Chromium

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What is Chromium

Chromium, in its trivalent state (i.e., Cr3+), is an essential trace element that is required for proper carbohydrate, lipid, and nucleic acid metabolism in the human body.

Dietary sources of chromium (Cr3+) include whole grains, egg yolks, brewer’s yeast, liver, meats, nuts, potatoes with skin, and beer.

Overt signs and symptoms of chromium deficiency are usually only observed in adult patients eating diets high in refined foods or who are receiving long-term total parenteral nutrition without chromium supplementation.

Clinically, overt deficiencies may be detected as the development of impaired glucose tolerance, glycosuria, and insulin resistance. Impaired protein and lipid metabolism, peripheral neuropathy, and encephalopathy secondary to chromium deficiency have also been reported.

Chromium supplementation should only be expected to improve disorders that are due to chromium deficiency.

Limited studies have reported that the addition of chromium picolinate supplements to the dietary regimens of patients with type 2 or steroid-induced diabetes mellitus may result in improvements in glycemic control and cholesterol in some patients, and may allow for the reduction of antidiabetic medication.

However, these trials have studied few patients; the importance of chromium deficiency in the average patient with type 2 diabetes has not been established.

Controversy exists concerning other claimed benefits of chromium supplementation. Among athletes, chromium is promoted as an alternative to anabolic steroids.

Multiple studies have concluded that there is no evidence that chromium supplementation increases muscle mass to a level greater than that which is produced with a healthy diet and exercise alone.

There also appears to be no basis for claims that chromium reduces body-fat or weight. Clinical studies of chromium intake have revealed no additional changes in body-fat percentages or weight loss in either obese females or young athletes following controlled diet and exercise regimens.

Other claimed uses, such as the adjunctive treatment to medical therapy for gestational diabetes after the 1st trimester or the adjunctive treatment of dysthymic disorder, are not accepted at this time.

In the US, sales of chromium picolinate supplements exceed 150-million dollars per year.

Indications

  • chromium deficiency
  • nutritional supplementation
  • type 2 diabetes mellitus

For nutritional supplementation and prevention of chromium deficiency

for the estimated safe and adequate intake (AI) of chromium for oral nutritional supplementation in healthy individuals

NOTE: AIs updated by the IOM in 2001. No RDA is established. Roughly 5 to 10% of oral dietary chromium intake is systemically absorbed. Most persons achieve appropriate chromium intakes with a healthy, balanced diet. True chromium deficiency is rare.

Side Effects

  1. clastogenesis
  2. interstitial nephritis
  3. renal failure (unspecified)
  4. renal tubular necrosis
  5. rhabdomyolysis

Monitoring Parameters

  • blood glucose
  • laboratory monitoring not necessary

Contraindications

  • accidental exposure
  • benzyl alcohol hypersensitivity
  • breast-feeding
  • children
  • diabetes mellitus
  • dialysis
  • intramuscular administration
  • intravenous administration
  • neonates
  • obesity treatment
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment

Interactions

  • Abacavir; Dolutegravir; Lamivudine
  • Acarbose
  • Acetohexamide
  • Albiglutide
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Atenolol
  • Atenolol; Chlorthalidone
  • Azilsartan; Chlorthalidone
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Betamethasone; Calcipotriene
  • Bictegravir; Emtricitabine; Tenofovir Alafenamide
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bisphosphonates
  • Calcipotriene
  • Calcitonin
  • Calcium Phosphate, Supersaturated
  • Canagliflozin
  • Canagliflozin; Metformin
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril; Hydrochlorothiazide, HCTZ
  • Cardiac glycosides
  • Chlorothiazide
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Ciprofloxacin
  • Conjugated Estrogens
  • Conjugated Estrogens; Bazedoxifene
  • Conjugated Estrogens; Medroxyprogesterone
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Delafloxacin
  • Dienogest; Estradiol valerate
  • Diethylstilbestrol, DES
  • Dipeptidyl Peptidase-4 Inhibitors
  • Dolutegravir
  • Dolutegravir; Lamivudine
  • Dolutegravir; Rilpivirine
  • Drospirenone; Estradiol
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Dulaglutide
  • Edetate Calcium Disodium, Calcium EDTA
  • Edetate Disodium, Disodium EDTA
  • Elagolix; Estradiol; Norethindrone acetate
  • Eltrombopag
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Ertugliflozin
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Esterified Estrogens
  • Esterified Estrogens; Methyltestosterone
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Estradiol; Levonorgestrel
  • Estradiol; Norethindrone
  • Estradiol; Norgestimate
  • Estradiol; Progesterone
  • Estramustine
  • Estrogens
  • Estropipate
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Ethotoin
  • Exenatide
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Gallium
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Ibritumomab Tiuxetan
  • Incretin Mimetics
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Levofloxacin
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Linagliptin
  • Linagliptin; Metformin
  • Liothyronine
  • Liraglutide
  • Lixisenatide
  • Meglitinides
  • Mestranol; Norethindrone
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methyclothiazide
  • Metolazone
  • Miglitol
  • Moxifloxacin
  • Nateglinide
  • Neuromuscular blockers
  • Norfloxacin
  • Ofloxacin
  • Omeprazole; Sodium Bicarbonate
  • Phosphorated Carbohydrate Solution
  • Phosphorus
  • Potassium Phosphate
  • Potassium Phosphate; Sodium Phosphate
  • Pramlintide
  • Repaglinide
  • Saxagliptin
  • Segesterone Acetate; Ethinyl Estradiol
  • Semaglutide
  • SGLT2 Inhibitors
  • Simvastatin; Sitagliptin
  • Sitagliptin
  • Sodium Bicarbonate
  • Sodium Fluoride
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Sulfonylureas
  • Tetracyclines
  • Thiazide diuretics
  • Thiazolidinediones
  • Thyroid hormones
  • Tolazamide
  • Tolbutamide
  • Trientine
  • Vitamin A
  • Vitamin D analogs

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