Choosing Vitamins and Supplements for Diabetes

Dr. Jedha, Host

Hello wonderful people. Thanks for joining me for episode 54. All of us at some point in our lives have probably taken vitamins and supplements. Maybe even now you have a whole cupboard full of them, lots of people do. In fact, globally we spend billions and billions of dollars each year on supplements. Without a doubt, many vitamins and supplements have proven benefits for boosting optimal health. And in some cases we absolutely need them to correct deficiencies or insufficiencies. For example, we might need to take vitamin D or vitamin B12 to boost levels to the healthy range. 

1:41 

But when you choose a supplement how do you go about it? Perhaps you look on Amazon and find the ones with the highest ratings and reviews. Or maybe you just choose the cheapest option, that’s fairly common. Maybe when you’ve looked it is something about the label, the color or writing on the label or a specific health claim the label states, maybe that’s what sells you on choosing the one you did. Interestingly, one thing most people don’t do is check the ingredients label and it’s here that we can find some interesting things. 

That’s what we’re diving deep into today. The world of supplements, specifically exploring the common ingredients found in supplements. With so many products on the market, it’s crucial to understand what you’re putting into your body and how these ingredients may impact your health. If you don’t look at the label and just choose the cheapest option, you might not realize they contain additives and fillers that may not be beneficial, or even potentially harmful. By the end of this episode today, you’ll be equipped with more knowledge about supplements so you can make informed decisions about the supplements you choose to support your health journey. 

To help make things easier, we’ve now added a supplement shop to our website. Well, it’s not just a shop but a diabetes supplement thesaurus and guide. We want you to have the best options, so our team has done all the hard work in choosing a range of the best vitamins and supplements, because it can take a lot of time to go through each supplement looking at the labels and wondering which brands are best. In our shop you can find a selection of options and each one vitamin or supplement includes points of research benefits they have for type 2 diabetes or prediabetes and recommended dosages that studies have found to be beneficial. So after listening today, head down to our website to find this amazing resource at Type2DiabetesTalk.com/supplements . If you’re one of our members, you can find this in the members site under Guides and the members version is a lot more comprehensive with other information about the supplement and so forth.

4:16

Let’s start by looking at some supplement comparisons. 

We’ll start with turmeric as an example, which has an active ingredient called curcumin, which is a potent anti-inflammatory agent.

One I’m looking at now on Amazon with top ratings has turmeric yes, but it also has Cellulose Gel, Gelatin, Water, Stearic Acid, Magnesium Stearate, Silicon Dioxide. 

Another one here has turmeric and black pepper, which is good as that can support enhanced absorption. And it has the Cellulose (vegetable capsule) and Magnesium Stearate. 

I’m now looking at a chromium supplement and yes it has chromium of course, along with dicalcium phosphate, microcystalline celulose, croscamelose sodium, stearic acid, silicon dioxide, and magnesium stearate.

Another I’m looking at has chromium, the vegetable capsule and rice flour. And yet another has only the chromium and the vegetable capsule.

One calcium supplement here has calcium and vitamin D, along with calcium carbonate, maltodextrin. Contains 2% or less of carnauba wax, cholecalciferol, croscarmellose sodium, fd&c blue no. 2 lake, fd&c red no. 40 lake, fd&c yellow no. 6 lake, glycerin, hydroxypropyl methylcellulose, medium chain triglycerides, mineral oil, polysorbate 80, silica, sodium ascorbate, starch, sugar, titanium dioxide (color), tocopherol, triethyl citrate.

You’d have to agree that’s a long list of ingredients and includes fillers, colors, sugars, preservatives, binders, and stabilizers. Another calcium has a much shorter list.

The point being is that some supplements have a list of additives and fillers, while others just have the supplement ingredients – the vitamins or minerals for example, but no fillers, just the capsule itself. So what exactly is better?

7:05

We’ll get to that, but let’s explore what some of these common additives and fillers actually are. 

Cellulose gel, also known as microcrystalline cellulose (MCC), is a refined form of cellulose, a naturally occurring polymer found in the cell walls of plants. Basically we’re talking about the capsules here.  The capsules hold the ingredients of tablets and capsules together, ensuring they stay intact until they are ingested. These can be labeled as cellulose gel, cellulose, microcrystalline cellulose, Hydroxypropyl Methylcellulose or sometimes it just says vegetable capsule. Often the capsule is of course necessary in order to provide the vitamin, mineral or therapeutic compound. 

Silicon Dioxide, commonly known as silica, is a naturally occurring compound composed of silicon and oxygen. It is found in a variety of forms including quartz, sand, and in plant cell walls. Silica is used as an anti-caking agent to prevent clumping, it absorbs moisture, which helps keep supplements dry and prolongs their shelf life, and it can act as a carrier agent. Majority of sources indicate there are no negative health consequences of silicon dioxide, unless you inhale silica dust over a long period of time, where it can lead to lung cancer and other respiratory issues. Although research from earlier in 2024, found that chronic intake of silicon dioxide may alter immune cell function. This is early research in animals but interesting nonetheless. However, silica nanoparticles are a newer type of additive being used, and there is certainly is some concern about their biological toxicity. Silica nanoparticles are an engineered form of silicon dioxide, consisting of particles that are typically less than 100 nanometers in size.  Due to their small size, silica nanoparticles can penetrate biological membranes and enter cells, raising concerns about potential toxicity and long-term health effects. Silica nanoparticles are used in specialized medications and not typically in standard dietary supplements, so at the moment that’s nothing to be concerned about with supplements at this stage but worth mentioning. 

Magnesium stearate is a compound made from magnesium and stearic acid, a fatty acid found in both plant and animal fats. Its main purpose is to act as a lubricant, preventing ingredients from sticking to manufacturing equipment, along with being a flow agent, improving the flow properties of powders during the production of tablets and capsules. Some studies suggest that high levels of magnesium stearate may suppress T-cell function, which is part of the immune system. At the levels in supplements, those types of outcomes are unlikely. So while there don’t seem to be any negative health consequences in consuming it, overall, magnesium stearate is an ingredient primarily related to the manufacturing process, to speed up production, rather than adding any value to the supplement. 

Stearic acid is a saturated fatty acid commonly found in both animal and plant fats. It is a waxy, solid substance at room temperature. Used as a lubricant and binder in the production of tablets and capsules. Being a natural compound found in both animal and plant fats, this ingredient doesn’t pose any negative consequences. 

Croscarmellose sodium is a modified type of cellulose. Its primary purpose is to aid in speedy disintegration of the capsule once it’s ingested. It absorbs water rapidly, causing the tablet or capsule to swell and disintegrate. Generally considered safe, although some individuals may experience mild gastrointestinal symptoms such as bloating or gas. And there have been cases of allergic reactions requiring hospitalization, though these are considered a rare event. 

Hydroxypropyl Cellulose is a derivative of cellulose used as a binder in tablet formulations, helping to hold the ingredients together and ensuring the tablet maintains its shape until it is ingested. Generally considered safe and there are rarely reported side effects.

Starch is a carbohydrate extracted from various plants such as corn, potatoes, wheat, and rice. It is widely used in the food and pharmaceutical industries for its thickening, stabilizing, and bulking properties. Starch used in supplements is also known as oxidized starch, it’s a modified starch that has been treated with oxidizing agents to alter its properties. Used in tablet formulations as a binder and disintegrant to ensure tablets hold together and disintegrate properly after ingestion. Generally considered safe, though it is a carbohydrate so depending on the quantity in a supplement it could potentially impact blood sugar. 

Talc is used as an anti-caking agent to prevent caking and clumping, a lubricant and a coating to improve the appearance and ease of swallowing of tablets. Generally considered safe at low dosages and research on negatives is for workers exposed to asbestos contaminated talc. 

Titanium dioxide is used as a colorant to provide a white color to tablets and capsules, enhancing their appearance. It is no longer considered safe, declared by the European Food Safety Authority after genotoxicity concerns had been noted, with titanium particles having the ability to accumulate in the body.  Genotoxicity refers to the ability of a chemical substance to damage DNA, the genetic material of cells, which can lead to carcinogenic effects, or in other words, the development of cancers.

Other ingredients that may be included are plyvinyl alcohol, hypromelose, rice flour, rice starch and so forth.

All of these fillers and additives are FDA approved of course and the general consensus is that many are poorly absorbed by the body, they are just there as fillers or to aid the manufacturing process or aid the delivery of the substance, and the general consensus is that most of them have little side effects. The thing is there will always be uncertainties and concerns. For example, titanium dioxide was once considered safe, now there is advice this might not be the case. It is possible that other fillers and additives may also be deemed toxic in future. The other thing that is concerning is our cumulative exposure to food additives and the synergistic effect of different additives used together. Overall we don’t have a great deal of research on this stuff so it is again an area of uncertainty. It’s also important to mention that some people can be allergic to any of these additives and fillers, so keep that in mind that they can all be allergens. 

16:16 

Now let’s talk about these gummies and chews, which now seem to be all the rage. In fact, the gummy supplements market has seen substantial growth and popularity in recent years, often outpacing other forms of supplements. But when it comes to their benefits or negatives, what are we actually looking at here?

Let’s think about this logically. Gummies and chews are essentially a type of candy, so is taking our vitamins and minerals in a candy really that good for us? Well, from a nutritional perspective, the ingredients they contain are often questionable. 

Let’s look closer at some calcium chews. 

The calcium soft chews I’m looking at contain: Calcium Carbonate (the active ingredient), Sugar, Corn Syrup, Hydrogenated Coconut Oil, Water, Corn Syrup Solids, Nonfat Dry Milk, Glycerin. Contains <2% of: Cholecalciferol (Vit. D3), Dextrose (Corn), Lecithin (Soy), Natural and Artificial Flavors, Salt. Contains: Milk, Soy.

Notice the second, third and fifth ingredients are all sugars. And with two chews recommended per day, they contain 6g carbs and 4g added sugars. 

The gummy bites are worse.The two first ingredients are Glucose Syrup and Sugar, followed by Tribasic Calcium Phosphate (the active ingredient), Water. Contains <2% of: Annatto Seed Extract (color), Cholecalciferol (Vit. D3), Citric Acid, Invert Sugar, Natural Flavors, Pectin, Purple Carrot Juice Concentrate (color), Sodium Citrate, Tocopherols (to preserve freshness).

These gummy bites contain 8g carbs for 2 gummies and 5g added sugars.

The ones I’m looking at here contain Calcium Carbonate (the active ingredient), Xylitol, Maltodextrin, Magnesium Oxide, Contains <2% of: Blue 2 Lake, Cholecalciferol (Vit. D3) – another active ingredient, Citric Acid, Copper Sulfate, Corn Syrup Solids, Hydrogenated Palm Oil, Magnesium Stearate, Manganese Sulfate, Mono- and Di-Glycerides, Natural and Artificial Flavors, Polydextrose, Red 40 Lake, Sucralose, Sugar, Tocopherols (to preserve freshness), Yellow 6 Lake, Zinc Oxide.

These really are rubbish. There’s various sugars and sugar substitutes, colors and emulsifiers, just overall not a quality product. 

A vitamin C gummy I’m looking at contains cane sugar and tapioca syrup, both sugars, followed by the active ingredients vit c and A. The recommendation is 3 gummies a day containing 7g carbs, 6g of those being added sugar. Other vitamin C powders or supplements contain nothing but the ascorbic acid or active ingredients. 

Some places you find on the wild west web suggest that because we chew them the content of gummies or chews are more bioavailable. Bioavailability refers to the proportion of a nutrient or active ingredient that is absorbed and utilized by the body. 

One small study suggested vitamin D had greater absorption than pills, while a study on vitamin C showed no difference in absorption between gummies and pills. There just isn’t much research on this to suggest gummies are superior in terms of bioavailability.

The question with these is the overall quality. From a nutrition perspective there is simply no benefit of taking a dose of vitamins or minerals with your sugar. Logically, that just doesn’t make any sense whatsoever. You’ll likely be far better off to steer clear of gummies and chews and select other forms, whether that be capsules, tabs, liquids or powders, as these won’t contain sugar. 

21:15

I also want to add a note about front-of-pack labels. Like food products, supplements often highlight different benefits or sell us on things that may not necessarily be true. In addition, statements that companies make are not always true either. I want to give you one example of this. The calcium supplement brand Caltrate. One of the statements on their website and some of their marketing materials said: “Caltrate is among the most clinically studied calcium supplement brands in the world.” I did a search and couldn’t locate any peer-reviewed research to confirm Caltrate is ‘the most clinically studied calcium supplement brands in the world.’ So, I emailed the company asking them to provide sources to confirm this statement, or whether they were just referring to research on calcium carbonate.

The response from the Medical Team was to “Kindly refer to the information available with the product”, which was exactly what I thought. Caltrate itself has no specific research so making a statement that Caltrate is the most clinically studied calcium supplement brands in the world is false. In fact, the information they gave me in the email presented a cople of studies about calcium and vitamin D supplementation being beneficial for treatment and prevention of osteoporosis. They didn’t even mention the main ingredients in the supplement ‘calcium carbonate’, which has had a lot of research surrounding it, but is also found in hundreds of other supplements. Strange response I thought, and nothing to confirm the statements they make. 

And when it comes to any supplements, always read the labels. Not just the front-of-pack label with any purported benefits. You want to assess the other ingredients a supplement contains and whether you want to be taking those, given some of the notes we’ve made today. 

Certainly, in some cases, supplements might contain necessary additives. For example, fat-soluble vitamins like vitamin D, E, A, and K often include oils such as olive oil, MCT or coconut oil to enhance their absorption and bioavailability. This is because these vitamins require fat to be efficiently absorbed by the body. But other fillers and additives such as some of those we’ve covered today don’t provide any necessary benefit and others may pose risks, so generally you want a product that contains minimal additives. It’s like when we look for a food product, we’d follow a similar process – look at the ingredients label to assess the quality of a food. And like food products, supplement labels always list the other ingredients in terms of quantity in the product in descending order, so if sugar is listed first, it contains more sugar than anything else. 

In any case, don’t just choose a supplement based on cheapest price or the color of a label. Or even because a friend recommended it. Read the label yourself and determine what’s in it. Better yet, do a bit of research to understand the ingredients you will be consuming. And hopefully you’ve learned a thing or two listening to this episode, just like I have in doing all this research to help inform you. 

After listening today, head down to our website to find our new supplement shop, which is a resource of quality supplements in relation to T2 and prediabetes. You can find that at Type2DiabetesTalk.com/supplements . If you’re one of our members, you can find this in the members site under Guides and the members version is a lot more comprehensive with other information about their facts and benefits.

That’s all from me today. 

Dr Jedha over and out.