Another Promising Treatment for PCOS

Alternative Promising Treatment for PCOS

An important educational objective in many of our newsletters and articles regarding women's hormones is understanding the relationship between blood sugar, insulin and androgen hormones. Upper range or elevated testosterone and/or DHEA levels are very common findings with saliva testing and treatment involves balancing blood sugar and treating insulin resistance to blunt the insulin stimulation of androgen hormones. Just recently we sent out a newsletter article with some treatment ideas including several botanical options as well as some key nutritional needs. One of the most common conventional treatments for insulin resistance and PCOS is the medication metformin which decreases intestinal glucose absorption as well as glucose production in the liver and increases insulin sensitivity at the receptor level. While reasonably effective, metformin has many common side effects including diarrhea, nausea, abdominal discomfort and general GI upset and has been known to induce a vitamin B12 deficiency.

A recent study published in August of this year compared the efficacy of metformin to N-actetyl-cysteine (NAC) in 100 women who had been diagnosed with PCOS and found that the two treatments had comparable effects on hyperandrogenism and hyperinsulinemia. Yep, that's right. The amino acid NAC was shown to be just as effective at controlling blood sugar and insulin levels as metformin. N-actetyl-cysteine is a derivative of the amino acid L-cysteine and is a precursor to the antioxidant glutathione. It is commonly used for detoxification support and for protecting against or treating exposure to environmental pollutants. Although the study comparing NAC and metformin didn't elucidate the mechanism of NAC's benefit with insulin resistance, it may be due to NAC's ability to reduce oxidative stress on the insulin receptor caused by elevated glucose, an action that has been shown in other studies.

NAC is a widely available and relatively safe amino acid therapy with many uses and may be a viable option for treating your patients with insulin resistance and/or PCOS, especially if they are experiencing GI side effects from metformin. The dosage used in this study was 600 mg of NAC three times daily, which is consistent with the dosing regimen for other conditions.




Haber CA, Lam TK, Zhiwen Y, et al. N-acetylcysteine and taurine prevent hyperglycemia-induced insulin resistance in vivo: possible role of oxidative stress. Am J Physiol Endocrinol Metab. 2003 Oct; 285(4)

Oner G, Muderris II. Clinical, endocrine and metabolic effects of metformin vs. N-acetyl-cysteine in women with polycystic ovary syndrome. EuroJ Obstet Gynecol Reprod Biol. 2011 Aug 8.

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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.