It is believed that chromium's influence on insulin metabolism might be due to its interaction with a protein called low molecular weight chromium-binding substance (LMWCr). Caution must be exercised by diabetics who are taking chromium supplements, as these can interact with the medication for diabetes, thereby increasing the risk of hypoglycemia.
Though chromium is an essential trace element that is required in small amounts for the healthy functioning of the body, the incidence of chromium deficiency is quite high. This is mainly attributed to the fact that processing of food leads to the removal of up to 80% of the chromium in foods. Chromium losses might also increase in the event of physical stress, trauma, or acute infections.
Generally, chromium supplementation or the inclusion of its dietary sources (whole grains, eggs, cheese, liver, lean meats, and brewer's yeast) is recommended for treating its deficiency. The common supplemental sources include chromium chloride, chromium picolinate, and chromium polynicotinate. The absorption rate of niacin-bound chromium polynicotinate is believed to be higher than the other two forms. According to a study by Dr. Ann de Wees Allen, the niacin-bound form is 672% and 311% better absorbed than chromium chloride and chromium picolinate respectively.
The Need for Chromium Supplementation
Our body's requirements for chromium can be met from the dietary sources to some extent; however, less than 0.4% to 2.5% of the amount consumed is absorbed by the intestinal tract. Chromium supplementation is recommended if a person has been diagnosed with its deficiency.
Out of the various supplements that are available, the niacin-bound form is widely used due to its bioavailability and better absorption rate. The bioavailability of this drug, which refers to the amount of drug that actually reaches the site of physiological activity after it is administered, is quite high. The higher absorption rate of this compound is due to niacin, which makes the process of assimilation easier.
Chromium acts as a co-factor to insulin, thereby increasing insulin sensitivity and facilitating the absorption of glucose into the cells. It might play a vital role in the regulation of blood sugar levels. Therefore, this supplement might be recommended for people affected by insulin resistance or diabetes.
Chromium Polynicotinate Vs. Chromium Picolinate
The niacin or nicotinic acid-bound chromium (Cr-N) supplements are widely used, as these have not been associated with toxicity. They are considered to be the safer form with better bioavailability in comparison to chromium picolinate (CR-P), which is the form of chromium that is bound to picolinic acid. Concerns were raised regarding the long-term safety of the latter, after a study linked its use to possible DNA damage. However, these claims are yet to be substantiated with concrete scientific evidence due to the absence of large, controlled clinical trials.
To add to that, the Institute of Medicine has not established a tolerable upper intake level, which is the maximum daily intake of a nutrient that is unlikely to cause adverse health effects. Since there isn't any conclusive evidence to support the aforementioned risk, the best option is to consult one's healthcare provider about the right dosage. Caution must be exercised when the supplements are taken in combination with the drugs for diabetes.
Chromium polynicotinate is considered to be a safer form of chromium. Generally, the dosage ranges anywhere between 50 and 200 mcg, but it might vary if one is taking the supplement for inducing weight loss. Studies have not yet provided any evidence that links cellular damage to its use. Unless recommended by one's healthcare provider, chromium supplementation must be avoided if:
✦ One is taking medication for lowering blood sugar
✦ One has a chromate or leather contact allergy
✦ One is pregnant or nursing
✦ One has been diagnosed with liver or kidney problems
Though supplementation might not pose health risks when pregnant women or nursing mothers take the supplements in doses that are equal to or less than adequate intake (AI) level of 30 mcg daily, the supplements must be taken as per the dosage recommended by one's healthcare provider.
There could be adverse drug interactions if the supplements are taken in combination with anti-inflammatory drugs or levothyroxine. Taking the supplements with NSAIDs can increase chromium levels, whereas these supplements can adversely affect the absorption of levothyroxine or synthetic thyroid hormone. Since the niacin-bound chromium helps in regulating the levels of insulin, taking these supplements with insulin might lower the blood sugar levels, thereby making one susceptible to hypoglycemia. There are contradictory reports on the effect of these supplements in case of people affected by depression, anxiety, or schizophrenia.
Though there have been isolated reports of kidney or liver problems in case of individuals taking chromium picolinate, a cause-effect relationship could not be proved in the absence of scientific evidence. On the other hand, various studies have suggested that the niacin-bound form of chromium is well-assimilated. According to the results of a few controlled clinical trials, toxic effects were not observed when 200-1000 mcg of chromium was taken daily in divided doses for several months. However, diabetics should consider a high-dose chromium supplementation, only if it is recommended by their healthcare provider. Since the tolerable upper intake level has not been established, it would be best to take the supplements under medical supervision.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.