows a “statistically significant” improvement in these symptoms for some, but not all women with PCOS (Minozzi et al. 20086; Zacche et al. 20097). The thing to keep in mind of course is that statistical significance can mean a pretty small improvement in real-life terms so this is more of a side-benefit than a PCOS acne supplement.

The one area where the marketing of inositol diverges the most from scientific fact is in claims about weight loss. Despite what you may read elsewhere, inositol does not help you to lose weight in a meaningful way. The blockbuster study quoted by promoters of the product Ovasitol, does not support this health claim (Nordio and Proietti 20128), and neither do many others (Gerli et al. 20079; Genazzani et al. 201410; Santamaria et al. 201211).

If weight loss is one of your main health goals right now, then you’ll be far better off joining my free 30 Day PCOS Diet Challenge rather than taking inositol. During this live event I typically see women lose 10 – 15 pounds in just 30 days, with high achievers like Erina, Kendall, and April going on to lose more than 50 pounds using the simple strategies I share during this free program.

11 Proven Supplements For PCOS

2. Zinc

Zinc is one of the essential 24 micronutrients needed for survival and thanks to its antioxidant and enzyme regulating behavior, supplementing with this mineral can affect several PCOS related symptoms such as ovulation, acne, weight management, insulin sensitivity and the regulation of blood glucose levels.

This is a nutrient you don’t want to be short on and as I explain in my free PCOS Nutrient Inadequacies Guide, there’s plenty of reasons to suspect you might be – especially if you’re on birth control.

Zinc might seem like an unusual choice for a PCOS supplements list, but it made it through my science filter because of its proven efficacy in fighting treatment-resistant depression (Ranjbar et al 201412; Siwek et al. 200913).

Depression is well known to be a REALLY common problem for women with PCOS (Barry et al. 201114; Jedel et al. 201015), so if this is a problem for you, then you’re definitely not alone.

11 Proven Supplements For PCOSAs someone that’s battled with depression for most of my adult life, this PCOS symptom also happens to be particularly close to my heart. Even today as I’m creeping my way towards freedom from SSRIs, monitoring and adjusting my zinc levels has made a massive difference to my daily wellbeing.

I couldn’t be sincerer when I say that if you’re struggling with depression, then you need to get your zinc levels tested.

As you’ll learn from the recommended resource included in my free PCOS Nutrient Inadequacies Guide, you need to make sure to test for zinc plasma and NOT serum. Ignore the “normal ranges” as these are usually too broad and know that the sweet spot for good health is likely to be between 100-120 micrograms per litre.

If your levels are less than 70 μg/L, then you should definitely be considering supplementing with either zinc acetate, zinc gluconate, zinc sulfate, zinc citrate, or zinc monomethionine. Don’t use zinc oxide or zinc picolinate as these are not absorbed as well by your body. Note that 70 μg/L is within the “normal range” but concentrations less than this indicate you’re actually on the low side.

If you go down this pathway, then you should also be considering a copper supplement too as zinc needs to be kept in balance with copper. Your zinc to copper ratio should be kept between 8:1 and 12:1. Talk to your doctor of course, as hopefully they can provide some guidance with this.

11 Proven Supplements For PCOS

3. Curcumin

Curcumin is the yellow pigment found in turmeric and it’s a hot topic thanks to its anti-inflammatory and anti-depressant effects.

This is one of the rare occasions where the science actually supports a lot of the marketing claims concerning metabolic, cardiovascular, and mental health in at-risk populations (Vieira de Melo et al. 201816; Atkin et al. 201717; Qin et al. 201718; Ng et al. 201719).

Chronic low grade inflammation is one of the distinctive characteristics of a PCOS diagnosis and is responsible for many of our unwanted symptoms. From unfair weight gain and cardiovascular disease risks, to infertility, hirsutism, and acne, inflammation plays a key role throughout.

The fact that curcumin supplements can combat this inflammation is the same reason why a PCOS friendly diet works so well. All the recipes included in both my free 30 Day PCOS Diet Challenge and in this free 3 Day PCOS Meal Plan are intentionally designed to lower inflammation with the results consistently speaking for themselves.

There’s no doubt that the foods we eat can fuel or extinguish the fires of inflammation, and a curcumin supplement can help tip the balance in your favor. The thing about curcumin supplements though, is that taking them effectively is vastly different to what most people assume.

If you jump online, or talk to your slightly eccentric, Aunt Selma, you’ll hear that consuming large amounts of turmeric will help you live to 100. The reality though is that your gut has a lot of trouble absorbing the curcumin found in turmeric and the same can be said for the majority of cheaper supplements.

While curcumin can be a safe and effective supplement, if you want to experience the “proven benefits”, then you’ll need to be taking one of the more expensive brands that use proprietary technology to increase bioavailability.

11 Proven Supplements For PCOS

4. Fish Oil

When people talk about fish oil, what they really mean is a concentrated supplement containing two particular omega-3 fatty acids – EPA and DHA. These are the super healthy fats that are predominantly found in oily fish and seafood, but you’ll also find them in less concentrated ratios in egg yolks provided the chickens are pasture raised.

One of the reasons I think fish oil supplements are well worth considering is because they help you balance your essential fatty acids. If you’re eating a PCOS friendly diet, like the sort we follow in my free 30 Day PCOS Diet Challenge and in this free 3 Day PCOS Meal Plan, then you should be consuming a relatively high amount of animal derived, omega-6 fats. Our bodies have evolved to require omega-6 and omega-3 fatty acids in a ratio of between 4:1 to 1:1 despite the fact that the average Western diet typically results in a ratio of 20:1 or higher (Simopoulos 201620).

The reason fish oil makes the cut as one of the best supplements for PCOS though is because there’s a lot of research that can back it up. If you’re confused on this point, then you’re not the only one as decades of competing interests has made it difficult to filter the truth from the noise. But after reading 68 randomized controlled trials and meta-analyses when researching for my Beat PCOS Supplements Guide, the answer seems fairly settled.

Fish oil formulations that predominantly contain EPA are most effective for treating depression (Hallahan et al. 201621) while combinations of EPA and DHA have pharmaceutical grade potency for reducing triglyceride levels in people at risk of heart disease (Alexander et al. 201722).

Having PCOS means you’re automatically going to be at risk for a DHA deficiency because chronic inflammation (the hallmark of a PCOS diagnosis) is a major risk factor. This is a big problem because along with another fatty acid (AA), DHA is one of the most important nutrients to support good health.

So if you don’t eat much seafood, you generally consume grain-fed meat, or you’re a vegetarian, then chances are you’re low on this important fatty acid and should be considering a fish oil supplement. This is one of the many reasons why I don’t recommend a plant based diet for women with PCOS. While you can find plenty of omega-3 fats in things like Chia seeds, flaxseeds, and walnuts etc. the conversion of these particular omega-3’s to DHA is very slow and inefficient.

If you’re interested in testing your fatty acid profile and want to know the best nutritional changes you can make depending on your personal lab results, then you can find a link to my recommended resource in this free PCOS Nutrient Inadequacies Guide.

5. Berberine

Berberine is a plant extract used in traditional Chinese medicine. It’s been making a big splash both in scientific journals and clinical practice thanks to its near pharmaceutical effects as an anti-diabetic agent.

11 Proven Supplements For PCOS
Berberine makes the list of the 11 best supplements for PCOS because it can be a fantastic tool for women who’s PCOS has advanced to insulin resistance or type II diabetes. If your doctor is prescribing you metformin or other oral hypoglycemic drugs to help with blood glucose regulation, this natural product can make these drugs more effective (Dong et al. 201223).

It can even be used as a replacement for those who’d rather not be taking drugs at all.

Berberine is not suitable for women that are pregnant or nursing though, so if you’re trying to conceive its best avoided. It can interact with a lot of medications too so you definitely don’t want to be self-prescribing this supplement.

6. Salacia Reticulata

You might not have heard of Salacia reticulata before, but this is a serious contender for anyone interested in scientifically credible natural supplements for PCOS. I only heard of it because it showed up one day in a literature search when I was researching for my Beat PCOS Supplement Guide.

Despite my ignorance, as it turns out this woody plant species has been used for centuries in India and Sri Lanka as part of Ayurvedic traditional medicine. While it can be taken as a powder, Salacia reticulata can be made into a tea known as Kothala Himbutu where it has been shown to be effective in the treatment of type II diabetes (Jayawardena et al. 200524).

The way this herb works is that it has a short term effect on glucose absorption and insulin levels (Heacock et al. 200525; Collene 200526) so it provides a useful treatment if you have trouble with blood glucose regulation.

11 Proven Supplements For PCOSBecause it’s best taken immediately after a meal, having a post-dinner Kothala Himbutu tea can be a pretty good habit to get into if you’re concerned about your metabolic health. Short term human studies suggest that Salacia reticulata is safe and well tolerated, even when taken along with metformin (Kajimoto et al. 200027; Shivaprasad et al. 201328) so it’s surprising to me that this isn’t better known in PCOS circles.

The thing to keep in mind though is that while you’ll find plenty of people that swear by PCOS supplements like berberine and Salacia reticulata for helping with blood glucose regulation, at the end of the day, they’re still really a band-aid solution because they only work as long as you’re taking them.

A more sustainable solution for anyone wanting to achieve genuine weight loss and improved metabolic health long term is to follow a PCOS diet as your primary intervention and then use supplements to enhance the great work you’re doing with food.

The way your body responds to glucose can be dramatically altered long term by what you decide to eat. When you choose foods like those I prescribe during my free 30 Day PCOS Diet Challenge and in this free 3 Day Meal Plan, you’re addressing the root cause of the problem rather using supplements to mask your symptoms.

11 Proven Supplements For PCOS

7. Winter Cherry (Ashwagandha)

Winter cherry also known as ashwagandha, Indian ginseng, poison gooseberry, or Withania somnifera is another rising superstar from the world of Ayuervedic medicine. While there’s growing evidence that winter cherry has positive effects on cholesterol levels and weight loss, its real value lies with women with PCOS that suffer from anxiety and stress.

I appreciate that this might seem like another fairly random choice for my top 11 PCOS Supplements list, but this is what anyone else would find too if they completed a completely non-biased review of the current scientific literature. I found at least three separate randomized controlled trials showing a notable reduction of stress and anxiety making this a genuine natural treatment for this common PCOS symptom (Chandrasekhar et al. 201229; Cooley et al. 200930; Andrade et al. 200031). It seems amazing to me that this plant isn’t better known.

Winter cherry is understood to work by reducing cortisol concentrations which is how it makes us more resilient to social stress (Chandrasekhar et al. 201229). For people looking for natural alternatives to anti-anxiety medications, this herb may be one of your best options.

8. Saffron

According to science, the world’s most expensive food spice also happens to be a powerful natural treatment option if depression is one of your PCOS symptoms.

11 Proven Supplements For PCOSSeveral high quality studies have found extracts from this flower to be as effective as common SSRI drugs (Hausenblas et al. 201532). There are also a few studies showing saffron extract helps with sexual function in both men and women who are being treated with SSRIs (Kashani et al. 201333; Modabbernia et al. 201234).

For people that are into essential oils, as well as smelling nice, it’s good to know that saffron aromatherapy may provide mild relief from anxiety (Fukui et al. 201135).

A recent trial also showed promising results for using saffron extract to reduce inflammation and treat the same metabolic health risks that confront women with PCOS (Kermani et al. 201736; Razavi et al. 201737).

Particular caution is warranted when considering saffron supplements as studies have shown that taking too much could be harmful (Safarinejad et al. 201138). High doses have also traditionally been used to induce abortions so this definitely isn’t something to be messing with when trying to conceive.

9. Melatonin

Getting a good night’s sleep of 7 – 8.5 hours is arguably one of the most important things you can do to help manage PCOS. This is doubly true if you’re trying to lose weight with PCOS as I explain in more detail here.

11 Proven Supplements For PCOSFor many people reading this though, I suspect that a good night’s sleep sounds more like a pipe dream than one you’ll actually have since insomnia is such a common PCOS related problem. If this sounds like you, then melatonin supplements may be one of your best options.

Melatonin is a naturally produced hormone that our brains release at night to regulate our sleep and there are many high quality studies showing that supplementing with this hormone can improve sleep quality and shorten the time it takes to fall asleep (Brzezinski et al. 200539).

I’ve taken melatonin in the past to help with insomnia and I definitely found it helpful. My take on this relatively safe and well tolerated supplement is that it can be a useful short term fix to help you get your sanity back, but longer term you want to be addressing your sleep disturbances at the root cause.

Caution is also warranted if you’re on neural active drugs such as antidepressants as interactions are likely.

In my experience with having run tens of thousands of women through my free 30 Day PCOS Diet Challenge, fixing your diet is often the most powerful treatment for the majority of sleep disorders. Quitting sugar, avoiding inflammatory foods, and consuming nutrient dense whole foods like the ones you’ll find here in this free 3 Day PCOS Meal Plan can radically alter your entire hormone profile and this includes those that are messing with your shut-eye.

11 Proven Supplements For PCOS

10. Minoxidil

While I don’t like to sound like an advertisement, even if you’re only looking at randomized trials, minoxidil a.k.a. “Rogaine” clearly works for the treatment of hair loss. Not just in men, but for women too (Adil and Goodwin 201740).

While the exact mechanisms are yet to be clearly understood, minoxidil helps restore thinning hair in women with PCOS by prolonging the growth phase of the hair follicles. These are often shortened due to the elevated testosterone levels that are one of the hallmark indicators of a PCOS diagnosis.

Apart from when I had my son, I’ve had the fortune of not having major issues with hair loss (who knew that having kids can make your hair fall out?). But there are a lot of lovely women in my PCOS Support Facebook Group that struggle with this symptom daily.

Amongst all the upsetting consequences of a PCOS diagnosis, this one can often be the absolute pits, so I was glad to find out that this topical supplement actually works.

11. Probiotics

Last but not least, we get to the most exciting PCOS supplement of them all – probiotics. These are live cultures of healthy gut bacteria that are proving to be one of the most promising fields in modern medicine. Particularly when it comes to treating chronic illnesses where conventional drugs have failed to deliver. Illnesses, like PCOS.

11 Proven Supplements For PCOSA number of recent high quality trials (randomized, double-blinded, and placebo-controlled) have shown promising results for using certain strains of bacteria to counter the basic mechanisms driving all of our PCOS symptoms (Ghanei et al. 201841; Karimi et al 201842; Karamali et al. 201843; Rasha et al. 201744). Studies like these are taking the knowledge that PCOS stems largely from imbalances in the gut, and tries to tackle these issues head-on by altering our gut health through the addition of different bacteria.

Probiotic supplements specifically for PCOS are at the cutting edge of medical research and as a result we’re still a long way away from understanding exactly how to tailor different strains of bacteria to achieve specific health goals in certain individuals.

What we can tell from the research to date though is that certain high dose strains of Lactobacillus, Bifidobacterium, and Streptococcus certainly seem to be beneficial and I expect that practice based evidence rather than evidence based practice will lead the charge here.

My best advice for anyone wanting to go down this path, is to have your physician order a stool test first to see which strains you’re missing. There are at least 14 different families of bacteria that are commonly affected by diet, so getting yourself tested means you can then choose the most suitable probiotic supplement for your unique situation.

An Important Warning + What To Do Next

These 11 supplements for PCOS are a bit like guns. They can be lifesaving or deadly depending on how you wield them. Okay… they’re probably more like bows and arrows, but the point I’m trying to make is that it’s all about how you use them.

With this in mind, before you spend any more time and energy researching PCOS supplements I highly recommend reading this blog first: 5 Mistakes To Avoid with PCOS Supplements.

11 Proven Supplements For PCOSClearly some supplements work, but using an individual nutrient as an “easy-fix” is always going to under-deliver. Supplements may not be well absorbed or in the “right” form for your body to use them and it’s common to find inadvertent negative interactions. At the very least, it’s an easy way to waste money and as I explain here, just because something is “natural” doesn’t mean it’s safe.

I also recommend you download a copy of my free PCOS Nutrient Inadequacies Guide. This will arm you with knowledge about the nutrient depletions caused by your PCOS diagnosis and those that result from any medications you may be taking. It also directs you to my recommended resource where you can determine your personal nutrient status through comprehensive dietary analysis and/or PROPER lab testing. This is the basic knowledge about micronutrients I think every women with PCOS needs to know.

Having evidence based supplements that can help treat PCOS is awesome and I have a much better appreciation for them after having reviewed the literature for my Beat PCOS Supplements Guide.

However, in spite of the hundreds of hours it took to complete this exercise, my view remains unchanged: Food, rather than dietary supplements, is the ultimate PCOS treatment and there’s little point in taking the later if your diet is off course.

PCOS Diet: A Beginner’s Ultimate 13 Step GuideUnlike supplements, food offers nutrition that is perfectly balanced and well accepted by your body. When you get your nutrition through food, there’s no need to get technical about all of the different biochemical pathways and cellular processes that even most molecular biologists have trouble explaining. You don’t need hundreds of blood tests and thousands of dollars consulting with a naturopathic doctor. And you don’t need to spend hours of research reading what the science has to say.

Food is safe, it’s affordable, and you never need to ask yourself if you’re making the right decision. If it came down to a choice between a PCOS friendly diet or a regular diet plus supplements, I’d pick the PCOS diet every time.

My best advice is that before you consider supplements, do as much as you can to improve your PCOS friendly diet. This is where you’ll get the biggest bang for your buck and you can start today using this free 3 Day PCOS Meal Plan or by joining my next free 30 Day PCOS Diet Challenge.

All the best for your ongoing success,

xo Kym


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References

1Ozay, Ali Cenk; Ozay, Ozlen Emekci; Okyay, Recep Emre; et al. Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY, 2016.

2Papaleo, Enrico; Unfer, Vittorio; Baillargeon, Jean-Patrice; et al. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial. FERTILITY AND STERILITY, 2009.

3Ciotta, L.; Stracquadanio, M.; Pagano, I.; et al. Effects of Myo-Inositol supplementation on oocyte’s quality in PCOS patients: a double blind trial. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, 2011.

4Raffone, Emanuela; Rizzo, Pietro; Benedetto, Vincenzo. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. GYNECOLOGICAL ENDOCRINOLOGY, 2010.

5Palatnik, A; Frolov, K; Fux, M; et al. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 2001.

6Minozzi, M.; D’Andrea, G.; Unfer, V. Treatment of hirsutism with myo-inositol: a prospective clinical study. REPRODUCTIVE BIOMEDICINE ONLINE, 2008.

7Zacche, Martino M.; Caputo, Luigi; Filippis, Susanna; et al. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. GYNECOLOGICAL ENDOCRINOLOGY, 2009.

8Nordio M; Proietti, E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, 2012.

9Gerli, S.; Papaleo, E.; Ferrari, A.; et al. Randomized, double blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, 2007.

10Genazzani, Alessandro D.; Santagni, Susanna; Ricchieri, Federica; et al. Myo-inositol modulates insulin and luteinizing hormone secretion in normal weight patients with polycystic ovary syndrome. JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH, 2014.

11Santamaria, A.; Giordano, D.; Corrado, F.; et al. One-year effects of myo-inositol supplementation in postmenopausal women with metabolic syndrome. CLIMACTERIC, 2012.

12Ranjbar, Elham; Shams, Jamal; Sabetkasaei, Masoumeh; et al. Effects of zinc supplementation on efficacy of antidepressant therapy, inflammatory cytokines, and brain-derived neurotrophic factor in patients with major depression. NUTRITIONAL NEUROSCIENCE, 2014.

13Siwek, Marcin; Dudek, Dominika; Paul, Ian A.; et al. Zinc supplementation augments efficacy of imipramine in treatment resistant patients: A double blind, placebo-controlled study. JOURNAL OF AFFECTIVE DISORDERS. 2009.

14Barry, J. A.; Kuczmierczyk, A. R.; Hardiman, P. J Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis.. HUMAN, 2011.

15Jedel, E.; Waern, M.; Gustafson, D.; et al. Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index. HUMAN REPRODUCTION, 2010.

16Vieira de Melo, Ingrid Sofia; dos Santos, Aldenir Feitosa; Bueno, Nassib Bezerra. Curcumin or combined curcuminoids are effective in lowering the fasting blood glucose concentrations of individuals with dysglycemia: Systematic review and meta-analysis of randomized controlled trials. PHARMACOLOGICAL RESEARCH, 2018.

17Atkin, Stephen L.; Katsiki, Niki; Derosa, Giuseppe; et al. Curcuminoids Lower Plasma Leptin Concentrations: A Meta-analysis. PHYTOTHERAPY RESEARCH, 2017.

18Qin, Si; Huang, Lifan; Gong, Jiaojiao; et al. Efficacy and safety of turmeric and curcumin in lowering blood lipid levels in patients with cardiovascular risk factors: a meta-analysis of randomized controlled trials. NUTRITION JOURNAL, 2017.

19Ng, Qin Xiang; Koh, Shawn Shao Hong; Chan, Hwei Wuen; et al. Clinical Use of Curcumin in Depression: A Meta-Analysis. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2017.

20Simopoulos, Artemis P. An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity. NUTRIENTS, 2016.

21Hallahan, Brian; Ryan, Timothy; Hibbeln, Joseph R.; et al. Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression. BRITISH JOURNAL OF PSYCHIATRY, 2016.

22Alexander, Dominik D.; Miller, Paige E.; Van Elswyk, Mary E.; et al. A Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies of Eicosapentaenoic and Docosahexaenoic Long-Chain Omega-3 Fatty Acids and Coronary Heart Disease Risk. MAYO CLINIC PROCEEDINGS, 2017.

23Dong, H; Wang, N; Zhao, L; Lu, F. Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE, 2012.

24Jayawardena, MHS; de Alwis, NMW; Hettigoda, V; et al. Double blind randomised placebo controlled cross over study of a herbal preparation containing Salacia reticulata in the treatment of type 2 diabetes. JOURNAL OF ETHNOPHARMACOLOGY, 2005.

25Heacock, PM; Hertzler, SR; Williams, JA; et al.Effects of a medical food containing an herbal alpha-glucosidase inhibitor on postprandial glycemia and insulinemia in healthy adults. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION, 2005.

26Collene, AL; Hertzler, SR; Williams, JA; et al. Effects of a nutritional supplement containing Salacia oblonga extract and insulinogenic amino acids on postprandial glycemia, insulinemia, and breath hydrogen responses in healthy adults. NUTRITION, 2005.

27Kajimoto, OKS; Shimoda, H; Kawahara, Y; Hirata, H; Takahashi, T. Effects of a diet containing Salacia reticulata on mild type 2 diabetes in humans. A placebo controlled, cross over trial. JOURNAL OF THE JAPANESE SOCIETY OF NUTRITION AND FOOD SCIENCE, 2000.

28Shivaprasad, H. N.; Bhanumathy, M.; Sushma, G.; et al. Salacia reticulata Improves Serum Lipid Profiles and Glycemic Control in Patients with Prediabetes and Mild to Moderate Hyperlipidemia: A Double-Blind, Placebo-Controlled, Randomized JOURNAL OF MEDICINAL FOOD, 2013.

29Chandrasekhar, K; Kapoor, J; Anishetty, S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. INDIAN JOURNAL OF PYSCHOLOGICAL MEDICINE, 2012.

30Cooley, Kieran; Szczurko, Orest; Perri, Dan; et al. Naturopathic Care for Anxiety: A Randomized Controlled Trial ISRCTN78958974. PLOS ONE, 2009.

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