Chromium Background
Practitioners have long valued the importance of the trace mineral chromium to help support healthy blood sugar and aid carbohydrate metabolism. Investigations also suggest chromium may play a role in protein and fat metabolism.[1] Chromium deficiency raises the need for insulin within the body as deficit impairs glucose utilization, needed for energy.1 Chromium is an essential nutrient that plays an important role in glucose metabolism by enhancing the effects of insulin.[2],[3],[4],[5],[6],[7]

Dietary and supplemental chromium is present in its trivalent form (chromium 3+). Chromium is available from a wide variety of foods, however most food sources only contain small amounts of chromium.[1] High discretionary food intake, including that of simple carbohydrates is typical in a Western diet. High intake of simple sugars may increase urinary chromium excretion, potentially giving rise to an impaired insulin response.[8]

Additional health states that may elevate chromium excretion include infection, states of stress and resistance training.[1],[9],[10]

Key Benefits

May help maintain healthy blood sugar
Chromium polynicotinate is also known as a niacin-bound chromium. This form demonstrates high bioavailability and effectiveness.[11] Safety of chromium supplements at doses up to 250µg per day has been supported by the European Food Safety Authority (EFSA). There have been no reports of toxicity associated with niacin-bound chromium.[12],[13],[14]

Researchers from Georgetown University Medical Centre compared the metabolic effects of six different trivalent chromium compounds. In the first study Chromium polynicotinate (NBC) was one of only two forms of chromium to aid in the maintenance of healthy blood sugar metabolism.[6],[15]

Alpha-lipoic acid
Alpha-lipoic acid (ALA) is an antioxidant that may reduce free radical formation in the body. An Iranian study investigated the effects of ALA supplementation (300 mg daily) in participants with type 2 diabetes (T2DM) over 8 weeks. Fasting blood glucose, post-prandial glucose and insulin resistance were lowered significantly in participants taking ALA compared to baseline.[16]

Research also suggests oral supplementation of ALA may improve insulin sensitivity in T2DM patients.[17] Additional investigations studied the effects of ALA supplementation on neuropathic symptoms in participants with diabetic neuropathy (600 mg daily) for 40 days. Neuropathic symptoms and fasting triglycerides reduced significantly with ALA supplementation.[18]

Inositol (vitamin B8)
Inositol (vitamin B8), is a vitamin-like substance that supports healthy blood sugar. Research demonstrates inositol’s potential for lowering blood glucose and insulin levels in addition to moderating the harmful effects of sustained insulin action on the endocrine system and adipose tissue.[19]

Zinc
Zinc glycinate is an absorbable form of zinc that may help maintain levels in the body.[20] Zinc deficiency is associated with diabetes.[21] Systematic reviews and meta-analyses suggest zinc supplementation may support glycaemic control.[20],[22]

(Wang et al 2019) reported significant reductions in fasting glucose, post-prandial glucose, fasting insulin, homeostasis assessment for insulin resistance, glycated haemoglobin and the inflammatory marker high-sensitivity C-reactive protein in subjects supplemented with zinc.[20] Of note, were the significant reductions in fasting glucose displayed in subjects with diabetes mellitus. Zinc is a known antioxidant that may improve insulin sensitivity.[23],[24]

Supports healthy glucose

Vanadium
Vanadium may assist sugar metabolism. Potential mechanisms include vanadium’s ability to normalise glycogen synthase activity, shown in some rodent models (fa/fa Zucker rats).[25] Certain ligands bound to vanadium have been shown to increase its insulin mimetic actions both in vitro and in vivo. Vanadium chelated with amino acids may be more effective than vanadium salts for assisting glucose metabolism.[26],[27]

Advisory statements

• Monitoring of individuals taking prescribed diabetic medication is recommended.

• Vanadium supplementation is not recommended in pregnancy and breastfeeding. The safety of vanadium during pregnancy or breastfeeding has not been established.

• Monitoring of individuals taking prescribed thyroid medication is recommended. Chromium supplementation should be separated by several hours.

• Chromium supplementation may interact with antacids, corticosteroids, H2 blockers and proton-pump inhibitors. These medications may affect chromium absorption and excretion.[1],[28],[29],[30]

• Chromium supplementation may interact with beta-blockers, prostaglandin inhibitors, nicotinic acid, nonsteroidal anti-inflammatories, corticosteroids and insulin. Co-administration with these medications may raise chromium absorption and potentiate drugs actions.[1],[25],[26],[27]

 

References

[1] NIH, Office of dietary supplements. Chromium – Health Professional Fact Sheet. Feb 2020. Available from: https://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/

[2] Lukashi HC. Chromium as a supplement. Annu Rev Nutr. 1999;19:279-302.

[3] Cheng, liu P, Pattar GR, etal. Chromium activates glucose transporter 4 trafficking and enhances insulin-stimulated glucose transport in 3T3-L1 adipocytes via a cholesterol-dependent mechanism. Mol Endocrinol, 2006;20(4):857-870.

[4] Anderson, RA. Chromium, glucose intolerance and diabetes. 1998 Dec;17(6):548-55.

[5] Anderson RA, Polansky MM, Bryden NA, Canary JJ. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr. 1991;54:909–16.

[6] Crawford V, Scheckenbach R, Preuss HG. Effects of niacin-bound chromium supplementation on body composition in overweight African-American women. Diabetes Obes Metab. 1999 Nov;1(6):331-7.

[7] Grant KE, Chandler RM, Castle AL, et al. Chromium and exercise training: effect on obese women. Med Science Sports Exer. 1997 Aug;29(8):992-8.

[8] NHMRC. Nutrient reference values for Australia and New Zealand, Chromium. Apr 2014. Available from: https://www.nrv.gov.au/nutrients/chromium

[9] Anderson R. Stress Effects on Chromium Nutrition in Humans and Animals, 10th Edition. Nottingham University Press, England, 1994.

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

[11] Lamson DS, Plaza SM. The safety and efficacy of high-dose chromium. Altern Med Rev. 2002 Jun;7(3):218-35.

[12] EFSA. Scientific Opinion on the safety of trivalent chromium as a nutrient added for nutritional purposes to foodstuffs for particular nutritional uses and foods intended for the general population (including food supplements). EFSA Journal 2010;8(12):1882

[13] Bagchi D, Stohs SJ, Downs BW, et al. Cytotoxicity and oxidative mechanisms of different forms of chromium. Toxicology 2002 Oct 30;180 (1):5-22.

[14] Deshmukh NS, Bagchi M, Lau FC, Bagchi D. Safety of an oxygen-coordinated niacin-bound chromium (III) complex (NBC): II. Developmental toxicity study in rats. J Inorg Biochem. 2009 Dec;103(12):1755-60.

[15] Preuss HG, Echard B, Perricone NV, Bagchi D, Yasmin T, Stohs SJ. Comparing metabolic effects of six different commercial trivalent chromium compounds. J Inorg Biochem. 2008 Nov;102(11):1986-90.

[16] Ansar H, Mazloom Z, Kazemi F, Hezjazi N. Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. Saudi Med J. 2011 Jun;32(6):584-8

[17] Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial. Free Radic Biol Med. Aug 1999;27(3-4):309-314

[18] Agathos E, Tentolouris A, Eleftheriadou I, Katsaouni P, Nemtzas A, Petrou A, Papaniolaou C, Tentolouris N. Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy. Journal of International Medical Research. 2018, Vol. 46(5) 1779–1790

[19] Bevilacqua A, Bizzarri M. Insositols in Insulin Signalling and Glucose Metabolism. International Journal of Endocrinology Volume Nov 2018. https://doi.org/10.1155/2018/1968450

[20] Schlegel P, Windisch W. Bioavailability of zinc glycinate in comparison with zinc sulphate in the presence of dietary phytate in an animal model with Zn labelled rats. J Anim Physiol Anim Nutr (Berl) 2006 Jun;90(5-6):216-22.

[21] Wang X, Wu W, Zheng W, Fang X, Chen L, Rink L, Min J, Wang F. Zinc supplementation improves glycemic control for diabetes prevention and management: a systematic review and meta-analysis of randomized controlled trials, AJCN. 2019;110(1), p. 76–90, https://doi.org/10.1093/ajcn/nqz041

[22] Jayawardena R, Ranasinghe P, Galappatthy P , Malkanthi RLDK , Constantine GR, Katulanda P. Effect of Zinc supplementation of Diabetes Mellitis: A systematic review and meta-analysis. Diabetology & Metabolic Syndrome 2012, 4:13.

[23] Faure P, Barclay D, Joyeux-Faure M, Halimi S. Comparison of the effects of zinc alone and zinc associated with selenium and vitamin E on insulin sensitivity and oxidative stress in high-fructose-fed rats. J Trace Elem Med Biol. 2007;21(2):113–119. doi: 10.1016/j.jtemb.2006.12.005.

[24] Vijayaraghavan K, Iyyampillai S, Subramanian SP. Antioxidant potential of zinc-flavonol complex studied in streptozotocin-diabetic rats. J Diabetes. 2013;5(2):149–156. doi: 10.1111/j.1753-0407.2012.00226.x.

[25] Treviño S, Díaz A, Sánchez-Lara E, Sanchez-Gaytan B, Perez-Aguilar J, González-Vergara E. Vanadium in Biological Action: Chemical, Pharmacological Aspects, and Metabolic Implications in Diabetes Mellitus. Biological Trace Element Research (2019) 188:68–98: https://doi.org/10.1007/s12011-018-1540-6

[26] Goldwaser I, Qian S, Gershonov E, Fridkin M, Schechter Y. Organic Vanadium Chelators Potentiate Vanadium-Evoked Glucose Metabolism In Vitro and In Vivo: Establishing Criteria for Optimal Chelators. Molecular Pharmacology October 2000, 58 (4) 738-746; DOI: https://doi.org/10.1124/mol.58.4.738

[27] Sciora T, Guevara-Garciab JA, Doc QT, Bernardc P and Lauferd S. Why Antidiabetic Vanadium Complexes are Not in the Pipeline of “Big Pharma” Drug Research? A Critical Review. Current Medicinal Chemistry, 2016, 23, 2874-2891

[28] Davis ML, Seaborn CD, Stoecker BJ. Effects of over-the-counter drugs on 51chromium retention and urinary excretion in rats. Nutr Res 1995;15:201-10

[29] Kamath SM, Stoecker BJ, Davis-Whitenack ML, Smith MM, Adeleye BO, Sangiah S. Absorption, retention and urinary excretion of chromium-51 in rats pretreated with indomethacin and dosed with dimethylprostaglandin E2, misoprostol or prostacyclin. J Nutr 1997;127:478-82.

[30] Chromium. In: Natural Medicines Comprehensive Database, 2005. http://www.naturalmedicines.com