Pregnitude is a blend of myo and d-chiro inositol (and folate, I think). D-chiro is expensive and Pregnitude is a proprietary blend (ie - they came up with the ratios), which is why it's so expensive. You can get myo-inositol by itself for about $30/lb in bulk form, which should last you somewhere around three months (my family goes through about half a pound a month, with a combined usage of about 25-30g daily, so a single person on the PCOS dosage of about 4g, or anything less than that, should be able to last far longer).

D-chiro and myo work together and complement each other, so it would probably still be worthwhile to include it if you can find it (even Amazon only has two listings -- if it doesn't specifically say it's D-chiro, then myo). Take a look around and see if you can find them cheaper separately.

You might also want to check out Vitex (chasteberry). It's got more side effects than Inositol, but it's pretty powerful for hormone balance (just make sure you talk with your doctor to ensure you don't accidentally cause interactions).

And yes, you can have cysts without having PCOS, you can also have PCOS without polycystic ovaries. It's a syndrome, so it's just a collection of symptoms.

Also, define "normal" for insulin levels. What did your test result come back with and what is the cut off number? "Normal" according to LabCorp isn't necessarily "healthy" for one's body.

andisue50 wrote: »

Thank you, Dragonwolf! Maybe I will continue pregnitude while TTC but definitely want to try the inositol and see if it provides the same relief from my cramps in the future. My insulin was 3.5 in April and then 5.6 this time.
Thank you, ravenstar25 for the response. It's definitely frustrating that things are so gray, not black and white. I really love my doctor (and of course she just moved across the country and I have to go to a new one!), but I wasn't expecting her to suggest PCOS. It makes me feel better to know there really is so much variability.

Let me just say I'm jealous of your insulin numbers. I've been fighting to keep mine under 20 (the cutoff between "normal" and "pre-diabetic"). I'd have zero weight issues if I could get mine to your levels, since it's the major roadblock for me!

Seems you have what's sometimes referred to as Type II PCOS. Or PCOS without insulin resistance. Have you done progesterone supplementation? It sounds like your issue may stem from estrogen dominance due to the low progesterone. The cysts on your ovaries and intermittant ovulation may also stem from the lack of progesterone (and I'm willing to bet low levels of lutenizing hormone (LH), too).

And I stand corrected, it seems Pregnitude does not contain d-chiro inositol, but rather it's a blend of myo-inositol and folic acid (which means it's expensive largely for the name, all the more reason to switch to something else). So, in light of that, here's what I recommend trying:

1. Drop the Pregnitude for a different, less expensive brand of Myo-Inositol (I recommend what I linked earlier). You can keep the same amount as a dose of Pregnitude (2 grams) if it's effective for you, but don't be afraid to increase the dosage (especially if you can't get your hands on DCI, or if you're still having limited benefit). There are no known adverse effects to larger doses and tested therapeutic dosages of myo-inositol go as high as 12-15 grams.
2. Take a separate folate supplement and make sure it's folate and not folic acid. Folate has better bioavailability (folic acid has to be converted for the body to use it). Also, don't be afraid to eat more eggs, especially if you can get your hands on pastured eggs. They're folate powerhouses.
3. Add in some d-chiro inositol (DCI) to help augment the action of the myo-insoitol.
4. If your progesterone is still low and/or testosterone still high, consider a natural progesterone cream, Vitex, or other progesterone supplementation. Bringing progesterone up may help reduce testosterone as the body is no longer trying to compensate for the estrogen dominance.

* Disclaimer -- I don't think Inositol has been tested for safety during pregnancy, and so most people will be like "use with caution" or whatever borderline paranoid verbiage they like to use. However, Folate is highly encouraged during pregnancy. Given that Inositol has very similar actions to Folate (improved neural function), helps modulate insulin much like Metformin (which is also usable during early stages of pregnancy), and is also a vitamin and has been proven to be safe in general, even at high doses, then it stands to reason that it's safe, and possibly even advantageous, during pregnancy. As always, though, consult with your doctor about it and go the route that makes you feel most comfortable.

On a side note, I found this nifty article on the safety of preconception herbs during pregnancy (as well as herbs that are great for common pregnancy ailments).

andisue50 wrote: »

Dragonwolf, sounds great. I have an appointment next week so I will definitely talk to her about changing the Inositol/Folate. As far as the progesterone, the doctor did have me take progesterone supplements along with my Clomid/Letrozole rounds. Sorry, should have mentioned that. The side effects of the progesterone SUCKS though!

KnitOrMiss, sorry you've been through so much! Glad the Metformin is helping you.

Was it natural or synthetic progesterone? I'm not as versed in progesterone supplementation, but that may make a difference in that. Hopefully you can work something out that doesn't require that, though, if you're getting bad side effects.

Good luck!

KnitOrMiss wrote: »

The progesterone I took was a natural topical cream that you rub into your thigh once daily so that it is slowly absorbed through the fat layer. Don't know about Andisue50's form... I just know that must stuff was so out of whack, it helped, but not the way it needed to help. It worked to balance out another deficit that was even worse...

I use a natural progesterone cream the last half of my cycle also. You can rub it into your inner arms, face, thighs, etc. It helps balance out the estrogen issues, which the Vitex is also helping. Since my miscarriage in September, i use the progesterone to straighten things out AND to help just in case we have another surprise.

andisue50 wrote: »

Mine was a prescription that is inserted vaginally.

After a positive pregnancy test, the insurance will pay for progesterone suppositories but until you get a positive pee stick, its natural progesterone cream off amazon.

Hey! PCOS can be very confusing because there are multiple ways that different medical organizations use data to make the diagnosis. They used to make the diagnosis solely based on polycystic ovaries on ultrasound, hence the name. I also have PCOS, but I'm what you call a "lean" PCOS. (I'm 5'4, around 130 lbs), however I have never had a period naturally or ovulated. I do not have insulin resistance which leaves less meds that might help my ovulate (such as those that help insulin resistance such as metformin and supplements like myo-inositol). I also had severe androgenic sx when I was diagnosed; getting laser hair removal on my face at the age of 13! I have not tried for pregnancy yet and am nervous about doing so. Thus, looking for support in general. I love that we are educating each other; such a positive group here. I am a physician assistant myself and have a strong interest in women's health and PCOS in general. Let me know if I can help with any medical questions also. I did my Master's thesis on comparing myo-inositol vs. metformin in regards to pregnancy rates. I should also say I am also hypo-thyroid, so I have both of those things going for me!

lysco08 wrote: »

Hey! PCOS can be very confusing because there are multiple ways that different medical organizations use data to make the diagnosis. They used to make the diagnosis solely based on polycystic ovaries on ultrasound, hence the name. I also have PCOS, but I'm what you call a "lean" PCOS. (I'm 5'4, around 130 lbs), however I have never had a period naturally or ovulated. I do not have insulin resistance which leaves less meds that might help my ovulate (such as those that help insulin resistance such as metformin and supplements like myo-inositol). I also had severe androgenic sx when I was diagnosed; getting laser hair removal on my face at the age of 13! I have not tried for pregnancy yet and am nervous about doing so. Thus, looking for support in general. I love that we are educating each other; such a positive group here. I am a physician assistant myself and have a strong interest in women's health and PCOS in general. Let me know if I can help with any medical questions also. I did my Master's thesis on comparing myo-inositol vs. metformin in regards to pregnancy rates. I should also say I am also hypo-thyroid, so I have both of those things going for me!

Also, if your thyroid issues are not under full control, look into Iodoral. It is a combination iodine/iodide supplement that is over the counter, but generally kept behind the counter in many pharmacies that carry it. Medication brought my numbers under control, but I didn't start having any symptom relief until adding Iodoral. I recommend it to anyone I hear suffering of hypothyroid. My doctor had me start taking 1/2 a pill a day to be sure I tolerated it okay (some have an allergy, similar to iodine allergies). After about 4 days, I switched to a full pill, and around day 8, I realized that it had slowly creeped up on me that I was waking up without multiple alarms and not feeling like a brain-dead zombie. I was still tired, but I was functionally awake with a single alarm, which hadn't happened in a decade! Nearest I can tell, it really kicked in around day 5-6... I missed that supplement accidentally the last 3-4 days, and I could really tell. Today, I was nearly catatonic... Took me a while to realize the problem.

I am not insulin resistant by the numbers, but have odd food processing borderline narcolepsy issues that are managed with Metformin. So, good luck. It is wonderful to see more PA's out there studying these difficult issues.

andisue50 wrote: »

I've been doing some research, and there are studies showing PCOS is linked to hypothyroidism. Also studies showing PCOS is linked to IBS (something else I deal with- anyone else?). This doesn't really provide any answers, but I just found it interesting that these are all interconnected. Hopefully the treatment/management can become interconnected as well.

The doctors only give me the TSH and the T3 and T4 blood tests, but they are all smack dab in the middle of normal so they wont dig further. Hoping that means no thyroid problems. But I do have some IBS symptoms but never been in to evaluate it for sure. There are things i cant eat without problems, milk because of the whey, gluten in any form, not just wheat but even oats give me a problem. Since I try to do a LC/HF diet, it isnt usually a problem for me because i dont eat the oats/wheat/gluten or drink milk. I can use dairy in cooking, cream cheese or sour cream or heavy whipping cream with out much of a problem but one 8 ounce glass of milk will bloat me by almost 4 inches (yes we measured) and give me some bad IBS symptoms.

It is interesting how interrelated everything is with PCOS. It isnt a 'fertility' only issue but the sad and frustrating part is most doctors only see it as a fertility issue. It actually affects all the rest of our lives, from self esteem issues based on weight or weightloss issues or excessive hair or cystic acne, to the depression and feelings of worthlessness from fertility issues, to digestive health, PMS symptoms, depression and anxiety.

I am SOOOO very very happy to see some doing their thesis and work in this field who really do care why and how to fix it because most of us are surrounded by doctors who view it as a fertility issue, stick us on birth control and tell us to come back if we want kids.