Chromium is an essential trace element for humans. In order for the body to use chromium, it must be converted to an active form. Glucose tolerance factor (GTF) is an active form of chromium that has been isolated from brewer's yeast. GTF chromium helps insulin pull glucose (blood sugar) from the bloodstream into the cells for energy. Insulin is very important for carbohydrate, protein, and fat metabolism. Not getting enough chromium in your diet can affect insulin's ability to process these nutrients.

It is estimated that as many as 90% of all Americans' diets are low in chromium. Eating a lot of highly processed foods may contribute to this problem because foods lose chromium during the refining process. Children with protein-calorie malnutrition, people who have diabetes, and older people may be especially at risk for chromium deficiency. Eating too many sugary foods, exercising strenuously, and having an infection or physical injury can cause your body to lose chromium. Low chromium levels can increase blood sugar and raise triglyceride (a type of fat) and cholesterol levels.

Here is a list of some of the health problems associated with low chromium levels:

• Diabetes. People with diabetes cannot adequately process blood sugar. People who have Type I diabetes (insulin-dependent) need insulin shots to help them process blood sugar. Type II diabetics (non-insulin-dependent) can often control their blood sugar with diet alone. Studies show that taking chromium supplements can improve the ability of people with Type II diabetes to process blood sugar, especially if their body's store of chromium is low. Some people have higher than normal blood sugar (hyperglycemia), but are not considered diabetic. These people often have low chromium levels and can also benefit from taking chromium supplements. High blood sugar levels due to low chromium levels are a common problem among older people.
• Hypoglycemia. Hypoglycemia is the opposite of hyperglycemia and diabetes. People who have hypoglycemia have low blood sugar. Low chromium levels may be a contributing factor of hypoglycemia in some people. Taking 200 mcg of chromium a day may improve the symptoms of hypoglycemia.
• Cardiovascular disease. Low chromium levels are associated with increased blood cholesterol and a greater risk of developing heart disease. Taking chromium supplements has been shown to increase HDL ("good") cholesterol and lower triglyceride and total cholesterol levels in people with diabetes and people with high blood sugar.
• Glaucoma. Chromium affects insulin receptors in the eye. There is a strong association between low chromium levels and increased risk of glaucoma. Glaucoma is a common problem among people with diabetes.
• Obesity. Preliminary evidence suggests that taking chromium supplements may help reduce body fat and increase muscle tissue.
• Osteoporosis. Chromium picolinate has been shown to decrease urinary excretion of calcium and hydroxyproline in women, and may help preserve bone density in postmenopausal women.

Brewer's yeast, lean meats (especially processed meats), cheeses, pork kidney, whole-grain breads and cereals, molasses, spices, and some bran cereals.

Brewer's yeast grown in chromium-rich soil is the best dietary source for chromium. Vegetables, fruits, and most refined and processed foods (except for some processed meats, which contain high amounts of chromium) contain low amounts of chromium. Hard tap water can supply 1 to 70% of your daily requirement. Cooking in stainless steel cookware increases the chromium content of food.

Chromium is available commercially in several forms, including chromium polynicotinate, chromium picolinate, chromium-enriched yeast, and chromium chloride. Chromium is available in multivitamins and alone in tablet and capsule forms. Preparation doses are typically between 15 and 200 mcg chromium a day in multivitamins.

To prevent and treat disease, you should take between 100 to 200 mcg of chromium daily.

As with all medicines and supplements, check with a health care provider before giving chromium supplements to a child.

The form of chromium found in foods is generally nontoxic. However, extremely high amounts can cause toxicity and gastric irritation. High amounts or tissue accumulation of chromium can make insulin less effective. Check with your health care provider before taking chromium if you have diabetes, hyperglycemia, or hypoglycemia.

There has been some debate about the safety of chromium picolinate; be sure to consult your doctor about its use.

Animal studies suggest that antacids may reduce the body's ability to absorb chromium. Although it is unclear how this research relates to humans at this time, it may be advisable to avoid taking chromium supplements at the same time as antacids.

Clinical studies have demonstrated that people with Type I or Type II diabetes who take chromium supplements may require lower doses of medications such as insulin, metformin, or sulfonylureas (a class of medications used to treat Type II diabetes that includes glyburide, glimepiride, and others).

Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes. 1997;46:1,786–1,791.

Anderson RA, Polansky MM, Bryden NA, Bhathena SJ, Canary JJ. Effects of supplemental chromium on patients with symptoms of reactive hypoglycemia. Metabolism. 1987;36:351–355.

Bahadori B, Wallner S, Schneider H, Wascher TC, Toplak H. Effect of chromium yeast and chromium picolinate on body composition of obese, non-diabetic patients during and after a formula diet. Acta Med Austriaca. 1997;24:185–187.

Davis ML, Seaborn CD, Stoecker BJ. Effects of over-the-counter drugs on 51chromium retention and urinary excretion in rats. Nutr Res. 1995;15:201-210.

Friedman E, ed. Biochemistry of the Essential Ultratrace Elements. New York, NY: Plenum Press; 1984.

Fujimoto S. Studies on the relationships between blood trace metal concentrations and the clinical status of patients with cerebrovascular disease, gastric cancer, and diabetes mellitus. Hokkaido Igaku Zasshi. 1987;62:913–932.

Krause MV, Mahan LK. Food, Nutrition, and Diet Therapy. 7th ed. Philadelphia, Pa: WB Saunders Co; 1984.

McCarty MF. Complementary measures for promoting insulin sensitivity in skeletal muscle. Med Hypotheses. 1998;51(6):451-464.

McCarty MF. Anabolic effects of insulin on bone suggests a role for chromium picolinate in preservation of bone density. Med Hypotheses. 1995;45:241–246.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998.

Ravina A, Slezack L. Chromium in the treatment of clinical diabetes mellitus. Harefuah. 1993;125(5-6):142-145,191.

Seaborn CD, Stoecker BJ. Effects of antacid or ascorbic acid on tissue accumulation and urinary excretion of chromium-51. Nutr Res. 1990;10:1401-1408.

Shils ME, Olsen JA, Shike M, eds. Modern Nutrition in Health and Disease. 8th ed. Media, Pa: Williams and Wilkins Co; 1994:1.

Somer E. The Essential Guide to Vitamins & Minerals. New York, NY: HarperCollins Publishers; 1992

Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. Metabolism. 1987;36:896–899.

Wilson BE, Gondy A. Effects of chromium supplementation on fasting insulin levels and lipid parameters in healthy, non-obese young subjects. Diabetes Res Clin Pract. 1995;28:179–184.