T Shintani, The Good Carbohydrate Revolution
16-1
Supplements for Health, Blood Sugar
and Cholesterol Control
Terry Shintani, MD, JD, MPH
The best source of any nutrient, such as vitamins, minerals, and fiber, is whole food. As for
weight control, blood sugar control, and cholesterol control, your diet is more important than any
herb. But if you cannot maintain a good diet, are unsure if you or getting adequate amounts of
essential nutrients, or if after your best efforts your weight, blood sugar and/or cholesterol is not
under adequate control, supplements and herbs may be helpful.
The health benefits of many of the herbs and supplements are just beginning to emerge in the
literature. Herbs and supplements are generally gentle and have minimal side effects when taken
properly. Although they have marginally documented value, supplements are worth trying if you
are having difficulty with blood sugar and/or cholesterol control. Please note for safety, it is
important to consult your physician before beginning any supplements.
Fiber Supplements
Dietary fiber is probably the supplement that is the best documented for control of insulin and
blood sugar. In general, dietary fiber supplements are useful in reducing blood sugar levels, as
well as improving insulin sensitivity and controlling cholesterol. Whether dietary fiber as a
supplement can induce weight loss is controversial.
Researchers at the Cleveland Clinic also found that fiber supplements can achieve a significant
reduction in cholesterol and risk of coronary heart disease. In a double-blind study, a fiber
supplement containing guar gum, locust bean gum, pectin, oat fiber, acacia fiber and barley fiber
– in other words, a supplement high in soluble fiber - was tested against a placebo. The
researchers found that after two months on a fiber supplement, participants’ LDL cholesterol was
nearly 10 percent lower than the LDL of those on a placebo.
Taking fiber supplements can be useful if you know you won’t get adequate fiber from your diet.
If you are considering taking fiber supplements, just be aware that the most commonly studied
fiber supplements include oat bran fiber, psyllium fibers, and guar gum. Both oat bran fiber and
guar gum were demonstrated to reduce insulin resistance and improve blood sugar control, while
psyllium fiber supplementation produced mixed results. The dosages of guar gum used in the
studies showing an improvement in insulin function ranged from four grams, twice a day to ten
grams, three times a day. Doses of guar gum higher than 10 grams per day should only be taken
with physician supervision as there is a rare possibility of obstruction with very high doses of
soluble fiber supplements.
© Shintani 2001 – 2008 all rights reserved
T Shintani, The Good Carbohydrate Revolution
16-2
Vitamins
Biotin
Biotin, a member of the Vitamin B family, has been shown to improve blood sugar levels and to
decrease insulin resistance in experimental models of Type II diabetes. Although there aren’t
enough studies to be definitive about the use of Biotin in the treatment of diabetes, it is fairly
gentle and is worth trying for specific cases on a trial basis. The dosages that are used in these
studies ranged from 9 mg to 16 mg of Biotin per day. If you choose to try Biotin, I recommend
that the source be one that includes other B Vitamins, such as in a Vitamin B Complex.
Vitamin E
Vitamin E may be useful in increasing blood sugar control by improving the effectiveness of
insulin. Clinical studies on the use of Vitamin E to improve insulin sensitivity have shown
conflicting results. Double blind studies showed that Vitamin E supplementation is associated
with improved glucose tolerance in people with Type II diabetes, but there have also been studies
that show that Vitamin E makes blood sugar control worse. Thus, Vitamin E should be taken
with caution, and with a view to individualizing its use. The dosage used in these studies was
600 mg per day. There are other potential benefits with Vitamin E, such as the reduction in heart
disease risk. The best source of Vitamin E is whole grains.
Niacin
Large doses of niacin, or Vitamin B-3, should be avoided by anyone with glucose intolerance or
diabetes. It has the potential to make blood sugar levels more difficult to control. Therapeutic
amounts of niacin are sometimes recommended for cholesterol control. Good research has
established that in some people, one to two grams of niacin per day will reduce cholesterol
levels. However, niacin supplementation must be done under the supervision of a physician as it
has a number of potential side effects. Flushing is the most common symptom, but this tends to
lessen as time goes on. A more serious side effect is liver damage. Therapeutic amounts of
niacin should be regarded as a medication that requires periodic blood testing for liver enzymes
to monitor liver injury. Again, supplementation with niacin should only be done under the
supervision of a physician.
Minerals
Calcium
I always encourage my clients to eat plenty of non-dairy high calcium foods such as greens and
sea vegetables in order to obtain enough calcium. If this is not possible, then I recommend a
calcium supplement. The most readily absorbed form of calcium is calcium citrate. Calcium
carbonate is also fairly good. A supplement of 500 mg per day in order to cover shortfalls in
calcium intake is reasonable.
© Shintani 2001 – 2008 all rights reserved
T Shintani, The Good Carbohydrate Revolution
16-3
Magnesium
Individuals with diabetes may have low magnesium levels, suggesting that magnesium is
important in blood sugar control. However, magnesium supplementation produces mixed results
in the control of Type II diabetes. There is evidence that magnesium supplementation helps to
increase insulin production in some studies and not in others. In short, while magnesium
supplementation in people with diabetes may reverse the magnesium deficiency, the effect on
blood sugar and insulin resistance is uncertain.
Chromium
Chromium is a mineral that is important in glucose metabolism. Some evidence indicates that
chromium deficiency can contribute to insulin resistance and glucose intolerance. A well-known
study examined the relationship between chromium picolinate and obesity. Two hundred
micrograms of chromium picolinate was demonstrated to induce a small amount of weight loss
in one study. Other studies have not shown similar results. In terms of blood sugar control,
results are also conflicting. One placebo-controlled study involved 180 men and women who
were randomly assigned to a placebo, 100 mcg of chromium, or 500 mcg of chromium twice
daily. The results indicated that fasting glucose and insulin levels decreased significantly during
the four months of the study in the group receiving the chromium. Other studies however,
showed no such improvement in a similar, double blind, placebo-controlled study. This is
another supplement that might be very individual, and is probably best determined on a trial
basis. The dosage used was about 200 mcg per day.
Vanadium
Vanadium is a trace mineral that is also used in blood sugar regulation. Some experts believe
that poor blood sugar control is a result of vanadium deficiency. A number of studies suggest
that for those with Type II diabetes, vanadium in the form of vanadyl sulfate helps improve
insulin sensitivity and blood sugar control. The amount used in these studies was 100 mg of
vanadyl sulfate per day. There is some concern about the long-term safety of using vanadium.
Vanadium is a pro-oxidant and can lead to irritation of mucosal lining such as in the eyes, nose,
and throat. For this reason vanadium should be used with caution and under your doctor’s
guidance.
Alpha-Lipoic Acid
Alpha-lipoic acid is a powerful natural antioxidant that has improved insulin sensitivity in animal
studies. Alpha-lipoic acid has been shown to increase insulin sensitivity in some individuals
with diabetes at doses of 600 mg per day.
© Shintani 2001 – 2008 all rights reserved
T Shintani, The Good Carbohydrate Revolution
16-4
Herbal Remedies
Asian Ginseng
Asian Ginseng is an ancient, traditional, Chinese remedy for diabetes. It increases the release of
insulin from the pancreas and possibly enhances insulin receptors. In a study published on
diabetes care in 1995, a double blind study demonstrated that 200 mg of ginseng extract per day
reduced blood sugar level significantly in patients with Type II diabetes.
Cinnamon
Cinnamon – the kind commonly used to flavor food items is now known to be helpful in
controlling blood sugar. A study published in Diabetes Care (26:3215; 2003) indicated that
blood sugar and lipids were improved in participants taking 1 to 6 grams of cinnamon per day.
With 3 to 6 grams, a significant difference was seen after 20 days and with just 1 gram, a
significant difference was seen in 40 days.
Milk Thistle
Milk thistle or silybum marianum has shown some value in specific situations for those with
diabetes and alcoholic liver disease. In one study, 30 patients who were given 600 mg of
silybum marianum daily demonstrated a significant decrease in fasting blood sugar and fasting
insulin levels after four months of therapy. The use of milk thistle on those without liver disease,
but with diabetes, has not been studied.
Herbal Sugar Substitute
Stevia
Stevia Rebaudiana is one of the best-kept secrets of the herbal world. It is a Paraguayan herb
that is also known as sweet leaf. It is an excellent substitute for sugar in sweetening beverages
and food. Stevia has been used for centuries in Paraguay as a sweetener. In the U.S. it cannot be
sold as a food product or a sugar substitute because it has not passed FDA regulations. It can
however be sold as an herb because of FDA laws that allow for the sale of herbs that have
traditionally been used in other countries, even though it has not gone through the rigorous FDA
testing process.
Stevia can be found in the herbal section of health food stores, herb shops, and herb and vitamin
shops. It is typically found in three forms: powdered, liquid drops, and tea. Be very careful
when using this as a sugar substitute. It is 200 to 300 times sweeter than sugar! A minute
amount is required for sweetening. Many natural health advocates prefer stevia to artificial
sweeteners because it is not an artificially produced chemical, but rather a natural herb. While
stevia is not known to improve insulin resistance or blood sugar control, it is very useful in
reducing the need for using refined sugar of any kind.
© Shintani 2001 – 2008 all rights reserved