- Chromium III
- Chromium picolinate
- Niacin-bound chromium
- Chromium chloride
For Patients & Caregivers
How It Works
There is no clear evidence to show that chromium supplementation is effective for improving glucose metabolism, losing weight, or building muscle mass.
Chromium is an element required by the body in very small amounts (0.025 mg a day). Adequate amounts are usually obtained in the diet from foods such as American cheese, meat, fish, fruits, and whole grains. Lab experiments suggest chromium is involved in maintaining adequate levels of glucose, fats, and insulin in the body. In theory, this could help patients with type 2 diabetes, but the current evidence in human studies is mixed.
Chromium is sometimes combined with GTF (Glucose Tolerance Factor) in over-the-counter products. GTF is a yeast extract that helps with glucose metabolism in lab studies, but this effect has not been confirmed in humans.
- To treat diabetes Clinical trials produced conflicting results regarding chromium’s ability to lower blood glucose, cholesterol, and triglycerides.
- To treat polycystic ovarian syndrome Data suggest that any effect of chromium on PCOS symptoms is small, with clinical relevance uncertain.
- To improve muscle mass Clinical trials do not support this use.
- To improve weight loss Clinical trials do not support this use.
Do Not Take If
In rare cases, liver toxicity has occurred.
- Kidney failure: In two patients who took chromium supplements to enhance weight loss.
- Red skin lesions: Accompanied with fever, swelling, and high white blood cell counts.
- Destruction of skeletal muscle: In one patient while taking chromium picolinate in addition to other dietary supplements. Therefore, whether chromium caused this condition is not clear.
- Low blood sugar: In a 29-year-old man with type 2 diabetes who took chromium supplements in addition to insulin.
For Healthcare Professionals
Chromium is a trace element that is necessary for glucose, insulin, and lipid metabolism in humans (1) (9). It is marketed as a dietary supplement for diabetes, weight loss, and to improve muscle mass. Trivalent chromium from yeast extract is sometimes referred to as glucose tolerance factor (GTF) in over-the-counter products.
Although most people consume adequate amounts through diet, chromium deficiency has been implicated in the development of diabetes (25). In vitro studies suggest that chromium produces beneficial modulatory effects under hyperglycemic conditions (26). Animal models also suggest antidiabetic (27) (28), antidepressant (29) (30) (31), and anxiolytic (32) properties.
In human studies, chromium supplementation with biotin may help to improve glycemic control in type 2 diabetes (T2D) (4) (5) (6), but results from other studies on chromium alone are mixed (33) (44). Another study showed that chromium picolinate may increase satiety (15). However, many clinical studies failed to demonstrate improvements in glucose metabolism, weight loss, or muscle mass (3) (7) (8) (9) (10) (11) (12) (13) (14). More recently one meta-analysis suggested that overall, chromium monosupplementation improved glycemic control and lipid profiles (34), while another determined that chromium picolinate did not affect A1C or fasting plasma glucose (35). It has been posited that mixed and modest effect sizes may reflect a greater glucoregulatory effect in complex patients with comorbid diabetes, depression, and binge eating (36). A large population study suggests that those who consumed chromium-containing supplements had a reduced risk of T2D compared with those who did not, and that more study is needed (37).
In women with polycystic ovary syndrome (PCOS), chromium supplementation did not affect endocrine profiles, and nitric oxide or glutathione levels, but did reduce acne, hirsutism, C-reactive protein, total antioxidant capacity, and malondialdehyde levels (45). However, meta-analyses suggest that for PCOS patients, chromium supplementation may not have significant benefits (46) or the magnitude of effect is small, with clinical relevance uncertain (47).
Chromium is poorly absorbed following oral administration, but salt forms such as chromium picolinate, niacin-bound chromium, and chromium chloride, appear to have better bioavailability. Other novel chromium compounds also have improved bioavailability (40) (41). Adverse effects are rare but can include renal failure (18) (19), rhabdomyolysis (20), liver damage (21), and dermatitis (22).
Mechanism of Action
Chromium is an essential trace element involved with glucose and lipid metabolism, circulating insulin levels, and the peripheral activity of insulin (1). In vitro and in vivo studies suggest that chromium potentiates the activity of insulin (23) (42). This is thought to occur via enhanced intracellular tyrosine kinase activity that results from an interaction between chromium, low molecular weight chromium-binding substance, and activated cell surface insulin receptors (2).
In animal models of diabetes, chromium recovered beta cell functioning and alleviated macroangiopathy (27). It also augmented the insulin signaling pathway, dulled negative-regulators of insulin signaling, enhanced adenosine monophosphate-activated protein kinase (AMPK) activity to increase cellular glucose uptake, and attenuated oxidative stress (42). Chromium may also modulate peroxisome proliferator-activated receptor-gamma (PPAR-gamma), insulin receptor substrate (IRS-1), and nuclear factor-kappaB (NF-κB) proteins (28). Antidepressant effects occur via modified brain 5-hydroxytryptamine receptor (5-HT) function and increased serotonergic and noradrenergic functioning (30) (31). Additional mechanisms for antidepressant and anxiolytic effects include the lowering of plasma corticosterone levels via reversal of hypothalamic–pituitary–adrenal axis (HPA) axis overactivity (32). In humans, suggested antidepressant mechanisms include 5HT2A downregulation and increased insulin sensitivity (38).
Rare: Hepatic toxicity (21)
Renal failure: In a 33-year-old white woman who also presented with weight loss, anemia, thrombocytopenia, hemolysis, and liver dysfunction after chronic high doses of chromium picolinate to enhance weight loss (18) ; and in a 49-year-old female nurse who took chromium picolinate 600 mcg daily for 6 weeks for weight reduction (19).
Acute generalized exanthematous pustulosis: Characterized by erythematous lesions, fever, edema, leukocytosis, and eosinophilia (22).
Rhabdomyolysis: In a 24-year old patient taking chromium picolinate in addition to other dietary supplements (20).
Hypoglycemia: In a 29-year-old man with T2D after ingesting oral chromium 1000 mcg daily in addition to taking insulin (43).