Chromium And Blood Sugar

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Chromium has garnered a lot of interest, in recent times, with people with diabetes type 2 as it has been reported that chromium picolinate has been found to lower blood glucose levels. Chromium is an essential mineral that helps insulin regulate blood sugar level in our body. I have long recommended taking chromium for blood sugar, since keeping your blood glucose levels in the normal range is extremely important for your heart and overall health. But recently I’ve been intently following the emerging research on a special form of chromium called Crominex ® 3+ that goes beyond blood sugar support.

Generic Name: chromium picolinate (KROME ee um pi KOE li nate)
Brand Name:Cr-GTF, CRM, Chromium GTF
Dosage Forms: oral capsule (200 mcg); oral tablet (200 mcg; 500 mcg; 800 mcg)

What is chromium picolinate?

Chromium is a mineral found in certain foods. The body needs only trace amounts of chromium, and deficiency of this mineral in humans is rare.

Chromium picolinate works together with insulin produced by the pancreas to metabolize carbohydrates.

Chromium picolinate has been used in alternative medicine to treat chromium deficiency, as an aid to controlling blood sugar in people with diabetes or prediabetes, to lower cholesterol, and as a weight-loss supplement.

Not all uses for chromium picolinate have been approved by the FDA. Chromium picolinate should not be used in place of medication prescribed for you by your doctor.

Chromium picolinate is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Chromium picolinate may also be used for purposes not listed in this product guide.

Warnings

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Chromium

Before taking this medicine

Before using chromium picolinate, talk to your healthcare provider. You may not be able to use chromium picolinate if you have certain medical conditions.

  • liver disease;

  • kidney disease;

  • diabetes (especially if you use insulin);

  • an allergy to leather products;

  • mental illness;

  • a thyroid disorder; or

  • if you use steroid medicine (fluticasone, beclomethasone, prednisone, and others).

It is not known whether chromium picolinate will harm an unborn baby. Do not use this product without medical advice if you are pregnant.

Chromium picolinate may pass into breast milk and may harm a nursing baby. Do not use this product without medical advice if you are breast-feeding a baby.

Do not give any herbal/health supplement to a child without medical advice.

How should I take chromium picolinate?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use chromium picolinate, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Check your blood sugar carefully if you are diabetic.

The recommended dietary allowance of chromium picolinate increases with age. Follow your healthcare provider's instructions. You may also consult the National Academy of Sciences 'Dietary Reference Intake' or the U.S. Department of Agriculture's 'Dietary Reference Intake' (formerly 'Recommended Daily Allowances' or RDA) listings for more information.

Chromium And Blood Sugar Control

Chromium picolinate may be only part of a treatment program that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very carefully.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include vomiting, diarrhea, blood in your urine or stools, or coughing up blood.

What should I avoid while taking chromium picolinate?

Blood

Avoid a diet that is high in sugar. It may interfere with the effectiveness of chromium picolinate.

Ask your doctor before using an antacid, and use only the type your doctor recommends. Some antacids can make it harder for your body to absorb chromium picolinate.

Chromium picolinate side effects

Get emergency medical help if you have signs of an allergic reaction:hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using chromium picolinate and call your doctor at once if you have:

  • thinking problems, trouble concentrating;

  • problems with balance or coordination; or

  • liver problems--nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • headache;

  • sleep problems (insomnia); or

  • mood changes, feeling irritable.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Chromium picolinate side effects(more detail)

What other drugs will affect chromium picolinate?

Other drugs may interact with chromium picolinate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Chromium picolinate drug interactions(more detail)

More about chromium picolinate

Consumer resources

Other brands
Cr-GTF, CRM

Chromium And Blood Sugar

Professional resources

Related treatment guides

Further information

  • Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Sugar

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2021 Cerner Multum, Inc. Version: 2.02.

Chromium And Blood Sugar

Chromium is claimed to be an essential element involved in the regulation of blood glucose levels within the body.[1] More recent reviews have questioned this however.[2]

It is believed to interact with the low-molecular weight chromium (LMWCr) binding substance to amplify the action of insulin. Today, the use of chromium as a dietary supplement for the treatment of diabetes mellitus type 2 is still controversial. This is because most of the clinical studies that have been conducted around chromium have been administered only for short periods of time on small sample populations, and have in turn yielded variable findings. To better understand the potential role chromium may play in the treatment of type II diabetes, long-term trials need to be conducted for the future.[3]

History[edit]

The notion of chromium as a potential regulator of glucose metabolism began in the 1950s when Walter Mertz and his co-workers performed a series of experiments controlling the diet of rats. The experimenters subjected the rats to a chromium deficient diet, and witnessed an inability of the organisms to respond effectively to increased levels of glucose within the blood. They then included 'acid-hydrolyzedporcinekidney and Brewer's yeast' in the diet of these rats, and found that the rats were now able to effectively metabolize glucose. Both the porcine kidney and Brewer's yeast were rich in chromium, and so it was from these findings that began the study of chromium as a regulator of blood glucose.[4]

The idea of chromium being used for the treatment of type II diabetes was first sparked in the 1970s. A patient receiving total parenteral nutrition (TPN) had developed 'severe signs of diabetes', and was administered chromium supplements based on previous studies that proved the effectiveness of this metal in modulating blood glucose levels. The patient was administered chromium for a total of two weeks, and by the end of this time-period, their ability to metabolize glucose had increased significantly; they also now required less insulin ('exogenous insulin requirements decreased from 45 units/day to none'). It was these experiments that were performed in the 1950s and 1970s that paved the foundation for future studies on chromium and diabetes.[3]

In 2005, the U.S. Food and Drug Administration approved a Qualified Health Claim for chromium picolinate with a requirement for very specific label wording: 'One small study suggests that chromium picolinate may reduce the risk of insulin resistance, and therefore possibly may reduce the risk of type 2 diabetes. FDA concludes, however, that the existence of such a relationship between chromium picolinate and either insulin resistance or type 2 diabetes is highly uncertain.'[5] In 2010, chromium(III) picolinate was approved by Health Canada to be used in dietary supplements. Approved labeling statements included: '...provides support for healthy glucose metabolism.'[6] The European Food Safety Authority (EFSA) approved claims in 2010 that chromium contributed to normal macronutrient metabolism and maintenance of normal blood glucose concentration.[7]

A 2016 review of meta-analyses concluded that whereas there may be modest decreases in fasting plasma glucose or gylcated hemoglobin that achieve statistical significance, the changes were rarely large enough to be expected to be relevant to clinical outcome.[8]

Human studies[edit]

Looking at the results from four meta-analyses, one reported a statistically significant decrease in fasting plasma glucose levels (FPG) and a non-significant trend in lower hemoglobin A1C (HbA1C).[9] A second reported the same,[10] a third reported significant decreases for both measures,[11] while a fourth reported no benefit for either.[12] A review published in 2016 listed 53 randomized clinical trials that were included in one or more of six meta-analyses. It concluded that whereas there may be modest decreases in FPG and/or HbA1C that achieve statistical significance in some of these meta-analyses, few of the trials achieved decreases large enough to be expected to be relevant to clinical outcome.[8]

Proposed mechanism of action[edit]

The mode of action through which chromium aided in the regulation of blood glucose levels is poorly understood. Recently, it has been suggested that chromium interacts with the low-molecular weight chromium (LMWCr) binding substance to potentiate the action of insulin.[3] LMWCr has a molecular weight of 1500, and is composed solely of the four amino acid residues of glycine, cysteine, aspartic acid and glutamate.[13] It is a naturally occurring oligopeptide that has been purified from many sources: rabbitliver, porcine kidney and kidney powder, bovine liver, colostrum, dog, rat and mouse liver.[14] Widely distributed in mammals, LMWCr is capable of tightly binding four chromic ions. The binding constant of this oligopeptide for chromium ions is very large, (K ≈ 1021 M−4), suggesting it is strong and tightly binding. LMWCr exists in its inactive or apo form within the cytosol and nucleus of insulin-sensitive cells.[13]

When insulin concentrations within the blood rise, insulin binds to the external subunit of the insulin-receptor proteins, and induces a conformational change. This change results in the autophosphorylation of the tyrosine residue located on the internal ß-subunit of the receptor, thereby activating the receptor's kinase activity.[14] An increase in insulin levels also signals for the movement of transferrin receptors from the vesicles of insulin-sensitive cells to the plasma membrane. Transferrin, the protein responsible for the movement of chromium through the body, binds to these receptors, and becomes internalized via the process of endocytosis. The pH of these vesicles containing the transferrin molecules is then decreased (resulting in increased acidity) by the action of ATP-driven proton pumps, and as a consequence, chromium is released from the transferrin. The free chromium within the cell is then sequestered by LMWCr.[3] The binding of LMWCr to chromium converts it into its holo or active form, and once activated, LMWCr binds to the insulin receptors and aids in maintaining and amplifying the tyrosine kinase activity of the insulin receptors. In one experiment that was performed on bovine liver LMWCr, it was determined that LMWCr could amplify the activity of protein kinase receptors by up to seven-fold in the presence of insulin.[13] Furthermore, evidence suggests that the action of LMWCr is most effective when it is bound to four chromic ions.[14]

When the insulin signaling pathway is turned off, the insulin receptors on the plasma membrane relax and become inactivated. The holo-LMWCr is expelled from the cell and ultimately excreted from the body via urine.[13] LMWCr cannot be converted back into its inactive from due to the high binding affinity of this oligopeptide for its chromium ions. As of currently, the mechanism through which apo-LMWCr is replaced within the body is unknown.[14]

See also[edit]

  • Chromium picolinate: a dietary supplement ingredient
  • Chromium chloride: a dietary supplement ingredient

References[edit]

  1. ^Guerrero-Romero, F; Rodríguez-Morán, M (2005). 'Complementary Therapies for Diabetes: The Case for Chromium, Magnesium, and Antioxidants'. Archives of Medical Research. 36 (3): 250–257. doi:10.1016/j.arcmed.2005.01.004. PMID15925015.
  2. ^Lay, Peter A. (2012). 'Chromium: Biological Relevance'. 'Chromium: biological relevance' in 'Encyclopedia of Inorganic and Bioinorganic Chemistry. John Wiley & Sons. doi:10.1002/9781119951438.eibc0040. ISBN9781119951438.
  3. ^ abcdCefalu, W. T.; Hu, F. B. (2004). 'Role of chromium in human health and in diabetes'. Diabetes Care. 27 (11): 2741–2751. doi:10.2337/diacare.27.11.2741. PMID15505017.
  4. ^Schwarz, K; Mertz, W (1959). 'Chromium(III) and the glucose tolerance factor'. Archives of Biochemistry and Biophysics. 85: 292–295. doi:10.1016/0003-9861(59)90479-5. PMID14444068.
  5. ^FDA Qualified Health Claims: Letters of Enforcement Discretion, Letters of Denial U.S. Food and Drug Administration, Docket #2004Q-0144 (August 2005).
  6. ^'Monograph: Chromium (from Chromium picolinate)'. Health Canada. December 9, 2009. Retrieved March 24, 2015.
  7. ^'Scientific Opinion on the substantiation of health claims related to chromium and contribution to normal macronutrient metabolism (ID 260, 401, 4665, 4666, 4667), maintenance of normal blood glucose concentrations (ID 262, 4667), contribution to the maintenance or achievement of a normal body weight (ID 339, 4665, 4666), and reduction of tiredness and fatigue (ID 261) pursuant to Article 13(1) of Regulation (EC) No 1924/2006'. EFSA Journal. 8 (10). October 2010. doi:10.2903/j.efsa.2010.1732. ISSN1831-4732.
  8. ^ abCostello RB, Dwyer JT, Bailey RL (2016). 'Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness'. Nutr. Rev. 74 (7): 455–468. doi:10.1093/nutrit/nuw011. PMC5009459. PMID27261273.
  9. ^San Mauro-Martin I, Ruiz-León AM, et al. (2016). '[Chromium supplementation in patients with type 2 diabetes and high risk of type 2 diabetes: a meta-analysis of randomized controlled trials]'. Nutr Hosp (in Spanish). 33 (1): 27. doi:10.20960/nh.27. PMID27019254.
  10. ^Abdollahi M, Farshchi A, Nikfar S, Seyedifar M (2013). 'Effect of chromium on glucose and lipid profiles in patients with type 2 diabetes; a meta-analysis review of randomized trials'. J Pharm Pharm Sci. 16 (1): 99–114. doi:10.18433/J3G022. PMID23683609.
  11. ^Suksomboon N, Poolsup N, Yuwanakorn A (2014). 'Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes'. J Clin Pharm Ther. 39 (3): 292–306. doi:10.1111/jcpt.12147. PMID24635480.
  12. ^Bailey CH (January 2014). 'Improved meta-analytic methods show no effect of chromium supplements on fasting glucose'. Biol Trace Elem Res. 157 (1): 1–8. doi:10.1007/s12011-013-9863-9. PMID24293356.
  13. ^ abcdVincent, J. B. (2000). 'Elucidating a biological role for chromium at a molecular level'. Accounts of Chemical Research. 33 (7): 503–510. doi:10.1021/ar990073r. PMID10913239.
  14. ^ abcdVincent, J. B. (2000). 'The biochemistry of chromium'. The Journal of Nutrition. 130 (4): 715–718. doi:10.1093/jn/130.4.715. PMID10736319.
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