Chromium and PCOS

Chromium is an essential trace mineral that is needed for insulin activity in carbohydrate, fat and protein metabolism. Optimal levels may reduce insulin resistance, improve blood sugar control, and may help to reduce the risk of cardiovascular disease and type 2 diabetes. Supplementation may also help to reduce triglycerides and total cholesterol while improving HDL "good" cholesterol.

A chromium insufficiency may result in insulin resistance. Animal experiments have shown that a chromium deficiency results in insulin resistance, and that its supplementation reduces their insulin resistance.

In humans, there also seems to be an association between insulin resistance and chromium status. Evidence also suggests that individuals consuming diets with the lowest amounts of chromium tend to have disruptions in glucose and insulin regulation.

Dietary Sources of Chromium

Brewer's yeast is the richest source of chromium. (However, nutritional yeast and torula yeast don't contain significant amounts). It can also be found in liver, mushrooms, wheat germ, oyster, some cheeses, whole wheat bread, beets, fresh fruit and chicken breasts.

Chromium is notably low or absent is highly refined carbohydrates and processed foods.

Do We Get Enough Chromium in Our Diet?

Most people eat less than the U.S. National Academy of Science’s recommended range of 50-200 mcg per day. The majority of Americans get less than 50 mcg per day. The frequency of actual chromium deficiency in the general population is unknown and difficult to assess. Blood chromium levels are not in equilibrium with chromium stores and therefore do not provide a good indicator of chromium status.

Are You Losing Chromium?

A compromised ability to retain chromium by individuals with type 2 diabetes might contribute to the insulin resistance found in this population. Compared with healthy controls, researchers have found 33% lower plasma levels of chromium and 100% higher urine values, suggesting a disruption in the ability to sustain appropriate chromium status. The researchers discovered that a reduction in plasma chromium levels and an increase in urinary elimination of chromium followed an infusion of glucose and the resultant insulin surge in healthy individuals. Based on their experiments, it appeared the elevated insulin levels were adversely impacting chromium status.

Since PCOS has metabolic attributes similar to diabetes, it's possible that PCOS women lose more chromium than healthy women as a result of excessive insulin levels and eating foods with a high glycemic index.

Does Chromium Supplementation Help PCOS and Insulin Resistance?

A small study of six women with PCOS and insulin resistance showed encouraging results with chromium supplementation. These women took 1000 mcg of chromium picolinate for two months, at which time their glucose disposal (insulin sensitivity) had improved by an average of 35%, and their baseline insulin levels fell by 22%. This is the only study we've found that deals specifically with PCOS.

Other studies suggest that daily chromium supplementation (400-1000 mcg per day) may favorably affect insulin and glucose levels not only in diabetics, but also in obese, insulin-resistant people.

In one study of 29 obese individuals with a high risk of developing type 2 diabetes, either a placebo or chromium picolinate (1,000 mcg per day) was given for eight months to evaluate glucose effectiveness and insulin sensitivity. Improvements were seen in the patients receiving chromium therapy vs. those receiving placebo without any significant changes in body fat distribution after 4 months and 8 months, suggesting that chromium picolinate can alter insulin sensitivity independent of a change in weight or body fat percentage.

Studies have not consistently found benefit for weight loss, but overall, research suggests chromium picolinate might produce modest weight loss, about a 1.1 kg greater weight loss than placebo over 90 days.

There is speculation that chromium supplementation is most helpful for individuals with low chromium levels, but not as helpful if your chromium levels are optimal. Supplemental chromium only seems to have a blood glucose-lowering effect in 40% to 80% of people with elevated blood glucose.

Drug Interactions

Nonsteroidal, anti-inflammatory drugs (NSAIDs) might increase chromium levels by increasing chromium absorption and retention. Some of these drugs include ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene), aspirin, and others.

Antacids, H2 blockers, or proton pump inhibitors (PPIs) may decrease chromium levels by inhibiting absorption of chromium. Reducing stomach acid seems to decrease chromium absorption due to formation of less soluble chromium salts. The H2 blockers include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid). PPIs include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix, Pantoloc), and esomeprazole (Nexium).

Use of corticosteroids can increase urinary chromium excretion, which might lead to chromium deficiency and/or corticosteroid-induced hyperglycemia.

Safety and Toxicity

Chromium is safe in amounts found in foods or supplemental amounts not exceeding adequate intake (AI) levels. The AI for chromium depends on gender and age. For women aged 19 to 50 years, the AI is 25 mcg per day. For women aged 51 and older, the AI is 20 mcg.

Short-term amounts greater than adequate intake (AI) levels appear safe. Short-term, chromium picolinate has been safely used in doses up to 1000 mcg per day. However, there is insufficient information to establish the safe upper limit of intake. There is also some concern that long-term supplemental use may not be safe due to potential mutagenic effects.

During pregnancy, chromium is safe in amounts not exceeding adequate intake (AI) levels. The AI for pregnant women aged 19 to 50 years is 30 mcg per day. There is some evidence that pregnant women with gestational diabetes can safely use chromium in doses of 4-8 mcg per kilogram.

Chromium supplementation might exacerbate renal (kidney) insufficiency.

If you are taking insulin or an insulin sensitizer such as metformin, chromium supplementation could reduce your blood sugar below the desired level.

Consult with your doctor before taking chromium supplements if you plan to take long-term high doses, have kidney trouble, are pregnant, or take drugs related to diabetes or glucose/insulin control.

Different Forms of Chromium

There are a number of different forms of chromium supplements. Controversy exists as to which form of chromium is preferable.

  • Chromium polynicotinate appears to have a beneficial effect on glucose metabolism in people with type 2 diabetes.
  • Chromium picolinate is another generally recommended form of chromium, although there is some suggestion that high doses could be mildly mutagenic (cause changes in DNA).
  • Chromium chloride is another common form, but it appears to be less effective than the other forms.

Dosage

A typical recommended dose of chromium is 200 mcg per day.

However, if you are looking for a therapeutic effect, higher doses might be more effective and work more quickly. Studies show that taking 500 mcg twice daily significantly decreases HbA1c after 2 months of treatment. (HbA1c is a blood test that reveals the average blood sugar level for the past 3 months.) Taking 100 mcg twice daily can take up to 4 months to decrease HbA1c levels.

Higher doses of 200 mcg three times daily or 500 mcg twice daily also seem to reduce triglyceride and total serum cholesterol levels after 2 to 4 months of treatment. This suggests that chromium might be beneficial for people with metabolic syndrome (syndrome X). PCOS and metabolic syndrome have a lot in common.

Where Can You Get It?

250 mcg of chromium per capsule (combined with vitamin D and d-pinitol) is available from our online PCOS Supplements Store. This combination is designed to support ovarian health.

You can also get 200 mcg of chromium in this high quality multi-vitamin/mineral.

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