Vitamin D and probiotic co-supplementation affects mental health, hormonal, inflammatory and oxidative stress parameters in women with polycystic ovary syndrome

Randomized, placebo-controlled trial in women with polycystic ovary syndrome diagnosed by Rotterdam criteria. The active intervention arm included 30 participants; the study enrolled women aged 18-40 years in Kashan, Iran.

Women in the active arm received oral vitamin D 50,000 IU every 2 weeks plus an oral probiotic capsule providing 8 × 10^9 CFU/day for 12 weeks. The probiotic contained Lactobacillus acidophilus, Bifidobacterium bifidum, Lactobacillus reuteri, and Lactobacillus fermentum.

Vitamin D plus probiotic co-supplementation produced overall beneficial effects in women with PCOS over 12 weeks. Compared with placebo, it improved mental health outcomes, with significant between-group effects for BDI total score (β -0.58, 95% CI -1.15 to -0.02; P = 0.04), GHQ (β -0.93, 95% CI -1.78 to -0.08; P = 0.03), and DASS (β -0.90, 95% CI -1.67 to -0.13; P = 0.02), while PSQI was not significant (P = 0.28). It also reduced total testosterone (β -0.19, 95% CI -0.28 to -0.10; P < 0.001), mF-G scores (β -0.95, 95% CI -1.39 to -0.51; P < 0.001), hs-CRP (β -0.67, 95% CI -0.97 to -0.38; P < 0.001), and MDA (β -0.25, 95% CI -0.40 to -0.10; P = 0.001), and increased TAC (β 82.81, 95% CI 42.86 to 122.75; P < 0.001) and GSH (β 40.42, 95% CI 4.69 to 76.19; P = 0.02). SHBG and NO were not significantly affected, and the authors reported no effect on acne, alopecia, or side effects.

The active arm was small (n = 30), the intervention lasted only 12 weeks, and the trial was conducted at a single center, which limits generalizability. Diet was monitored with 3-day recalls, but baseline dietary pattern and physical activity information were limited, and the combined regimen prevents separation of the individual effects of vitamin D and probiotics.