Brian Mastroianni is a health and science journalist based in New York. His work has been published by The Atlantic, The Paris Review, CBS News, The TODAY Show, Barron's PENTA, Engadget and Healthline, among others.
Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles, California.
If you have hyperglycemia, it means that your blood glucose levels are too high. Often a result of diabetes, elevated glucose levels are due to your body not producing enough insulin or not utilizing this hormone properly. Elevated blood sugar levels can have a negative impact on your health as a whole, affecting everything from your vision to weight to heart health.
While changing your diet or incorporating more exercise can help manage high blood sugar, there are also many supplements that may help. Common examples include vitamin D, cinnamon, and magnesium, among others.
However, according to the American Diabetes Association, there is no clear evidence of benefit from herbal or nonherbal supplementation for people with diabetes who have no underlying deficiencies.
Keep in mind that these supplements are not meant to replace diabetes medications. What they can do is serve as helpful complements to any blood sugar-lowering medications your healthcare provider has prescribed.
Here’s an overview of 10 common supplement options and the current research behind them.
A 2016 review of eight clinical trials found that oral aloe vera improved glycemic control in prediabetes and type 2 diabetes. However, there still is a lack of high-quality, randomized, controlled trials to support the beneficial effects of this supplement.
Similarly, another review pointed to aloe vera being particularly helpful at lowering blood sugar levels for individuals with prediabetes. As with the other study, the authors concluded that more research and clinical trials need to be conducted to investigate the benefits of oral aloe vera.
Interest in aloe vera as a treatment for blood sugar in people with diabetes has long been on researchers’ radar, with a study back in 1996 looking at the effectiveness of aloe vera juice. The authors examined the impact of taking one tablespoon of the juice twice a day for at least two weeks in people with diabetes. They found that triglyceride levels in the treated group fell, but as with other reports, suggested more research needs to be done.
Aloe vera comes in juice that is ingested orally. It can also come in a topical gel applied to the skin and is even found in shampoos and soaps, but the oral form is what has been studied as a way to regulate blood sugar.
Oral aloe vera has been shown to cause diarrhea, hives, and cramping. Aloe latex (the outer leaf) contains compounds that are stimulating laxatives. When consuming aloe orally, it is best to choose products made from the inner leaf or fillet only, as to avoid any laxative effects. This designation should be clearly indicated on the product label.
Aloe vera that’s ingested orally has been shown to interact with drugs that are cytochrome P450 substrates. Aloe vera-based juice has been found to inhibit CYP3A4 and CYP2D6. Antidepressants and opioids are in this category.
It can also exacerbate side effects of sevoflurane, an anesthetic, potentially causing excessive bleeding during surgery. Consult your healthcare provider and mention you are using aloe vera juice before undergoing a surgery.
Research has shown that aloe vera extracts can cause intestinal cancer. In recent years, aloe vera whole leaf extract has been classified as a “possible human carcinogen” by the International Agency for Research on Cancer. Consult your healthcare provider with any concerns about aloe vera or any other supplements before using.
Cinnamon is made from the bark of the cinnamon tree and is an extract or whole cinnamon powder in its supplement form.
A 2020 study found that daily consumption of supplemental cinnamon might control blood sugar levels in people with prediabetes. This is crucial to preventing the onset of type 2 diabetes.
The research examined what impact three daily 500 milligram (mg) doses of cinnamon would have over 12 weeks, surveying 54 participants. All had prediabetes, with 27 receiving the supplement and the remainder a placebo.
Those who received the placebo had a higher level of sugar in their bloodstream after an overnight fasting period, while levels were stable in people who took the supplement. Those receiving cinnamon also had an improved ability to metabolize sugar.
Another study gave people with prediabetes 250 mg of cinnamon extract. They consumed their doses before both breakfast and dinner over three months, and reported an 8.4% decrease in fasting blood sugar levels compared with those on placebo.
Cinnamon is taken orally. One study cites the recommended dosage of cinnamon extract to be 250 mg two times a day before each meal. Non-extract cinnamon-based supplements have a recommended dose of 500 mg two times a day.
Cassia cinnamon is most widely studied and may have blood sugar control effects. On the other hand, Ceylon cinnamon has not been shown to have the same effect.
One easy way to integrate cinnamon into your diet is to sprinkle it on oatmeal or cereal, or incorporate it into your cooking, using about a half teaspoon each day.
Some types of cinnamon may contain the compound coumarin, which can negatively impact liver function in those who have liver disease. As always, consult your healthcare provider before adding a new supplement to your regimen.
Vitamin D, or the “sunshine vitamin,” is generated when your body is exposed to the sun’s ultraviolet rays. It helps strengthen your bones. Vitamin D deficiency can have wide-ranging negative effects on your body, including a higher risk of type 2 diabetes.
A 2019 study found that vitamin D may improve insulin sensitivity, lowering glucose levels and the risk of developing type 2 diabetes. The researchers examined 680 women in Brazil from the ages of 35 to 74. They found that vitamin D supplements increase glucose levels. Regular sun exposure was also tied to lower blood sugar levels.
A 2015 study found that a two-month regimen of taking daily vitamin D supplements resulted in participants having both improved fasting blood sugar and blood glucose levels.
Another study from 2016 echoed these findings. While emphasizing that more research needs to be conducted, the authors concluded that vitamin D supplementation may have beneficial effects on controlling the glycemic indicator.
Consult with your doctor about the best dosage of vitamin D for you before using it. It’s recommended that you embrace a well-rounded, nutritious diet to ensure that you get all the nutrients your body needs.
Vitamin D supplements may interact with various medications, including:
Some health risks are associated with taking too much vitamin D. Since this vitamin increases the body’s calcium absorption in your gastrointestinal tract, too much vitamin D can lead to hypercalcemia. Additionally, too much vitamin D can result in renal failure, but only in extreme cases. It can also result in the calcification of soft tissues like your heart valves, causing irregular heartbeats and even death.
Magnesium is a common mineral that plays a central role in regulating your blood pressure, muscle function, heart rhythm, and blood sugar levels.
In general, diets with higher amounts of magnesium are tied to a lower risk of diabetes, which suggests it plays a role in glucose metabolism.
A 2019 study showed that taking oral magnesium supplements reduced participants’ resistance to insulin and improved glycemic regulation in people living with type 2 diabetes.
Magnesium supplements come in different forms. Some include magnesium oxide and citrate, as well as chloride. It’s recommended that you take magnesium with a meal each day for better absorption.
Magnesium supplements can interact with medications, including antibiotics and diuretics. Consult with your healthcare provider and give them a list of medications you’re currently on to avoid any interactions.
High doses of magnesium supplements can cause nausea, abdominal cramping, and bloating, as well as diarrhea. Magnesium oxide, chloride, gluconate, and carbonate are the forms that tend to cause diarrhea and other gastrointestinal problems. Taking large doses of laxatives and antacids that contain magnesium are tied to magnesium toxicity.
Bitter melon, or Momordica charantia, is a fruit that has been used for medicinal purposes in Chinese as well as Indian medicine for centuries. It is often used as an herbal remedy for diabetes because it contains active anti-diabetic substances which are said to lower blood glucose levels.
There are not a lot of conclusive studies reviewing the impact of bitter melon on lowering blood sugar levels, but a 2011 report does hypothesize that bitter melon capsules contain at least one ingredient for inhibitory activity against the production of a specific enzyme—11β-HSD1. This is said to break down cortisone to the active form cortisol, leading to hyperglycemia. The authors theorize this inhibitory property might be why this fruit is said to possess anti-diabetic properties.
The sample sizes of most studies included in a separate 2013 review were incredibly small. It is hard to definitively say that bitter melon is as effective as more vetted supplements and herbal remedies for lowering blood sugar. The authors concluded that the research is encouraging, but calls for more studies to investigate the benefits of bitter melon.
Bitter melon can be eaten as a whole fruit or squeezed into a juice, or its seeds can be crushed into powdered form for consumption. Bitter melon extract is also sold as an herbal supplement.
For those considering using bitter melon as a supplement to lower blood glucose levels, limit how much you eat or take, since consuming it in excess can result in diarrhea as well as mild abdominal pain.
There may be a risk of hypoglycemia, or extremely low blood sugar, when taken with insulin. One case report suggests that use of bitter melon could result in paroxysmal atrial fibrillation, where a rapid heartbeat begins suddenly and goes away on its own in seven days.
Gymnema, or Gymnema sylvestre, is a perennial woody vine found in tropical regions of India, China, Australia, and parts of Africa. It is often used in Ayurvedic medicine.
Research has shown that this plant can diminish a person’s craving for sugar. Additionally, it can lower the rate of the body’s sugar absorption—playing a role in the treatment of diabetes.
One study out of 2017 looked at the impact of taking 200 to 400 mg of gymnemic acid. It showed that taking this substance reduced the intestines’ sugar absorption.
An earlier study in 2010 looked at participants with type 2 diabetes given 500 mg of gymnema every day for a period of three months. The researchers found that participants’ glucose levels, both fasting blood sugar and levels after meals, lowered. Also, diabetic symptoms such as thirst and fatigue were less prominent, lipid levels improved, and levels of a type of hemoglobin bound to glucose known as glycated hemoglobin decreased.
Gymnema can be taken in the form of an extract, tea, or powder. You can also chew on the leaves of the plant itself and can find gymnema in capsule form. If you opt for the capsule form of gymnema supplements, you should consult with your doctor or healthcare provider about the best dosage for you.
There isn’t enough research out there about whether people who are pregnant or breastfeeding should take extra precautions. As always, consult with your provider before using any new supplement.
Given that gymnema can regulate blood sugar levels in people with diabetes, look out for signs of hypoglycemia and monitor your blood sugar. Since it can impact blood sugar levels, it might affect blood sugar control during as well as after a surgery. Consult your provider and let them know you are using this supplement before going in for any surgical procedure.
Be careful about how gymnema might interact with other blood sugar-lowering medications. If you’re taking gymnema and insulin at the same time, for instance, your blood sugar could potentially run too low.
Stay on top of your blood sugar levels and consult your healthcare provider if you worry your glucose levels are too low. This might impact the recommended dosage of either gymnema or insulin.
American ginseng, also called Panax quinquefolius, is an herb commonly used in traditional Native American and Chinese medicine. It is believed the ginseng plant’s roots can prevent infections and treat conditions like cancer and diabetes.
One 2018 study of 39 people living with diabetes found that the herb, coupled with fiber, helped lower blood sugar levels over the course of 12 weeks. However, the authors made it clear that more research needs to be done to better understand the health impacts of this herbal supplement.
That was the similar conclusion of the authors of a 2014 review of 16 different studies. They looked at randomized, controlled trials that took place for a month or longer among people with and without diabetes. They found that those who used ginseng herbal supplements had significantly improved blood sugar levels compared to the control groups.
You can get ginseng as an extract or in capsule form. As with other supplements, herbal treatments like ginseng are highly unregulated and there is no standardized dosing to adhere to. Consult your doctor or healthcare provider about best ways to incorporate this herbal supplement into your diet or regimen.
Ginseng has been found to have moderate interactions with diabetes medications like insulin and sulfonylureas, including Amaryl (glimepiride), DiaBeta (glyburide), and Glucotrol (glipizide). These interactions could result in hypoglycemia.
Ginseng products may also interfere with Coumadin (warfarin), a blood thinner.
In general, ginseng is found to be a safe supplement, but some people have reportedly experienced insomnia, diarrhea, headaches, and anxiety while using this herbal treatment. It might also lower blood sugar with other herbs such as devil’s claw, ginger, guar gum, Panax ginseng, eleuthero, and fenugreek.
Chromium is a natural mineral found in certain foods. It comes in two forms: hexavalent (chromium 6+) and trivalent (chromium 3+). The trivalent form is what you will most likely encounter and is found in foods. However, you should steer clear of its hexavalent form, which is toxic and found in industrial waste and pollution.
A 2014 review found favorable effects of chromium supplementation on glycemic control in patients with diabetes. This was echoed years earlier by an older review that came to a similar conclusion, but as with many of the supplements covered here, the authors advised caution and that more research should be carried out to better determine the health effects of chromium.
There is no established Recommended Daily Allowance (RDA) for chromium. Generally, multivitamin or mineral supplements that contain chromium have doses of 35-120 mcg. You can also find supplements that are exclusively chromium, which provide 200 mcg to 500 mcg of the mineral. Some can go as high as 1,000 mcg, but they are not as common.
Some medications may interact with chromium supplements. Insulin is one, as taking it with chromium increases the risk of hypoglycemia. Metformin and other diabetes medications taken together with chromium also carry this risk.
A small study showed that chromium picolinate supplements taken at the same time as the hypothyroidism treatment levothyroxine can delay that drug’s absorption by over six hours.
Individuals with renal and liver disease may suffer from worse symptoms of their condition if they take a lot of chromium. Some isolated symptoms include weight loss, anemia, liver dysfunction, thrombocytopenia, renal failure, rhabdomyolysis, dermatitis, and hypoglycemia.
Berberine is a chemical compound extracted from the roots, stem, and bark of plants. It’s included as an ingredient in a wide range of supplements and has been a staple of traditional Chinese and Indian medicine. It has been used in the treatment of type 2 diabetes, hypertension, and hyperlipidemia.
A 2019 study examined 80 people who were in the hospital for metabolic syndrome from January 2017 to December 2017. They were divided in half into a control group and an observation group, with the control group being treated with Western therapies and drugs and the observation group with berberine-based therapy. The researchers concluded that the combined application of berberine in patients with metabolic syndrome can effectively regulate blood glucose and blood lipid, alleviate insulin resistance, and reduce the level of inflammatory response in the body.
Berberine has been shown to be incredibly effective and potentially on the same footing as more traditional treatment options. A 2014 meta-analysis concluded that berberine is so effective that it might be a good alternative to more traditional medicine. The authors conclude that the supplement is a good option for treating conditions like type 2 diabetes in people of lower socioeconomic status due to the fact that it is relatively low cost and and is effective with no serious side effects.
As with other herbal supplements, more research on the benefits of berberine needs to be conducted.
Taking 500 mg of berberine two to three times a day for up to three months could be an effective way to control blood sugar levels.
Berberine does have some interactions with medications you may already be taking. Keep in mind this is not an exhaustive list and that there may be other interactions:
Berberine could cause some gastrointestinal problems like diarrhea, cramping, or constipation. It is unsafe to use on newborns, and people who are pregnant or breastfeeding should avoid using this supplement.
Alpha-lipoic acid is a compound found inside each cell in the human body. It converts your glucose into energy by way of oxygen. This is called aerobic metabolism.
A 2012 study surveyed 38 people with type 2 diabetes who were put on daily 300, 600, 900, and 1,200 mg treatments of alpha-lipoic acid over six months. After treatment, the participants were monitored for their glucose status and oxidative biomarkers. The researchers found that these individuals’ fasting blood sugar levels and A1C decreased in measure with dosage increase.
Another 2011 review looking at how alpha-lipoic acid has been used to treat diabetes cited the compound’s impact on glucose levels, but focused more on its role as an antioxidant. Most of the available research has focused on that element of the supplement’s effectiveness.
A 2019 review examined a series of studies on the effectiveness of alpha-lipoic acid. The analysis offers a mixed bag—while some of the research was encouraging, others showed alpha-lipoic acid to be no more effective than placebos administered to participants. Overall, the authors suggested that while some of the research is encouraging, more studies with larger sample sizes need to be conducted to paint a more conclusive picture of this supplement.
Dosage of alpha-lipoic acid greatly varies. One study cited a dosage range from 600 mg to as high as 1,200 mg daily before eating.
Alpha-lipoic acid can interact with some medications, including diabetes medications, chemotherapy medications, thyroid medications, and vitamin B1. As always, consult with your healthcare provider before adding any new supplement to your treatment regimen.
In general, alpha-lipoic acid is fairly safe to take and side effects are rare. It hasn’t been studied in pregnant or breastfeeding people. Known side effects include fatigue, diarrhea, skin rash, and insomnia. Given that alpha-lipoic acid lowers blood sugar, people with already low blood sugar levels and diabetes should consult with their doctor or healthcare provider before adding this to their treatment regimen.
Before going on any new medications or herbal supplements and treatments, make sure you consult with your doctor or healthcare provider about any possible side effects or interactions.
While all of these supplements have been shown to be helpful in lowering blood sugar levels, make sure you are aware of other ways they could impact your overall health or your treatments for other health conditions. Be sure to discuss with your provider what might be the best course of treatment for you.
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