Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in PCOS women

• Published in: Journal of endocrinological investigation Vol. 43; no. 6; pp. 779 - 786
• Main Authors: Schiuma, N., Costantino, A., Bartolotti, T., Dattilo, M., Bini, V., Aglietti, M. C., Renga, M., Favilli, A., Falorni, A., Gerli, S.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2020; Springer Nature B.V
• Subjects: Adult; Biomarkers - blood; Blood; Carbon; Carbon cycle; Carbon Cycle - physiology; Cardiovascular diseases; Drug therapy; Endocrinology; Fasting; Fasting - blood; Female; Folic acid; Follow-Up Studies; Homocysteine; Homocysteine - blood; Humans; Infertility; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Micronutrients; Micronutrients - administration & dosage; Original; Original Article; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - diagnosis; Polycystic Ovary Syndrome - diet therapy; Prospective Studies; Testosterone; Young Adult; Micronutrients; One carbon cycle; PCOS; Homocysteine
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-019-01163-x

Purpose Fasting blood homocysteine is increased in PCOS women and is involved in several of its co-morbidities including cardiovascular disease and infertility. Corrective interventions based on the administration of supra-physiologic doses of folic acid work to a low extent. We aimed to test an alternative approach. Methods This was a prospective, randomized, parallel group, open label, controlled versus no treatment clinical study. PCOS women aged > 18, free from systemic diseases and from pharmacological treatments were randomized with a 2:1 ratio for treatment with activated micronutrients in support to the carbon cycle (Impryl, Parthenogen, Switzerland— n  = 22) or no treatment ( n  = 10) and followed-up for 3 months. Fasting blood homocysteine, AMH, testosterone, SHBGs, and the resulting FTI were tested before and at the end of the follow-up. Results The mean baseline fasting blood homocysteine was above the normal limit of 12 μMol/L and inversely correlated with SHBG. AMH was also increased, whereas testosterone, SHBG, and FTI were within the normal limit. The treatment achieved a significant reduction of homocysteine, that did not change in the control group, independently of the starting value. The treatment also caused an increase of AMH and a decrease of SHBGs only in the subgroup with a normal homocysteine at baseline. Conclusions In PCOS ladies, blood homocysteine is increased and inversely correlated with the SHBGs. Physiologic amounts of activated micronutrients in support to the carbon cycle achieve a reduction virtually in all exposed patients. Whether this is of clinical benefit remains to be established.