• Chromium Picolinate, Chromium Polynicotinate, Chromium Chloride, High-Chromium Brewer's Yeast
• ]]>Diabetes]]>, Insulin Resistance and Abnormal Glucose Tolerance, ]]>Heart Disease Prevention]]>
• ]]>Acne]]>, ]]>Depression]]>, Functional Hypoglycemia, ]]>High Cholesterol]]>, ]]>Migraine Headaches]]>, ]]>Sports Performance Enhancement]]>, ]]>Psoriasis]]>, ]]>Metabolic Syndrome (Syndrome X)]]>, ]]>Weight Loss ("Fat Burning")]]>
Chromium is a mineral the body needs in very small amounts, but it plays a significant role in human nutrition. Chromium's most important function in the body is to help regulate the amount of glucose (sugar) in the blood. Insulin plays a starring role in this fundamental biological process, by regulating the movement of glucose out of the blood and into cells. Scientists believe that insulin uses chromium as an assistant (technically, a cofactor ) to "unlock the door" to the cell membrane, thus allowing glucose to enter the cell. In the past, it was believed that to accomplish this the body first converted chromium into a large chemical called glucose tolerance factor (GTF). Intact GTF was thought to be present in certain foods, such as Brewer’s yeast, and for that reason such products were described as superior sources of chromium. However, subsequent investigation indicated that researchers were actually creating GTF inadvertently during the process of chemical analysis. Scientists now believe that there is no such thing as GTF. Rather, chromium appears to act in concert with a very small protein called low molecular weight chromium-binding substance (LMWCr) to assist insulin's action. LMWCr does not permanently bind chromium and is not a likely source of chromium in foods. ]]>83-85]]>
Based on chromium's close relationship with insulin, this trace mineral has been studied as a treatment for diabetes. The results have been somewhat positive: it seems fairly likely that chromium supplements can improve blood sugar control in people with diabetes. Chromium also might be helpful for milder abnormalities in blood sugar metabolism. One study suggests that chromium might aid in weight loss, as well, but other studies failed to find this effect.
The official US recommendations for daily intake are as follows:
- 0-6 months: 0.2 mcg
- 7-12 months: 5.5 mcg
- 1-3 years: 11 mcg
- 4-8 years: 15 mcg
- 9-13 years: 25 mcg
- 14-50 years: 35 mcg
- 50 years and older: 30 mcg
- 9-13 years: 21 mcg
- 14-18 years: 24 mcg
- 19-50 years: 25 mcg
- 50 years and older: 20 mcg
- Pregnant Women
- 18 years or younger: 29 mcg
- 19 years and older: 30 mcg
- Nursing Women
- 18 years or younger: 44 mcg
- 19 years and older: 45 mcg
Some evidence suggests that chromium deficiency may be relatively common. 1,86]]> However, this has not been proven, and the matter is greatly complicated by the fact that we lack a good test to identify chromium deficiency. ]]>2]]>
Severe chromium deficiency has only been seen in hospitalized individuals receiving nutrition intravenously. Symptoms include problems with blood sugar control that cannot be corrected by insulin alone.
Corticosteroid treatment may cause increased chromium loss in the urine. ]]>3]]> It is possible that this loss of chromium may contribute to corticosteroid-induced diabetes.
Chromium is found in drinking water, especially hard water, but concentrations vary widely. Many good sources of chromium, such as whole wheat, are depleted of this important mineral during processing. The most concentrated sources of chromium are brewer's yeast (not nutritional or torula yeast) and calf liver. Two ounces of brewer's yeast or 4 ounces of calf liver supply between 50 mcg and 60 mcg of chromium. Other good sources of chromium are whole grains, beer, and cheese.
The dosage of chromium used in studies ranges from 200 mcg to 1,000 mcg daily, mostly in the form of chromium picolinate. However, there may be potential risks in the higher dosages of chromium (see Safety Issues]]> ).
Note: These and all other dosages of chromium regard the amount of the actual chromium ion in the supplement (“elemental chromium”), discounting the weight of the substances, such as picolinate, attached to it.
Some products state that they contain “GTF chromium.” Some of these products are manufactured from brewer’s yeast, which was once thought to contain GTF. Others contain chromium as chromium nicotinate, which bears a faint resemblance to the proposed GTF molecule. However, since GTF is no longer believed to exist, this claim should be disregarded.
Chromium has principally been studied for its possible benefits in improving blood sugar control in people with diabetes]]> . Several, but not all, studies suggest that people with adult-onset (type 2) diabetes may show some improvement when given appropriate dosages of chromium. ]]>5,43,44,45,47-48,102]]> One study suggests that chromium may also be useful for diabetes that occurs during ]]>pregnancy]]> . ]]>6]]> In addition, nondiabetic individuals with mildly impaired blood sugar control might attain better control of blood sugar with chromium supplementation. ]]>7-10]]> Since mild impairment of blood sugar control is believed to increase risk of heart disease, chromium supplementation might help reduce heart disease rates.
Chromium has been sold as a "fat burner" and is also said to help build muscle tissue. However, most studies evaluating chromium's ability to promote ]]>weight loss]]> have not found benefits. ]]>11-21,104]]> One study failed to find benefit with a combination of chromium and ]]>conjugated linoleic acid]]> . ]]>107]]>
Studies on whether chromium can improve ]]>cholesterol]]> levels have returned mixed results. ]]>32-40]]> However, one study suggests that chromium combined with ]]>grape seed extract]]> might have a beneficial effect. ]]>41]]> In addition, among individuals taking beta-blockers, chromium may raise levels of HDL ("good") cholesterol. ]]>42]]>
When depression is characterized by rapid mood changes, excessive sleeping and eating, a sense of leaden paralysis, and extreme sensitivity to negative life events, the condition is called “atypical depression.” A very small (15 participants) double-blind, placebo-controlled study found that ]]>chromium picolinate]]> might be helpful for this form of ]]>depression]]> ; ]]>46]]> however, a much larger study failed to find statistically significant benefits. ]]>97]]>
According to some researchers, impaired blood sugar control, high cholesterol, weight gain, and high blood pressure are all part of a bigger picture, called ]]>metabolic syndrome]]> , or syndrome X. Since chromium may be helpful for the first three of these conditions, chromium deficiency has been proposed as the cause of syndrome X. However, this has not been proven.
What Is the Scientific Evidence for Chromium?
The evidence regarding use of chromium for type 2 (adult onset) diabetes]]> , as well as other forms of diabetes, remains incomplete and inconsistent.
In a ]]>double-blind, placebo-controlled study]]> , 180 people with type 2 diabetes were given placebo, 200 mcg of chromium picolinate, or 1,000 mcg chromium picolinate daily. ]]>43]]> The results showed that HbA1c values (a measure of long-term blood sugar control) improved significantly after 2 months in the group receiving 1,000 mcg and in both chromium groups after 4 months. Fasting glucose (a measure of short-term blood sugar control) was also lower in the group taking the higher dose of chromium.
A double-blind trial of 78 individuals with type 2 diabetes compared two forms of chromium (brewer's yeast and chromium chloride) against placebo. ]]>44]]> This rather complex crossover study consisted of four 8-week intervals of treatment in random order. The results in the 67 participants who completed the study showed that both forms of chromium significantly improved blood sugar control.
Positive results were also seen in three other double-blind, placebo-controlled studies enrolling a total of more than 130 people with type 2 diabetes. ]]>45,95,101-102]]> However, several other studies have failed to find benefit for people with type 2 diabetes. ]]>47-48,99,105]]> These contradictory findings suggest that the benefit, if it really exists, is small at best.
A combination of chromium and biotin might be more effective. Following positive results in a small pilot trial, ]]>103]]> researchers conducted a double-blind study of 447 people with poorly controlled type 2 diabetes. ]]>106]]> Half the participants were given placebo and the rest were given a combination of 600 mg chromium (as chromium picolinate) along with 2 mg of ]]>biotin]]> daily. All participants continued to receive standard oral medications for diabetes. Over the 90 day study period, participants given the chromium/biotin combination showed significantly better glucose regulation than those given placebo. The relative benefit was clear in levels of fasting glucose as well as in HgA1c.
One placebo-controlled study of 30 women with ]]>pregnancy]]> -related diabetes found that supplementation with chromium (at a dosage of 4 mcg or 8 mcg chromium picolinate for each kilogram of body weight) significantly improved blood sugar control. ]]>49]]>
Improved Blood Sugar Control in People Without Diabetes
Many people develop impaired responsiveness to insulin (insulin resistance) and mildly abnormal blood sugar levels. A few small, double-blind trials have found that chromium supplementation may be helpful, ]]>52-55]]> although two studies found no benefit. ]]>56,100]]> Another small double-blind trial found that chromium improved the body's response to insulin among overweight people at risk of developing diabetes. ]]>57]]> There is growing evidence that mildly impaired blood sugar control increases the risk of heart disease, suggesting that chromium supplementation might be useful. (See the section below on ]]>Heart Disease Prevention]]> .)
Weight Loss ("Fat Burning")
The evidence is mixed on whether chromium is an effective aid for ]]>reducing weight]]> or improving body composition (improving the ratio of fatty tissue to lean tissue).
In one study, 219 people were given either placebo or 200 mcg or 400 mcg of chromium picolinate daily. ]]>58]]> Participants were not advised to follow any particular diet. Over a period of 72 days, people taking chromium experienced significantly greater weight loss than those not taking chromium, more than 2-½ pounds versus about ¼ pound. Interestingly, people taking chromium actually gained lean body mass, so the loss of fatty tissue was even more dramatic: more than 4 pounds versus less than ½ pound. However, a very high dropout rate makes the results of this study somewhat unreliable.
However, in another double-blind study by the same researcher, 130 moderately overweight people attempting to lose weight were given either placebo or 400 mcg of chromium daily. ]]>59]]> At the end of the trial, no statistically significant differences in weight or body composition were seen between groups. Researchers were able to show benefit only by resorting to fairly complicated statistical maneuvers.
In a third study, 44 overweight women were given either placebo or 400 mcg of chromium per day. ]]>60]]> All participants were placed on an exercise program. Over a period of 12 weeks, no differences were seen between the two groups in terms of body weight, waist circumference, or percentage body fat. A small double-blind trial of older women undergoing resistance training also failed to find evidence of benefit. ]]>92]]> Generally negative results were seen in other small double-blind trials as well. ]]>61-66, 104]]>
When larger studies find positive results and smaller studies do not, it often indicates that the treatment under study is only weakly effective. This may be the case with chromium as a weight-loss treatment. ]]>93]]> If chromium is effective for weight loss, one small study suggests it may work by influencing the brain and its role in appetite and food cravings. ]]>108]]>
Insulin resistance, as well as mildly elevated blood sugar levels, appears to increase risk of heart disease]]> . ]]>67-74]]> Chromium supplementation might help by improving insulin responsiveness and normalizing blood sugar.
In support of this, an observational trial found associations between higher chromium intake and reduced risk of heart attack. ]]>75]]>
Although the precise upper limit of safe chromium intake is not known, it is believed that chromium is safe when taken at a dosage of 50 mcg to 200 mcg daily. 88]]> Side effects appear to be rare.
However, chromium is a heavy metal and might conceivably build up and cause problems if taken to excess. There is one report of kidney, liver, and bone marrow damage in a person who took 1,200 mcg to 2,400 mcg of chromium for several months; in another report, as little as 600 mcg for 6 weeks was enough to cause damage. ]]>77,78]]> Such problems appear to be quite rare, and it is possible that these individuals already had health problems that predisposed them to such a reaction. The risk of chromium toxicity is believed to be higher in individuals who already have liver or kidney disease. ]]>88]]>
Nonetheless, based on these reports, it’s possible that the dosage of chromium found most effective for individuals with type 2 diabetes—1,000 mcg daily—might present some health risks. For example, there is some evidence that if chromium is taken in high enough amounts, it may be converted from its original safe form (chromium 3) into a known carcinogen, chromium 6. ]]>96]]> We advise seeking medical supervision before taking more than 200 mcg of chromium daily.
Also, keep in mind that if you have diabetes and chromium is effective, you may need to cut down your dosage of any medication you take for diabetes. ]]>79]]> Medical supervision is advised.
There are also several concerns about the picolinate form of chromium in particular. Picolinate can alter levels of neurotransmitters. ]]>89]]> This has led to concern among some experts that chromium picolinate might be harmful for individuals with ]]>depression]]> , ]]>bipolar disease]]> , or ]]>schizophrenia]]> . ]]>81]]> There has also been one report of a severe skin reaction caused by chromium picolinate. ]]>80]]>
Finally, there are also concerns, still fairly theoretical and uncertain, that chromium picolinate could cause adverse effects on DNA. ]]>82,90,91,94]]>
The maximum safe dosage of chromium for women who are pregnant or nursing and for individuals with severe liver or kidney disease has not been established.
Interactions You Should Know About
If you are taking
- You may need extra chromium if you are taking:
You may need extra chromium if you are taking:
- Seek medical supervision before taking chromium because you may need to reduce your dose of these medications:
Chromium supplementation may improve levels of HDL ("good") cholesterol
if you are taking:
8. Anderson RA, Polansky MM, Bryden NA, et al. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr. 1991;54:909-916.
11. Kaats GR, Blum K, Pullin D, et al. A randomized, double-masked, placebo-controlled study of the effects of chromium picolinate supplementation on body composition: a replication and extension of a previous study. Curr Ther Res. 1998;59:379-388.
14. Bahadori B, Wallner S, Schneider H, et al. Effect of chromium yeast and chromium picolinate on body composition of obese, non-diabetic patients during and after a formula diet [in German; English abstract]. Acta Med Austriaca. 1997;24:185-187.
16. Clancy SP, Clarkson PM, DeCheke ME, et al. Effects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players. Int J Sport Nutr. 1994;4:142-153.
17. Amato P, Morales AJ, Yen SS. Effects of chromium picolinate supplementation on insulin sensitivity, serum lipids, and body composition in healthy, nonobese, older men and women. J Gerontol A Biol Sci Med Sci. 2000;55:M260-M263.
18. Lukaski HC, Bolonchuk WW, Siders WA, et al. Chromium supplementation and resistance training: effects on body composition, strength, and trace element status of men. Am J Clin Nutr. 1996;63:954-964.
21. Volpe SL, Huang HW, Larpadisorn K, et al. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. J Am Coll Nutr. 2001;20:293-306.
24. Joseph LJO, Farrell PA, Davey SL, et al. Effect of resistance training with or without chromium picolinate supplementation on glucose metabolism in older men and women. Metabolism. 1999;48:546-553.
26. Clancy SP, Clarkson PM, DeCheke ME, et al. Effects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players. Int J Sport Nutr. 1994;4:142-153.
30. Lukaski HC, Bolonchuk WW, Siders WA, et al. Chromium supplementation and resistance training: effects on body composition, strength and trace element status of men. Am J Clin Nutr. 1996;63:954-965.
37. Roeback JR Jr, Hla KM, Chambless LE, et al. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med. 1991;115:917-924.
39. Offenbacher EG, Rinko CJ, Pi-Sunyer FX. The effects of inorganic chromium and brewer's yeast on glucose tolerance, plasma lipids, and plasma chromium in elderly subjects. Am J Clin Nutr. 1985;42:454-461.
40. Preuss HG, Wallerstedt D, Talpur N, et al. Effects of niacin-bound chromium and grape seed proanthocyanidin extract on the lipid profile of hypercholesterolemic subjects: a pilot study. J Med. 2000;31:227-246.
41. Preuss HG, Wallerstedt D, Talpur N, et al. Effects of niacin-bound chromium and grape seed proanthocyanidin extract on the lipid profile of hypercholesterolemic subjects: a pilot study. J Med. 2000;31:227-246.
42. Roeback JR, Hla KM, Chambless LE, et al. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med. 1991;115:917-924.
44. Bahijiri SM, Mira SA, Mufti AM, et al. The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Saudi Med J. 2000;21:831-837.
48. Trow LG, Lewis J, Greenwood RH, et al. Lack of effect of dietary chromium supplementation on glucose tolerance, plasma insulin and lipoprotein levels in patients with type 2 diabetes. Int J Vitam Nutr Res. 2000;70:14-18.
54. Anderson RA, Polansky MM, Bryden NA, et al. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr. 1991;54:909-916.
56. Uusitupa MI, Mykkanen L, Siitonen O, et al. Chromium supplementation in impaired glucose tolerance of elderly: effects on blood glucose, plasma insulin, C-peptide and lipid levels. Br J Nutr. 1992;68:209-216.
59. Kaats GR, Blum K, Pullin D, et al. A randomized, double-masked, placebo-controlled study of the effects of chromium picolinate supplementation on body composition: a replication and extension of a previous study. Curr Ther Res. 1998;59:379-388.
60. Volpe SL, Huang HW, Larpadisorn K, et al. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. J Am Coll Nutr. 2001;20:293-306.
63. Clancy SP, Clarkson PM, DeCheke ME, et al. Effects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players. Int J Sport Nutr. 1994;4:142-153.
64. Amato P, Morales AJ, Yen SS. Effects of chromium picolinate supplementation on insulin sensitivity, serum lipids, and body composition in healthy, nonobese, older men and women. J Gerontol A Biol Sci Med Sci. 2000;55:M260-M263.
65. Lukaski HC, Bolonchuk WW, Siders WA, et al. Chromium supplementation and resistance training: effects on body composition, strength, and trace element status of men. Am J Clin Nutr. 1996;63:954-964.
67. Laws A, King AC, Haskell WL, et al. Relation of fasting plasma insulin concentration to high density lipoprotein cholesterol and triglyceride concentrations in men. Arterioscler Thromb. 1991;11:1636-1642.
69. Fontbonne A, Tchobroutsky G, Eschwege E, et al. Coronary heart disease mortality risk: plasma insulin level is a more sensitive marker than hypertension or abnormal glucose tolerance in overweight males. The Paris Prospective Study. Int J Obes. 1988;12:557-565.
71. Pyorala K, Savolainen E, Kaukola S, et al. Plasma insulin as coronary heart disease risk factor: relationship to other risk factors and predictive value during 9 1/2-year follow-up of the Helsinki Policemen Study population. Acta Med Scand Suppl. 1985;701:38-52.
72. Lamarche B, Tchernof A, Mauriege P, et al. Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. JAMA. 1998;279:1955-1961.
88. Institute of Medicine. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. National Academy of Sciences; Washington DC; 2001.
90. Stearns DM, Silveira SM, Wolf KK, Luke AM. Chromium(III) tris(picolinate) is mutagenic at the hypoxanthine (guanine) phosphoribosyltransferase locus in Chinese hamster ovary cells. Mutat Res. 2002;513:135-142.
92. Campbell WW, Joseph LJ, Anderson RA, et al. Effects of resistive training and chromium picolinate on body composition and skeletal muscle size in older women. Int J Sport Nutr Exerc Metab. 2002;12:125-135.
95. Houweling ST, Kleefstra N, Jansman GA, et al. Effects of chromium treatment in patients with poorly controlled, insulin-treated type 2 diabetes mellitus [abstract]. 18th International Diabetes Federation Congress; August 24-29, 2003; Paris, France.
97. Docherty JP, Sack DA, Roffman M, et al. A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving. J Psychiatr Pract. 2005;11:302-14.
98. Lucidi RS, Thyer AC, Easton CA, et al. Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome. Fertil Steril. 2005;84:1755-1757.
99. Kleefstra N, Houweling ST, Jansman FG, et al. Chromium treatment has no effect in patients with poorly controlled, insulin-treated type 2 diabetes in an obese western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care. 2006;29:521-525.
100. Gunton JE, Cheung NW, Hitchman R, et al. Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance. Diabetes Care. 2005;28:712-713.
101. Pei D, Hsieh CH, Hung YJ, et al. The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Metabolism. 2006;55:923-927.
102. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care. 2006;29:1826-32.
103. Singer GM, Geohas J. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Diabetes Technol Ther. 2006;8:636-643.
105. Kleefstra N, Houweling ST, Bakker SJ, et al. Chromium treatment has no effect in patients with type 2 diabetes mellitus in a western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care. 2007 Feb 15. [Epub ahead of print].
106. Albarracin CA, Fuqua BC, Evans JL, et al. Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Diabetes Metab Res Rev. 2007 May 16. [Epub ahead of print]
107. Diaz ML, Watkins BA, Li Y, et al. Chromium picolinate and conjugated linoleic acid do not synergistically influence diet- and exercise-induced changes in body composition and health indexes in overweight women. J Nutr Biochem. 2007 May 23. [Epub ahead of print]
Last reviewed April 2009 by EBSCO CAM Review Board]]>
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