Overwhelming scientific evidence confirms that vitamin, mineral and antioxidant deficiencies suppress immune function and contribute to chronic inflammatory degenerative processes, such as arthritis, cancer, Alzheimer’s, cardiovascular disease and diabetes. We have seen over and over the myriad of scientific studies that demonstrate the ability to prevent, treat and even reverse type 2 diabetes through diet and lifestyle. Lifestyle intervention has also been demonstrated to be more effective than metformin (the preferred initial pharmacological agent recommended by the American Diabetes Association) for reducing the incidence of metabolic syndrome, pre diabetes and type 2 diabetes.
Unfortunately, however, serious nutritional deficiencies can occur even with a healthy eating plan due to many possible factors, including inadequate absorption of nutrients due to pre-existing medical conditions, toxins in our environment that may interfere with transport of nutrients, or nutrient-drug interactions as a result of the use of both prescription and over-the-counter medications. Metformin, for example, used by many people with type 2 diabetes and prediabetes, has been shown to lower vitamin B12 and folate, which can then lead to an increase in homocysteine levels, a major risk factor for cardiovascular disease. A folate deficiency has also been associated with the diabetes complications of retinopathy (a leading cause of blindness) and renal failure (kidney diseases). Many other pharmaceutical medications and over-the-counter treatments have been implicated in causing micronutrient deficiencies.
Although, fresh, whole (unprocessed) foods are the basis of this lifestyle intervention approach to treat and reverse chronic disease, we cannot ignore that a number of supplemental nutrients have been shown to improve blood sugar control and reduce insulin resistance, and other inflammatory processes, such as alpha-lipoic acid, chromium, vitamin D, riboflavin and niacin. This is not an exclusive list, however, as there are many more micronutrients that can be considered to effect glycemic management.
Always keep in mind that supplementation of nutritional supplements without proper diagnostic testing and monitoring is absolutely contraindicated. Routine conventional serum concentration measurements are not what is meant by proper diagnostic testing. Most micronutrient deficiencies go undetected with conventional serum testing until a severely malnourished state exists. Instead, specialized micronutrient laboratory testing that assess the white blood cells is necessary since it will evaluate not just the levels of a nutrient, but also the function of a nutrient that is present in blood or tissue. This type of testing can be obtained through specialized laboratories, and is not always reimbursed by health insurance, but has more recently become more affordable. The investment in this type of testing can prevent unnecessary and costly supplementation use, as well as possibly prevent the need for prescription medications since it can pinpoint specific individual requirements and get at the root of the problem.
Micronutrient testing needs to be performed before supplementation is considered and repeat testing should occur at least every six months when supplementation is indicated. Dosing will vary individually and may not necessarily be in line with the Recommended Dietary Allowances (RDA) for that nutrient. Repeat diagnostic testing is necessary so that you can assess if you are getting the correct dose. Repeat testing is also necessary in order to assess if you are affecting other micronutrients, as micronutrient supplementation cannot be in isolation. As an example, with too much chromium supplementation, nutrient-nutrient interactions can occur, such as decreased zinc absorption, which can then worsen glycemic control. Vitamin C can cause increased chromium absorption, and iron metabolism can be affected since chromium competes with iron for transport on transferrin. Nutrients in excess can also have serious effects, such as too much chromium can cause kidney and liver toxicity, rhabdomyolyisis (breakdown of muscle tissue), psychiatric disturbances, and hypoglycemia.
Although safety is seldom an issue for nutritional supplements, just like pharmaceutical medications, nutritional supplements can also carry risks and side effects, especially when taken with other pharmaceutical agents. Remember to also test your blood glucose often when taking supplements that are indicated to lower blood glucose, in order to reduce the risk of hypoglycemia, especially if taking along with pharmaceutical anti-diabetes medications or other herbs and supplements that may affect blood glucose levels.
Nutritional supplements must be used cautiously and with your healthcare providers knowledge. This is not “cookbook” medicine. Your health needs are different from your neighbors needs therefore always seek the assistance of a professional before using supplements.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. Recently, four well-known national retail stores received cease-and-desist letters to stop selling a number of their dietary supplements after an investigation determined that they did not contain the active ingredient shown on the label and/or included potential allergens not identified in the ingredient list. Purchasing pharmaceutical-grade nutritional supplements prescribed by a healthcare professional is always your best option.
When using any nutritional supplementation, you must take a sensible approach to avoid risks and side effects:
- Start low and go slow but give it a honest try for at least one month
- Try one new supplement at a time (every 3-4 weeks)
- Only take what you need (not every potential supplement)
- Test your blood sugar often to monitor effects
- Don’t take at the same time as your other medications
- Contact your health care professional for adjustment in your other medications if needed, due to low blood sugar and/or medication interactions
- Purchase only quality products and avoid supplements with artificial sweeteners, artificial colors, and binders (that often include genetically modified organisms [GMOs])