Drugs A - Z
Generic Name: chromium picolinate
CategoryHerbs & Supplements
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.
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.
EvidenceDISCLAIMER: 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.
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.
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.
There is lack of sufficient available evidence to recommend chromium for bipolar disorder.
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.
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.
Early research suggests that chromium picolinate may help improve cognitive function in the elderly. Further study is needed in this area.
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.
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.
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.
Chromium, in combination with copper, may have potential suppressive effects on immune function. Further research is needed to confirm these results.
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.
Early study shows a lack of effect of chromium supplementation on mental state and body weight in people with schizophrenia. Additional study is needed.
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.
TraditionWARNING: DISCLAIMER: 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.
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.
SafetyDISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
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.
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 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.
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 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.
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Dawn Costa, BA, BS (Natural Standard Research Collaboration); Cynthia Dacey, PharmD (Northeastern University); Alicia I. Dalton, PhD (Harvard University); Sean Dalton, MD, PhD, MPH (Harvard University); Paul Hammerness, MD (Harvard Medical School); Kerri MacWhorter, PharmD. (University of Rhode Island); Anabela Santos, PharmD (Northeastern University); Michael Smith, ND (Canadian College of Naturopathic Medicine); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Minney Varghese, BS (Northeastern University); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).
BibliographyDISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
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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.
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.
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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.
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Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr 2004;Apr, 79(4):529-536.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.