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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #162

Making herbal dietary supplement in lab with plant leaves. Health and beauty concept

In conjunction with the release of the new Functional Vitamin, Supplement, and Nutrition Course, this week’s clinical pearl focuses on two great supplements to consider using in the presence of diabetes, insulin resistance, estrogen dominance, and/or PCOS. 

Studies have shown that berberine works in similar pathways as metformin with good results, improving fasting glucose, insulin, and triglyceride levels, without the uncomfortable GI side effects commonly associated with metformin use.

Inositol is the other supplement that is effective against these metabolic imbalances; in addition, inositol has also been shown to improve difficult-to-control anxiety. 

In addition to using these supplements, I am a massive advocate of grain-free, lower carbohydrate eating patterns to help improve these conditions, making these supplements even more effective and more quickly; the course goes over how to implement this kind of dietary change in great detail, just FYI. Reducing grains and carbs will improve glucose, insulin, lipids, hormones, and inflammation markers.

The two products I use most often are CM Core, produced by OrthoMolecular, and Cenitol from Metagenics. 

I have selected these products specifically for my patients for a few reasons; one reason is that these products cannot be purchased “willy nilly” from any website or program – if found elsewhere, I’d consider them counterfeit and not from the actual manufacturers. This step ensures that my patients get high-quality nutraceutical grade lab-tested ingredients in the optimal dosing available. These products do require a “prescription” within my vitamin dispensary. Hence, it ensures the patient obtains a quality supplement, improving my practice’s bottom line (also discussed in more detail in the course).

CM Core contains active ingredients berberine and alpha-lipoic acid, both of which have strong clinical evidence in reducing glucose, insulin, and triglycerides; when combined into this single product, those benefits are likely synergistic and more effective. While berberine can be dosed as low as 400 mg TID and be somewhat effective, dosing it more like metformin typically provides even better improvements in lab markers; the CM Core dose is 1 g in 3 capsules; I typically dose this 1 capsule TID or 2 caps in the morning and 1 cap in the evening to get the full day’s dose. It can be dosed 3 capsules BID, but it gets pretty pricey for your patient. 

Cenitol contains myo-inositol, one of the inositols that shows improvement in glucose, insulin, and hormone markers, especially in patients with elevated estrogen and/or low testosterone.

Inositol supports healthy cell membrane support. Inositol, vitamin B8, also plays a significant role in cell signaling by functioning as a precursor of an intracellular second messenger system. This system is responsible for regulating a large number of key cellular processes in the body, including hormone balance, insulin sensitivity, and it is an integral communicator among neurotransmitters in the brain.

According to Metagenics’ website, “Cenitol also supplies magnesium in the form of a fully reacted amino acid chelate for nervous system support. These two complementary ingredients are supplied in powder form for ease of delivery and enhanced dosing flexibility.” Mag glycinate is one of my favorite magnesium supplements to recommend as well!

These products can be used separately or in conjunction with each other, but I do not use berberine in the presence of metformin since the pathways and utilization are similar; in the same way, we wouldn’t typically prescribe 2 drugs of the same classification, I feel these ingredients fall into that category.

If you are looking for more evidence-based information on recommending vitamins or supplements and want to learn more about improving your patients’ metabolic health through nutritional support, check out The Functional Vitamin, Supplement, and Nutrition Course today!

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