JABSOM Tech Talk is a collection of blogs to share in depth coverage of science, research and clinical programs happening at JABSOM. The aim is to provide a close-up view of life at the medical school and the impact on the health and well-being of the community.

Natural Dietary Supplement Demonstrates Positive Results in the Fight Against Diabetes

5-Aminolevulinic Acid Dietary Supplement Has Shown to Reduce Blood Glucose

Research conducted by the John A. Burns School of Medicine’s Complementary and Alternative Medicine department has demonstrated that a dietary supplement containing 5-Aminolevulinic acid (5-ALA) has the potential to prevent or delay the progression of diabetes in pre-diabetic populations (Rodriguez et al. 2012).  In their study researchers demonstrated a statistically significant decrease in two hours post-oral glucose tolerance test levels in those that took the dietary supplement.  The decreases were shown in comparison to participant baseline levels and between the experiment and control groups.  Results contribute to knowledge on the benefits of 5-ALA as a safe and potentially effective dietary supplement to help prevent the progression of diabetes.

Results from this and other research conducted by the Department contribute to the growing knowledge and interest in complementary and alternative medicine.

CAM Department's (left to right) Noelani Apau, Nuela Mead, Rosanne Harrigan, Amy Brown, Terry Shintani

CAM Department’s (left to right) Noelani Ludlum, Nuela Mead, Rosanne Harrigan, Amy Brown, Terry Shintani

5-ALA Supplement Study Details

The Complementary and Alternative Medicine (CAM) department conducted a double blinded study  (neither the research nor the study participants knew whether they are taking the dietary supplement or a placebo) using the 5-ALA supplement on a pre-diabetic population (HbA1c – average level of blood glucose over the previous three months, ranged from 5.8 to 7.0%).  The study hypothesized that the supplement would reduce blood glucose levels and HbA1c.  Participants were divided into three different groups:  1) low dose supplement (15mg capsule); 2) high dose supplement (50mg capsule); and 3) control group (placebo capsule).  A total of 154 participants were recruited.  After taking the capsules for 12 weeks, results showed that both the high dose and the low dose groups had statistically significant differences in the results of a two hours post-oral glucose tolerance test compared to baseline levels and as compared to the control group.  The glucose tolerance test measures how much glucose is cleared from the blood after a set amount of time (in this case two hours).  Measures of fasting glucose, HbA1c and glycosylated albumin all showed post-baseline decreases, however, results were not shown to be statistically significant.  The finding from this study indicate that the use of the 5-ALA supplement may improve insulin resistance in those diagnosed as pre-diabetic.  The study also validated that the supplement is safe to take (no adverse effects were found).

What exactly is 5-ALA?
5-ALA (5-aminolevulinic acid or δ-aminolevulinic acid) is compound that acts as an intermediate in the biosystheisis of hemes, vitamin B12 and bacteriocholoropyhyll. 5-ALA has been used as a photosensitzer to make cells more receptive to light and also to kill cells when exposed to specific wavelengths of light. Studies have shown that 5-ALA has been successfully used for detecting existence of cancer (Ahmad, Aboumarzouk, Somani, Nabi, & Kata, 2012), reducing tumor growth in mice models (Yamaguchi, Asakura, Takahashi, Kitamura, & Teramoto, 2013), and shown to boost immune systems in pig (Chen et al., 2008) and chicken models (Sato et al., 2012).
5-ALA is naturally available and consumed by eating foods such as spinach, shitake mushrooms, bananas, squid, and octopus. Beverages that contain 5-ALA include wine and sake. However, recent innovations have reduced the cost of naturally producing this supplement, which allows a less expensive and more available distribution.

Complementary Alternative and Medicine at JABSOM
Dr. Long performing acupuncture

Dr. Long performing acupuncture

The CAM department at JABSOM focuses on evidence-based theory, research and clinical approaches to complementary care and alternative therapies, such as this study exploring the use of 5-ALA and diabetes.  Other types of therapies that the department practices include acupuncture, harp therapy, Chinese herbal supplements, nutrition therapy, Ayurvedic Medicine (traditional healing arts of India), and scalar field therapy (therapy using electromagnetic energy fields).  The CAM department is committed to  research, education , clinical care, and promotion of complementary and alternative therapies in Hawaiʻi and the Pacific region.  Other recent publications by CAM faculty include include a case study describing the application of scalar field therapy to a pediatric patient with a history of seizures.  Application of the scalar field therapy resulted in a dramatic reduction of and duration of seizures (Ludlum, Shintani, & Harrigan, 2012).  Another recent publication  examined the validity of a highly cited paper on the relationship between chocolate consumption and acne.  Their findings suggests that the study was methodologically flawed (Goh et al., 2011).

Q: What sparked your interested in CAM?

Dr. Shintani:
My interest in CAM started when I learned my father got cancer and a permanent colostomy when I was 6 months old. We were told there was no cure and that he would die soon, but he lived another 40 years. Because of that, I always wondered why cancer couldn’t be cured, and that we should be looking  for alternatives.

Results from the 5-ALA study and other research conducted by the CAM department contribute to the growing knowledge and interest in complementary and alternative medicine.  As seen with the vast amount of dietary supplements and growing number of alternative therapies (such as acupuncture and massage), the use of CAM is steadily increasing, especially with those that are living with chronic illnesses.  According to the National Center for Complementary and Alternative Medicine, the definition of “Complementary medicine” refers to use of CAM together with conventional or western medicine, such as using acupuncture in addition to usual care. “Alternative medicine” refers to use of CAM in place of conventional medicine.  Most use of CAM by Americans is complementary to western medicine.  The importance of researching the effectiveness and validity of CAM is not only essential in discovering and validating new therapies, but also in testing CAM therapies that could be potentially harmful.  This is very relevant to our Hawaiʻi community since the use of CAM has shown to be significantly greater than on the mainland United States (Harrigan et al., 2006).

CAM Wellness Center

The CAM department has recently opened a new Wellness Center in located within the Mokichi Okada Association (MOA) Wellness Center in Kakaʻako at 600 Queen Street (corner of Queen and South Streets).  In addition to the therapies offered by the CAM department, the MOA Wellness Center offers therapies that include tea ceremony, flower arranging and energy healing.  The Center will soon include a Kale’s Natural Foods store.  The concept of the MOA and CAM department’s Wellness is to promote holistic, healthy, and balanced health.  All the practitioners of the CAM department’s Wellness Center are licensed practitioners with medical, nursing or health related doctorate degrees from accredited universities.

Q: Where do you see the role of CAM going into the future?

Dr. Shintani:
Hawaii should be a national and world center of CAM research and practice because of our ethnic mix, traditional Hawaiian culture, and position as the crossroads between East and West. We have already published a study showing how high the interest is in Hawaiʻi. IN 1979, I published a law review paper on the right to choice of therapy in Hawaiʻi’s law as far back as the early 1900’s. In other words, it is even in the DNA of Hawaiʻi’s legal system and with all the other factors together, Hawaiʻi should become a world center of CAM. The sooner the medical school and our legislature realize this and put some resources behind it, the better for all of us.

Department of Complementary & Alternative Medicine at MOA Wellness Center

Department of Complementary & Alternative Medicine at MOA Wellness Center


  • Ahmad, S., Aboumarzouk, O., Somani, B., Nabi, G., & Kata, S. G. (2012). Oral 5-aminolevulinic acid in simultaneous photodynamic diagnosis of upper and lower urinary tract transitional cell carcinoma – a prospective audit. BJU International, 110, E596-E600.
  • Baglo, Y., Gabrielsen, M., Sylte, I., & Gederaas, O. A. (2013). Homology Modeling of Human δ -Butyric Acid Transporters and the Binding of Pro-Drugs 5-Aminolevulinic Acid and Methyl Aminolevulinic Acid Used in Photodynamic Therapy. Plos One, 8, e65200.
  • Chen, Y. J., Kim, I. H., Cho, J. H., Min, B. J., Yoo, J. S., & Wang, Q. (2008). Effect of δ-aminolevulinic acid on growth performance, nutrient digestibility, blood parameters and the immune response of weanling pigs challenged with Escherichia coli lipopolysaccharide. Livestock Science, 114, 108-116.
  • Goh, W., Kallianpur, K. J., Chow, D., Almeida, P. G., Brown, A. C., Pager, S., & Sil, P. (2011). Chocolate and acne: how valid was the original study? Clinics In Dermatology, 29, 459-460.
  • Harrigan, R., Mbabuike, N., Efird, J. T., Easa, D., Shintani, T., Hammatt, Z., Perez, J., & Shomaker, T. S. (2006). Use of provider delivered complementary and alternative therapies in Hawai’i: results of the Hawai’i Health Survey. Hawaii Medical Journal, 65, 130.
  • Kato, S., Kawamura, J., Kawada, K., Hasegawa, S., & Sakai, Y. (2012). Fluorescence Diagnosis of Metastatic Lymph Nodes Using 5-Aminolevulinic Acid (5-ALA) in a Mouse Model of Colon Cancer. Journal of Surgical Research, 176, 430-436.
  • Ludlum, N. A., Shintani, T., & Harrigan, R. (2012). Scalar Field Therapy and Mitigation of Seizure Disorder:  A Case Report. J Neurol Res, 2, 172-175.
  • National Institutes of Health (2013). NIH National Center for Complementary and Alternative Medicine (NCCAM). http://nccam.nih.gov/ [Announcement posted on the World Wide Web]. 6-5-2013, from the World Wide Web: http://nccam.nih.gov/
  • Rodriguez, B. L., Curb, J. D., Davis, J., Shintani, T., Perez, M. H., Apau-Ludlum, N., Johnson, C., & Harrigan, R. C. (2012). Use of the Dietary Supplement 5-Aminiolevulinic Acid (5-ALA) and Its Relationship with Glucose Levels and Hemoglobin A1C among Individuals with Prediabetes. CTS: Clinical & Translational Science, 5, 314-320.
  • Sato, K., Matsushita, K., Takahashi, K., Aoki, M., Fuziwara, J., Miyanari, S., & Kamada, T. (2012). Dietary supplementation with 5-aminolevulinic acid modulates growth performance and inflammatory responses in broiler chickens. Poultry Science, 91, 1582-1589.


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