D- chiro-inositol (DCI)
D- chiro-inositol (DCI) explored by Eco Therapies in Leigh on Sea Essex with qualified Therapist Elaine Otrofanowei
DCI is what is known as a secondary messenger in the insulin signalling process and is considered an insulin sensitizer. When you eat food, sugar is extracted and goes into your blood. Your pancreas releases insulin in response to the sugar. The insulin tells the cells of your body to either burn the sugar for energy or to store it as fat for later. As the sugar level goes down, the insulin level goes down as well. Insulin doesn’t communicate directly with the cells, however. It communicates through a secondary messenger made out of DCI.
Another important thing that happens to women when there is insulin in your blood: the ovaries release testosterone in response to the insulin. This is natural. As the sugar is disposed of, the insulin level goes down and the ovaries stop releasing testosterone.
DCI is not abundant in diet. It is scarce in foods, so your body must make it from myo-inositol, which is abundant in many foods. But, the transformation is a complicated process with many steps that some people are not able to do very well. As a result, they don’t have enough DCI and the sugar doesn’t get disposed of quickly.
If you don’t have enough DCI, the insulin level stays high, which means that the gonads keep producing testosterone. This high level of testosterone is the origin of many of the signs and symptoms of PCOS – anovulation (not ovulating), irregular or absent periods, ovarian cysts, unwanted body hair, hair loss, belly fat, acne, infertility, etc.
For many women with PCOS, DCI can solve these problems by allowing the body to dispose of sugar effectively. This YouTube video animation describes the whole process in a bit more detail.
Who benefits from taking DCI?
PCOS is complicated. There are many ways in which it can develop. If you are a woman who has insulin resistance issues, there is a good chance that DCI will work for you. If you first noticed signs of PCOS at or soon after puberty, the likelihood of DCI being effective is even greater. A recent study showed that if you have diabetic relatives, your chances are even greater. Women with “lean” PCOS can also benefit from DCI, especially if they have insulin resistance.
If your PCOS is due to problems with your thyroid, it is less likely that DCI will relieve your PCOS. If you developed PCOS later in life as a result of metabolic syndrome, you would probably do better to look at other natural insulin sensitizers. That is not to say that women with thyroid disorders or metabolic syndrome would see no benefit – some women do – it’s just that those problems may not be caused by a lack of DCI.
How much should I take? When do I take it?
Our dosing recommendations are based on the scientific literature. Of course, every woman is different: some find they need more, some find they can do with less.
We recommend one 600 mg capsule for every 130 pounds (80 kg) of body weight. That is, if you weigh less than 130 pounds, take one capsule per day. If you weigh between 130 and 260, take two per day. And so on.
We recommend taking DCI first thing in the morning, before you have eaten. This gives the DCI some time to get into your blood and be ready to go to work when you the first sugars of the day hit your blood.
If you are taking two per day, take the second capsule in the evening before your dinner. If you find that you forget to take that second dose, just take them both in the morning.
How will I know if it works? How long will it take?
It is important to give DCI a fair chance to work before you make any determination about its effectiveness. Some women notice a change in their energy level within a few days. Most women will take about six weeks before they notice any changes. Some women take even longer. It is important that you do not compare your experience to others’ – it can be discouraging. Every woman is different and so will react differently to the therapy. Give yourself time. We recommend that you take at least eight weeks to evaluate DCI.
Some changes you may notice if DCI is working: increase in energy level; stabilization of moods; restoration of menses/ovulation; loss of weight, especially from the mid-section; reduction in acne.
Some changes that may be seen with lab work: decrease in insulin level; improved glucose disposal; improved A1C level; decrease in testosterone (and other androgens); decrease in blood pressure; decrease in plasma triglycerides; increase in sex hormone binding globulin; decrease in luteinizing hormone (LH) and improvement of the LH/FSH (follicle stimulating hormone) ratio.
Some changes take longer to manifest. The softening of body hair and regrowth of head hair can take several months. The disappearance of cysts from the ovaries may take even longer.
Can I take DCI with prescription drugs?
DCI is not known to have any drug interactions. After all, it is a natural human metabolite. That is to say, it is already in your body.
We do not recommend that you take DCI with spironolactone or other such androgen antagonists. Your body does need androgens, and if DCI is able to lower the level to the normal range, you wouldn’t want to lower it further with drugs.
Since metformin is often prescribed for PCOS and has unpleasant side effects, many women try DCI as an alternative. Some of those women take them together, often with the hope that they can discontinue metformin.
Why not take myo-inositol?
Some women with PCOS take 4-9 grams of myo-inositol daily and get good results. It’s really a matter of how well your body can make the conversion described above. If you are a good converter, then supplementing with DCI or myo may be unnecessary if you are eating well. (Myo is in many foods in good quantities – see the clinical evidence section below for a study of myo-inositol content in common foods.)
If you are a fair converter, then flooding the body with myo may work for you. Having more myo in the blood increases the likelihood that you will create enough DCI for yourself. If you are a poor converter, then flooding the body with myo may have little effect.
You can read more about the myo or DCI question here: https://www.chiralbalance.com/myo-inositol-d-chiro-inositol
or purchase Here
Is there clinical evidence that supports DCI therapy for PCOS?
Here are some scientific papers on DCI that you can read online for free:
A clinical trial published by New England Journal of Medicine:
Nestler JE, Jakubowicz DJ, Reamer P, Gunn RD, Allan G (1999). Ovulatory and metabolic effects of D-chiro-inositol in the polycystic ovary syndrome. N. Engl. J. Med. 340 (17): 1314-20.
Two papers on DCI insulin signaling:
Larner J. D-chiro-inositol–its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res. 2002;3(1):47-60.
Cheang KI, Baillargeon JP, Essah PA, et al. Insulin-stimulated release of D-chiro-inositol-containing inositolphosphoglycan mediator correlates with insulin sensitivity in women with polycystic ovary syndrome. Metab Clin Exp. 2008;57(10):1390-7.
Myo-inositol content paper:
Clements RS, Darnell B. Myo-inositol content of common foods: development of a high-myo-inositol diet. Am J Clin Nutr. 1980;33(9):1954-67.
An animal study that shows DCI is more effective when taken with manganese:
Fonteles MC, Almeida MQ, Larner J. Antihyperglycemic effects of 3-O-methyl-D-chiro-inositol and D-chiro-inositol associated with manganese in streptozotocin diabetic rats. Horm Metab Res. 2000;32(4):129-32.
These are not free, but you can read the abstracts:
A clinical trial in women with “lean” PCOS, published in Endocrine Practice:
Luorno MJ, Jakubowicz DJ, Baillargeon JP, et al (2002). Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome. Endocrine practice 8 (6): 417-23.
Another paper on DCI insulin signaling in women with PCOS:
Nestler JE, Jakubowicz DJ, Iuorno MJ (2000). Role of inositolphosphoglycan mediators of insulin action in the polycystic ovary syndrome. J. Pediatr. Endocrinol. Metab. 13 Suppl 5: 1295-8.
A recent clinical trial in which they used 500 mg of DCI per day:
Genazzani AD, Santagni S, Rattighieri E, et al. Modulatory role of D-chiro-inositol (DCI) on LH and insulin secretion in obese PCOS patients. Gynecol Endocrinol. 2014;30(6):438-43.