In 1959, chromium was first identified as an element that enables the hormone insulin to function properly. Since then, chromium has been studied for diabetes and has become a popular dietary supplement. It is widely available in health food stores, drug stores and online.
There are two types of chromium that are commonly studied. Trivalent chromium is found in food and is usually safe to consume in small amounts. This article is about chromium picolinate, a type of trivalent chromium. This article is not about hexavalent chromium, which is an environmental toxin.
Uses of Chromium Picolinate
Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
However, even if supplements are third-party tested, that doesn’t mean they are necessarily safe for all people or effective in general. It is important to talk to your healthcare provider about any supplements you plan to take and to check in about any potential interactions with other supplements or medications.
The amount of trivalent chromium in food is so small that it is measured in micrograms. That is one-millionth of a gram. For example, an egg has about 0.2 micrograms of chromium, and a cup of grape juice has about 7.5 micrograms of chromium. Adults may need between 20 to 35 micrograms of chromium per day, depending on factors like sex assigned at birth and age. Most supplements don’t exceed 500 micrograms. In some studies, however, taking up to 1000 micrograms has been noted.
Scientists have studied the effect that chromium has on biomarkers in the body. A biomarker is a level that can be measured, like cholesterol, triglycerides, or blood sugar. These can be clues to help healthcare providers assess the risk of medical conditions. For example, high cholesterol and high blood sugar are biomarkers that are part of the diagnostic picture of polycystic ovarian syndrome (PCOS).
This summary describes studies that treated several diseases with chromium and measured biomarkers for those diseases. The types of chromium used in these studies included chromium picolinate and other trivalent chromium forms.
Type 2 Diabetes
Various vitamins and supplements, including chromium, have been studied as additions to conventional diabetes treatment. Chromium works by improving how well insulin works in the body. Although numerous studies are ongoing, consistent evidence that chromium helps people with type 2 diabetes is lacking.
A narrative review of 20 randomized controlled studies that used chromium in type 2 diabetes concluded that while chromium may have lowered fasting blood sugar and HbA1c, whether the blood sugar-lowering was statistically significant or clinically meaningly across studies was unclear. For included studies, daily movement, diet and baseline chromium levels, how much chromium was taken and how often (dosage range and frequency), and chromium type used for each of the studies were unclear. The majority of people included in the studies were taking blood sugar-lowering medications. The quality of some of the trials was in question. This made it challenging to estimate the efficacy of chromium for blood sugar control for this review. Please follow the guidance of your healthcare team (ex., endocrinologist, registered dietitian nutritionist, pharmacist, etc.) and tune into your body for optimal blood sugar control and your general well-being.
Scientists did another systematic review of 25 randomized controlled studies to investigate the effects of chromium supplements on diabetes. People in these studies were given chromium at doses from 150 micrograms to 1000 micrograms daily for three to 24 weeks. Most studies in this review used chromium alone, but three used additional supplements, such as vitamin C. The results showed small but significant improvements compared with a placebo.
They found that blood sugar control improved in people who took chromium doses greater than 200 micrograms daily and that people who started with uncontrolled blood sugar levels had improved hemoglobin A1C and fasting blood sugar levels. Triglycerides and high-density lipoprotein (HDL) cholesterol also improved in people who took chromium.
A different systematic review of 28 studies showed similar results, though the researchers came to a different conclusion. The doses of chromium in these studies ranged from 1.28 micrograms to 3,000 micrograms daily. The scientists who published this review found that the effects of chromium on blood sugar and cholesterol levels were not dependent on dosage.
Even though some studies report the benefits of chromium for type 2 diabetes, the effect has been small and not always predictable across different studies. Additional research is needed before drawing a definite conclusion.
Polycystic Ovarian Syndrome (PCOS)
Polycystic ovarian syndrome is a condition where abnormal hormone and insulin levels cause irregular menstrual cycles, pain, ovarian cysts, and other symptoms. When a healthcare provider diagnoses PCOS, their criteria include several biomarkers and symptoms that add to the picture like weight, insulin resistance, cholesterol levels, and hormone levels.
Two ways that chromium could theoretically help with PCOS are by decreasing insulin resistance and lowering cholesterol levels. Because the body’s metabolism involves a lot of hormones that influence cholesterol and insulin, it is hard to pinpoint one specific way that chromium helps. Scientists have studied chromium as a treatment for PCOS with mixed results.
Researchers conducted a systematic review of six randomized controlled studies in 351 women with PCOS to find out if chromium affected their condition. Study participants were given doses of chromium picolinate between 200 micrograms and 1000 micrograms by mouth daily for eight weeks to six months. They found that overall, there was a decrease in insulin resistance and an increase in free testosterone and total testosterone compared with the placebo groups. However, there was not a significant difference in fasting blood sugar or cholesterol. The researchers reported that three of the studies they included were high quality and three were moderate quality. So these results are a good start but more study is needed.
In another small, randomized controlled trial in 40 women with PCOS who were candidates for in vitro fertilization, scientists studied chromium as a treatment for blood sugar control, oxidative stress, and metabolic and cardiovascular health. Study participants were given 200 micrograms of chromium picolinate or placebo by mouth daily for eight weeks. Scientists noticed a significant improvement in chromium vs. placebo groups for lowered fasting blood sugar, insulin levels, triglycerides, and total cholesterol concentrations. This was a very small study, so the results can’t be generalized to a large group.
Chromium continues to be studied as a treatment for PCOS, but its effectiveness is still unclear. You can ask your healthcare provider if chromium, other supplements, or integrative therapies are an appropriate addition to your PCOS care plan. They might have other ideas for decreasing insulin resistance and cholesterol like changing your diet and exercise routine.
Depression
Researchers conducted a double-blind, controlled study in 15 people with atypical depression to evaluate possible uses of chromium picolinate. Participants in the treatment group were given 600 micrograms of chromium picolinate or a placebo for eight weeks. They started on 400 micrograms daily and then increased to 600 micrograms at the two-week mark. The Hamilton depression (HAM-D) scale showed mixed results, and the Symptom Checklist-90 did not show any significant difference between the two groups. This was a very small study, so the results can’t be applied to larger groups.
Scientists conducted another double-blind, controlled study with a similar design but 113 participants. People in this study took 600 micrograms of chromium picolinate daily for eight weeks. The treatment group showed a difference in increased eating, daily variation in feelings, increased appetite, and decreased carbohydrate craving, which are all parts of the HAM-D scale. These results can be used as a starting point to design larger studies in the future.
Atypical depression can be challenging to treat, so speaking with your healthcare provider about integrative approaches that can be safely added to medication is worthwhile.
Researchers carried out a randomized controlled trial in 24 people with binge eating disorder to study the effects of chromium on depression and glucose tolerance. Participants were given 600 micrograms or 1000 micrograms of chromium picolinate or placebo by mouth daily for six months. Both chromium dosages lowered glucose levels before eating compared with placebo. There was also a decrease in symptoms of depression in the chromium groups, but it was not significant. Like the studies above, this one was too small to apply the results to a larger group, but it suggests possible future treatments.
Heart Rate
Heart rate refers to the number of times your heart beats per minute. Chromium was not studied for the purpose of decreasing heart rate, but a study in people with a different condition showed a result of lowered heart rate.
Researchers conducted a double-blind, randomized controlled study in 70 people with metabolic syndrome and impaired glucose tolerance. Participants were treated with 200 micrograms of chromium-enriched yeast in the morning and 100 micrograms in the evening for six weeks. They had a small decrease in resting heart rate of five beats per minute, which was a statistically significant change compared with the placebo group. There were no other significant differences in biomarkers between the treatment and placebo groups. The participants also got advice on how to improve their health, which may have contributed to the results. Whether or not this may be clinically significant, however, remains to be seen. More study is needed.
Weight Training
There have been many claims that chromium supplements help with weight loss, so it is worthwhile to mention that there is evidence against this use.
A detailed systematic review was conducted in 9 randomized controlled studies with 622 people who took chromium to help with weight loss or weight training. The dosages ranged from 200 micrograms to 1000 micrograms daily for 12 to 16 weeks. Biomarkers included body weight, waist circumference, body mass index, and percentage body fat. Scientists concluded that no substantial evidence was found that chromium supplements affected weight loss or weight training compared with placebo.
Additionally, a meta-analysis was done in 21 studies with 1316 people. Chromium doses ranged from 200 micrograms to 400 micrograms by mouth daily. Scientists found a clinically very small (0.75 kilograms) but significant weight loss in the chromium groups compared with placebo. They concluded that chromium’s effects in weight loss remain uncertain.
Be mindful of companies that try to sell weight loss solutions that sound too good to be true. Safe weight loss can be achieved through diet and exercise at a slow pace that is healthy for your body.
Other Related Conditions
Chromium has also been studied specifically in metabolic syndrome and dyslipidemia. These conditions are often related to PCOS and Type 2 diabetes, so the same study may include several conditions.
Overall, there is not enough evidence to support using chromium as the primary treatment for any disease. But talk with your healthcare team to find out whether it is a safe addition to your treatment plan.
Chromium Deficiency
Chromium deficiency is not common in industrialized countries. It has only been reported in people who were unable to eat normally and required intravenous nutrition.
How Do I Know If I Have a Chromium Deficiency?
A chromium deficiency may need to be properly identified and diagnosed by a health care provider through specific labs; however, there are some identifying factors that may signify a deficiency. Signs and symptoms of a chromium deficiency may include:
Glucose intolerance High blood sugar Numbness or pain in the hands, feet, or face Confusion
Chromium deficiency is resolved by treating with pharmacologic doses of chromium. Speak with your healthcare provider about any concerns you may have about chromium deficiency.
What Are the Side Effects of Chromium Picolinate?
Several of the trivalent chromium forms are available over the counter. Any side effects that you experience can be reported to the FDA. The Food and Nutrition Board of the Institute of Medicine has acknowledged the possibility of negative impact from high oral intakes of trivalent chromium, but in the absence of evidence to suggest otherwise, has not set a maximum limit for ingestion.
Chromium does not have many reported side effects. The side effects that are typically reported are theoretical or based on very few individual case reports.
Common Side Effects
Hypoglycemia (low blood sugar) is the most commonly reported side effect of chromium. However, the blood sugar lowering effect of chromium is sufficiently small that it is unlikely hypoglycemia will be caused by chromium alone.
Severe Side Effects
Case reports have mentioned isolated instances of the following severe side effects.
Rhabdomyolysis (muscle breakdown) Dermatitis (skin inflammation) Anemia (low iron levels in the blood) Thrombocytopenia (low platelet count in the blood) Liver problems Kidney failure Weight loss
A case report is the least reliable type of clinical evidence. Chromium supplements from reputable manufacturers are unlikely to cause severe side effects.
Precautions
Chromium has been used in children, pregnant individuals, and people over 65. While there are no specific concerns, please check with your or your child’s healthcare provider before using supplements.
Dosage: How Much Chromium Should I Take?
There is not one right dose of chromium for everyone. It’s a good idea to ask your healthcare provider for help choosing the dose that works for you. There is an adequate intake (AI) of chromium and pharmacologic dosing used by researchers.
The Food and Nutrition Board decided on chromium AI amounts based on age and sex assigned at birth. The amount of chromium in the AI level can easily be found in a healthy diet:
For males aged 19-50, the daily AI is 35 micrograms (mcg). For females aged 19-50, the daily AI is 25 micrograms. For males aged 51 and older, the daily AI is 30 micrograms. For females aged 51 and older, the daily AI is 20 micrograms.
Multivitamins usually have 35-120 micrograms of chromium. Chromium supplement doses are higher. They are based on doses used in clinical research. These higher doses are also called pharmacologic doses. They are usually between 200 micrograms and 500 micrograms of chromium.
What Happens If I Take Too Much Chromium?
Although other supplements have a tolerable upper intake level (UL), chromium does not. You may want to be careful with chromium dosing if you have liver or kidney disease. There are a few case reports of chromium side effects, which may be more likely to happen if you take a large amount.
Interactions
Blood Sugar Lowering Medications
Chromium has been studied to treat insulin resistance, and when it is effective as a treatment, blood sugar can be decreased. This creates a theoretical drug interaction with other drugs that decrease blood sugar like metformin, sulfonylureas (glipizide), and insulin. The result would be hypoglycemia, which is blood sugar that gets too low. Symptoms of hypoglycemia include but aren’t limited to shaking, disorientation, and dizziness.
Insulin
Chromium increased insulin sensitivity slightly in some studies. This effect is often helpful in people with insulin resistance but can also theoretically be considered an interaction with insulin. The negative outcome of this interaction is hypoglycemia.
Levothyroxine
A small amount of evidence links chromium to decreased absorption of levothyroxine medication (used to replace thyroid hormone). This interaction was reported in a small study with seven people who took 1 milligram (mg) levothyroxine daily with chromium picolinate. Blood levels of thyroxine were significantly decreased compared with people who took levothyroxine alone.
NSAIDS (ibuprofen, aspirin, naproxen, indomethacin)
There is a theoretical interaction between chromium and non-steroidal anti-inflammatory drugs (NSAIDS). This theoretical interaction that NSAIDS increase chromium absorption in the body is based on very small study in rats, so it cannot be generalized to humans.
Antacids
There is a theoretical interaction between chromium and antacids like aluminum hydroxide and magnesium hydroxide (ingredients in Maalox and calcium carbonate (Tums)). This theoretical interaction that antacids lead to lower chromium absorption is based on a small study in female rats, so it cannot be generalized to humans.
Vitamin C
There is a theoretical interaction between chromium and vitamin C. This theoretical interaction that vitamin C increases chromium absorption and also increases chromium excretion through the urine is based on a very small study in female rats, so it cannot be generalized to humans.
It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss any potential interactions with foods, other supplements, and medications.
How to Store Chromium
Most chromium supplements can be stored in a cool, dry place. If the supplement is mixed with something that needs refrigeration, it may need to be kept cooler. Read the label carefully. The expiration date on the bottle will let you know when to discard it.
Similar Supplements
In addition to chromium picolinate, several trivalent chromium salts are available as supplements.
Chromium citrate Chromium histidinate Chromium chloride Chromium polynicotinate
Note that chromium polynicotinate is chromium combined with niacin which will work differently than chromium alone. Ask your healthcare provider if one type of chromium supplement is better for your particular case.
Sources of Chromium & What To Look For
You can find chromium in trace (very small) amounts in a lot of foods. The easiest way to get chromium is through a healthy diet that includes fruits, vegetables, and grains. Chromium picolinate also comes as a supplement.
Food Sources of Chromium
A lot of foods have chromium, including grains, meats, fruits, and vegetables. These are a few examples of foods that were tested for chromium and had relatively high amounts (more than one microgram).
BroccoliGrape juiceHamTurkeyWafflesWhole wheat English muffin
These are just a few examples. You may not need to change your diet to get more chromium. Consult a healthcare provider like a registered dietitian nutritionist if you have questions.
Chromium Supplements
A lot of chromium supplements are being sold, and it can be overwhelming to choose one. Ask a pharmacist or dietitian for help choosing a reliable brand. Chromium supplements are available in several different forms. You can select the form that is easiest for you to take.
CapsulesTabletsPowdersLiquidsMultivitaminsCombination products
Multivitamins have a small amount of chromium. They usually contain about 35-120 micrograms. Capsules and tablets that contain chromium alone have a higher dose. They typically contain about 20-500 micrograms. The higher dose is sometimes called a pharmacologic dose. Clinical research on chromium to treat health conditions usually uses pharmacologic doses.
To ensure quality and safety, opt for supplements independently tested by a certifying body like the U.S. Pharmacopeia (USP), NSF International, or ConsumerLab. The certification confirms that the supplement contains the ingredients and ingredient amounts listed on the product label.
Always read the label to check for added ingredients you may be allergic to or sensitive to, including gluten and animal-based gelatins.
Also, keep in mind that the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications has not been established.
If you’re considering using chromium or making other dietary changes, talk with your healthcare provider first. Self-treating a condition and avoiding or delaying standard care may have serious consequences.
Summary
Chromium is an element that is found in trace amounts in food. The chromium in food is trivalent chromium. It has been studied in type 2 diabetes. It has also been studied in PCOS, dyslipidemia, depression, weight training, and other conditions. There is not enough solid evidence that chromium is an effective treatment for any condition.
There are a few possible drug interactions with chromium, including levothyroxine. Let your healthcare provider know if you are taking chromium in case it interacts with any of your current medications.
You can likely get enough chromium in a healthy diet that includes grains, vegetables, and fruit. It also comes in supplements (capsules, tablets, powders, and liquids). Chromium comes in different forms such as chromium picolinate and chromium polynicotinate. If you choose to take a chromium supplement, check with a healthcare provider to find a reliable brand.