21666 Health Library | Health and Wellness | Wellmont Health System
  • Chromium

    Supplement Forms/Alternate Names:

    • Chromium Picolinate
    • Chromium Polynicotinate
    • Chromium Chloride
    • High-Chromium Brewer's Yeast

    Uses

    Principal Proposed Uses

    Chromium is a mineral the body needs in very small amounts, but it plays a significant role in human nutrition. Chromium's most important function in the body is to help regulate the amount of glucose (sugar) in the blood. Insulin plays a starring role in this fundamental biological process, by regulating the movement of glucose out of the blood and into cells. Scientists believe that insulin uses chromium as an assistant (technically, a cofactor ) to "unlock the door" to the cell membrane, thus allowing glucose to enter the cell. In the past, it was believed that to accomplish this the body first converted chromium into a large chemical called glucose tolerance factor (GTF). Intact GTF was thought to be present in certain foods, such as Brewer’s yeast, and for that reason such products were described as superior sources of chromium. However, subsequent investigation indicated that researchers were actually creating GTF inadvertently during the process of chemical analysis. Scientists now believe that there is no such thing as GTF. Rather, chromium appears to act in concert with a very small protein called low molecular weight chromium-binding substance (LMWCr) to assist insulin's action. LMWCr does not permanently bind chromium and is not a likely source of chromium in foods. 83-85
    Based on chromium's close relationship with insulin, this trace mineral has been studied as a treatment for diabetes. The results have been somewhat positive: it seems fairly likely that chromium supplements can improve blood sugar control in people with diabetes. Chromium also might be helpful for milder abnormalities in blood sugar metabolism. One study suggests that chromium might aid in weight loss, as well, but other studies failed to find this effect.

    Requirements/Sources

    Requirments

    The official US recommendations for daily intake are as follows:
      Infants
      • 0-6 months: 0.2 mcg
      • 7-12 months: 5.5 mcg
      Children
      • 1-3 years: 11 mcg
      • 4-8 years: 15 mcg
      Males
      • 9-13 years: 25 mcg
      • 14-50 years: 35 mcg
      • 50 years and older: 30 mcg
      Females
      • 9-13 years: 21 mcg
      • 14-18 years: 24 mcg
      • 19-50 years: 25 mcg
      • 50 years and older: 20 mcg
      Pregnant Women
      • 18 years or younger: 29 mcg
      • 19 years and older: 30 mcg
      Nursing Women
      • 18 years or younger: 44 mcg
      • 19 years and older: 45 mcg

    Food Sources

    The National Institutes of Health's Office of Dietary Supplements offers this list of food sources for chromium:110
    Food Serving size Chromium content
    (microgram [mcg])
    Broccoli ½ cup 11
    Grape juice 1 cup 8
    English muffin, whole wheat 1 4
    Potatoes, mashed 1 cup 3
    Garlic, dried 1 teaspoon 3
    Basil, dried 1 tablespoon 2
    Beef cubes 3 ounces 2
    Orange juice 1 cup 2
    Turkey breast 3 ounces 2
    Whole wheat bread 2 slices 2
    Red wine 5 ounces 1-13
    Apple 1 medium 1
    Banana 1 medium 1
    Green beans ½ cup 1
    Chromium is also found in drinking water, especially hard water, but concentrations vary widely. Many good sources of chromium, such as whole wheat, are depleted of this important mineral during processing. The most concentrated sources of chromium are brewer's yeast and calf liver. Two ounces of brewer's yeast or 4 ounces of calf liver supply between 50 mcg and 60 mcg of chromium.

    Chromium Deficiency

    Some evidence suggests that chromium deficiency may be relatively common. 1,86 However, this has not been proven, and the matter is greatly complicated by the fact that we lack a good test to identify chromium deficiency. 2
    Severe chromium deficiency has only been seen in hospitalized individuals receiving nutrition intravenously. Symptoms include problems with blood sugar control that cannot be corrected by insulin alone.
    Corticosteroid treatment may cause increased chromium loss in the urine. 3 It is possible that this loss of chromium may contribute to corticosteroid-induced diabetes.

    Chromium Absorption

    Calcium carbonate interferes with the absorption of chromium. 4

    Therapeutic Dosages

    The dosage of chromium used in studies ranges from 200 mcg to 1,000 mcg daily, mostly in the form of chromium picolinate. However, there may be potential risks in the higher dosages of chromium (see Safety Issues ).
    Note: These and all other dosages of chromium regard the amount of the actual chromium ion in the supplement (“elemental chromium”), discounting the weight of the substances, such as picolinate, attached to it.
    Some products state that they contain “GTF chromium.” Some of these products are manufactured from brewer’s yeast, which was once thought to contain GTF. Others contain chromium as chromium nicotinate, which bears a faint resemblance to the proposed GTF molecule. However, since GTF is no longer believed to exist, this claim should be disregarded.

    Therapeutic Uses

    Chromium has principally been studied for its possible benefits in improving blood sugar control in people with diabetes . Several, but not all, studies suggest that people with adult-onset (type 2) diabetes may show some improvement when given appropriate dosages of chromium. 5,43,44,45,47-48,102 One study suggests that chromium may also be useful for diabetes that occurs during pregnancy . 6 In addition, nondiabetic individuals with mildly impaired blood sugar control might attain better control of blood sugar with chromium supplementation. 7-10 Since mild impairment of blood sugar control is believed to increase risk of heart disease, chromium supplementation might help reduce heart disease rates.
    Chromium has been sold as a "fat burner" and is also said to help build muscle tissue. However, most studies evaluating chromium's ability to promote weight loss have not found benefits. 11-21,104 One study failed to find benefit with a combination of chromium and conjugated linoleic acid . 107
    Studies evaluating chromium as a performance enhancer or aid to bodybuilding have yielded almost entirely negative results. 23-31,87
    Studies on whether chromium can improve cholesterol levels have returned mixed results. 32-40 However, one study suggests that chromium combined with grape seed extract might have a beneficial effect. 41  In addition, among individuals taking beta-blockers, chromium may raise levels of HDL ("good") cholesterol. 42
    When depression is characterized by rapid mood changes, excessive sleeping and eating, a sense of leaden paralysis, and extreme sensitivity to negative life events, the condition is called “atypical depression.” A very small (15 participants) double-blind, placebo-controlled study found that chromium picolinate might be helpful for this form of depression ; 46 however, a much larger study failed to find statistically significant benefits. 97
    According to some researchers, impaired blood sugar control, high cholesterol, weight gain, and high blood pressure are all part of a bigger picture, called metabolic syndrome , or syndrome X. Since chromium may be helpful for the first three of these conditions, chromium deficiency has been proposed as the cause of syndrome X. However, this has not been proven.
    One study failed to find that chromium picolinate at 200 mcg/day can improve symptoms of polycystic ovaries (a common cause of infertility ). 98
    Chromium has also been proposed as a treatment for acne , migraine headaches , and psoriasis , but there is as yet no real evidence that it works.

    What Is the Scientific Evidence for Chromium?

    Diabetes

    The evidence regarding use of chromium for type 2 (adult onset) diabetes , as well as other forms of diabetes, remains incomplete and inconsistent.
    In a double-blind, placebo-controlled study , 180 people with type 2 diabetes were given placebo, 200 mcg of chromium picolinate, or 1,000 mcg chromium picolinate daily. 43 The results showed that HbA1c values (a measure of long-term blood sugar control) improved significantly after 2 months in the group receiving 1,000 mcg and in both chromium groups after 4 months. Fasting glucose (a measure of short-term blood sugar control) was also lower in the group taking the higher dose of chromium.
    A double-blind trial of 78 individuals with type 2 diabetes compared two forms of chromium (brewer's yeast and chromium chloride) against placebo. 44 This rather complex crossover study consisted of four 8-week intervals of treatment in random order. The results in the 67 participants who completed the study showed that both forms of chromium significantly improved blood sugar control.
    Positive results were also seen in three other double-blind, placebo-controlled studies enrolling a total of more than 130 people with type 2 diabetes. 45,95,101-102 However, several other studies have failed to find benefit for people with type 2 diabetes. 47-48,99,105 These contradictory findings suggest that the benefit, if it really exists, is small at best.
    A combination of chromium and biotin might be more effective. Following positive results in a small pilot trial, 103 researchers conducted a double-blind study of 447 people with poorly controlled type 2 diabetes. 106 Half the participants were given placebo and the rest were given a combination of 600 mcg chromium (as chromium picolinate) along with 2 mg of biotin daily. All participants continued to receive standard oral medications for diabetes. Over the 90 day study period, participants given the chromium/biotin combination showed significantly better glucose regulation than those given placebo. The relative benefit was clear in levels of fasting glucose as well as in HgA1c.
    One placebo-controlled study of 30 women with pregnancy -related diabetes found that supplementation with chromium (at a dosage of 4 mcg or 8 mcg chromium picolinate for each kilogram of body weight) significantly improved blood sugar control. 49
    Chromium has shown a bit of promise for treating diabetes caused by corticosteroid treatment. 50,51

    Improved Blood Sugar Control in People Without Diabetes

    Many people develop impaired responsiveness to insulin (insulin resistance) and mildly abnormal blood sugar levels. A few small, double-blind trials have found that chromium supplementation may be helpful, 52-55 although two studies found no benefit. 56,100 Another small double-blind trial found that chromium improved the body's response to insulin among overweight people at risk of developing diabetes. 57 There is growing evidence that mildly impaired blood sugar control increases the risk of heart disease, suggesting that chromium supplementation might be useful. (See the section below on Heart Disease Prevention .)

    Weight Loss ("Fat Burning")

    The evidence is mixed on whether chromium is an effective aid for reducing weight or improving body composition (improving the ratio of fatty tissue to lean tissue).
    In one study, 219 people were given either placebo or 200 mcg or 400 mcg of chromium picolinate daily. 58 Participants were not advised to follow any particular diet. Over a period of 72 days, people taking chromium experienced significantly greater weight loss than those not taking chromium, more than 2-½ pounds versus about ¼ pound. Interestingly, people taking chromium actually gained lean body mass, so the loss of fatty tissue was even more dramatic: more than 4 pounds versus less than ½ pound. However, a very high dropout rate makes the results of this study somewhat unreliable.
    However, in another double-blind study by the same researcher, 130 moderately overweight people attempting to lose weight were given either placebo or 400 mcg of chromium daily. 59 At the end of the trial, no statistically significant differences in weight or body composition were seen between groups. Researchers were able to show benefit only by resorting to fairly complicated statistical maneuvers.
    In a third study, 44 overweight women were given either placebo or 400 mcg of chromium per day. 60 All participants were placed on an exercise program. Over a period of 12 weeks, no differences were seen between the two groups in terms of body weight, waist circumference, or percentage body fat. A small double-blind trial of older women undergoing resistance training also failed to find evidence of benefit. 92 Generally negative results have been seen in other small double-blind trials as well. 61-66, 104,109
    When larger studies find positive results and smaller studies do not, it often indicates that the treatment under study is only weakly effective. This may be the case with chromium as a weight-loss treatment. 93 If chromium is effective for weight loss, one small study suggests it may work by influencing the brain and its role in appetite and food cravings. 108

    Heart Disease Prevention

    Insulin resistance, as well as mildly elevated blood sugar levels, appears to increase risk of heart disease . 67-74 Chromium supplementation might help by improving insulin responsiveness and normalizing blood sugar.
    In support of this, an observational trial found associations between higher chromium intake and reduced risk of heart attack. 75

    Safety Issues

    Although the precise upper limit of safe chromium intake is not known, it is believed that chromium is safe when taken at a dosage of 50 mcg to 200 mcg daily. 88 Side effects appear to be rare.
    However, chromium is a heavy metal and might conceivably build up and cause problems if taken to excess. There is one report of kidney, liver, and bone marrow damage in a person who took 1,200 mcg to 2,400 mcg of chromium for several months; in another report, as little as 600 mcg for 6 weeks was enough to cause damage. 77,78 Such problems appear to be quite rare, and it is possible that these individuals already had health problems that predisposed them to such a reaction. The risk of chromium toxicity is believed to be higher in individuals who already have liver or kidney disease. 88
    Nonetheless, based on these reports, it’s possible that the dosage of chromium found most effective for individuals with type 2 diabetes—1,000 mcg daily—might present some health risks. For example, there is some evidence that if chromium is taken in high enough amounts, it may be converted from its original safe form (chromium 3) into a known carcinogen, chromium 6. 96 We advise seeking medical supervision before taking more than 200 mcg of chromium daily.
    Also, keep in mind that if you have diabetes and chromium is effective, you may need to cut down your dosage of any medication you take for diabetes. 79 Medical supervision is advised.
    There are also several concerns about the picolinate form of chromium in particular. Picolinate can alter levels of neurotransmitters. 89 This has led to concern among some experts that chromium picolinate might be harmful for individuals with depression , bipolar disease , or schizophrenia . 81 There has also been one report of a severe skin reaction caused by chromium picolinate. 80
    Finally, there are also concerns, still fairly theoretical and uncertain, that chromium picolinate could cause adverse effects on DNA. 82,90,91,94
    The maximum safe dosage of chromium for women who are pregnant or nursing and for individuals with severe liver or kidney disease has not been established.

    Interactions You Should Know About

    If you are taking
      You may need extra chromium if you are taking:
      • Calcium carbonate supplements
      • Antacids
      • You should also separate your chromium supplement and your doses of these substances by at least 2 hours, because they may interfere with chromium's absorption
      You may need extra chromium if you are taking: Seek medical supervision before taking chromium because you may need to reduce your dose of these medications: Chromium supplementation may improve levels of HDL ("good") cholesterol if you are taking:

    References

    1 Mertz W. Chromium in human nutrition: a review. J Nutr. 1993;123:626-633.

    2 Mertz W. Chromium in human nutrition: a review. J Nutr. 1993;123:626-633.

    3 Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced diabetes mellitis with supplemental chromium. Diabet Med. 1999;16:164-167.

    4 Seaborn CD, Stoecker BJ. Effects of antacid or ascorbic acid on tissue accumulation and urinary excretion of 51-chromium. Nutr Res. 1990;10:1401-1407.

    5 Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes. 1997;46:1786-1791.

    6 Jovanovic L, Gutierrez M, Peterson CM. Chromium supplementation for women with gestational diabetes mellitus. J Trace Elem Med Biol. 1999;12:91-97.

    7 Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin and lipid variables. Metabolism. 1983;32:894-899.

    8 Anderson RA, Polansky MM, Bryden NA, et al. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr. 1991;54:909-916.

    9 Wilson BE, Gondy A. Effects of chromium supplementation on fasting insulin levels and lipid parameters in healthy, non-obese young subjects. Diabetes Res Clin Pract. 1995;28:179-184.

    10 Bahijri SM. Effect of chromium supplementation on glucose tolerance and lipid profile. Saudi Med J. 2000;21:45-50.

    11 Kaats GR, Blum K, Pullin D, et al. A randomized, double-masked, placebo-controlled study of the effects of chromium picolinate supplementation on body composition: a replication and extension of a previous study. Curr Ther Res. 1998;59:379-388.

    12 Grant KE, Chandler RM, Castle AL, et al. Chromium and exercise training: effect on obese women. Med Sci Sports Exerc. 1997;29:992-998.

    13 Trent LK, Thieding-Cancel D. Effects of chromium picolinate on body composition. J Sports Med Phys Fitness. 1995;35:273-280.

    14 Bahadori B, Wallner S, Schneider H, et al. Effect of chromium yeast and chromium picolinate on body composition of obese, non-diabetic patients during and after a formula diet [in German; English abstract]. Acta Med Austriaca. 1997;24:185-187.

    15 Clarkson PM. Effects of exercise on chromium levels. Is supplementation required? Sports Med. 1997;23:341-349.

    16 Clancy SP, Clarkson PM, DeCheke ME, et al. Effects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players. Int J Sport Nutr. 1994;4:142-153.

    17 Amato P, Morales AJ, Yen SS. Effects of chromium picolinate supplementation on insulin sensitivity, serum lipids, and body composition in healthy, nonobese, older men and women. J Gerontol A Biol Sci Med Sci. 2000;55:M260-M263.

    18 Lukaski HC, Bolonchuk WW, Siders WA, et al. Chromium supplementation and resistance training: effects on body composition, strength, and trace element status of men. Am J Clin Nutr. 1996;63:954-964.

    19 Hallmark MA, Reynolds TH, DeSouza CA, et al. Effects of chromium and resistive training on muscle strength and body composition. Med Sci Sports Exerc. 1996;28:139-144.

    20 Kaats GR, Blum K, Fisher JA, et al. Effects of chromium picolinate supplementation on body composition: a randomized, double-masked, placebo-controlled study. Curr Ther Res. 1996;57:747-765.

    21 Volpe SL, Huang HW, Larpadisorn K, et al. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. J Am Coll Nutr. 2001;20:293-306.

    22 Guallar E, Jimenez J, van t' Veer P, et al. The association of chromium with the risk of a first myocardial infaction in men. The EURAMIC Study [abstract]. Circulation. 2001;103:1366.

    23 Clarkson PM. Effects of exercise on chromium levels. Is supplementation required? Sports Med. 1997;23:341-349.

    24 Joseph LJO, Farrell PA, Davey SL, et al. Effect of resistance training with or without chromium picolinate supplementation on glucose metabolism in older men and women. Metabolism. 1999;48:546-553.

    25 Lefavi RG, Anderson RA, Keith RE, et al. Efficacy of chromium supplementation in athletes: emphasis on anabolism. Int J Sport Nutr. 1992;2:111-122.

    26 Clancy SP, Clarkson PM, DeCheke ME, et al. Effects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players. Int J Sport Nutr. 1994;4:142-153.

    27 Hallmark MA, Reynolds TH, DeSouza CA, et al. Effects of chromium and resistive training on muscle strength and body composition. Med Sci Sports Exerc. 1996;28:139-144.

    28 Campbell WW, Joseph LJ, Davey SL, et al. Effects of resistance training and chromium picolinate on body composition and skeletal muscle in older men. J Appl Physiol. 1999;86:29-39.

    29 Walker LS, Bemben MG, Bemben DA, et al. Chromium picolinate effects on body composition and muscular performance in wrestlers. Med Sci Sports Exer. 1998;30:1730-1737.

    30 Lukaski HC, Bolonchuk WW, Siders WA, et al. Chromium supplementation and resistance training: effects on body composition, strength and trace element status of men. Am J Clin Nutr. 1996;63:954-965.

    31 Davis JM, Welsh RS, Alerson NA. Effects of carbohydrate and chromium ingestion during intermittent high-intensity exercise to fatigue. Int J Sport Nutr Exerc Metab. 2000;10:476-485.

    32 Mertz W. Chromium in human nutrition: a review. J Nutr. 1993;123:626-633.

    33 Press RI, Geller J, Evans GW. The effect of chromium picolinate on serum cholesterol and apolipoprotein fractions in human subjects. West J Med. 1990;152:41-45.

    34 Abraham AS, Brooks BA, Eylath U. The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes. Metabolism. 1992;41:768-771.

    35 Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care. 1994;17:1449-1452.

    36 Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes. 1997;46:1786-1791.

    37 Roeback JR Jr, Hla KM, Chambless LE, et al. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med. 1991;115:917-924.

    38 Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin, and lipid variables. Metabolism. 1983;32:894-899.

    39 Offenbacher EG, Rinko CJ, Pi-Sunyer FX. The effects of inorganic chromium and brewer's yeast on glucose tolerance, plasma lipids, and plasma chromium in elderly subjects. Am J Clin Nutr. 1985;42:454-461.

    40 Preuss HG, Wallerstedt D, Talpur N, et al. Effects of niacin-bound chromium and grape seed proanthocyanidin extract on the lipid profile of hypercholesterolemic subjects: a pilot study. J Med. 2000;31:227-246.

    41 Preuss HG, Wallerstedt D, Talpur N, et al. Effects of niacin-bound chromium and grape seed proanthocyanidin extract on the lipid profile of hypercholesterolemic subjects: a pilot study. J Med. 2000;31:227-246.

    42 Roeback JR, Hla KM, Chambless LE, et al. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med. 1991;115:917-924.

    43 Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes. 1997;46:1786-1791.

    44 Bahijiri SM, Mira SA, Mufti AM, et al. The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Saudi Med J. 2000;21:831-837.

    45 Ghosh D, Bhattacharya B, Mukherjee B, et al. Role of chromium supplementation in Indians with type 2 diabetes mellitus. J Nutr Biochem. 2002;13:690-697.

    46 Davidson JR, Abraham K, Connor KM, et al. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biol Psychiatry. 2003;53:261-264.

    47 Rabinowitz MB, Gonick HC, Levin SR, et al. Effects of chromium and yeast supplements on carbohydrate and lipid metabolism in diabetic men. Diabetes Care. 1983;6:319-327.

    48 Trow LG, Lewis J, Greenwood RH, et al. Lack of effect of dietary chromium supplementation on glucose tolerance, plasma insulin and lipoprotein levels in patients with type 2 diabetes. Int J Vitam Nutr Res. 2000;70:14-18.

    49 Jovanovic L, Gutierrez M, Peterson CM. Chromium supplementation for women with gestational diabetes mellitus. J Trace Elem Med Biol. 1999;12:91-97.

    50 Ravina A, Slezak L, Mirsky N, et al. Control of steroid-induced diabetes with supplemental chromium. J Trace Elem Exp Med. 1999;12:375-378.

    51 Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced diabetes mellitis with supplemental chromium. Diabet Med. 1999;16:164-167.

    52 Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin and lipid variables. Metabolism. 1983;32:894-899.

    53 Wilson BE, Gondy A. Effects of chromium supplementation on fasting insulin levels and lipid parameters in healthy, non-obese young subjects. Diabetes Res Clin Pract. 1995;28:179-184.

    54 Anderson RA, Polansky MM, Bryden NA, et al. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr. 1991;54:909-916.

    55 Bahijri SM. Effect of chromium supplementation on glucose tolerance and lipid profile. Saudi Med J. 2000;21:45-50.

    56 Uusitupa MI, Mykkanen L, Siitonen O, et al. Chromium supplementation in impaired glucose tolerance of elderly: effects on blood glucose, plasma insulin, C-peptide and lipid levels. Br J Nutr. 1992;68:209-216.

    57 Cefalu WT, Bell-Farrow AD, Stegner J, et al. Effect of chromium picolinate on insulin sensitivity in vivo. J Trace Elem Exp Med. 1999;12:71-83.

    58 Kaats GR, Blum K, Fisher JA, et al. Effects of chromium picolinate supplementation on body composition: a randomized, double-masked, placebo-controlled study. Curr Ther Res. 1996;57:747-765.

    59 Kaats GR, Blum K, Pullin D, et al. A randomized, double-masked, placebo-controlled study of the effects of chromium picolinate supplementation on body composition: a replication and extension of a previous study. Curr Ther Res. 1998;59:379-388.

    60 Volpe SL, Huang HW, Larpadisorn K, et al. Effect of chromium supplementation and exercise on body composition, resting metabolic rate and selected biochemical parameters in moderately obese women following an exercise program. J Am Coll Nutr. 2001;20:293-306.

    61 Grant KE, Chandler RM, Castle AL, et al. Chromium and exercise training: Effect on obese women. Med Sci Sports Exerc. 1997;29:992-998.

    62 Trent LK, Thieding-Cancel D. Effects of chromium picolinate on body composition. J Sports Med Phys Fitness. 1995;35:273-280.

    63 Clancy SP, Clarkson PM, DeCheke ME, et al. Effects of chromium picolinate supplementation on body composition, strength, and urinary chromium loss in football players. Int J Sport Nutr. 1994;4:142-153.

    64 Amato P, Morales AJ, Yen SS. Effects of chromium picolinate supplementation on insulin sensitivity, serum lipids, and body composition in healthy, nonobese, older men and women. J Gerontol A Biol Sci Med Sci. 2000;55:M260-M263.

    65 Lukaski HC, Bolonchuk WW, Siders WA, et al. Chromium supplementation and resistance training: effects on body composition, strength, and trace element status of men. Am J Clin Nutr. 1996;63:954-964.

    66 Hallmark MA, Reynolds TH, DeSouza CA, et al. Effects of chromium and resistive training on muscle strength and body composition. Med Sci Sports Exerc. 1996;28:139-144.

    67 Laws A, King AC, Haskell WL, et al. Relation of fasting plasma insulin concentration to high density lipoprotein cholesterol and triglyceride concentrations in men. Arterioscler Thromb. 1991;11:1636-1642.

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    73 Saydah SH, Loria CM, Eberhardt MS, et al. Subclinical states of glucose intolerance and risk of death in the US. Diabetes Care. 2001;24:447-453.

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    75 Guallar E, Jimenez J, van t' Veer P, et al. The association of chromium with the risk of a first myocardial infaction in men. The EURAMIC Study [abstract]. Circulation. 2001;103:1366.

    76 Anderson RA, Bryden NA, Polansky MM. Lack of toxicity of chromium chloride and chromium picolinate in rats. J Am Coll Nutr. 1997;16:273-279.

    77 Cerulli J, Grabe DW, Gauthier I, et al. Chromium picolinate toxicity. Ann Pharmacother. 1998;32:428-431.

    78 Wasser WG, Feldman NS, D'Agati VD. Chronic renal failure after ingestion of over-the-counter chromium picolinate [letter]. Ann Intern Med. 1997;126:410.

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    80 Young PC, Turiansky GW, Bonner MW, et al. Acute generalized exanthematous pustulosis induced by chromium picolinate. J Am Acad Dermatol. 1999;41(5 Pt 2):820-823.

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    82 Speetjens JK, Collins RA, Vincent JB, et al. The nutritional supplement chromium(III) tris(picolinate) cleaves DNA. Chem Res Toxicol. 1999;12:483-487.

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    87 Livolsi JM, Adams GM, Laguna PL. The effect of chromium picolinate on muscular strength and body composition in women athletes. J Strength Cond Res. 2001;15:161-166.

    88Institute of Medicine. Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. National Academy of Sciences; Washington DC; 2001.

    89 Attenburrow MJ, Odontiadis J, Murray BJ, et al. Chromium treatment decreases the sensitivity of 5-HT(2A) receptors. Psychopharmacology. 2002;159:432-436.

    90 Stearns DM, Silveira SM, Wolf KK, Luke AM. Chromium(III) tris(picolinate) is mutagenic at the hypoxanthine (guanine) phosphoribosyltransferase locus in Chinese hamster ovary cells. Mutat Res. 2002;513:135-142.

    91 Hepburn DD, Vincent JB. In vivo distribution of chromium from chromium picolinate in rats and implications for the safety of the dietary supplement. Chem Res Toxicol. 2002;15:93-100.

    92 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;12:125-135.

    93 Pittler MH, Stevinson C, Ernst E. Chromium picolinate for reducing body weight: meta-analysis of randomized trials. Int J Obes Relat Metab Disord. 2003;27:522-529.

    94 Hepburn DD, Xiao J, Bindom S, et al. Nutritional supplement chromium picolinate causes sterility and lethal mutations in Drosophilamelanogaster. Proc Natl Acad Sci. 2003.

    95Houweling ST, Kleefstra N, Jansman GA, et al. Effects of chromium treatment in patients with poorly controlled, insulin-treated type 2 diabetes mellitus [abstract]. 18th International Diabetes Federation Congress; August 24-29, 2003; Paris, France.

    96 Mulyani I, Levina A, Lay PA. Biomimetic oxidation of chromium(III): Does the antidiabetic activity of chromium(iii) involve carcinogenic chromium(vi)? Angew Chem Int Ed Engl. 2004;43:4504-4507.

    97 Docherty JP, Sack DA, Roffman M, et al. A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving. J Psychiatr Pract. 2005;11:302-14.

    98 Lucidi RS, Thyer AC, Easton CA, et al. Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome. Fertil Steril. 2005;84:1755-1757.

    99 Kleefstra N, Houweling ST, Jansman FG, et al. Chromium treatment has no effect in patients with poorly controlled, insulin-treated type 2 diabetes in an obese western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care. 2006;29:521-525.

    100 Gunton JE, Cheung NW, Hitchman R, et al. Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance. Diabetes Care. 2005;28:712-713.

    101 Pei D, Hsieh CH, Hung YJ, et al. The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Metabolism. 2006;55:923-927.

    102 Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care. 2006;29:1826-32.

    103 Singer GM, Geohas J. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Diabetes Technol Ther. 2006;8:636-643.

    104 Lukaski HC, Siders WA, Penland JG. Chromium picolinate supplementation in women: effects on body weight, composition, and iron status. Nutrition. 2007 Feb 7. [Epub ahead of print]

    105 Kleefstra N, Houweling ST, Bakker SJ, et al. Chromium treatment has no effect in patients with type 2 diabetes mellitus in a western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care. 2007 Feb 15. [Epub ahead of print].

    106 Albarracin CA, Fuqua BC, Evans JL, et al. Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Diabetes Metab Res Rev. 2007 May 16. [Epub ahead of print]

    107 Diaz ML, Watkins BA, Li Y, et al. Chromium picolinate and conjugated linoleic acid do not synergistically influence diet- and exercise-induced changes in body composition and health indexes in overweight women. J Nutr Biochem. 2007 May 23. [Epub ahead of print]

    108 Anton SD, Morrison CD, Cefalu WT, et al. Effects of chromium picolinate on food intake and satiety. Diabetes Technol Ther. 2008;10:405-412.

    109 Yazaki Y, Faridi Z, Ma Y, et al. A pilot study of chromium picolinate for weight loss. J Altern Complement Med . 2010 Mar;16(3):291.

    110Dietary supplement fact sheet: chromium. Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/. Accessed September 7, 2012.

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