Talk:Chromium deficiency

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The[edit]

The whole "glucose tolerance factor" thing seems to have been abandoned as a serious line of enquiry many years ago. Why are we still giving it so much weight? This was the subject of an edit war in diabetes mellitus a while ago. JFW | T@lk 07:20, 19 February 2007 (UTC)[reply]

My guess: this is fringe science[edit]

The article assumes that a biological role for Cr is established, when in fact the so-called problem of chromium deficiency is probably a construct of the marketers of nutritional supplements. Biochemically, the topic appears to be either unimportant and flimsy, based on the lack of references. I cant find much on beneficial bio-Cr either.--Smokefoot (talk) 16:55, 16 February 2008 (UTC)[reply]

Further Information[edit]

Does anyone have information on Chromium Chelate? Have there been studies upon this form in particular? 68.121.171.33 (talk) 20:41, 17 September 2010 (UTC)[reply]

If Chromium is linked to how the body establishes cholesterol and has a significant ability to reduce the bad cholesterol (LDL), why if this not the first port of call with the doctors to reduce peoples high LDL, then they still have the contingency plan which is to give patients STATINS!!!!! — Preceding unsigned comment added by 217.43.145.216 (talk) 17:29, 29 June 2011 (UTC)[reply]

Meta-analyses show that chromium not effective in controlling LDL-cholesterol. David notMD (talk) 10:25, 25 April 2017 (UTC)[reply]

Stress on the commercial patented picolinate and omission of the natural GTF is NPOV ad copy.[edit]

Some reference needs be made in this article to Glucose Tolerance Factor (GTF) chromium. The natural form of chromium from yeast is better, cheaper, and not patented. There is a large NPOV advertising-like bias in favor of the commercial picolinate product by the complete omission of GTF.

The natural form of chromium from yeast (GTF chromium) is has better-established health effects, and is cheaper. GTF chromium is not patented, because it cannot be - it's a natural substance. Chromium Picolinate was an attempt to profit by patenting an analogue to the beneficial GTF chromium, and it was heavily promoted based on very thin research, and without mention of GTF chromium. I believe the FDA finally cracked down on the claims.

Glucose tolerance factor (GTF) in Wikipedia redirects to Chromium deficiency, which lays out the threadbare claims for picolinate without ever directly mentioning Glucose Tolerance Factor chromium. — Preceding unsigned comment added by 99.190.133.143 (talk) 14:51, 11 February 2012 (UTC)[reply]

The therapeutic potential of glucose tolerance factor. PMID 7005627[edit]

McCarty MF.

The therapeutic potential of glucose tolerance factor.

Med Hypotheses. 1980 Nov;6(11):1177-89.

Abstract

Glucose Tolerance Factor (GTF) is synthesized in vivo from absorbed dietary chromium, and acts as a physiological enhancer of insulin activity, binding to insulin and potentiating its action about three-fold. Since GTF is well absorbed orally, the development of sufficiently concentrated and stable supplementary sources of this agent may enable convenient and physiologically appropriate pharmacological modulation of insulin activity. A review of the numerous physiological actions of insulin suggests a number of therapeutic applications for GTF, in such diverse ailments as diabetes mellitus, hyperlipidemia, reactive hypoglycemia, obesity, cancer, protein malnutrition or malabsorption, endogenous depression, Parkinsonism, hypertension and cardiac arrhythmias. GTF supplementation may also have value in preventive medicine.

PMID 7005627 — Preceding unsigned comment added by Ocdnctx (talkcontribs) 13:18, 8 October 2012 (UTC)[reply]

The tone of this article is that chromium deficiency is very rare and only occurs when people are on TPN. There is even a line questioning if it is a nutrient. I would like to suggest that any benefit from a supplement will only be seen if the person is deficient. If the person is getting adequate amounts from food, then there will be no benefit from the supplement. This is true for all nutrients. So to see the effect of a chromium supplement, you have to find a population that is deficient. The place to look for that is in the subpopulation of people over age 65. I think if you go to any retirement home, at least 50% of the folks there will be deficient because they can no longer absorb it properly from the food. I am in that group. I was experiencing severe muscle weakness that was getting worse and worse. I tried boosting iron and B12 to no effect. Finally I found references that said chromium deficiency could cause the symptoms I was experiencing. I tried boosting my supplement dose up to 70%RDA and the problem was quickly fixed. Here is a ref that better captures the symptoms: www.newsmax.com/FastFeatures/deficiency-of-Chromium-signs/2010/11/id/371438 Please update this article so it takes into consideration older people that cannot absorb. I was not able to use this article as written to get the help that I needed.Bluesky2013 (talk) 13:32, 24 December 2012 (UTC)bluesky2013[reply]

I concur with the point made above, is somebody is not deficient in a mineral, they are clearly not going to benefit hence the negative comments based on 'healthy individuals' are irrelevant and of inappropriate tone. The purported benefit of these supplements is on those individuals with poor energy generation and/or insulin resistance hence clearly only people with these illnesses will benefit. Finally Chromium is not commonly tested, hence any statements about the commonality of otherwise are questionable. I was recently tested (not by my doctor) for intracellular minerals and was found to have minor Chromium deficiency despite it never having been tested.

This article does not give the impression of objectivity. --Leopardtail (talk) 14:08, 3 May 2014 (UTC)[reply]

ad copy moved here from main page (Image of patented proprietary picolinate form)[edit]

Chromium picolinate

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Editing toward NPOV[edit]

Attempting to edit toward a neutral point of view, as there was some chromium bashing in the article. Touchy topic, as EFSA (European Union) denies chromium is an essential nutrient, but U.S. says it is, and even approved a Qualified Health Claim. A topic not yet adequately addressed in the article is whether chromium as a supplement helps manage glucose in people with type 2 diabetes. Also not addressed are the weight loss claims.

I am declaring a COI on the supplementation topic, as I am a science consultant to dietary supplement companies that make and sell chromium-containing products. None of my clients have asked me to edit about chromium, and in fact, none of them are not aware that I am a Wikipedia editor. I am not editing on any client's (unknowing) behalf. Regardless, if I compose text and citations about chromium as a supplement for people with diabetes, and/or any role in weight management, I will create it as a section here in Talk, for others to review and decide whether it belongs in the article. An important question - which article? Supplementation at 200 to 500 micrograms per day in people who are not chromium deficient may be more appropriate in the chromium article, biological role section, than here in Chromium deficiency. David notMD (talk) 16:20, 13 April 2018 (UTC)[reply]

For what its worth and with respect, my advice would be to tap into your expertise to remove or challenge only egregious material, if any, add a superb source or two and then back off. There is the COI issue. If animal studies show no benefit, why not leave such material?--Smokefoot (talk) 14:46, 14 April 2018 (UTC)[reply]
Vis-a-vis diabetes, there are more than 50 clinical trials cited in seven meta-analyses (see PMID 27261273 page 459 for list of trials and meta-analyses) so I see no need to dilly-dally with animal-based evidence. As a preview of where this is going, modest decreases in hemoglobin A1C and/or fasting blood glucose are either statistically significant or not, depending on which meta-analysis. The authors' point from that 2016 article is that few of the trials reported decreases large enough to be considered clinically relevant, i.e., large enough to expect to make a difference in disease outcome. And the trials in the main were not long enough to report changes in disease outcome. Finally, it needs to be stated that all (?) of these trials were with people who had been and continued to be treated with prescription medications for their diagnosed diabetes, so there is an absence of evidence for chromium having any efficacy as a first or only treatment, an alternative to drugs. David notMD (talk) 23:40, 14 April 2018 (UTC)[reply]

Proposed replacement for Supplementation section[edit]

What follows is a proposed replacement for the existing supplementation section. My own understanding of the evidence is that chromium as a supplement, consumed by people who have type 2 diabetes and are not thought to be chromium deficient, results in statistically significant but modest decreased in FPG and HbA1C that may not be large enough to have a significant impact on clinical outcome. What is missing from the literature are trials that are long and large enough to test whether standard medical treatment plus chromium was superior to standard medical treatment alone. Weight loss is a second purported benefit that supplement companies claim. Here again, there appears to be a measurable but very, very modest effect. Because of my declared consultant involvement in the supplement industry I leave to other editors whether any of the proposed content should be added to the article (and whether it belongs in the chromium deficiency article, or the chromium article, or both). David notMD (talk) 10:57, 15 April 2018 (UTC)[reply]

Seems like this is much more of an expansion than a replacement. In any event, I didn't have any concerns with policy/guideline compliance after reading through the content below, so plus Added. Seppi333 (Insert ) 12:37, 17 April 2018 (UTC)[reply]
Proposed content replacement
Supplementation

Chromium is an ingredient in total parenteral nutrition (TPN) because deficiency can occur after months of intravenous feeding with chromium-free TPN. For this reason, chromium is added to TPN solutions, along with other trace minerals.[1] It is also in nutritional products for preterm infants.[2] In the United States, chromium-containing products are sold as non-prescription dietary supplements.

Diabetes

Given the evidence for chromium deficiency causing problems with glucose management in the context of intravenous nutrition products formulated without chromium,[1] research interest turned to whether chromium supplementation for people who have type 2 diabetes but are not chromium deficient could benefit. Looking at the results from four meta-analyses, one reported a statistically significant decrease in fasting plasma glucose levels (FPG) and a non-significant trend in lower hemoglobin A1C (HbA1C).[3] A second reported the same,[4], a third reported significant decreases for both measures,[5] while a fourth reported no benefit for either.[6] A review published in 2016 listed 53 randomized clinical trials that were included in one or more of six meta-analyses. It concluded that whereas there may be modest decreases in FPG and/or HbA1C that achieve statistical significance in some of these meta-analyses, few of the trials achieved decreases large enough to be expected to be relevant to clinical outcome. The authors also mentioned that trial design was for chromium as an addition to standared glycemic control medications, and so did not evaluate chromium as a first treatment for type 2 diabetes, or for prevention of progression from pre-diabetes to diabetes. The conclusion was that "...there is still little reason to recommend chromium dietary supplements to achieve clinically meaningful improvements in glycemic control."[7] The American Diabetes Association publishes a standards of care review every year. The 2018 review makes no mention of chromium supplementation as a possible treatment.[8]

Weight management

Two systematic reviews looked at chromium supplements as a mean of managing body weight in overweight and obese people. One, limited to chromium picolinate, a popular supplement ingredient, reported a statistically significant -1.1 kg (2.4 lb) weight loss in trials longer than 12 weeks.[9] The other included all chromium compounds and reported a statistically significant -0.50 kg (1.1 lb) weight change.[10] Authors of both reviews considered the clinical relevance of this modest weight loss as uncertain/unreliable.[9][10] The European Food Safety Authority reviewed the literature and concluded that there was insufficient evidence to support a claim.[11]

Reflist
  1. ^ a b Stehle P, Stoffel-Wagner B, Kuhn KS (2016). "Parenteral trace element provision: recent clinical research and practical conclusions". Eur J Clin Nutr. 70 (8): 886–893. doi:10.1038/ejcn.2016.53. PMC 5399133. PMID 27049031.
  2. ^ Finch, C. W (2015). "Review of trace mineral requirements for preterm infants: What are the current recommendations for clinical practice?". Nutrition in Clinical Practice. 30 (1): 44–58. doi:10.1177/0884533614563353. PMID 25527182.
  3. ^ San Mauro-Martin I, Ruiz-León AM, et al. (2016). "[Chromium supplementation in patients with type 2 diabetes and high risk of type 2 diabetes: a meta-analysis of randomized controlled trials]". Nutr Hosp (in Spanish; Castilian). 33 (1): 27. doi:10.20960/nh.v33i1.27. PMID 27019254.{{cite journal}}: CS1 maint: unrecognized language (link)
  4. ^ Abdollahi M, Farshchi A, Nikfar S, Seyedifar M (2013). "Effect of chromium on glucose and lipid profiles in patients with type 2 diabetes; a meta-analysis review of randomized trials". J Pharm Pharm Sci. 16 (1): 99–114. PMID 23683609.
  5. ^ Suksomboon N, Poolsup N, Yuwanakorn A (2014). "Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes". J Clin Pharm Ther. 39 (3): 292–306. doi:10.1111/jcpt.12147. PMID 24635480.
  6. ^ Bailey CH (January 2014). "Improved meta-analytic methods show no effect of chromium supplements on fasting glucose". Biol Trace Elem Res. 157 (1): 1–8. doi:10.1007/s12011-013-9863-9. PMID 24293356.
  7. ^ Costello RB, Dwyer JT, Bailey RL (2016). "Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness". Nutr. Rev. 74 (7): 455–468. doi:10.1093/nutrit/nuw011. PMID 27261273.
  8. ^ Standards of Medical Care for Diabetes - 2018 Diabetes Care 2008:41:Supplement 1.
  9. ^ a b Tian H, Guo X, Wang X, He Z, Sun R, Ge S, Zhang Z (2013). "Chromium picolinate supplementation for overweight or obese adults". Cochrane Database Syst Rev (11): CD010063. doi:10.1002/14651858.CD010063.pub2. PMID 24293292.
  10. ^ a b Onakpoya I, Posadzki P, Ernst E (2013). "Chromium supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials". Obes Rev. 14 (6): 496–507. doi:10.1111/obr.12026. PMID 23495911.
  11. ^ Scientific Opinion on the substantiation of health claims related to chromium and contribution to normal macronutrient metabolism (ID 260, 401, 4665, 4666, 4667), maintenance of normal blood glucose concentrations (ID 262, 4667), contribution to the maintenance or achievement of a normal body weight (ID 339, 4665, 4666), and reduction of tiredness and fatigue (ID 261) pursuant to Article 13(1) of Regulation (EC) No 1924/2006 European Food Safety Authority EFSA J 2010;8(10)1732.