Avoid in patients with a known allergy or hypersensitivity to chromium. People with allergies to chromate or leather may be more likely to have allergic reactions to chromium.
Allergic reactions from handling chromium or its use in medical devices (orthopedic prosthesis, dental restorations) may occur.
Side Effects and Warnings
Chromium, in its trivalent form, appears to be well tolerated with rare or uncommon adverse effects. However, the hexavalent form is not well tolerated and may be toxic. Hexavalent chromium appears to be associated with lung cancers. Long-term occupational exposure to hexavalent chromium may also lead to skin problems and a perforated nasal septum.
The most common complaints include stomach discomfort and nausea or vomiting. Very rarely, skin rashes, insomnia or sleep disturbances, headaches, mood changes, muscle damage, or anemia may occur.
It is possible that chromium may lower blood sugar levels. As a result, it should be used cautiously in patients who are taking drugs for diabetes.
It is possible that chromium may have adverse effects on the heart, blood, kidneys, or liver. There are also rare reports of respiratory effects, such as cough, shortness of breath, wheezing, rhinitis, asthma, and headache, after inhaling chromium.
Cognitive, perceptual, and motor changes may also occur, although they are unlikely.
Early data show that chromium, in combination with copper, may have potential suppressive effects on the immune system. Caution should be used in those with a suppressed immune system, such as in HIV or transplant patients.
Pregnancy & Breastfeeding
Many natural medicine experts and textbooks state that chromium is safe if taken by pregnant or breastfeeding women in the amount of 45 micrograms per day by mouth. However, scientific studies have not clearly proven safety and effectiveness.
Adults (over 18 years old)
Chromium is available in several forms, such as trivalent chromium, chromium-enriched yeast, and chromium picolinate. Chromium has been studied short-term and long-term. Although there have been many studies involving chromium, overall, the evidence is mixed. There is no proven effective dose for any type of chromium for any indication. Studies in humans have used doses of 200-1,000 micrograms of chromium picolinate per day by mouth as capsules or tablets. As chromium-enriched yeast, 150-400 micrograms has been commonly studied. As chromium picolinate, lower doses of 200-250 micrograms have been used. It should be noted, however, that some natural medicine experts believe that adequate dietary intake of chromium is only 24-45 micrograms per day, although others recommend 50-200 micrograms per day.
Children (under 18 years old)
The dosing and safety of chromium have not been studied thoroughly in children and high doses of chromium are generally not recommended. Some practitioners have recommended an adequate chromium intake of 0.2-35 micrograms per day, depending on age.
Interactions with Drugs
Chromium may lower blood sugar levels. Caution is advised if taking drugs that may lower blood sugar levels. Patients taking oral drugs for diabetes or using insulin should be monitored closely by healthcare professionals while using chromium.
Lithium and nicotinic acid may also increase the tendency for blood sugar levels to become low. In contrast, when chromium is used with corticosteroids, such as prednisone, increases in blood sugar levels may occur. Dosing adjustments may be necessary.
Chromium may modify serotonin function in the brain and therefore may interact with prescription antidepressants, such as sertraline (Zoloft®) and fluoxetine (Prozac®).
In theory, some drugs may decrease chromium levels in the body and may interfere with chromium's activities. Examples include drugs that reduce acid in the stomach, such as esomeprazole (Nexium®), ranitidine (Zantac®), antacids, and corticosteroids (for example, prednisone). In contrast, aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin® or Advil®) and naproxen (Naprosyn®, Aleve®, or Anaprox®), may increase chromium levels in the body, which could lead to increased side effects.
Picolinic acid, a component often found with chromium, may alter the metabolism of certain chemicals in the brain. If these chemicals are altered, the doses of some drugs used to treat conditions, such as depression or Parkinson's disease, may need to be changed.
Chromium may interact with drugs that alter the body's immune response. Caution is advised in patients with compromised immune systems.
Corticosteroids may increase the amount of chromium excreted in the urine. This may result in chromium deficiency or increased blood sugar levels.
Chronic alcohol use may increase the chance of liver and kidney damage when taken, or exposed to, a form of chromium called hexavalent chromium.
Chromium supplementation may increase cholesterol (HDL) concentrations among patients taking beta-blockers. Caution is advised in patients taking medications for heart disorders along with chromium.
Chromium may increase blood pressure. Caution is advised in patients taking medications that alter blood pressure.
Chromium may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be decreased in the blood and the intended effects may be reduced. Patients taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
There is insufficient evidence to support the use of chromium in the treatment of weight loss; caution may be warranted with the use of chromium and weight loss agents.
Interactions with Herbs & Dietary Supplements
Chromium may alter blood sugar levels. People using herbs or other supplements that may alter blood sugar levels, such as bitter melon (, should be monitored closely by healthcare professionals while using chromium. Dosing adjustments may be necessary.
Chromium taken with other supplements may alter the amount of chromium in the body. In theory, anti-inflammatory herbs and supplements may increase chromium levels in the body, which could lead to a tendency for increased side effects. In theory, zinc may decrease chromium levels in the body and may interfere with chromium's activities. It is possible that vitamin C may also alter chromium levels. Chromium taken with iron may affect the way iron is processed in the body. Chromium picolinate used with biotin may show favorable effects on regulating blood sugar, but additional study is needed in this area.
Chromium has been shown to decrease serotonin levels and may interact with herbs and supplements that affect serotonin.
Chromium may interact with herbs or supplements that alter the body's immune response. Caution is advised in patients with compromised immune systems.
Although not well studied in humans, chromium supplementation may increase cholesterol (HDL) concentrations when taken with other herbs or supplements used for heart disorders. Caution is advised.
Chromium may increase blood pressure. Caution is advised in patients taking herbs or supplements that alter blood pressure.
Chromium may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
There is insufficient evidence to support the use of chromium in the treatment of weight loss. Caution may be warranted with use of chromium and herbs and supplements used for weight loss.