The Effect of Vitamin B and Folic Acid Supplementation on Plasma Homocystiene Levels in Women with Polycystic Ovary Syndrome Treated with Metformin. A Randomized Controlled Trial

Objective: To assess the effect of vitamin B-group and folic acid supplementation on serum levels of homocysteine (Hcy) in patients with polycystic ovarian syndrome (PCOS) on short term metformin treatment. Design: Randomized controlled study. Methods: PCOS patients were randomly assigned to two groups. Group 1 (n =40) received metformin only (500mg 3 times daily); group 2 (n=40) received metformin (500mg 3 times daily) plus vitamin B-group (twice daily) and folic acid (once daily) for 16 weeks. In groups, plasma Hcy, vitamin B12, folic acid, lipid profile, and HOMA test were recorded at baseline and after 16 weeks. Results: There were no statistically significant differences with respect to background and hormonal characteristics of the two groups. An 18% increase in Hcy levels was seen after 16 weeks of metformin therapy, while 23% decrease in Hcy levels was detected when B-group vitamin and folic acid were added to metformin. There was a 14.3% decrease in vitamin B12 levels and 5.8% in folic acid levels in Group 1. Conclusions: Vitamin B-group and folic acid supplementation to PCOS women treated with metformin is essential when one considers the elevated levels of Hcy and the possible increasing effect of metformin on Hcy levels in patients with PCOS.