A study of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS

Veena Gupta, Amrita Chaurasia, Shazia Khatoon, Urvashi Barman Singh


Background: Polycystic ovarian syndrome (PCOS) is characterized by the combination of hyperandrogenism, chronic anovulation and polycystic ovaries. Objective of present study was to compare the effects of N-acetyl cysteine, metformin and vitamin D3 with calcium on clinical and metabolic profile in PCOS.

Methods: 66 women were randomly assigned into three equal treatment groups. Group 1 received N-acetyl cysteine, 600 mg three times a day. Group 2 metformin hydrochloride, 500 mg two times a day for 1 week, then three times a day for rest of the study and Group 3 Vit-D3 60,000 IU weekly with calcium 1500mg daily. Clinical and metabolic assessment was done at baseline and after three months of treatment.

Results: After 12 weeks of treatment improvement of symptoms was seen in all the three groups, however better improvement in oligomenorrhea and hirsutism was seen in metformin group than others two groups. The clinical parameters like weight, BMI, waist hip ratio, biochemical markers of insulin resistance, fasting glucose, fasting insulin, fasting glucose/insulin ratio were significantly decreased in N-acetyl cysteine group than others two groups.

Conclusions: N-acetyl cysteine had better improvement in clinical, and metabolic profile than metformin and vitamin D3 with Calcium group in PCOS patients. It can be used as a substitute for insulin reducing medications in treatment of PCOS patients, considering its limited adverse effects.


Clinical and metabolic profile, Metformin, N-acetyl cysteine, PCOS, vitamin D3

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Schulte N, Sonntag B, Kiesel L. Androgens and insulintwokey players in polycystic ovary syndrome. Recent concepts in the pathophysiology and genetics of polycystic ovary syndrome. Gynakol Geburtshilfliche Rundsch. 2008;48(1):9-15.

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19=25.

Ammon HP, Muller PH, Eggstein M, Wintermantel C, Aigner B, Safayhi H. Increase in glucose consumption by acetylcysteine during hyperglycemic clamp A study with healthy volunteers. Arzneimittelforschung. 1999;42:642-5.

Ventura P, Panini R, Pasini MC, Scarpetta G, Salvioli G. N -Acetyl-cysteine reduces homocysteine plasma levels after single intravenous administration byincreasing thiols urinary excretion. Pharmacol Res. 1999;40(4):345-50.

Nazarian S1, St Peter JV, Boston RC, Jones SA, Mariash CN. Vitamin D3 supplementation improves insulin sensitivity in subjects with impaired fasting glucose. Transl Res. 2011;158(5):276-81.

Gayatri K, Kumar JS, Kumar BB. Metformin and N-acetyl Cysteine in Polycystic Ovarian Syndrome--A Comparative Study. Indian J Clin Med. 2010;1:7.

dehghani Firouzabadi R, Aflatoonian A, Modarresi S, Sekhavat L, MohammadTaheri S. Therapeutic effects of calcium & vitamin D supplementation in women with PCOS. Complementary Therap Clin Pract. 2012;18(2):85-8.

Thakker D, Raval A, Patel I, Walia R. N-acetylcysteine for polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled clinical trials. Obstet Gynecol Int. 2015;2015:817849.

Javanmanesh F, Kashanian M, Rahimi M, Sheikhansari N. A comparison between the effects of metformin and N-acetyl cysteine (NAC) on some metabolic and endocrine characteristics of women with polycystic ovary syndrome. Gynecol Endocrinol. 2016;32(4):285-9.

Galusha AM. Improvement of symptoms in patients with polycystic ovarian syndrome by vitamin d and calcium supplementation. 2013.