Inositol (Myo / D-Chiro)

PCOSAnxietyInsulin sensitivitySleep

A quasi-B-vitamin that acts as a second messenger for insulin and serotonin signalling. Most evidence-backed natural intervention for PCOS, and a sleeper for anxiety.

EvidenceStrong

Strong for PCOS — multiple RCTs show improvements in ovulation, menstrual regularity, insulin sensitivity, and androgen levels comparable to metformin without the side effects. Strong for panic disorder (12–18 g/day comparable to fluvoxamine in trials). Moderate for OCD and depression. Effects: 8–12 weeks for PCOS markers; 2–6 weeks for mood / anxiety.

Inositol (technically myo-inositol, the most common of nine isomers) is a sugar alcohol that the body uses as a signalling molecule downstream of multiple hormones — most notably insulin, FSH, and TSH. It modulates serotonin receptor sensitivity and has anxiolytic properties. The 40:1 myo-inositol-to-D-chiro-inositol ratio matches what's in healthy ovaries and is the most-studied protocol for PCOS — improving menstrual regularity, ovulation, insulin sensitivity, and androgen levels. Separately, high-dose myo-inositol alone has shown RCT-grade benefit for panic disorder, OCD, and depression. It's safe, well-tolerated, and disarmingly powerful for a 'just a sugar.'

Form
Myo-inositol — the standard form, mildly sweet powder, mixes in water. 40:1 myo + D-chiro blend for PCOS (the Ovasitol formulation is the most-studied). Avoid 'inositol hexaphosphate (IP6)' for these uses — different mechanism, different effects.
Dose
PCOS: 2 g myo + 50 mg D-chiro twice daily (4 g + 100 mg total). Anxiety / OCD / depression: 12–18 g/day myo-inositol divided into 2–3 doses. General use / sleep: 2–4 g pre-bed.
Timing
With food. AM and PM for PCOS dose. Pre-bed for sleep / calm.
Schedule
Daily.
Side effects
Generally well-tolerated. GI upset, gas, mild loose stools at high doses (>10 g). Dizziness or fatigue in some at therapeutic doses.
Interactions
Lithium — inositol may reduce lithium's mood-stabilising effect (mechanism: lithium works partly by depleting inositol). Diabetes medications — additive glucose lowering. Hormonal contraceptives — interaction debated.
Contraindications
On lithium for bipolar disorder (without psychiatrist input). Bipolar disorder generally (theoretical mania risk at very high doses).
Lab markers
Fasting insulin, HbA1c, and androgen panel (testosterone, DHEAS, free androgen index) for PCOS tracking. Hamilton Anxiety / Y-BOCS for mood/anxiety conditions.
Food sources
Fruits (cantaloupe, oranges, strawberries), beans, brown rice, oats, nuts. Total dietary intake is typically 0.5–1 g/day — supplementation delivers far more.

Pairs with

Folate (methylfolate) + vitamin D in PCOS protocols. Magnesium glycinate + L-theanine for anxiety / sleep stack. Berberine, alpha-lipoic acid for additional insulin sensitisation.