Glucosamine, Magnesium &
St. John's Wort by Ray Sahelian, M.D.

Is Glucosamine Safe for Diabetics?
One of the most common questions I get asked about glucosamine is whether it raises blood sugar levels and whether it’s a safe supplement to take for a person with diabetes. As you may already know, glucosamine is widely and often effectively used to treat osteoarthritis, but since part of the molecule of glucosamine is glucose, questions have been raised as to whether taking glucosamine supplements raise blood sugar levels. In a study published in Archives of Internal Medicine, 38 elderly patients with type 2 diabetes were divided into two groups. The first group took 1,500 mg of glucosamine a day combined with 1,200 mg of chondroitin sulfate. Chondroitin is another supplement often used in combination with glucosamine to treat osteoarthritis.

The other group took placebo pills. Two thirds of the dose was taken in the morning and one-third in the evening. The study lasted for 90 days. Blood studies were done to evaluate blood sugar levels, and also levels of hemoglobin A1c, a specific blood marker than can tell us average blood sugar levels over long periods of time. There was no statistically significant rise in hemoglobin A1c levels in those who took glucosamine. I believe patients with diabetes are often at risk from toxic effects from many of the current treatments for osteoarthritis, such as the NSAIDs like ibuprofen or naprosyn. These medicines cause stomach ulcers and kidney damage if used for prolonged periods. Glucosamine provides a safe and natural alternative.

Magnesium Good for Heart Patients
Patients with heart disease are often placed on several medicines including beta-blockers and nitrates, but doctors rarely think about suggesting mineral supplements. In a study published in the American Journal of Cardiology, researchers enrolled 187 patients with heart disease to try oral magnesium and compare the results with those on placebo pills. The dose of magnesium was about 200 mg twice daily and it was in the form of magnesium citrate. At the beginning of the study, blood magnesium levels were similar in both groups, but increased significantly in those who took the magnesium supplements. After six months of treatment, those taking magnesium were found to have a significant improvement in the amount of time they could exercise without chest pain, but there were no changes in cholesterol levels between the two groups. I believe that for patients who are already taking heart medicines and still have not had the best results possible, it seems that magnesium is a safe, cheap and effective natural mineral to add to the regimen. The ideal dose of magnesium is not known, but it would seem reasonable to take 100 to 200 mg twice daily.

St. John's Wort an Anti-inflammatory Herb?
For many centuries, St. John's Wort has been used in Europe to treat a variety of conditions including infections and depression. Compounds within this herb, one being hypericum, have very strong biological activity, including the ability to reduce inflammation and fight against bacterial infections. In a study conducted at Ege University, in Izmir, Turkey, scientists investigated the in vitro effects of three Hypericum species, on human white blood cell myeloperoxidase (MPO) activity. MPO is a major component of the antimicrobial system of white blood cells. MPO helps the conversion of hydrogen peroxide and chloride to hypochlorous acid. Hypochlorous acid is a strong oxidant produced by white blood cells that contributes to inflammatory tissue damage.

The researchers found that hypericum in St. John's wort reduces the oxidative activity of white blood cells, thus potentially reducing damage from oxidation. It appears that St. John's wort has many roles to play in the human body. For now, the most common use for St. John's wort is as an antidepressant. Even though studies have used 300 mg three times a day, I find that most people notice some uplifting in mood even with 300 mg once a day in the morning. High doses could cause insomnia.

Ray Sahelian, M.D., is the best-selling author of Mind Boosters and The Stevia Cookbook. He maintains a comprehensive health site on nutrition and supplements at