supplements
Questions about supplements that have been answered by a Diabetes Educator. Browse our site to see many more diabetes questions and answers.
Q: During the entire past 9 months, my thyroid medication has been adjusted a few times and has been very unstable. I also receive shots for B12 deficiency. Do either of these impact glucose levels?
A: Imbalances in our systems can affect glucose levels. Once your B12 and thyroid levels are stable in a normal range, you may see glucose levels improve. Being active is a real key, especially if your metabolism is on the lower side. These are good questions to ask your physician.
Q: I am a type 2 diabetic with neuropathy in my feet. I would prefer to treat the problem vs taking drugs to cover up the pain (drugs really haven't done much of anything). Will alpha lipoic acid help?
A: Alpha lipoic acid has been shown to positively affect blood sugar levels, as have other nutritional supplements and herbals. The B vitamins, B6 in particular, may be helpful with neuropathy. Capsaicin topical creams may also help with pain. Remember: supplements are only effective if you are taking good care of your baseline health. This means eating more unrefined foods and being as active as you can to keep blood sugar and other levels as close to normal range as possible.
Q: My husband is taking a whey protein supplement in the mornings because he doesn't eat enough protein at breakfast time. His glucose levels have been pretty high about 2-3 hours later. Does whey protein interfere with Humulin N?
A: Look at the carb content of the whey protein, as I'm assuming it is flavored. Include the carb content of milk, if that is what he is mixing it in. The whey protein doesn't interfere with insulin per se, but the entire drink may not have enough coverage of insulin. Protein is converted into glucose at about 60% 2-3 hours after eating. He is better off with a drink that is balanced with carbs, protein, fat if he is not eating food and using this drink as a meal replacement. Eating a piece of high fiber toast along with the drink may slow down the rate of absorption. Of course, eating a morning meal that includes such foods as eggs, for those who eat them, should have less of an impact on sugar levels.
Q: How will Metamucil help me? It says on bottle for keeping blood glucose stable. How should I use it and how often? I’m nervous about adding it because it’s got 10 carbs per serving.
A: A good source of fiber in your daily diet is helpful to control how quickly your food is converted to glucose. This is why refined carbs should be limited and veggies are the better carb source. Metamucil is psyllium-based fiber that forms an intestinal gel that may block initial impact of carb digestion, delaying some of the action to slow an initial spike. If you are eating a more unrefined diet now and are active, keep that up. If your practitioner prescribed this for you, discuss with him/her. As long as you are seeing improvements based on life style changes and good food choices with plenty of fiber in your diet, it is not necessary to add a fiber supplement.
Q: Do acidophilus supplements help diabetes?
A: Yes, taking probiotic or "friendly" bacteria such as acidophilus may help your digestive tract improve your metabolism, and in turn, improve blood sugar control. Yeast overgrowth is something you don't want and it can be common when blood sugars run high. Yeast feeds on sugar from high intake of refined foods including fruits in excess. Get guidance with your diet if needed for a good foundation.
Q: What brand of multivitamin is best for someone with diabetes?
A: I cannot advise you on a brand to select, but give you some advice based on my experience. Overall, liquid and powdered vitamins are best, being sure they are preservative free and hypo-allergenic. There is no one vitamin that will magically address diabetes, nor is one vitamin the same for all. Most of the one a day vitamins are large tablets and your body will most likely only absorb a small amount of the contents.
There are well researched vitamins, minerals, and herbs that will give support, but never be a replacement, for a healthy diet and lifestyle. I suggest you review our diabetes management booklet to inform you of what has been researched in this area and also inform you of what the targets are for each of the nutritional supports discussed. If you are on multiple medications, you need to be aware of nutrient/drug interactions. Otherwise, your physician may be supportive of fish oil and CoQ10, especially if you are on a statin. Best first advice: eat unrefined foods and stay very active!
Q: I am presently taking 6 mg. of cystein which is in a greens formula and I am wondering if taking it is harmful for someone with diabetes?
A: Not to worry. Actually, cysteine in the form of NAC is showing promise as a powerful antioxidant for diabetes. That small amount you have is just part of the amino acid blend. Cysteine can be manufactured by the body and is found in abundance in many foods. It plays a big role in the formation of glutathione, a major antioxidant for the body. Enjoy your greens formula!
Q: Will supplementing with glucosamine raise my daily blood sugar or A1C? I have had type 2 diabetes for over 6 years and am in good control of my blood sugar levels.
A: There have been some reports of glucosamine raising levels, but it is not a given for everyone. The same can be said for other medications and supplements, but one shoe does not fit all. Glucosamine has noted benefits for many who use it. Trying it will let you know if it helps, and your tests will let you know if your numbers are affected. You probably won't see any dramatic change. If you have concerns, check with your physician.
Q: Would it be a good thing to ask my dad's doctor to do a Vitamin D Blood Test and then to take Vitamin D tablets to get his immune system up to a healthy level, or should he not take any more tablets than he is doing for his diabetes?
A: I would suggest you do ask for the D-OH, 25 test and hopefully his physician will recommend supplements as needed. Many of us are testing in the insufficiency range. A therapeutic dose is 50,000 IU's once/week for 1 to 3 months. Most of us will then need a daily dose of at least 1000 IUs. There is mixed opinions in the medical community as to what is the best treatment path but the evidence is growing on the need for vitamin D, especially for diabetes (see Dr. Bradley's article about vitamin D).
Q: I am hearing lots of news lately on the benefits of the herb fenugreek (seeds, leaves, extracts) for diabetes. Is this true?
A: Some studies, primarily in India, have shown that fenugreek can help lower blood sugar. If you are on diabetes medications, you will want to introduce fenugreek slowly and monitor your blood sugar carefully. The goal would be to need less medication. There are no contra-indications nor health risks associated with fenugreek except for use in pregnancy. One can take up to 6 grams/day as internal dose. Most capsules have around 600 mg. Fenugreek can also be made as a tea. Fenugreek seeds are a good source of soluble fiber. When starting any new program, I say it is best to start with a low dose and build up.
Q: Does glutamine affect the pancreas?
A: Glutamine, one of the most abundant amino acids found in the body, is a factor in muscle building and gut health. It is found in beef, chicken, fish, eggs, milk, dairy products, wheat, cabbage, beets, beans, spinach, miso, and parsley. It is not detrimental to the pancreas; it is certainly a positive factor for any organ function. The questions and concerns always arise where one takes supplements to supply this amino acid in greater abundance, hoping for the "miracle muscle bulk up". Too much of anything may have an adverse effect. Protein powders are best used with professional guidance, especially when one has a chronic condition such as diabetes.
Q: Is it alright to take grape seed extract and vitamin B12 if I am also taking Metformin?
A: Grape seed and B12 will not interfere with your Metformin. What you should or should or should not take depends on many factors: overall health, other medications, lifestyle, diet, etc. I do advocate nutritional supplementation after one has made necessary baseline adjustments for diet and lifestyle. Certainly a multivitamin in 2 doses and fish oil are very basic suggestions, with buffered vitamin C, vitamin D3, and COQ10 being some other basic supplements that may be indicated, especially around flu seasons. Nutritional supplements should be free of preservatives. It is always wise to seek professional guidance when adding nutritionals.
Q: My husband has diabetes and has severe arthritis of the knees. Is there any problem for him to use a supplement for his arthritis pain that includes turmeric and boswellia?
A: He should be fine with that supplement as both turmeric and boswellia are natural anti-inflammatories. I would suggest you double check with your pharmacist to make sure there are no contraindications with any medications he may be taking. Drinking 2 ounces of Acai berry juice twice a day has been reported by many to help with arthritis without raising blood sugar. You may find this in a health food store. Glucosamine has also provided some relief for many. I suggest experimenting with limiting tomatoes from his diet, especially sauces as they can contribute to arthritic pain. It is important he eat as many vegetables as possible and drink lots of water to keep his system more alkaline than acidic.
Q: Coaches and friends are encouraging my 15 year old son with type 1 diabetes to drink whey protein and consume CLA to build muscle strength for football. Wouldn't this be hard on his kidneys? He has spilled small amounts of protein before, but not lately. My son wants to keep up with the other guys. Please respond as I am scared he is fixing to take the CLA without telling me.
A: CLA (conjugated linoleic acid) is fatty acid which is found primarily in the milk and meat of grass fed animals. Range fed animals contain 10 times the CLA of those that are grain fed. CLA has been shown to be safe and effective for people with diabetes needing to lose body fat, depending on what else is involved with lifestyle, etc.
To build muscle mass, your protein cautions are warranted if kidney damage is evident. It's also tough to feel "left behind" one's passion. A protein drink at breakfast, along with something like whole grain toast and an egg may work; gives the day a good start and is a boost to the thyroid glands. He may be able to repeat the shake as late afternoon snack before a workout. Monitoring his kidney functions (he can monitor microalbuminaria at home) will help with seeing if there are any side effects. It may be that psychologically this will work in the short run, and not be viewed as a longer term aspiration. Keep working for the balance here.
Q: Is it safe to take creatine and glutamine supplements for the purpose of muscle gain if I am type 2?
A: Before any nutritional supplements are applied, it is first necessary to assess your diet and lifestyle. Appropriate balancing of dietary needs with blood sugar goals should be the first target. Secondly, be realistic about your body type, and what would be a target for gain in muscle size. At low dose levels, this supplement combination may be of benefit without compromising any health status. I suggest you truly fine tune your diet focusing on eating legumes and veggies in a 4:1 ratio to any animal/fish protein - with high omega-3 fish such as salmon being the best choice.
Q: Will taking cinnamon supplements help lower my blood sugar?
A: If you have type 2 diabetes, cinnamon may be beneficial in reducing your blood sugar levels. At Diabetes Action, we have funded some of the important research on cinnamon at the USDA’s Beltsville Human Nutrition Research Center where Dr. Richard Anderson identified the water-soluble extract of cinnamon which was found to be the specific component responsible for improving insulin activity (1,2).
However, a 2007 study published in Diabetes Care (3) questions the benefits of cinnamon based on a meta-analysis of five other cinnamon studies. It is critical to note that the form of cinnamon used was not identified in all of these studies. This is important because it is hard to compare the results to those obtained by other research that used the water soluble extract of cinnamon identified by Dr. Anderson. Also, this meta-analysis included studies which looked at the effect of cinnamon on type 1 diabetes which would not be expected to have the same response as with type 2 diabetes. There have been other recent reports confirming the benefits of cinnamon (4,5,6).
If you want to see whether cinnamon can help you, be sure to purchase a product which includes the water soluble extract (trademarked as Cinnulin PF or CinSulin), not just any cinnamon product saying cinnamon bark, etc. since other components of whole cinnamon in high doses could be toxic. Since a minimum dose of 500-1000mg a day was used in some of the studies with positive outcomes, you could try this for 6 weeks and see if your blood sugar levels are improving. Like any medication or nutraceutical, results will vary by individual so testing your glucose levels is the only way to know for sure what works for you.
Because of the conflicting reports of the value of cinnamon, Diabetes Action is committed to funding further quality research. We are currently funding an exciting project exploring whether this same water soluble cinnamon extract can protect brain cells from risk factors associated with Alzheimer’s disease which many researchers are calling “Type 3 Diabetes”. Preliminary data is promising.
References
J. Agric. Food Chem., 52(1)65-70, 2004.
Diabetes Care 26:3215-3218, 2003
Diabetes Care 30:813-816, 2007
American Journal of Clinical Nutrition, Vol 85, No6, 1552-1556, June 2007
Journal of International Society of Sports Nutrition 3(2):45-53, 2006 http://www.jissn.com/
The Archives of Biochemistry and Biophysics 459(2007) 214-222.