N-Acetyl Cysteine (NAC) is a powerful antioxidant that has shown promising results in PCOS research, though with smaller study sizes than inositol.

What it is: NAC is a precursor to glutathione, the body's main antioxidant. It works through antioxidant and anti-inflammatory pathways.

What the research shows:

• Improves insulin sensitivity (some studies show comparable effects to metformin) • Reduces testosterone levels • May improve ovulation rates • Reduces oxidative stress markers • May improve lipid profiles

Dose ranges in research: 1,200-1,800 mg daily, usually split into 2-3 doses.

Common side effects: GI discomfort (nausea, gas) is possible, especially at higher doses. Starting at a lower dose and increasing gradually may help.

Important notes: • Study sizes are generally smaller than inositol research • More research is needed for definitive conclusions • NAC has a strong safety profile and has been used medically for decades (as a mucolytic and for acetaminophen overdose) • Some practitioners combine NAC with inositol, though research on this combination is limited

NAC is a reasonable supplement to discuss with your doctor, especially if oxidative stress or inflammation is a prominent feature of your PCOS.