Chromium supplement side effects
Chromium from foods is generally considered safe and short-term use of chromium supplement is probably safe to most healthy adults. High doses of
chromium supplement can reduce how effective insulin is at controlling blood sugar and chromium side effects may include stomach irritation, itching,
and flushing. Chromium side effects may further include skin irritation, headaches, dizziness, nausea, mood changes and impaired thinking, judgment,
and coordination. [X] However, it is still unclear if chromium is the actual cause of these side effects.

Chromium - Drug Interaction
Chromium may produce unwanted side effects in the presence of certain kinds of drugs. Do not take chromium together with anti-diabetic agents such
as insulin, Metformin, glyburide, glipizide and chlorpropamide, as chromium may also have glucose-lowering effects.

Medications containing calcium, such as most of the antacid products, may interfere the chromium absorption. Further, antacids, corticosteriods, H2
blockers (such as cimetidine, famotidine, nizatidine, and rantidine), proton-pump inhibitors (such as omeprazole, lansoprazole, rabeprazole,
pantoprazole and esomeprazole) alter stomach acidity and may impair chromium absorption or enhance excretion, [AA1] while NSAIDs may raise
chromium absorption. [X] Further, beta-blockers (such as atenolol or propanolol), corticosteroids, insulin, nicotinic acid, and prostaglandin inhibitors
(such as ibuprofen, indomethacin, naproxen, piroxicam, and aspirin) may have their effects enhanced if taken together with chromium or they may
increase chromium absorption. [AA1]

Finally, analogues of picolinic acid may induce profound alterations in the metabolism of serotonin, dopamine, and norepnephrine in brain. This side
effect can be serious. Thus, patients with behavioral disorders should consult with doctors before taking any chromium picolinate supplements. [6]

Contra-indication and Warning
Researchers believe that supplements of chromium may have serious side effects to certain users, Individual patients with type-2 diabetes mellitus
may have an increased risk of hypoglycaemic episodes when taking chromium supplements. [4] Women should not take chromium supplements
during breast-feeding or pregnancy.

Chromium Toxicity
It is generally believed that chromium has a low absorption rate but a high excretion rate, chromium toxicity is uncommon. However, chromium
supplementation does result in tissue retention in the kidney, although no pathogenic effect has been demonstrated despite considerable study. [5]
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Chromium Side Effects at High Doses, Prolonged Uses

High doses of chromium
have been linked to more serious side effects including blood disorders, liver or kidney damage, and other problems.
However,
it is not sure if chromium is really the cause for these side effects. There are reports of kidney and liver damages in users who took
chromium picolinate. Further, users should monitor their psychiatric conditions, as chromium might affect brain chemistry. Chromium may also cause
the side effect of allergic reaction - redness, swelling, and scaling of the skin. [X]

Chromium Picolinate Side Effects on Gene
There are several reports that chromium can have adverse side effects related to gene mutation. In order to study the mechanism of observed cellular
toxicity and mutagenicity, chromium picolinate and its component compounds, chromium (III) chloride and picolinic acid, were evaluated in Salmonella
typhimurium and L5178Y mouse lymphoma cells. Neither chromium picolinate nor chromium chloride induced a mutagenic response in S. typhimurium.
However, in the L5178Y mouse lymphoma mutation assay chromium picolinate induced mutagenic responses without and with the addition of S9.

Chromium induced oxidative stress with both similar and unique genes and pathways responding to this stress. Evidence for DNA damage exists in
response to chromium.[X2]

Under the conditions of 2-year feed studies there was equivocal evidence of carcinogenic activity of chromium picolinate monohydrate in male F344/N
rats based on an increase in the incidence of preputial gland adenoma. There was no evidence of carcinogenic activity of chromium picolinate
monohydrate in female F344/N rats or in male or female B6C3F1 mice. [7]
Do not take chromium picolinate for more than six months, Users
must fully understand the benefits and potential side effects of chromium picolinate, before taking it.
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Chromium Dosages
Chromium picolinate is the most efficacious form of chromium supplementation. Supplements containing 200-1,000 mcg chromium as chromium
picolinate a day have been found to improve blood glucose control. However, it is unclear if this dose range is safe.

Supplement doses typically range from 50 to 200 mcg. Chromium supplements are available as chromium chloride, chromium nicotinate, chromium
picolinate, high-chromium yeast, and chromium citrate. Chromium chloride in particular appears to have poor bioavailability. More studies needed to
determine the dosages. Because of the severe toxic effects at high dosages, users must consult with their medical doctors, before taking this
supplement.
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CHROMIUM PICOLINATE SIDE EFFECTS, BENEFITS AND TOXICITY   
August 24, 2013
Introduction
Chromium is a chemical element which has the symbol Cr and atomic number 24. Chromium is also odorless, tasteless, and malleable. Chromium has
high corrosion resistance and hardness. Chromium oxide was used by the Chinese in the Qin dynasty over 2,000 years ago to coat weapons.
Chromium is found primarily in two forms: 1) trivalent (chromium 3+), which is biologically active and found in food, and 2) hexavalent (chromium 6+), a
toxic form that results from industrial pollution. A large number of trivalent (III) compounds are known. Chromium(III) can be obtained by dissolving
elemental chromium in acids. Chromium (Cr(III)) is required for sugar and lipid metabolism. Chromium deficiency has been reported, but, larger
amounts and different forms chromium can be toxic and carcinogenic.

Chromium(III) ions are popularly used in industry, Chromium (III) sulfate usually refers to the inorganic compound with the formula Cr2(SO4)3 • 12
(H2O).

Chromium is known to enhance the action of insulin [A1-A3], a hormone critical to the metabolism and storage of carbohydrate, fat, and protein in the
body [A4]. In 1957, a compound in brewers' yeast was found to prevent an age-related decline in the ability of rats to maintain normal levels of sugar
(glucose) in their blood [A3]. Chromium was identified as the active ingredient in this so-called "glucose tolerance factor" in 1959 [A5].

Chromium picolinate is one of the most commonly used chromium dietary supplements available in the United States, and it has been marketed to
consumers for use in weight loss, increasing muscle mass, and lowering serum cholesterol. Chromium picolinate is a synthetic compound that
provides a bioavailable form of Cr(III) that is absorbed better than dietary chromium.

Related Compounds Chromic Chloride, Chromium Acetate, Chromium Nicotinate, Chromium Picolinate, Chromium Polynicotinate, Chromium
Proteinate, Chromium Trichloride, Chromium Tripicolinate... Chromium (3) Chloride
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Chromium Source
Chromium is widely distributed in the food supply, but most foods provide only small amounts (less than 2 micrograms [mcg] per serving). Meat and
whole-grain products, as well as some fruits, vegetables, and spices are relatively good sources. In contrast, foods high in simple sugars (like sucrose
and fructose) are low in chromium. Good sources of chromium include broccoli, grape juice, English muffin (whole wheat), mashed potatoes and dried
garlic. [A6]
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This website discusses the benefits and side effects of various supplements, herbs and drug products. Different side effects to FDA, its website is
www.fda.gov., or report the adverse side effects to the manufacturer, you should be able to find the contact information on the label.

There are always new information. Please, send me an email (
zhion@zhion.com) to correct my mistake(s). Reasonable care has been taken in
preparing this document and the information provided herein is believed to be accurate. The information is not intended to be a substitute for
professional medical advice. It is important to seek the advice of a physician about any medical condition or symptom or the benefits and side effects
of a supplement or a drug product. Finally, please, do not transfer the article to other website. Thank you. ALL RIGHTS RESERVED.
Chromium Absorption and Distribution
Oral chromium absorption is low, ranging from less than 0.4% to 2.5% of the amount consumed, and the remainder is
excreted in the feces. Enhancing the mineral's absorption are vitamin C and the B vitamin niacin. Absorbed chromium is
stored in the liver, spleen, soft tissue, and bone. Diets high in simple sugars can increase chromium excretion in the urine.
Infection, acute exercise, pregnancy and lactation, and stressful states (including physical trauma) increase chromium
losses and can lead to deficiency, especially if chromium intakes are already low. [A6]
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Chromium deficiency
Chromium deficiency is a disorder that results from an insufficient dietary intake of chromium. Only about 2% of ingested
chromium(III) is absorbed. After absorption, this metal accumulates in organs like liver, bone, and spleen. The symptoms of
chromium deficiency are severely impaired glucose tolerance, weight loss, and confusion. Peripheral neuropathy may also
occur. [
Wikipedia.com]
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Chromium Picolinate Supplements - Health Benefits
Supplementation of chromium picolinate may prevent chromium deficiency and it may be helpful for people at risk of
diabetes. In the 1960s, chromium was found to correct glucose intolerance and insulin resistance in deficient animals [A1].
In a case, three hospitalized patients who were fed intravenously showed signs of diabetes (including weight loss,
neuropathy, and impaired glucose tolerance) until chromium was added to their feeding solution. The chromium, added at
dosages of 150 to 250 mcg/day for up to two weeks, corrected their diabetes symptoms. Chromium is now routinely added
to intravenous solutions. [A6] Here is a review of such health benefits:

Diabetes
Insulin resistance is an epidemic condition that dramatically increases risk for type 2 diabetes, coronary heart disease and
stroke, estimated to affect 33% Americans. [2,3] Insulin resistance is present in two serious health problems in women;
polycystic ovarian syndrome (PCOS) and gestational diabetes. [3] Chromium is an essential mineral that is needed for
insulin activity in carbohydrate, fat and protein metabolism. Chromium deficiency impairs the body's ability to use glucose
to meet its energy needs and raises insulin requirements. Thus, it makes sense to believe that chromium supplements
might help to control type 2 diabetes or the glucose and insulin responses in persons at high risk of developing the
disease. A review of randomized controlled clinical trials evaluated this hypothesis.

A recent study has demonstrated that chromium picolinate may increase the amount of AMP-activated protein kinase
(AMPK) - a key enzyme involved in metabolism - in skeletal muscle cells, thus improving energy balance and insulin
function.[2]

Studies show that people with type 2 diabetes have lower blood levels of chromium than those without the disease. [3]
Consequently, researchers supplied chromium supplementation to patients suffered from types 1 and 2 diabetes. They
found improvement in serum glucose. The beneficial effects of chromium on serum glucose and lipids and insulin
resistance occur even in the healthy subjects. [5]
In 2009, FDA issued a favorable response to a qualified health claim petition filed by Nutrition 21, recognizing chromium
picolinate as a safe nutritional supplement that may reduce the risk of insulin resistance and possibly type 2 diabetes.
[1]
See the section of Qualified Health Claims below.

Qualified Health Claims October 2009
Chromium Picolinate & Diabetes
Docket No. 2004Q-0144 08/25/2005 enforcement discretion letter

Eligible Foods
Dietary supplements containing chromium

Factors for Exercising Enforcement Discretion
Dietary supplement containing chromium must meet or exceed the requirement for a "high" level of chromium as defined in
21 CFR 101.54(b) (i.e., 24 mg or more per RACC under the current regulation) for FDA to exercise enforcement
discretion.

Claim Statements
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.
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REFERENCES
[1] FDA Approves First Qualified Health Claim for Chromium Picolinate and Risk of Type 2 Diabetes, Purchase, N.Y.
(PRWEB) September 2, 2005. [2] New Study Suggests Chromium Picolinate Triggers Key Enzyme to Improve Glucose
Metabolism, Pennington Biomedical Research Center News Release, September 14, 2005 [3] A scientific review: the role
of chromium in insulin resistance. Diabetes Educ. 2004;Suppl:2-14. [4] Kleefstra N et al, Chromium and insulin resistance.
Ned Tijdschr Geneeskd. 2004 Jan 31;148(5):217-20. [5] Lamson DS et al, The safety and efficacy of high-dose
chromium. Altern Med Rev. 2002 Jun;7(3):218-35. [7] NTP toxicology and carcinogenesis studies of chromium picolinate
monohydrate (CAS No. 27882-76-4) in F344/N rats and B6C3F1 mice (feed studies).Natl Toxicol Program Tech Rep Ser.
2010 Jun;(556):1-194. [8] Yazaki Y et al, A pilot study of chromium picolinate for weight loss.J Altern Complement Med.
2010 Mar;16(3):291-9. [X] WebMD.com, October 24, 2011, The University of Maryland, October 24, 2011, The New York
Times, October 24, 2011 [X1] P. Whittaker et al Mutagenicity of chromium picolinate and its components in Salmonella
typhimurium and L5178Y mouse lymphoma cells The 2005 FDA Science Forum J-43 [X2] Permenter MG, et la, Exposure
to nickel, chromium, or cadmium causes distinct changes in the gene expression patterns of a rat liver derived cell line.
PLoS One. 2011;6(11):e27730. A1 Mertz W. Chromium occurrence and function in biological systems. Physiol Rev
1969;49:163-239. A2 Mertz W. Chromium in human nutrition: a review. J Nutr 1993;123:626-33. A3 Mertz W. Interaction of
chromium with insulin: a progress report. Nutr Rev 1998;56:174-7. A4 Porte Jr. D, Sherwin RS, Baron A (editors).
Ellengerg & Rifkin's Diabetes Mellitus, 6th Edition. McGraw-Hill, New York, 2003. A5 Schwarz K, Mertz W. Chromium(III)
and the glucose tolerance factor. Arch Biochem Biophys 1959;85:292-5. A6 Chromium Dietary Supplement Fact Sheet,
Office of Dietary Supplements, NIH, August 05, 2005 A7 Roeback Jr. JR, Hla KM, Chambless LE, Fletcher RH. Effects of
chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A
randomized, controlled trial. Ann Intern Med 1991;115:917-24. A8 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;41:768-71. A8 Hermann J, Arquitt A. Effect of chromium supplementation on plasma lipids,
apolipoproteins, and glucose in elderly subjects. Nutr Res 1994;14: 671-4. A9 Doisy RJ, Streeten DHP, Freiberg JM,
Schneider AJ. Chromium metabolism in man and biochemical effects. In: Trace Elements in Human Health and Disease,
Volume 2: Essential and Toxic Elements (edited by Prasad A, Oberleas D). Academic Press, New York, 1976, pp. 79-104.
A10 Lifschitz ML, Wallach S, Peabody RA, Verch RL, Agrawal R. Radiochromium distribution in thyroid and parathyroid
deficiency. Am J Clin Nutr 1980:33:57-62. A11 Riales R, Albrink MJ. Effect of chromium chloride supplementation on
glucose tolerance and serum lipids including high-density lipoprotein of adult men. Am J Clin Nutr 1981;34:2670-8. A12
Mossop RT. Effects of chromium III on fasting blood glucose, cholesterol and cholesterol HDL levels in diabetics. Cent Afr
J Med 1983;29:80-2. [AA1]
Chromium, Office of Dietary Supplements, NIH, online publication 2013
Can chromium picolinate be used for weight loss?
Chromium is an essential trace element and nutritional supplement that has garnered interest for use as a weight loss aid.
Chromium supplements are sometimes claimed to reduce body fat and increase lean (muscle) mass. However, a
randomized, double-blind, placebo-controlled trial of 80 healthy overweight adults showed supplementation of 1000 microg
of chromium picolinate alone, or in combination with nutritional education, did not affect weight loss in population of
overweight adults. Response to chromium did not vary with central adiposity. [8]
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Chromium Picolinate dosages, safety issues, toxicity and side effects
Chromium is probably safe for most healthy adults when used at recommended doses for six months or less. Numerous
animal studies and human clinical trials have demonstrated that chromium picolinate supplements are safe. [3]