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Inositol

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Supplement Forms/Alternate Names:

IP6; Inositol Hexaphosphate; Myoinositol; Phytic Acid; Vitamin B 8

Principal Proposed Uses

Depression; Panic Disorder

Other Proposed Uses

Alzheimer's Disease; Attention Deficit Disorder; Bipolar Disorder; Bulimia; Cancer Treatment Support; Cancer Prevention; Diabetic Neuropathy; Metabolic Syndrome; Obsessive-Compulsive Disorder; Premenstrual Syndrome (PMS); Polycystic Ovarian Syndrome (PCOS); Psoriasis Caused by Treatment With Lithium

Inositol, unofficially referred to as "vitamin B 8," is present in all animal tissues, with the highest levels in the heart and brain. It is part of the membranes (outer coverings) of all cells, and plays a role in helping the liver process fats as well as contributing to the function of muscles and nerves.

Inositol may also be involved in depression. People who are depressed may have lower than normal levels of inositol in their spinal fluid. In addition, inositol participates in the action of serotonin, a neurotransmitter known to be a factor in depression. (Neurotransmitters are chemicals that transmit messages between nerve cells.) For these two reasons, inositol has been proposed as a treatment for depression, and preliminary evidence suggests that it may be helpful.

Inositol has also been tried for other psychological and nerve-related conditions.

Sources

Inositol is not known to be an essential nutrient. However, nuts, seeds, beans, whole grains, cantaloupe, and citrus fruits supply a substance called phytic acid (inositol hexaphosphate, or IP6), which releases inositol when acted on by bacteria in the digestive tract. The typical American diet provides an estimated 1,000 mg daily.

Therapeutic Dosages

Experimentally, inositol dosages of up to 18 g daily have been tried for various conditions.

Therapeutic Uses

Some but not all studies suggest that high-dose inositol may be useful for depression.1-4

Inositol has also been studied for bipolar disorder,5panic disorder,6,7bulimia,8 and obsessive-compulsive disorder,9,10 but the evidence remains far from conclusive. Other potential uses include Alzheimer's disease11 and attention deficit disorder.12

According to double-blind studies enrolling over 400 people, inositol may help improve various symptoms of polycystic ovary syndrome (PCOS), including infertility and weight gain.31,33,35

There is also some preliminary evidence that inositol may be helpful for postmenopausal women who have metabolic syndrome.34

Another very small double-blind study found that inositol supplements could help reduce symptoms of psoriasis triggered or made worse by use of the drug lithium.32

A small double-blind study failed to find inositol helpful for premenstrual dysphoric disorder, a severe form of premenstrual syndrome (PMS).30

Inositol is sometimes proposed as a treatment for diabetic neuropathy, but there have been no double-blind, placebo-controlled studies on this subject, and two uncontrolled studies had mixed results.13,14

Inositol has also been investigated for potential cancer-preventive properties,15-22 and there is some evidence that it may help reduce the side effects of chemotherapy in women with breast cancer.37

What Is the Scientific Evidence for Inositol?

Small double-blind studies have found inositol helpful for depression.23,24 In one such trial, 28 depressed individuals were given a daily dose of 12 g of inositol for 4 weeks.25 By the fourth week, the group receiving inositol showed significant improvement compared to the placebo group.

However, a double-blind study of 42 people with severe depression that was not responding to standard antidepressant treatment found no improvement when inositol was added.26

People with panic disorder frequently develop panic attacks, often with no warning. The racing heartbeat, chest pressure, sweating, and other physical symptoms can be so intense that they are mistaken for a heart attack. A small double-blind study (21 participants) found that people given 12 g of inositol daily had fewer and less severe panic attacks as compared to the placebo group.27

A double-blind, crossover study of 20 individuals compared inositol to the antidepressant drug fluvoxamine (Luvox), a medication related to Prozac.28 The results over 4 weeks of treatment showed that the supplement was at least as effective as the drug.

In a 6-week, double-blind study, 24 individuals with bipolar disorder received either placebo or inositol (2 g three times daily for a week, then increased to 4 g three times daily) in addition to their regular medical treatment.5 The results of this small study failed to show statistically significant benefits; however, promising trends were seen that suggest a larger study is warranted.

Polycystic ovary syndrome (PCOS) is a chronic endocrine disorder in women that leads to infertility, weight gain, and many other problems. In a double-blind, placebo-controlled trial, 136 women with PCOS were given inositol at a dose of 100 mg twice daily, while 147 were given placebo.31 Over the study period of 14 weeks, participants given inositol showed improvement in ovulation frequency as compared to those given placebo. Benefits were also seen in terms of weight loss and levels of HDL ("good") cholesterol. Other studies have also found positive results.33,35,36

Metabolic syndrome consists of a cluster of conditions that promote cardiovascular disease, including obesity, unhealthy cholesterol and triglyceride levels, high blood pressure, and pre-diabetes. In one study, 80 postmenopausal women with metabolic syndrome were treated with diet plus inositol (2 grams, twice daily) or diet plus placebo.34 After 6 months of treatment, those in the inositol group had improvements in cholesterol and triglyceride levels, blood pressure, and insulin resistance (an indicator of pre-diabetes).

Safety Issues

No serious ill effects have been reported for inositol, even with a therapeutic dosage that equals about 18 times the average dietary intake. However, no long-term safety studies have been performed.

Although inositol has sometimes been recommended for bipolar disorder, there is evidence to suggest inositol may trigger manic episodes in people with this condition.29 If you have bipolar disorder, you should not take inositol unless under a doctor's supervision.

Safety has not been established in young children, women who are pregnant or nursing, and those with severe liver and kidney disease. As with all supplements used in very large doses, it is important to purchase a reputable product, because a contaminant present even in small percentages could add up to a real problem.

References

Levine J, Barak Y, Kofman O, et al. Follow-up and relapse analysis of an inositol study of depression. Isr J Psychiatry Relat Sci. 1995;32:14-21.

Levine J. Controlled trials of inositol in psychiatry. Eur Neuropsychopharmacol. 1997;7:147-155.

Benjamin J, Agam G, Levine J, et al. Inositol treatment in psychiatry. Psychopharmacol Bull. 1995;31:167-175.

Nemets B, Mishory A, Levine J, et al. Inositol addition does not improve depression in SSRI treatment failures. J Neural Transm. 1999;106:795-798.

Chengappa KN, Levine J, Gershon S, et al. Inositol as an add-on treatment for bipolar depression. Bipolar Disord. 2000;2:47-55.

Benjamin J, Levine J, Fux M, et al. Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder. Am J Psychiatry. 1995;152:1084-1086.

Palatnik A, Frolov K, Fux M, et al. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. J Clin Psychopharmacol. 2001;21:335-339.

Gelber D, Levine J, Belmaker RH. Effect of inositol on bulimia nervosa and binge eating. Int J Eat Disord. 2001;29:345-348.

Fux M, Levine J, Aviv A, et al. Inositol treatment of obsessive-compulsive disorder. Am J Psychiatry. 1996;153:1219-1221.

Fux M, Benjamin J, Belmaker RH. Inositol versus placebo augmentation of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder: a double-blind cross-over study. Int J Neuropsychopharmcol. 1999;2:193-195.

Levine J. Controlled trials of inositol in psychiatry. Eur Neuropsychopharmacol. 1997;7:147-155.

Levine J. Controlled trials of inositol in psychiatry. Eur Neuropsychopharmacol. 1997;7:147-155.

Salway JG, Finnegan JA, Barnett D, et al. Effect of myo-inositol on peripheral-nerve function in diabetes. Lancet. 1978;2:1282-1284.

Gregersen G, Bertelsen B, Harbo H, et al. Oral supplementation of myoinositol: effects on peripheral nerve function in human diabetics and on the concentration in plasma, erythrocytes, urine and muscle tissue in human diabetics and normals. Acta Neurol Scand. 1983;67:164-172.

Wattenberg LW. Chemoprevention of pulmonary carcinogenesis by myo-inositol. Anticancer Res. 1999;19:3659-3661.

Dong Z, Huang C, Ma WY. PI-3 kinase in signal transduction, cell transformation, and as a target for chemoprevention of cancer. Anticancer Res. 1999;19:3743-3747.

Yang GY, Shamsuddin AM. IP6-induced growth inhibition and differentiation of HT-29 human colon cancer cells: involvement of intracellular inositol phosphates. Anticancer Res. 1995;15:2479-2487.

Ishikawa T, Nakatsuru Y, Zarkovic M, et al. Inhibition of skin cancer by IP6 in vivo: initiation-promotion model. Anticancer Res. 1999;19:3749-3752.

Shamsuddin AM. Metabolism and cellular functions of IP6: a review. Anticancer Res. 1999;19:3733-3736.

Shamsuddin AM, Vucenik I. Mammary tumor inhibition by IP6: a review. Anticancer Res. 1999;19:3671-3674.

Vucenik I, Kalebic T, Tantivejkul K, et al. Novel anticancer function of inositol hexaphosphate: inhibition of human rhabdomyosarcoma in vitro and in vivo. Anticancer Res. 1998;18:1377-1384.

Shamsuddin AM, Vucenik I, Cole KE. IP6: a novel anti-cancer agent. Life Sci. 1997;61:343-354.

Levine J, Barak Y, Kofman O, et al. Follow-up and relapse analysis of an inositol study of depression. Isr J Psychiatry Relat Sci. 1995;32:14-21.

Levine J. Controlled trials of inositol in psychiatry. Eur Neuropsychopharmacol. 1997;7:147-155.

Benjamin J, Agam G, Levine J, et al. Inositol treatment in psychiatry. Psychopharmacol Bull. 1995;31:167-175.

Nemets B, Mishory A, Levine J, et al. Inositol addition does not improve depression in SSRI treatment failures. J Neural Transm. 1999;106:795-798.

Benjamin J, Levine J, Fux M, et al. Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder. Am J Psychiatry. 1995;152:1084-1086.

Palatnik A, Frolov K, Fux M, et al. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. J Clin Psychopharmacol. 2001;21:335-339.

Levine J, Witztum E, Greenberg BD, et al. Inositol-induced mania? [letter]. Am J Psychiatry. 1996;153:839.

Nemets B, Talesnick B, Belmaker RH, et al. Myo-inositol has no beneficial effect on premenstrual dysphoric disorder. World J Biol Psychiatry. 2002;3:147-149.

Gerli S, Mignosa M, Di Renzo GC. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci. 2003;7:151-9.

Allan SJ, Kavanagh GM, Herd RM, et al. The effect of inositol supplements on the psoriasis of patients taking lithium: a randomized, placebo-controlled trial. Br J Dermatol. 2004;150:966-969.

Gerli S, Papaleo E, Ferrari A, et al. Randomized, double-blind, placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur Rev Med Pharmacol Sci. 2007;11:347-354.

Giordano D, Corrado F, Santamaria A, et al. Effects of myo-inositol supplementation in postmenopausal women with metabolic syndrome: a perspective, randomized, placebo-controlled study. Menopause. 2011;18(1):102-104.

Costantino D, Minozzi G, Minozzi E, Guaraldi C. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: a double-blind trial. Eur Rev Med Pharmacol Sci. 2009;13(2):105-110.

Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol. 2010;26(4):275-280.

Bacić I, Druzijanić N, Karlo R, Skifić I, Jagić S. Efficacy of IP6 + inositol in the treatment of breast cancer patients receiving chemotherapy: prospective, randomized, pilot clinical study. J Exp Clin Cancer Res. 2010;29:12.

Last reviewed July 2012 by EBSCO CAM Review Board

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Copyright © EBSCO Publishing. All rights reserved.

 
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