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< LEADERBOARD/s/inositolVitamins

Inositol

Also sold as: Myo-inositol · D-chiro-inositol · MI / DCI

An endogenous sugar alcohol involved in cellular signaling, studied mainly for PCOS and gestational-diabetes prevention. Psychiatric benefits suggested by early small trials were not confirmed in pooled analyses.

Anxiety

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NERD_PROTOCOL // EVIDENCE_MATRIXper goal

Research

AnxietyLimited · no benefit
  • Anxiety: Small early panic-disorder trials were positive, but the psychiatric meta-analysis found no significant anxiety benefit across four studies with 70 participants.

REALITY CHECK // Positive PCOS reviews coexist with a 30-study, 2230-participant guideline review finding low or very-low-certainty evidence. Early anxiety/OCD trials did not survive pooled analysis, and the 40:1 marketing story relies heavily on a limited research network.

Levels: how we grade evidence. Grey = evidence of no benefit; amber = evidence it makes this goal worse.

Ratings are self-reported by a self-selected group of users: how it felt, not proof that it works.

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Compare what your label says with what was used in trials. This is a trial range, not a personal prescription.

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How it was studied

01 // STUDIED_DOSE_RANGE
Trial context
PCOS studies commonly use 2-4 g/day myo-inositol over about 12 weeks to 6 months. Psychiatric studies used much higher 12-18 g/day amounts with greater GI burden. A comparative oocyte trial used MI 2 g twice daily versus DCI 0.6 g twice daily, but has an Expression of Concern; do not use it as a dosing prescription.
02 // TIMING_&_MATRIX
Form and schedule
Clock-time superiority is unestablished; splitting large study amounts may address GI burden, but does not establish psychiatric efficacy.
03 // EVALUATION_WINDOW
Outcome-specific follow-up
PCOS trials typically last 12 weeks to 6 months. Psychiatric and pregnancy outcomes require their own study designs and cannot be assessed from one night of use.
04 // SAFETY_&_QUALITY_GATE
Review before use
Pregnancy/GDM prevention, IVF and fertility care require the treating clinician. Bipolar disorder needs psychiatric oversight because mood activation is a theoretical concern. Stop and seek review for new palpitations, marked anxiety or mood activation; paradoxical anxiety is anecdotal. Large amounts cause nausea, bloating and diarrhea. Neonatal hospital use is a separate high-risk context.

UPPER LIMIT // No numerical EFSA/NIH UL is established in the dossier. Common study doses and endogenous synthesis are not safe upper limits. Long-term high-dose adult safety remains thin.

NERD'S NOTENerd Protocols · a clinical and sports dietitian based in the EU

Summary

PCOS metabolic signals are plausible, but the independent review supporting the international guideline judged the evidence limited and inconclusive. Fertility, live birth and high-dose psychiatric effects remain uncertain; a premium 40:1 blend is not independently established as necessary.

Mechanism

Myo-inositol and D-chiro-inositol participate in phosphoinositide and insulin-related signaling. Tissue distribution and epimerization differ; these mechanisms do not prove benefit for ADHD, sleep or all insulin-resistant populations.

Typical studied dose

PCOS studies commonly use 2-4 g/day myo-inositol over about 12 weeks to 6 months. Psychiatric studies used much higher 12-18 g/day amounts with greater GI burden. A comparative oocyte trial used MI 2 g twice daily versus DCI 0.6 g twice daily, but has an Expression of Concern; do not use it as a dosing prescription.

Upper limit

No numerical EFSA/NIH UL is established in the dossier. Common study doses and endogenous synthesis are not safe upper limits. Long-term high-dose adult safety remains thin.

POPULAR_STACKScombos with n ≥ 5

Popular stacks with Inositol

Not enough stack data yet. A combination with Inositol appears here once 5 people rate the same set.

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Forms and label traps

Forms compared
Form on labelActive contentStudied range / dayAbsorption & GI toleranceVerdict
Pure myo-inositol powder / capsule
Best for: Comparing a declared pure MI amount to PCOS-study amounts.
 100% elemental / active 2000–4000 mg Well studied relative to other isomers; oral exposure does not establish each advertised outcome.
Often tolerated at 2-4 g/day; 12-18 g/day can cause dose-limiting GI effects.		 Studied standard [FORM // REFERENCE]
100% means a pure MI ingredient. Psychiatric amounts are a different, unconfirmed indication.
D-chiro-inositol
Best for: Identifying DCI rather than treating it as stronger MI.
 Unstandardized: active content unknown no comparable trial range An orally absorbed isomer with a different tissue profile; cannot substitute one-for-one for MI clinical results.
GI effects remain possible.		 Caution [FORM // CAUTION]
No reliable general DCI therapeutic interval is established here. High-dose oocyte concerns arise from a paper with an Expression of Concern and require specialist review.
MI:DCI 40:1 combination
Best for: Checking both ingredient amounts and the claimed ratio.
 Unstandardized: active content unknown no comparable trial range Combination exposure depends on separately declared MI and DCI amounts.
Similar GI concerns to the individual isomers.		 Caution [FORM // CAUTION]
A ratio is not a dose or proof of optimality. Do not compare total mixed mass to a pure-MI target.
Inositol hexanicotinate / no-flush niacin
Best for: Recognizing a different molecule.
 Unstandardized: active content unknown no comparable trial range A niacin-related compound; clinical lipid effects differ from extended-release niacin.
No flushing does not establish equivalence or efficacy.		 Caution [FORM // CAUTION]
Not interchangeable with MI/DCI in PCOS or psychiatric trials.
Inositol hexaphosphate / IP6
Best for: Avoiding a label mix-up.
 Unstandardized: active content unknown no comparable trial range A phosphorylated mineral-binding molecule, not free myo-inositol.
Mineral-binding properties distinguish it from MI.		 Caution [FORM // CAUTION]
No MI-equivalent conversion or clinical target is supplied; separate experimental applications are outside this card.

Common label traps

  • TRAP_01 // Natural metformin without side effects
    Some surrogate outcomes improve and GI tolerance may be better, but absence of a significant difference is not proof of equivalence; independent guideline evidence is inconclusive.
  • TRAP_02 // A premium 40:1 blend is required
    A small ratio trial and related-group reviews do not establish universal superiority over pure MI.
  • TRAP_03 // More DCI is always better
    Different isomers have different roles; high-dose fertility use is not justified and one influential oocyte paper has an Expression of Concern.
  • TRAP_04 // No-flush niacin is inositol for mood
    Inositol hexanicotinate and IP6 are different compounds; neither substitutes for MI.

Other outcomes studied

Outside the five leaderboard goals. Same evidence levels as above.

Reader questions

Why do I see 2 g and 18 g doses?

They come from different populations and endpoints. PCOS studies often use 2-4 g/day; early psychiatric studies used 12-18 g/day and pooled benefit was not confirmed.

Could it worsen anxiety or cause palpitations?

Such reactions are reported anecdotally, without reliable incidence data. Stop and seek assessment for marked symptoms; bipolar mood activation needs urgent psychiatric review.

Can it replace an SSRI?

No confirmed pooled psychiatric benefit supports replacement. Never stop or change psychiatric medication based on an inositol claim.

Is 40:1 necessary for fertility?

It is a proposed ratio with limited independent evidence, not a universal standard. IVF, PCOS and pregnancy require individualized specialist care.

Does it work without PCOS?

General metabolic, thyroid and sleep claims rely on thinner evidence or extrapolation; PCOS surrogate findings cannot be transferred automatically.

Stack interactions

  • Caution Metformin / insulin / sulfonylureas [CAUTION // REVIEW]
    Possible additive glucose lowering warrants monitoring. Combination trials in PCOS do not justify unsupervised stacking.
    PMID 27808588 PMID 39331347 PMID 34407851
  • Caution SSRIs / psychiatric medication [CAUTION // REVIEW]
    The open OCD augmentation trial and pooled psychiatric evidence do not establish benefit. Do not stop medication or megadose without the prescriber.
    PMID 10565802 PMID 24424706
  • Caution Berberine [CAUTION // REVIEW]
    Potential overlapping insulin-sensitizing effects; reader anxiety/nausea reports are anecdotes, not established interaction rates.
  • Caution DCI / fertility formulations [CAUTION // REVIEW]
    Check actual MI and DCI amounts. The proposed 40:1 ratio has limited independent replication, and oocyte-quality concerns require specialist interpretation.
    PMID 31298405 PMID 35057707

Red flags: interactions and who should avoid it

Interactions

Potential additive glucose lowering with metformin, insulin or sulfonylureas, and possibly berberine. SSRI augmentation was studied with weak results; no dangerous serotonergic interaction is established, but psychiatric combinations and medication changes require the prescriber. Thyroxine interactions and inositol-selenium thyroid benefits remain uncertain.

Avoid or ask a doctor first if

Pregnancy/GDM prevention, IVF and fertility care require the treating clinician. Bipolar disorder needs psychiatric oversight because mood activation is a theoretical concern. Stop and seek review for new palpitations, marked anxiety or mood activation; paradoxical anxiety is anecdotal. Large amounts cause nausea, bloating and diarrhea. Neonatal hospital use is a separate high-risk context.

Sources (PubMed, 42)

  1. Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials.
    PMID 36703143 · 2023 · systematic review / meta-analysis
    Positive reviews report insulin/HOMA-IR and androgen improvements, but the independent 30-study, 2230-person guideline review judged evidence limited and inconclusive with low/very-low certainty. Less GI upset than metformin does not establish therapeutic equivalence. Well studied relative to other isomers; oral exposure does not establish each advertised outcome. 100% means a pure MI ingredient. Psychiatric amounts are a different, unconfirmed indication.
  2. Effectiveness of myoinositol for polycystic ovary syndrome: a systematic review and meta-analysis.
    PMID 29052180 · 2018 · systematic review / meta-analysis
    Positive reviews report insulin/HOMA-IR and androgen improvements, but the independent 30-study, 2230-person guideline review judged evidence limited and inconclusive with low/very-low certainty. Less GI upset than metformin does not establish therapeutic equivalence.
  3. Inositol for Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis to Inform the 2023 Update of the International Evidence-based PCOS Guidelines.
    PMID 38163998 · 2024 · systematic review / meta-analysis
    Positive reviews report insulin/HOMA-IR and androgen improvements, but the independent 30-study, 2230-person guideline review judged evidence limited and inconclusive with low/very-low certainty. Less GI upset than metformin does not establish therapeutic equivalence. Small PCOS trials suggest ovulation or cycle improvement, but live-birth and reproductive outcomes remain inconclusive. A retracted ovarian-function trial in the supplied catalog is excluded from affirmative evidence. Well studied relative to other isomers; oral exposure does not establish each advertised outcome. 100% means a pure MI ingredient. Psychiatric amounts are a different, unconfirmed indication.
  4. Effects of myo-inositol vs. metformin on hormonal and metabolic parameters in women with PCOS: a meta-analysis.
    PMID 37148410 · 2023 · systematic review / meta-analysis
    Positive reviews report insulin/HOMA-IR and androgen improvements, but the independent 30-study, 2230-person guideline review judged evidence limited and inconclusive with low/very-low certainty. Less GI upset than metformin does not establish therapeutic equivalence.
  5. The effects of myo-inositol vs. metformin on the ovarian function in the polycystic ovary syndrome: a systematic review and meta-analysis.
    PMID 33877679 · 2021 · systematic review / meta-analysis
    Positive reviews report insulin/HOMA-IR and androgen improvements, but the independent 30-study, 2230-person guideline review judged evidence limited and inconclusive with low/very-low certainty. Less GI upset than metformin does not establish therapeutic equivalence.
  6. Short period-administration of myo-inositol and metformin on hormonal and glycolipid profiles in patients with polycystic ovary syndrome: a systematic review and updated meta-analysis of randomized controlled trials.
    PMID 35363325 · 2022 · systematic review / meta-analysis
    Positive reviews report insulin/HOMA-IR and androgen improvements, but the independent 30-study, 2230-person guideline review judged evidence limited and inconclusive with low/very-low certainty. Less GI upset than metformin does not establish therapeutic equivalence.
  7. Comparison of two insulin sensitizers, metformin and myo-inositol, in women with polycystic ovary syndrome (PCOS).
    PMID 27808588 · 2017 · randomized controlled trial
    Positive reviews report insulin/HOMA-IR and androgen improvements, but the independent 30-study, 2230-person guideline review judged evidence limited and inconclusive with low/very-low certainty. Less GI upset than metformin does not establish therapeutic equivalence. Possible additive glucose lowering warrants monitoring. Combination trials in PCOS do not justify unsupervised stacking.
  8. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial.
    PMID 15206484 · 2003 · randomized controlled trial
    Small PCOS trials suggest ovulation or cycle improvement, but live-birth and reproductive outcomes remain inconclusive. A retracted ovarian-function trial in the supplied catalog is excluded from affirmative evidence. Well studied relative to other isomers; oral exposure does not establish each advertised outcome. 100% means a pure MI ingredient. Psychiatric amounts are a different, unconfirmed indication.
  9. Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome: a prospective, controlled, randomized trial.
    PMID 28277112 · 2017 · randomized controlled trial
    Small PCOS trials suggest ovulation or cycle improvement, but live-birth and reproductive outcomes remain inconclusive. A retracted ovarian-function trial in the supplied catalog is excluded from affirmative evidence.
  10. Impact of myoinositol with metformin and myoinositol alone in infertile PCOS women undergoing ovulation induction cycles - randomized controlled trial.
    PMID 32945218 · 2021 · randomized controlled trial
    Small PCOS trials suggest ovulation or cycle improvement, but live-birth and reproductive outcomes remain inconclusive. A retracted ovarian-function trial in the supplied catalog is excluded from affirmative evidence.
  11. Comparison of metformin plus myoinositol vs metformin alone in PCOS women undergoing ovulation induction cycles: randomized controlled trial.
    PMID 30614289 · 2019 · randomized controlled trial
    Small PCOS trials suggest ovulation or cycle improvement, but live-birth and reproductive outcomes remain inconclusive. A retracted ovarian-function trial in the supplied catalog is excluded from affirmative evidence.
  12. Antenatal dietary supplementation with myo-inositol for preventing gestational diabetes.
    PMID 36790138 · 2023 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  13. Inositol Nutritional Supplementation for the Prevention of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
    PMID 35889788 · 2022 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  14. Myo-inositol lowers the risk of developing gestational diabetic mellitus in pregnancies: A systematic review and meta-analysis of randomized controlled trials with trial sequential analysis.
    PMID 29325728 · 2018 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  15. Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials.
    PMID 30564926 · 2019 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  16. Myo-inositol supplementation for the prevention of gestational diabetes: A meta-analysis of randomized controlled trials.
    PMID 35460931 · 2022 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  17. Myoinositols Prevent Gestational Diabetes Mellitus and Related Complications: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
    PMID 37836508 · 2023 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  18. Efficacy of inositol supplementation for the prevention and treatment of gestational diabetes in pregnant women: Results from an umbrella meta-analysis.
    PMID 41792927 · 2026 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  19. The Efficacy and Safety of Myo-inositol Supplementation for the Prevention of Gestational Diabetes Mellitus in Overweight and Obese Pregnant Women: A Systematic Review and Meta-Analysis.
    PMID 38045667 · 2023 · systematic review / meta-analysis
    Meta-analyses suggest fewer GDM cases in at-risk pregnancies, but Cochrane 2023 rated evidence low/very low, with small studies concentrated in one region. Use only with obstetric supervision.
  20. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder.
    PMID 11386498 · 2001 · randomized controlled trial
    An early small crossover trial at 18 g/day was encouraging; a meta-analysis of four anxiety trials with 70 participants was nonsignificant, as was acute experimentally induced anxiety.
  21. A meta-analysis of inositol for depression and anxiety disorders.
    PMID 24424706 · 2014 · systematic review / meta-analysis
    An early small crossover trial at 18 g/day was encouraging; a meta-analysis of four anxiety trials with 70 participants was nonsignificant, as was acute experimentally induced anxiety. An early 18 g/day crossover trial improved Y-BOCS, but an open SSRI augmentation trial was negative and pooled OCD results were nonsignificant. Pooled depressive symptoms were not significantly improved; response and PMDD trends at p=0.06 and p=0.07 are not significant. Bipolar augmentation data are weak and require psychiatric oversight. The open OCD augmentation trial and pooled psychiatric evidence do not establish benefit. Do not stop medication or megadose without the prescriber.
  22. Acute inositol does not attenuate m-CPP-induced anxiety, mydriasis and endocrine effects in panic disorder.
    PMID 9352475 · 1997 · randomized controlled trial
    An early small crossover trial at 18 g/day was encouraging; a meta-analysis of four anxiety trials with 70 participants was nonsignificant, as was acute experimentally induced anxiety.
  23. Inositol treatment of obsessive-compulsive disorder.
    PMID 8780431 · 1996 · randomized controlled trial
    An early 18 g/day crossover trial improved Y-BOCS, but an open SSRI augmentation trial was negative and pooled OCD results were nonsignificant.
  24. Inositol augmentation of serotonin reuptake inhibitors in treatment-refractory obsessive-compulsive disorder: an open trial.
    PMID 10565802 · 1999 · clinical report / other study
    An early 18 g/day crossover trial improved Y-BOCS, but an open SSRI augmentation trial was negative and pooled OCD results were nonsignificant. The open OCD augmentation trial and pooled psychiatric evidence do not establish benefit. Do not stop medication or megadose without the prescriber.
  25. Inositol as an add-on treatment for bipolar depression.
    PMID 11254020 · 2000 · randomized controlled trial
    Pooled depressive symptoms were not significantly improved; response and PMDD trends at p=0.06 and p=0.07 are not significant. Bipolar augmentation data are weak and require psychiatric oversight.
  26. Inositol augmentation of lithium or valproate for bipolar depression.
    PMID 16542187 · 2006 · randomized controlled trial
    Pooled depressive symptoms were not significantly improved; response and PMDD trends at p=0.06 and p=0.07 are not significant. Bipolar augmentation data are weak and require psychiatric oversight.
  27. Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone.
    PMID 16449473 · 2006 · randomized controlled trial
    Pooled depressive symptoms were not significantly improved; response and PMDD trends at p=0.06 and p=0.07 are not significant. Bipolar augmentation data are weak and require psychiatric oversight.
  28. Myo-inositol for insulin resistance, metabolic syndrome, polycystic ovary syndrome and gestational diabetes.
    PMID 35236761 · 2022 · study; design not established in dossier
    Mechanistic reviews and extrapolation from PCOS/GDM do not establish a large independent T2D or fatty-liver treatment evidence base.
  29. Potential role and therapeutic interests of myo-inositol in metabolic diseases.
    PMID 23764390 · 2013 · narrative review
    Mechanistic reviews and extrapolation from PCOS/GDM do not establish a large independent T2D or fatty-liver treatment evidence base.
  30. Effect of inositol and its derivatives on diabetes: a systematic review.
    PMID 29053004 · 2019 · systematic review / meta-analysis
    Mechanistic reviews and extrapolation from PCOS/GDM do not establish a large independent T2D or fatty-liver treatment evidence base.
  31. The 40:1 myo-inositol/D-chiro-inositol plasma ratio is able to restore ovulation in PCOS patients: comparison with other ratios.
    PMID 31298405 · 2019 · randomized controlled trial
    A small ratio study favors 40:1, but independent replication is limited; an influential MI-versus-DCI oocyte study has an Expression of Concern. A universal optimal ratio is not established. Check actual MI and DCI amounts. The proposed 40:1 ratio has limited independent replication, and oocyte-quality concerns require specialist interpretation. Combination exposure depends on separately declared MI and DCI amounts. A ratio is not a dose or proof of optimality. Do not compare total mixed mass to a pure-MI target.
  32. The Effects of Myo-Inositol and D-Chiro-Inositol in a Ratio 40:1 on Hormonal and Metabolic Profile in Women with Polycystic Ovary Syndrome Classified as Phenotype A by the Rotterdam Criteria and EMS-Type 1 by the EGOI Criteria.
    PMID 38295772 · 2024 · cohort study
    A small ratio study favors 40:1, but independent replication is limited; an influential MI-versus-DCI oocyte study has an Expression of Concern. A universal optimal ratio is not established. Combination exposure depends on separately declared MI and DCI amounts. A ratio is not a dose or proof of optimality. Do not compare total mixed mass to a pure-MI target.
  33. D-Chiro-inositol and PCOS: between myth and reality. The never-ending story.
    PMID 35057707 · 2022 · narrative review
    A small ratio study favors 40:1, but independent replication is limited; an influential MI-versus-DCI oocyte study has an Expression of Concern. A universal optimal ratio is not established. Check actual MI and DCI amounts. The proposed 40:1 ratio has limited independent replication, and oocyte-quality concerns require specialist interpretation. An orally absorbed isomer with a different tissue profile; cannot substitute one-for-one for MI clinical results. No reliable general DCI therapeutic interval is established here. High-dose oocyte concerns arise from a paper with an Expression of Concern and require specialist review.
  34. Inositol Treatment for PCOS Should Be Science-Based and Not Arbitrary.
    PMID 32308679 · 2020 · narrative review
    A small ratio study favors 40:1, but independent replication is limited; an influential MI-versus-DCI oocyte study has an Expression of Concern. A universal optimal ratio is not established.
  35. Combining treatment with myo-inositol and D-chiro-inositol (40:1) is effective in restoring ovary function and metabolic balance in PCOS patients.
    PMID 27898267 · 2017 · narrative review
    A small ratio study favors 40:1, but independent replication is limited; an influential MI-versus-DCI oocyte study has an Expression of Concern. A universal optimal ratio is not established. Combination exposure depends on separately declared MI and DCI amounts. A ratio is not a dose or proof of optimality. Do not compare total mixed mass to a pure-MI target.
  36. Inositol in preterm infants at risk for or having respiratory distress syndrome.
    PMID 31283839 · 2019 · systematic review / meta-analysis
    An updated Cochrane review of six trials with 1177 infants reversed earlier optimism; a large trial with 638 infants stopped recruitment after higher mortality. This neonatal hospital exposure must not be generalized to ordinary adult oral MI.
  37. Inositol for respiratory distress syndrome in preterm infants.
    PMID 14583919 · 2003 · systematic review / meta-analysis
    An updated Cochrane review of six trials with 1177 infants reversed earlier optimism; a large trial with 638 infants stopped recruitment after higher mortality. This neonatal hospital exposure must not be generalized to ordinary adult oral MI.
  38. Inositol for respiratory distress syndrome in preterm infants.
    PMID 22419275 · 2012 · systematic review / meta-analysis
    An updated Cochrane review of six trials with 1177 infants reversed earlier optimism; a large trial with 638 infants stopped recruitment after higher mortality. This neonatal hospital exposure must not be generalized to ordinary adult oral MI.
  39. Inositol in preterm infants at risk for or having respiratory distress syndrome.
    PMID 25927089 · 2015 · systematic review / meta-analysis
    An updated Cochrane review of six trials with 1177 infants reversed earlier optimism; a large trial with 638 infants stopped recruitment after higher mortality. This neonatal hospital exposure must not be generalized to ordinary adult oral MI.
  40. Comparison of metformin with inositol versus metformin alone in women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials.
    PMID 39331347 · 2025 · systematic review / meta-analysis
    Possible additive glucose lowering warrants monitoring. Combination trials in PCOS do not justify unsupervised stacking.
  41. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.
    PMID 29183107 · 2017 · systematic review / meta-analysis
    An orally absorbed isomer with a different tissue profile; cannot substitute one-for-one for MI clinical results. No reliable general DCI therapeutic interval is established here. High-dose oocyte concerns arise from a paper with an Expression of Concern and require specialist review.
  42. Wax-matrix extended-release niacin vs inositol hexanicotinate: a comparison of wax-matrix, extended-release niacin to inositol hexanicotinate \"no-flush\" niacin in persons with mild to moderate dyslipidemia.
    PMID 23351578 · 2013 · randomized controlled trial
    A niacin-related compound; clinical lipid effects differ from extended-release niacin. Not interchangeable with MI/DCI in PCOS or psychiatric trials.

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