Mineral Biomarkers: Chromium

Optimal Takeaways

Chromium is an essential nutrient that participates in the metabolism of carbohydrates, proteins, and fat and influences glucose and lipid regulation in the body. Chromium insufficiency is associated with poor blood glucose control, hyperlipidemia, and obesity. Excess chromium can be toxic and contribute to liver and kidney dysfunction.

Standard Range: 0.10 – 2.10 ug/L (1.92 – 40.39 nmol/L)

The ODX Range: 0.6 – 2.10 ug/L (11.54 – 40.39 nmol/L)  

Low levels of chromium contribute to insulin resistance, glucose intolerance, and dysfunctional glucose and lipid metabolism. Proton pump inhibitors and acid blockers can reduce chromium absorption (Gropper 2021), while glucocorticoids may increase urinary losses (Noland 2020). Lower levels can be seen with obesity and diabetes (Lewicki 2014). Overt chromium deficiency may be characterized by dysglycemia, negative nitrogen balance, peripheral neuropathy, weight loss, and confusion (Gaby 2017).

High levels of chromium are associated with chromium toxicity, organ damage, hepatic dysfunction, and renal failure (Gropper 2021). Excess chromium in the blood may indicate toxicity from metal-on-metal orthopedic implants (Labcorp, Pijls, 2019).

Overview

Chromium, in its trivalent state, is an essential trace mineral for humans and is found in food such as broccoli, potatoes, grape juice, yeast, cinnamon, cloves, and turmeric. Chromium is carried through the blood on transferrin, the same glycoprotein that transports iron, copper, manganese, zinc, nickel, and cadmium. It may also be transported on albumin, globulin, and lipoproteins (Gropper 2021).

Food processing can deplete up to 70% of the chromium in food, e.g., by converting whole wheat to refined white flour. Excess sugar consumption can significantly increase the urinary excretion of chromium and contribute to its insufficiency. Chromium deficiency may be characterized by glucose intolerance, negative nitrogen balance, peripheral neuropathy, weight loss, and confusion. Chromium supplementation may resolve symptoms in such cases (Gaby 2017). Chromium supplementation may also be effective in diabetes, prediabetes, reactive hypoglycemia, metabolic syndrome, and PCOS (Raymond 2021).

Chromium participates in the metabolism of carbohydrates, protein, and lipids. Lower serum levels have been observed in metabolic disorders, including diabetes and obesity (Lewicki 2014). Serum chromium was significantly lower in older diabetics versus non-diabetics with levels of 0.22-0.36 ug/L (4.23-6.92 nmol/L) versus 0.66-0.84 ug/L (12.69-16.15 nmol/L) in non-diabetics (Ding 1998).

Meta-analysis and systematic review research found that chromium supplementation with more than 200 ug/day (maximum of 1000 ug/day) significantly improved glycemic control, fasting glucose, and hemoglobin A1C. Researchers note that the effect of chromium supplementation observed in the meta-analysis was similar to that produced by antidiabetic agents such as alpha-glucosidase and DPP-4 inhibitors. As monotherapy, especially chromium picolinate, supplementation was associated with a significant decrease in triglycerides and increased HDL cholesterol (Suksomboon 2014).

One double-blind crossover study in 72 type 2 diabetics found that supplementation with chromium as brewer’s yeast and chromium chloride improved serum chromium and significantly decreased fasting glucose, 2-hour post-prandial glucose, fructosamine, and triglyceride levels, and increased HDL-cholesterol. Some subjects had their diabetes medication reduced, and some subjects were able to discontinue insulin. Researchers note that a lower dose of chromium from brewer’s yeast was as effective as a higher dose from chromium chloride (Bahijiri 2000).

Research in 76 subjects with established atherosclerosis found that 250 ug chromium chloride increased serum chromium from 0.14 ug/L (2.69 nmol/L) to 0.63 ug/L (12.12 nmol/L). A significant decrease in triglycerides and VLDL cholesterol and a significant increase in HDL cholesterol were observed in the supplemented group. No significant changes were seen in this group's total cholesterol or blood glucose levels with supplementation (Abraham 1992).

Note that the hexavalent form of chromium is highly toxic and different from trivalent chromium found in food (Gaby 2017).

References

Abraham, A S et al. “The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes.” Metabolism: clinical and experimental vol. 41,7 (1992): 768-71. doi:10.1016/0026-0495(92)90318-5

Bahijiri, S M 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 medical journal vol. 21,9 (2000): 831-7.

Ding, W et al. “Serum and urine chromium concentrations in elderly diabetics.” Biological trace element research vol. 63,3 (1998): 231-7. doi:10.1007/BF02778941

Gaby, Alan R. Nutritional Medicine. Fritz Perlberg Publishing, 2017.

Gropper, Sareen S.; Smith, Jack L.; Carr, Timothy P. Advanced Nutrition and Human Metabolism. 8^th edition. Wadsworth Publishing Co Inc. 2021.

Labcorp. Chromium and Cobalt, Whole Blood.

Lewicki, Sławomir et al. “The role of Chromium III in the organism and its possible use in diabetes and obesity treatment.” Annals of agricultural and environmental medicine : AAEM vol. 21,2 (2014): 331-5. doi:10.5604/1232-1966.1108599

Noland, Diana, Jeanne A. Drisko, and Leigh Wagner, eds. Integrative and functional medical nutrition therapy: principles and practices. Springer Nature, 2020.

Pagana, Kathleen Deska, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed., Mosby, 2021.

Pijls, Bart G et al. “MoM total hip replacements in Europe: a NORE report.” EFORT open reviews vol. 4,6 423-429. 3 Jun. 2019, doi:10.1302/2058-5241.4.180078

Raymond, Janice L., et al. Krause and Mahan's Food & the Nutrition Care Process. Elsevier, 2021.

Suksomboon, N et al. “Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes.” Journal of clinical pharmacy and therapeutics vol. 39,3 (2014): 292-306. doi:10.1111/jcpt.12147