by Dr. Mark Hyman: “Can I get all the nutrients I need from food?” a patient will occasionally ask. On the surface, this makes sense…

After all, if you are eating a whole, fresh, unprocessed foods diet, shouldn’t you be able to get an abundant supply of vitamins, minerals, antioxidants and other nutrients?

Unfortunately, things aren’t that easy. Even with a perfect diet, the combination of many things—including our depleted soils, the storage and transportation of our food, genetic alterations of traditional heirloom species, and the increased stress and nutritional demands resulting from a toxic environment—make it impossible for us to get the vitamins and minerals we need solely from the foods we eat.

Simply put, the evidence shows we cannot get away from the need for nutritional supplements.

Doctors used to think you got all your vitamins and minerals from food. Any extra nutrients were excreted, or worse, became toxic. But the tide is shifting. Doctors now prescribe over $1 billion in fish oil supplements. Most cardiologists recommend folate, fish oil and coenzyme Q10. Gastroenterologists recommend probiotics. Obstetricians have always recommended prenatal vitamins.

Emerging scientific evidence shows the importance of nutrients as essential helpers in our biochemistry and metabolism. They are the oil that greases the wheels of our metabolism. And large-scale deficiencies of nutrients in our population—including omega-3 fats, vitamin D, folate, zinc, magnesium and iron—have been well documented in extensive government-sponsored research.

Four main reasons we are nutrient depleted

There are numerous reasons most of us are nutrient malnourished, anything from eroding topsoil depleting our mineral supply, to a toxic environment and the abundance of junk food many Americans eat. If I had to narrow nutrient depletion down to four primary reasons, this is what I would say:

1. We evolved eating wild foods that contained dramatically higher levels of all vitamins, minerals, and essential fats.

2. Because of depleted soils, industrial farming and hybridization techniques, the animals and vegetables we eat have fewer nutrients.

3. Processed factory-made foods have no nutrients.

4. The total burden of environmental toxins, lack of sunlight and chronic stress lead to higher nutrient needs.

These are among the reasons why everyone, at the very least, needs a good multivitamin, fish oil and vitamin D. I also recommend probiotics because modern life, diet and antibiotics, as well as other drugs, damage our gut ecosystem, which is so important in keeping us healthy and thin.

Nutrient deficiencies and “diabesity”

Paradoxical though it might seem, obesity and malnutrition often go hand in hand. Processed, high-sugar, high-calorie foods contain almost no nutrients, yet require even more vitamins and minerals to metabolize them. It’s a double whammy.

Obesity and diabetes both stem from malnutrition. Experts have described diabetes as starvation in the midst of plenty. The sugar can’t get into the cells. Your metabolism is sluggish, and the cells don’t communicate as a finely tuned team.

Nutrients are an essential part of getting back into balance and correcting the core problem, which is insulin resistance.

There are two ways in which supplements work:

1. They make your cells more sensitive to insulin and more effective at metabolizing sugar and fats.
2. Special fibers (that I will discuss in a minute) can slow the absorption of sugars and fats into the bloodstream.

This leads to a faster metabolism, more balanced blood sugar, improved cholesterol, less inflammation, fewer cravings, more weight loss and more energy.

If you have diabesity—and keep in mind most people do to some degree—I recommend additional nutrients to reset and correct metabolic imbalances, improve insulin function, balance blood sugar and reduce inflammation.  But first, let’s delve a little further into this perplexing topic.

Why are nutrient studies so confusing?

I’m sure you are confused by conflicting studies about supplements. One day folic acid is good; the next it is found to cause cancer. One day vitamin D is a lifesaver; the next it is found to be not helpful.

This media whiplash is enough to make you give up altogether. The problem with these studies is that they treat nutrients as drugs, where researchers give one nutrient alone and see what happens.

But nutrients work as a team. Broccoli is great for you and can help prevent and cure many diseases, but if all you ate was broccoli, you would get sick and die.  You need to eat a well rounded diet to stay healthy.  Similarly, nutrients work synergistically to maintain the proper balance in your body.

Potential problems with choosing supplements

You know what you are getting when your pharmacist fills your prescription. The government makes sure of it. Over-the-counter supplements are not controlled in this same way. Manufacturers often cut corners and this can become problematic for the average consumer.

The issues you might experience with over-the-counter supplements that you buy at your local drugstore or warehouse store include:

1. The form of the nutrient may be cheap and poorly absorbed or used by the body.

2. The dosage on the label may not match the dose in the pill.

3. It may be filled with additives, colors, fillers and allergens.

4. The raw materials (especially herbs) may not be tested for toxins, such as mercury or lead, or may not be consistent from batch to batch.

5. The factory in which it is produced may not follow good manufacturing standards, leading to inconsistent quality.

I use supplements in my practice as a cornerstone of healing and repair, so I have investigated supplement makers, toured factories and studied independent analyses of their finished products. I have learned there are a few companies I can rely on, many of which you can find in my online store.

Whether you follow my product recommendations or not, be sure to pick quality supplements and ones that contain nutrients and compounds that research has shown to be helpful in the treatment of diabesity and insulin resistance.

Think of them as part of your diet. You want the best-quality food and the best-quality supplements you can buy. Guidance from a trained dietitian, nutritionist, or nutritionally oriented physician or health care practitioner can be helpful in selecting the products that are right for you.

If you haven’t done so already, I encourage you to read my book, The Blood Sugar Solution, which provides a comprehensive nutrient plan that discusses the benefits of each supplement. To get you started, I will discuss how the supplements I recommend benefit you and then tell you my basic plan.

The basic nutrient plan

Everyone reading this blog should get on the basic plan of supplements and stay on them for life. Even if you are “cured” of diabesity, you will need to keep taking them, because you need special vitamins, minerals and herbs to help compensate for your genetic tendency toward insulin resistance.

Let’s take a few moments to review the specifics about each of these supplements or ingredients to understand why they are so important in the treatment of diabesity.

High-quality, high-potency, complete multivitamin

The right multivitamin will contain all the basic vitamins and minerals. Keep in mind that getting the optimal doses usually requires two to six capsules or tablets a day. Some people may have unique requirements for much higher doses that need to be prescribed by a trained nutritional or functional medicine physician.

Note that B complex vitamins are especially important for those with diabesity, as they help protect against diabetic neuropathy, or nerve damage, and improve metabolism and mitochondrial function. Antioxidants such as vitamin E, C and selenium are also important as they may help reduce oxidative stress, which is a significant cause of diabesity.

Vitamin D3

The vitamin D deficiency is epidemic, with up to 80 percent of modern day humans deficient or suboptimal in their intake and blood levels. Depending on what’s in your multivitamin, I recommend taking additional vitamin D. Vitamin D3 improves metabolism by influencing more than 200 different genes that can prevent and treat diabetes and metabolic syndrome.

There are several important things to keep in mind when taking vitamin D:

1. Take the right type of vitamin D—D3 (cholecalciferol), not D2. Most doctors prescribe vitamin D2. Do not take prescription vitamin D; it is not as effective and not very biologically active.
2. For serious deficiencies, you may need more vitamin D, as much as 5,000 to 10,000 IU a day for three months or more. Do this with your doctor’s supervision, if needed.
3. Monitor your vitamin D status with your doctor. Get your blood level to 45 to 60 ng/dl. Be sure to request the right blood test, which is the Vitamin D 25 Blood test to accurately check vitamin D levels.
4. Give time to fill up your tank. It can take six to 12 months for some people. The average daily dose for maintenance for most people is 1,000 to 2,000 IU a day.

Omega-3 fatty acids (EPA and DHA)

These important fats improve insulin sensitivity, lower cholesterol by lowering triglycerides and raising HDL, reduce inflammation, prevent blood clots and lower the risk of heart attacks. Fish oil also improves nerve function and may help prevent the nerve damage common in diabetes.

Magnesium

Diets low in magnesium are associated with increased insulin levels, and magnesium deficiency is common in diabetics. Magnesium helps glucose enter the cells and turn those calories into energy for your body.

Some people with severe magnesium deficiency may need more than the amount outlined below. If you are concerned you may be severely deficient, discuss the details with your doctor.

Diarrhea is often a sign that you are getting too much magnesium. If this occurs, just back off on the dose, and avoid magnesium carbonate, sulfate, gluconate or oxide. They are the cheapest and most common forms found in supplements but are poorly absorbed. Switch to magnesium glycinate. If you tend to be constipated, use magnesium citrate.

People with kidney disease or severe heart disease should take magnesium only under a doctor’s supervision.

Alpha lipoic acid

Alpha lipoic acid is a powerful antioxidant and mitochondrial booster shown to reduce blood sugar and heal a toxic liver. It may also be useful in preventing diabetic nerve damage and neuropathy. It can improve the clearance of glucose from the blood by 50 percent.

Chromium and biotin

Chromium is very important for proper sugar metabolism and insulin sensitivity and can help you make more insulin receptors. Biotin has been shown to enhance insulin sensitivity, lower triglycerides, reduce expression of cholesterol-producing genes and improve glucose metabolism.

Herbs

A number of herbs, including cinnamon and catechins from green tea, are helpful in controlling blood sugar and improving insulin sensitivity. Green tea can even increase fat burning and metabolism. The best products provide combinations of herbs in one supplement.

PGX (Polyglycoplex)

PGX is a very viscous fiber from a Japanese tuber or root combined with seaweeds into a super fiber. It has profound effects on insulin, glucose and hemoglobin A1c.

PGX reduces the absorption of sugars and fats into your bloodstream and helps control appetite, weight loss, blood sugar and cholesterol.

When taken before meals with a glass of water, it can be a critical component to overcoming diabesity. It can lower your insulin response after a meal by 50 percent, while lowering LDL cholesterol by 20 percent and blood sugar by 23 percent. I have had patients lose up to 40 pounds just by using this super fiber.

Protein powder for your shakes

I strongly encourage the use of a high-quality, hypoallergenic rice, pea, hemp, chia or soy protein powder. Some of these powders are anti-inflammatory and support detoxification. Soy protein from whole soy foods with isoflavones can lower blood sugar and cholesterol.

A protein shake also makes an excellent breakfast and snack option, helping balance your blood sugar and heal your liver. See here for great shake recipes (and some other easy breakfast ideas).

My basic nutrient plan

Now that you understand what these vitamins and nutrients do for your body,  you might be wondering what your daily regimen should be. Below, I provide an overview of what I suggest for basic supplementation for my patients.  All of the supplements should be taken with a meal, such as breakfast and dinner; PGX fiber should be taken before meals, as directed. Click on the links to purchase top-quality versions of these supplements in my store.

1. A high-quality multivitamin and mineral—you can find an array of multivitamins at my store. This is the one I frequently recommend, especially if you have any degree of diabesity. To find out the degree of diabesity you have, log in and take this quiz.
2. 1,000 to 2,000 IU of vitamin D3,once a day with breakfast—you can get this as a liquid or
3. 1,000 to 2,000 mg of omega-3 fats (should contain a ratio of approximately 300/200 mg of EPA/ DHA), twice a day, once with breakfast and once with dinner
4. 100 to 200 mg of magnesium, twice a day, once with breakfast and once with dinner—you can find several forms in my store, including citrate and glycinate.
5. 300 to 600 mg of alpha lipoic acid twice a day, once with breakfast and once with dinner. Note the multi I recommended above contains 600 mg of alpha lipoic acid.
6. 200 to 600 mcg of chromium, once a day (up to 1,200 mcg a day can be helpful). The multi I recommended above contains 500 mcg of chromium
7. 1 to 2 mg of biotin, twice a day, once with breakfast and once with dinner. The multi I recommended above has 4 mg of biotin.
8. 125 to 250 mg of cinnamon, twice a day, once with breakfast and once with dinner
9. 25 to 50 mg of green tea catechins, twice a day, once with breakfast and once with dinner
10. 5 grams of PGX, three times a day, 15 minutes before each meal with 8 ounces of water
11. (Optional) A hypoallergenic protein powder to add to a morning protein shake. 1 to 2 scoops of rice, soy, hemp, pea, or chia protein powder for breakfast. Follow the directions on the label. This can be added to your UltraShake.

In addition to these, most people should use high-quality probiotics, but this is optional.

Many of the components listed can be obtained by taking combination supplements. Getting these ingredients in the listed dosage ranges is important. So be sure to look for combination supplements that match my recommendations as closely as possible.

Conclusion

I hope this blog provides you a better understanding about supplements and choosing the right formula for your needs. While many people do very well with this basic program, more advanced conditions require additional supplements. I highly recommend talking with an integrative nutritionist or physician to address your unique needs.