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Updated 19 February 2013

Your complete guide to chromium

Chromium is an essential trace element which may alter blood sugar levels but should be closely monitored in people with diabetes.

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RELATED TERMS

Atomic number 24, chromic chloride, chromium (III), chromium 3, chromium 3+, chromium acetate, chromium chloride, chromium III picolinate, chromium III, chromium nicotinate, chromium picolinate, chromium polynicotinate, chromium trichloride, chromium tripicolinate, chromium yeast, chromium-3+, chromium-enriched yeast, Cr, Cr III, Cr-3, Cr-3+, Cr-III, glucose tolerance factor, glucose tolerance factor-Cr, GTF, GTF-Cr, hexavalent chromium, trivalent chromium.

BACKGROUND

Chromium is an essential trace element that exists naturally in trivalent and hexavalent states. Trivalent chromium (chromium/Cr III), typically found in foods and supplements, appears to have very low toxicity and a wide margin of safety. Hexavalent chromium (chromic oxide, chromate) is a known toxin and long-term occupational exposure may lead to skin problems, a perforated nasal septum, and lung cancer.

Although chromium has been suggested for many conditions, there is not enough information to make any strong recommendations at this time. Chromium is available in several forms, such as chromium-enriched yeast and chromium picolinate. Chromium has been studied for its short-term and long-term effects. Chromium picolinate is the most studied synthetic chromium product that is commonly promoted for weight loss, although there is a lack of research to support this.

Chromium may alter blood sugar levels, which should be closely monitored in people with diabetes.

EVIDENCE TABLE

Conditions

Uses
disclaimer: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Grade*

Hypoglycemia (low blood sugar)

Chromium has been studied in the treatment of diabetes and high blood sugar. It may also help regulate blood sugar in patients with low blood sugar disorders. More research is needed in this area to make a strong recommendation.

B

Polycystic ovary syndrome (glucose tolerance)

Chromium picolinate may help improve glucose tolerance in women with polycystic ovary syndrome. However, chromium does not appear to alter hormones. Additional research is needed to confirm these findings.

B

Bipolar disorder

There is lack of sufficient available evidence to recommend chromium for bipolar disorder.

C

Bone loss (postmenopausal women)

There is a lack of evidence for or against the use of chromium for the treatment of bone resorption in postmenopausal women.

C

Cardiovascular disease

An association has been made between high chromium levels in the blood and a lower risk of coronary artery disease (clogged arteries in the heart). Chromium should be used cautiously, however, due to possible increases in blood pressure. Better studies are needed to provide more definitive answers.

C

Cognitive function

Early research suggests that chromium picolinate may help improve cognitive function in the elderly. Further study is needed in this area.

C

Depression

Early studies show that chromium picolinate may improve symptoms of depression in people with atypical depression. Further research is needed before a recommendation can be made.

C

Diabetes mellitus

Chromium has been studied for sugar abnormalities in people with types 1 and 2 diabetes, as well as at-risk populations. Some studies suggest that taking chromium by mouth may lower blood sugar levels, whereas other studies show no effects. Some research reports that chromium may improve symptoms of hypoglycemia (low blood sugar). Better studies are needed to provide more definitive answers.

C

High cholesterol

Studies show conflicting results in using chromium to treat high cholesterol. A few studies show that chromium may lower cholesterol, but other studies show no effects. Many natural medicine experts and textbooks do not recommend chromium for treating high cholesterol over more proven therapies.

C

Immunosuppression

Chromium, in combination with copper, may have potential suppressive effects on immune function. Further research is needed to confirm these results.

C

Parkinson's disease

Chromium has been studied for its protective benefits in Parkinson's disease and is included in antioxidant multivitamins. However, there is lack of scientific evidence in humans in this area. Additional study is needed.

C

Schizophrenia

Early study shows a lack of effect of chromium supplementation on mental state and body weight in people with schizophrenia. Additional study is needed.

C

Obesity/weight loss

Chromium has been studied for its ability to treat obesity, but overall, results have not shown any benefit. Although chromium may help improve lean body mass (by reducing fat and increasing muscle), it does not appear to show effects in general weight loss.

F

*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

TRADITION

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Acne, antioxidant, athletic performance, hypothyroidism, glaucoma, migraines, premenstrual syndrome (PMS), psoriasis, Turner's syndrome.

DOSING

disclaimer: The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

Chromium is available in several forms, such as trivalent chromium, chromium-enriched yeast, and chromium picolinate. Chromium has been studied short-term and long-term. Although there have been many studies involving chromium, overall, the evidence is mixed. There is no proven effective dose for any type of chromium for any indication. Studies in humans have used doses of 200-1,000 micrograms of chromium picolinate per day by mouth as capsules or tablets. As chromium-enriched yeast, 150-400 micrograms has been commonly studied. As chromium picolinate, lower doses of 200-250 micrograms have been used. It should be noted, however, that some natural medicine experts believe that adequate dietary intake of chromium is only 24-45 micrograms per day, although others recommend 50-200 micrograms per day.

Children (under 18 years old)

The dosing and safety of chromium have not been studied thoroughly in children and high doses of chromium are generally not recommended. Some practitioners have recommended an adequate chromium intake of 0.2-35 micrograms per day, depending on age.

SAFETY

disclaimer: The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in patients with a known allergy or hypersensitivity to chromium. People with allergies to chromate or leather may be more likely to have allergic reactions to chromium.

Allergic reactions from handling chromium or its use in medical devices (orthopedic prosthesis, dental restorations) may occur.

Side Effects and Warnings

Chromium, in its trivalent form, appears to be well tolerated with rare or uncommon adverse effects. However, the hexavalent form is not well tolerated and may be toxic. Hexavalent chromium appears to be associated with lung cancers. Long-term occupational exposure to hexavalent chromium may also lead to skin problems and a perforated nasal septum.

The most common complaints include stomach discomfort and nausea or vomiting. Very rarely, skin rashes, insomnia or sleep disturbances, headaches, mood changes, muscle damage, or anemia may occur.

It is possible that chromium may lower blood sugar levels. As a result, it should be used cautiously in patients who are taking drugs for diabetes.

It is possible that chromium may have adverse effects on the heart, blood, kidneys, or liver. There are also rare reports of respiratory effects, such as cough, shortness of breath, wheezing, rhinitis, asthma, and headache, after inhaling chromium.

Cognitive, perceptual, and motor changes may also occur, although they are unlikely.

Early data show that chromium, in combination with copper, may have potential suppressive effects on the immune system. Caution should be used in those with a suppressed immune system, such as in HIV or transplant patients.

Pregnancy and Breastfeeding

Many natural medicine experts and textbooks state that chromium is safe if taken by pregnant or breastfeeding women in the amount of 45 micrograms per day by mouth. However, scientific studies have not clearly proven safety and effectiveness.

INTERACTIONS

disclaimer: Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Chromium may lower blood sugar levels. Caution is advised if taking drugs that may lower blood sugar levels. Patients taking oral drugs for diabetes or using insulin should be monitored closely by healthcare professionals while using chromium.

Lithium and nicotinic acid may also increase the tendency for blood sugar levels to become low. In contrast, when chromium is used with corticosteroids, such as prednisone, increases in blood sugar levels may occur. Dosing adjustments may be necessary.

Chromium may modify serotonin function in the brain and therefore may interact with prescription antidepressants, such as sertraline (Zoloft©) and fluoxetine (Prozac©).

In theory, some drugs may decrease chromium levels in the body and may interfere with chromium's activities. Examples include drugs that reduce acid in the stomach, such as esomeprazole (Nexium©), ranitidine (Zantac©), antacids, and corticosteroids (for example, prednisone). In contrast, aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin© or Advil©) and naproxen (Naprosyn©, Aleve©, or Anaprox©), may increase chromium levels in the body, which could lead to increased side effects.

Picolinic acid, a component often found with chromium, may alter the metabolism of certain chemicals in the brain. If these chemicals are altered, the doses of some drugs used to treat conditions, such as depression or Parkinson's disease, may need to be changed.

Chromium may interact with drugs that alter the body's immune response. Caution is advised in patients with compromised immune systems.

Corticosteroids may increase the amount of chromium excreted in the urine. This may result in chromium deficiency or increased blood sugar levels.

Chronic alcohol use may increase the chance of liver and kidney damage when taken, or exposed to, a form of chromium called hexavalent chromium.

Chromium supplementation may increase cholesterol (HDL) concentrations among patients taking beta-blockers. Caution is advised in patients taking medications for heart disorders along with chromium.

Chromium may increase blood pressure. Caution is advised in patients taking medications that alter blood pressure.

Chromium may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be decreased in the blood and the intended effects may be reduced. Patients taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

There is insufficient evidence to support the use of chromium in the treatment of weight loss; caution may be warranted with the use of chromium and weight loss agents.

Interactions with Herbs and Dietary Supplements

Chromium may alter blood sugar levels. People using herbs or other supplements that may alter blood sugar levels, such as bitter melon (Momordica charantia), should be monitored closely by healthcare professionals while using chromium. Dosing adjustments may be necessary.

Chromium taken with other supplements may alter the amount of chromium in the body. In theory, anti-inflammatory herbs and supplements may increase chromium levels in the body, which could lead to a tendency for increased side effects. In theory, zinc may decrease chromium levels in the body and may interfere with chromium's activities. It is possible that vitamin C may also alter chromium levels. Chromium taken with iron may affect the way iron is processed in the body. Chromium picolinate used with biotin may show favorable effects on regulating blood sugar, but additional study is needed in this area.

Chromium has been shown to decrease serotonin levels and may interact with herbs and supplements that affect serotonin.

Chromium may interact with herbs or supplements that alter the body's immune response. Caution is advised in patients with compromised immune systems.

Although not well studied in humans, chromium supplementation may increase cholesterol (HDL) concentrations when taken with other herbs or supplements used for heart disorders. Caution is advised.

Chromium may increase blood pressure. Caution is advised in patients taking herbs or supplements that alter blood pressure.

Chromium may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

There is insufficient evidence to support the use of chromium in the treatment of weight loss. Caution may be warranted with use of chromium and herbs and supplements used for weight loss.

ATTRIBUTION

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

  • Amann BL, Mergl R, Vieta E, et al. A 2-year, open-label pilot study of adjunctive chromium in patients with treatment-resistant rapid-cycling bipolar disorder. J Clin Psychopharmacol 2007 Feb;27(1):104-6. View abstract
  • Anderson RA. Chromium in the prevention and control of diabetes. Diabetes Metab 2000;26(1):22-27.
  • Bahijri SM, Mufti AM. Beneficial effects of chromium in people with type 2 diabetes, and urinary chromium response to glucose load as a possible indicator of status. Biol Trace Elem Res 2002;85(2):97-109.
  • Balk EM, Tatsioni A, Lichtenstein AH, et al. Effect of chromium supplementation on glucose metabolism and lipids: a systematic review of randomized controlled trials. Diabetes Care 2007 Aug;30(8):2154-63. View abstract
  • 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(2):125-135.
  • Davidson JR. Abraham K, Connor KM, et al. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biol Psychiatry 2003;53(3):261-264.
  • Fowler JF. Systemic contact dermatitis caused by oral chromium picolinate. Cutis 2000;65(2):116.
  • Hockney RA, Montgomery P, Williams C, et al. Lack of effect of chromium supplementation on mental state and body weight in people with schizophrenia. J Clin Psychopharmacol 2006 Oct;26(5):544-5. View abstract
  • Hoeger WW, Harris C, Long EM, et al. Four-week supplementation with a natural dietary compound produces favorable changes in body composition. Adv Ther 1998 Sep-Oct;15(5):305-14. View abstract
  • Jovanovic L, Gutierrez M, Peterson CM. Chromium supplementation for women with gestational diabetes mellitus. J Trace Elem Exp Med 1999;12(2):91-97.
  • Kleefstra N, Houweling ST, Bakker SJ, et al. Chromium treatment has no effect in patients with type 2 diabetes in a Western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care 2007 May;30(5):1092-6. View abstract
  • Lenz TL, Hamilton WR. Supplemental products used for weight loss. J Am Pharm Assoc (Wash DC) 2004;Jan-Feb, 44(1):59-67; quiz, 67-68.
  • Lydic ML, McNurlan M, Bembo S, et al. Chromium picolinate improves insulin sensitivity in obese subjects with polycystic ovary syndrome. Fertil Steril 2006 Jul;86(1):243-6. View abstract
  • 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 Jul;55(7):923-7. View abstract
  • Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr 2004;Apr, 79(4):529-536.

disclaimer: Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. disclaimer: While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy. disclaimer: The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Copyright © 2011 Natural Standard (www.naturalstandard.com)



Copyright © 2011 Natural Standard (www.naturalstandard.com)

 
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