Natural Products

Chromium

Chromium chloride, Chromium picolinate

Efficacy

• Indications with proven efficacy:
  None
• Indications with possible, but poorly documented efficacy - the use of this product cannot be recommended:
  Glycemic control in adult diabetics
  Reactive hypoglycemia
  Serum cholesterol and triglycerides reduction
  Serum good cholesterol increase in men taking beta-blockers
  Steroid-induced diabetes
• Indications with proof that it is not effective:
  Weight loss
• Also used for these other indications, but with no proof of efficacy:
  Enhancement of athletic performances

Security

• Risk of Drug Interactions: Moderate
• Adverse Effects: Not Frequent

What is it?

Chromium is a trace element essential to the body's proper function. It is found in abundance in the Earth's crust, as chromium ore, in concentrations of 100 to 300 ppm (parts per million). Organic chromium, which is easier to assimilate, can also be found in a variety of foods such as brewer's yeast, liver, potatoes (with peel), beef, fresh vegetables and cheese. The adequate intake (AI) level is different based on gender and age:

Chromium appears to play an important role in the regulation of normal glucose (sugar) use by the body. It may facilitate insulin activity, thus improving glucose tolerance. Due to its action on blood glucose level, chromium may reduce blood lipid levels. In the general population, chromium deficiency is rare but may be involved in the development of diabetes in adults and of atherosclerosis. People whose diet is mainly based on extensively refined foods (rich in sugar and starch) appear more at risk of developing chromium deficiency.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

There is no evidence that chromium is effective in any indication. However, it is used to treat some medical conditions where it may be of some benefits:

• Glycemic control in adult diabetics
  Reducing serum cholesterol and triglyceride levels:
  200 to 1000 mcg daily has been used. The actual efficacy of chromium in these indications has not been established.
• Increasing serum good cholesterol level in men taking beta-blockers:
  200 mcg three times daily has been used. The actual efficacy of chromium in these indications has not been established.
• Steroid-induced diabetes:
  400 to 600 mcg daily has been used. The actual efficacy of chromium in these indications has not been established.
• Reactive hypoglycemia:
  200 mcg daily of chromium chloride has been used. The actual efficacy of chromium in these indications has not been established.

There is insufficient reliable information to conclude that chromium is effective in any other indication.

Is it safe?

• The administration of "safe" doses of chromium is not associated with any severe toxicity. However, when doses larger than those usually recommended are administered, chromium may cause learning and perception problems, motor disturbances. High doses (600 to 2400 mcg daily) may lead to behavioral problems, anemia, hepatic dysfunction and renal impairment. The long-term safety profile of prolonged chromium use is not established.
• Chromium appears to be safe during pregnancy and lactation when doses thought to be safe for healthy adults are used.
• In theory, chromium may increase the effects of insulin. Close monitoring of blood glucose levels is recommended in diabetics. Vitamin C increases chromium absorption while zinc decreases it. Before taking chromium supplement, check with your pharmacist to make sure that there are no interactions with your regular medications.

Clinical notes

• Most people do not need chromium supplements as long as they eat a variety of foods. Those whose diet consists mainly of highly refined foods may benefit from chromium supplements, at doses ranging from 50 to 200mcg daily. Avoid large doses of chromium.
• Chromium picolinate is recommended because this salt increases absorption.

References

1. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
2. Peirce, Andrea. Practical Guide to Natural Medicines, APha, 1999
3. Facts & Comparisons, The Lawrence review of natural products, 1998
4. Taylor J. CE: Phytomedicinals: Uses, precautions, and drug interactions. Drug Topics 2003;1:79
5. Passeportsanté.net. Chrome. http://www.passeportsante.net