Diabetes Safety Caveats

An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

Bilberry

• Consult your doctor before taking Bilberry if you take warfarin (Coumadin). Bilberry has blood-thinning properties.
• Bilberry can cause gastrointestinal symptoms such as nausea and diarrhea.

Chromium

• Consult your doctor before taking chromium if you have hyperglycemia or type 2 diabetes. See your doctor and monitor your blood glucose level frequently if you take chromium and have hyperglycemia or type 2 diabetes.

Cinnulin

• Cinnulin can lower plasma glucose levels.
• Consult your doctor before taking cinnulin if you have hyperglycemia or type 2 diabetes. See your doctor and monitor your blood glucose level frequently if you take cinnulin and have hyperglycemia or type 2 diabetes.

Coenzyme Q10

• See your doctor and monitor your blood glucose level frequently if you take CoQ10 and have diabetes. Several clinical reports suggest that taking CoQ10 may improve glycemic control and the function of beta cells in people who have type 2 diabetes.
• Statin drugs (such as lovastatin, simvastatin, and pravastatin) are known to decrease CoQ10 levels.

Coffee Berry

• Coffee berry can lower plasma glucose levels.
• Consult your doctor before taking coffee berry if you have hyperglycemia or type 2 diabetes. See your doctor and monitor your blood glucose level frequently if you take coffee berry and have hyperglycemia or type 2 diabetes.

DHEA

• Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or ovarian cancer.
• DHEA can cause androgenic effects in woman such as acne, deepening of the voice, facial hair growth and hair loss.

EPA/DHA

• Consult your doctor before taking EPA/DHA if you take warfarin (Coumadin). Taking EPA/DHA with warfarin may increase the risk of bleeding.
• Discontinue using EPA/DHA 2 weeks before any surgical procedure.

Fiber

• Take fiber supplements with a full 8-ounce glass of water.
• Drink eight 8-ounce glasses of water daily while taking fiber.

Folic acid

• Consult your doctor before taking folic acid if you have a vitamin B12 deficiency.
• Daily doses of more than 1 milligram of folic acid can precipitate or exacerbate the neurological damage caused by a vitamin B12 deficiency.

GLA

• Consult your doctor before taking GLA if you take warfarin (Coumadin). Taking GLA with warfarin may increase the risk of bleeding.
• Discontinue using GLA 2 weeks before any surgical procedure.
• GLA can cause gastrointestinal symptoms such as nausea and diarrhea.

Garlic

• Garlic has blood-thinning, anticlotting properties.
• Discontinue using garlic before any surgical procedure.
• Garlic can cause headache, muscle pain, fatigue, vertigo, watery eyes, asthma, and gastrointestinal symptoms such as nausea and diarrhea.
• Ingesting large amounts of garlic can cause bad breath and body odor.

Ginkgo Biloba

• Individuals with a known risk factor for intracranial hemorrhage, systematic arterial hypertension, diabetes, or seizures should avoid ginkgo.
• Do not use prior to or after surgery.
• Avoid concomitant use of ginkgo with NSAIDS, blood thinners, diuretics, or SSRI’s.
• Gastrointestinal symptoms (nausea and diarrhea) may occur.
• Allergic skin reactions may occur.
• Elevations in blood pressure may occur.

Green Tea

• Consult your doctor before taking green tea extract if you take aspirin or warfarin (Coumadin). Taking green tea extract and aspirin or warfarin can increase the risk of bleeding.
• Discontinue using green tea extract 2 weeks before any surgical procedure. Green tea extract may decrease platelet aggregation.
• Green tea extract contains caffeine, which may produce a variety of symptoms including restlessness, nausea, headache, muscle tension, sleep disturbances, and rapid heartbeat.

L-Carnitine

• L-carnitine can cause gastrointestinal symptoms such as nausea and diarrhea.

Lipoic Acid

• Consult your doctor before taking lipoic acid if you have diabetes and glucose intolerance. Monitor your blood glucose level frequently. Lipoic acid may lower blood glucose levels.

Magnesium

• Do not take magnesium if you have kidney failure or myasthenia gravis.

NAC

• NAC clearance is reduced in people who have chronic liver disease.
• Do not take NAC if you have a history of kidney stones (particularly cystine stones).
• NAC can produce a false-positive result in the nitroprusside test for ketone bodies used to detect diabetes.
• Consult your doctor before taking NAC if you have a history of peptic ulcer disease. Mucolytic agents may disrupt the gastric mucosal barrier.
• NAC can cause headache (especially when used along with nitrates) and gastrointestinal symptoms such as nausea and diarrhea.

Niacin (nicotinic acid)

• Do not take high doses of nicotinic acid (1.5 to 5 grams daily or more) if you have liver dysfunction, an unexplained elevation in your serum aminotransferase (transaminase) level, active peptic ulcer disease, arterial bleeding, or if you consume large amounts of alcohol.
• Consult your doctor before taking high doses of nicotinic acid if you have a history of jaundice, peptic ulcer disease, gastritis, disease of the liver or bile ducts, gout, kidney dysfunction, or cardiovascular disease (especially acute myocardial infarction or unstable angina).
• Consult your doctor before taking high doses of nicotinic acid if you have diabetes. High doses of nicotinic acid can negatively affect glucose tolerance. Monitor your serum glucose level frequently if you take nicotinic acid and have diabetes.
• Have your doctor monitor your serum aminotransferase level if you take high-doses of nicotinic acid.
• Nicotinic acid may cause flushing, principally of the face, neck, and chest. This flushing is thought to be prostaglandin-prostacyclin mediated. Histamine may also play a role in the flushing.
• Nicotinic acid can cause dizziness, palpitations, rapid heartbeat, shortness of breath, sweating, chills, insomnia, nausea, vomiting, abdominal pain, and muscle pain.
• High doses of nicotinic acid can cause blurred vision, macular edema, toxic amblyopia, and cystic maculopathy.

Quercetin

• Quercetin can cause headache, mild tingling of the extremities, and gastrointestinal symptoms such as nausea.

Vitamin B1 (Thiamin)

• Consult your doctor before taking vitamin B1 for a thiamin deficiency, lactic acidosis secondary to thiamin deficiency, Wernicke-Korsakoff syndrome, Wernicke's encephalopathy, or Korsakoff's psychosis.

Vitamin B2 (riboflavin)

• High doses of vitamin B2 (riboflavin) may interfere with the Abbott TDx drugs-of-abuse assay.
• Riboflavin absorption is increased in hypothyroidism and decreased in hyperthyroidism.
• If you are taking nucleoside reverse-transcriptase inhibitors, even a mild riboflavin deficiency can increase your risk of lactic acidosis.

Vitamin B6

• Do not take 5 milligrams or more of vitamin B6 daily if you are being treated with levodopa, unless you are taking carbidopa at the same time.

Vitamin B12 (cyanocobalamin)

• Do not take cyanocobalamin if you have Leber's optic atrophy.

Vitamin C

• Do not take vitamin C if you have a history of kidney stones or of kidney insufficiency (defined as having a serum creatine level greater than 2 milligrams per deciliter and/or a creatinine clearance less than 30 milliliters per minute.
• Consult your doctor before taking large amounts of vitamin C if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD) deficiency. You can experience iron overload if you have one of these conditions and use large amounts of vitamin C.

Vitamin E

• Consult your doctor before taking vitamin E if you take warfarin (Coumadin).
• Consult your doctor before taking high doses of vitamin E if you have a vitamin K deficiency or a history of liver failure.
• Consult your doctor before taking vitamin E if you have a history of any bleeding disorder such as peptic ulcers, hemorrhagic stroke, or hemophilia.
• Discontinue using vitamin E 1 month before any surgical procedure.

For more information see the Safety Appendix