QUESTION

I'm 58 and have prediabetes. What's the best multivitamin supplement for me?

ANSWER

A good multivitamin can't replace healthful eating, but it can help people with prediabetes, whose blood sugar levels are chronically elevated but who don’t quite have diabetes. Getting the full range of vitamins and minerals will help stave off metabolic syndrome—a group of risk factors including abdominal fat, high blood pressure and abnormal cholesterol levels—which can lead to full-blown diabetes. Certain vitamins and minerals, as well as other nonvitamin supplements, have been shown to be instrumental in regulating blood sugar. Check with your MD, naturopathic doctor (ND) or nutritionist before taking any new supplement—especially if you take any medication or other supplements—to avoid interactions or side effects. Here are the nutritional supplements that I often prescribe for my patients with prediabetes. B vitamins work together as a group and are important for proper glucose metabolism and keeping blood sugar stable. People with prediabetes are often low in…

  • Vitamin B-6, which is needed to properly metabolize protein and carbs and helps regulate blood sugar. I recommend supplementing daily with at least 15 mg of B-6, taken in divided doses twice a day. That's important because vitamin B-6 has a short duration in the circulation, so it's best to replenish it twice a day.
  • Vitamin B-12, also instrumental in blood sugar control. Levels of B-12 tend to get lower and lower as we age (even without prediabetes). The recommended dietary allowance is 2.4 mcg per day. It's best to find out your level before supplementing—your doctor can test you and recommend the proper dosage, which, if your level is low enough, might include B-12 injections.
Warning: Regularly taking a proton-pump–inhibiting drug such as omeprazole (Prilosec) or lansoprazole (Prevacid), which many people do for heartburn, can reduce levels of B-12. These heartburn pills are also bad for your heart—and that's particularly important for people with prediabetes (or diabetes), because cardiovascular disease is a big danger for people with high blood sugar. Vitamin D tends to be low in people with prediabetes—less than 20 ng/mL. I usually recommend supplementation to achieve a level of 40 ng/mL to 60 ng/mL. Low vitamin D can trigger inflammation and hamper glucose (sugar) tolerance. Your doctor can test your level of vitamin D and recommend the proper supplement dosage. For my patients with low vitamin D, I often prescribe 4,000 IU to 6,000 IU daily. Chromium is a mineral that helps move blood sugar into cells. We need only small amounts, but many people with prediabetes are deficient. For someone with prediabetes, I would recommend a minimum of 200 mcg up to a maximum of 1,000 mcg daily. Look for a multivitamin that contains chromium within this range. Alpha-lipoic acid. Finally, although it is neither a vitamin nor a mineral, the antioxidant alpha-lipoic acid (R-ALA) has also been shown to improve blood sugar levels. I routinely prescribe a daily dosage of 600 mg for most of my prediabetic patients. You'll find it in some multivitamin/multimineral supplements—particularly those formulated for people with diabetes. But if it's not included, you can find it as a separate supplement.