|Classification and external resources|
Chromium deficiency is a proposed disorder that results from an insufficient dietary intake of chromium. It is an unlikely condition. Clear cases of deficiency have only been observed in hospital patients who were fed defined liquid diets intravenously for long periods of time.
Dietary guidelines 
The US dietary guidelines for adequate daily chromium intake were lowered in 2001 from 50–200 µg for an adult to 30–35 µg (adult male) and to 20–25 µg (adult female). These amounts were set to be the same as the average amounts consumed by healthy individuals. Consequently, it is thought that few Americans are chromium deficient.
Chromium may fall in the same category as manganese, where it is likely that many people get too much.
Approximately 2% of ingested chromium(III) is absorbed, with the remainder being excreted in the feces. Amino acids, vitamin C and niacin may enhance the uptake of chromium from the intestinal tract. After absorption, this metal accumulates in the liver, bone, and spleen.
Trivalent chromium is found in a wide range of foods, including: whole-grain products, processed meats, high-bran breakfast cereals, coffee, nuts, green beans, broccoli, spices, and some brands of wine and beer. Most fruits and vegetables and dairy products only contain low amounts. Most of the chromium in people's diet comes from processing or storing food in pans and cans made of stainless steel, which can contain up to 18% chromium.
The amount of chromium in the body can be decreased as a result of a diet high in simple sugars, which increases the excretion of the metal through urine. Because of the high excretion rates and the very low absorption rates of most forms of chromium, acute toxicity is uncommon.
The symptoms of chromium deficiency caused by long-term total parenteral nutrition are severely impaired glucose tolerance, a loss of weight, and confusion. Another patient also developed nerve damage (peripheral neuropathy).
In a mouse model, Glucose Tolerance Factor (GTF) was found to exert remarkable beneficial insulin-mimetic and insulin-potentiating effects, both in vivo and in vitro. It was seen to produce an insulin-like effect by acting on cellular signals downstream of the insulin receptor. These beneficial results suggest Glucose Tolerance Factor as a potential source for a novel oral medication for diabetes. Similar favorable blood sugar changes as well as markers for resistance to oxidative stress when compared to controls were observed in an experimental group of human volunteers receiving chromium-enriched yeast (yeast grown on chromium-rich nutrients).
Although it is controversial whether supplements should be taken by healthy adults eating a normal diet, chromium is needed as a component of the defined liquid diet that is given to patients receiving total parenteral nutrition (TPN), since deficiency can occur after many months of this highly restricted diet. As a result chromium is added to normal TPN solutions, although the trace amounts from even in "chromium free" preparations may be enough to prevent deficiency in some individuals. Indeed, a 1992 paper in The Lancet suggested that adding chromium to feeding solutions given to children produces excessive levels of this metal in their bodies.
A proprietary synthetic biomolecule containing chromium is chromium polynicotinate. This patented proprietary formulation is purported to correct imbalances in glucose metabolism due to chromium deficiency, even though the occurrence of such a deficiency is extremely rare in countries where the supplement is sold. The mechanism by which this complex enters the cells in the body differs from that for the introduction of trivalent chromium found naturally in food does, and for this reason the safety of this supplement is debatable, since chromium is toxic at high levels. Moreover, recent studies "have concluded that chromium supplements have no demonstrated effects on healthy individuals" and chromium picolinate in particular is described as a "poor choice" as a supplement. A meta-analysis in 2002 found no effect on blood glucose or insulin in healthy people, and the data were inconclusive for diabetics. Subsequent trials gave mixed results, with one finding no effect in people with impaired glucose tolerance, but another seeing a small improvement in glucose resistance. In a 2007 review of these and other clinical trials it was again concluded that chromium supplements had no beneficial effect on healthy people, but that there might be an improvement in glucose metabolism in diabetics, although the authors stated that the evidence for this effect remains weak.
A 2003 pilot trial of 15 patients suggested that chromium picolinate might have antidepressant effects in atypical depression. A larger trial in 2005 set up to test this finding found no effect on depression in its test group, but suggested that the use of chromium supplementation could help to reduce carbohydrate cravings and regulate appetite in these patients. A post-hoc analysis of a subpopulation of patients in this study that experienced high carbohydrate cravings suggested that these patients experienced significant improvements in their depression compared to those treated with a placebo.
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- Kozlovsky, Adriane S.; Moser, Phylis B.; Reiser, Sheldon; Anderson, Richard A. (1986). "Effects of diets high in simple sugars on urinary chromium losses". Metabolism: Clinical and Experimental 35 (6): 515–518. doi:10.1016/0026-0495(86)90007-7. PMID 3713513.
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- Weksler-Zangen, Sarah; Mizrahi, Tal; Raz, Itamar; Mirsky, Nitsa (September 2012). "Glucose tolerance factor extracted from yeast: oral insulin-mimetic and insulin-potentiating agent: in vivo and in vitro studies". British Journal of Nutrition 108 (5): 875–882. doi:10.1017/S0007114511006167. PMID 22172158.
- Racek, Jaroslav; Trefil, Ladislav; Rajdl, Daniel; Mudrova, Vlasta; Hunter, Douglas; Senft, Václav (March 2006). "Influence of chromium-enriched yeast on blood glucose and insulin variables, blood lipids, and markers of oxidative stress in subjects with type 2 diabetes mellitus". Biological Trace Element Research 109 (3): 215–230. doi:10.1385/BTER:109:3:215. PMID 16632892.
- Anderson, R. A. (1995). "Chromium and parenteral nutrition". Nutrition 11 (1 Suppl): 83–86. PMID 7749258.
- Kien, C. L.; Veillon, C.; Patterson, K. Y.; Farrell, P. M. (1986). "Mild peripheral neuropathy but biochemical chromium sufficiency during 16 months of "chromium-free" total parenteral nutrition". Journal of Parenteral and Enteral Nutrition 10 (6): 662–664. doi:10.1177/0148607186010006662. PMID 3099015.
- Moukarzel, A. A.; Song, M. K.; Buchman, A. L.; et al. (1992). "Excessive chromium intake in children receiving total parenteral nutrition". Lancet 339 (8790): 385–388. doi:10.1016/0140-6736(92)90078-H. PMID 1346659.
- Preuss, H. G.; Bagchi, D.; Bagchi, M.; Rao, C. V. S.; Dey, D. K.; Satyanarayana, S. (May 2004). "Effects of a natural extract of (–)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss". Diabetes, Obesity & Metabolism 6 (3): 171–180. doi:10.1111/j.1462-8902.2004.00328.x. PMID 15056124.
- Bagchi, Debasis; Stohs, Sidney J.; Downs, Bernard W.; Bagchi, Manashi; Preuss, Harry G. (2002). "Cytotoxicity and oxidative mechanisms of different forms of chromium". Toxicology 180 (1): 5–22. doi:10.1016/S0300-483X(02)00378-5. PMID 12324196.
- Althuis, Michelle D.; Jordan, Nicole E.; Ludington, Elizabeth A.; Wittes, Janet T. (July 2002). "Glucose and insulin responses to dietary chromium supplements: a meta-analysis". The American Journal of Clinical Nutrition 76 (1): 148–155. PMID 12081828. Retrieved February 24, 2013.
- Gunton, Jenny E.; Cheung, N. Wah; Hitchman, Rosemary; et al. (2005). "Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance". Diabetes Care 28 (3): 712–713. doi:10.2337/diacare.28.3.712. PMID 15735214. Retrieved February 24, 2013.
- Singer, Gregory M.; Geohas, Jeff (2006). "The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial". Diabetes Technology and Therapeutics 8 (6): 636–643. doi:10.1089/dia.2006.8.636. PMID 17109595. Retrieved February 24, 2013.
- Balk, Ethan M.; Tatsioni, Athina; Lichtenstein, Alice H.; Lau, Joseph; Pittas, Anastassios G. (2007). "Effect of chromium supplementation on glucose metabolism and lipids: a systematic review of randomized controlled trials". Diabetes Care 30 (8): 2154–63. doi:10.2337/dc06-0996. PMID 17519436. Retrieved February 24, 2013.
- Davidson, Jonathan R. T.; Abraham, Kurian; Connor, Kathryn M.; McLeod, Malcolm N. (2003). "Effectiveness of chromium in atypical depression: a placebo-controlled trial". Biological Psychiatry 53 (3): 261–264. doi:10.1016/S0006-3223(02)01500-7. PMID 12559660.
- Docherty, John P.; Sack, David A.; Roffman, Mark; Finch, Manley; Komorowski, James R. (September 2005). "A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving". Journal of Psychiatric Practice 11 (5): 302–314. doi:10.1097/00131746-200509000-00004. PMID 16184071.
Further reading 
- Cefalu, William T.; Hu, Frank B. (2004). "Role of Chromium in Human Health and in Diabetes". Diabetes Care 27 (11): 2741–2751. doi:10.2337/diacare.27.11.2741. PMID 15505017. Retrieved February 24, 2013.
- Wallach, Stanley (1985). "Clinical and biochemical aspects of chromium deficiency". Journal of the American College of Nutrition 4 (1): 107–120. PMID 3886757.
- "Dietary Supplement Fact Sheet: Chromium". Office of Dietary Supplements, National Institutes of Health. Retrieved February 24, 2013.
- UC Berkeley
- -66715645 at GPnotebook
- Diabetes Journal - Role of Chromium in Human Health and in Diabetes