Hi Dr. McLeod,

I am writing from Hawaii and read your wonderful book, "Lifting Depression." I have suffered from depression, anxiety and OCD all my life (starting at a young age). I have tried almost all of the antidepressants in the market with side effects and have tried almost all herbs, minerals, vitamins, etc. I had seen two naturopaths/homeopaths and have tried everything, including homeopathic remedies with little or no relief. I came across info on chromium on the internet and thought it wouldn't hurt to try... As with other things that I have tried, it immediately worked and lasted for the first three days, then I became angry and irritable. I have had these effects with kava, B complex, fish oil, 5-HTP, etc. Then, after I would try the supplements again, I would become immediately angry and irritable. I was told by a naturopath that this was a sign of my liver not being able to process the supplements correctly. After the chromium made me angry and irritable, I was very discouraged because this actually lifted my depression, anxiety, social anxiety and OCD symptoms immediately and I was so happy when it did! But, after a few days, I became very angry and irritable.

Do you have any suggestions? I had a hormone blood test done recently and am awaiting the results. I am 45 and was told that my depression/anxiety/OCD could be worsening because of my being premenopausal...

Thank you for reading this lengthy email. Everytime a supplement works, then stops working, I get really discouraged.... I wonder if I will ever find something that will help me. FYI - I fit in the category of having atypical depression...

Aloha,
A

Dear Ms. A,

I apologize for not answering your email sooner.
While chromium may rarely cause some degree of irritability, we don't know whether chromium is the culprit in your case. You have had the same response with other dietary supplements and herbs.

Please don't neglect exercise, reduction in carbs, and psychotherapy, as they are necessary elements in an overall treatment program.

You might consider reducing the dose of chromium. I would also urge you to take the ChromaxR brand as it is the most tested form of chromium.

Please semd me a followup up.

Regards,
Malcolm McLeod

Below is an e-mail I received. It's in red

Dear Dr. McLeod,
A family member suffers from depression and anxiety, so I am continually looking for ways to help her feel better. The drugs don’t seem to help much... and we’ve tried them all.
I have been reading some information about Chromium GTF and why some believe it is much more well absorbed than is the picolinate type of chromium. In fact, they say the GTF form is absorbed 10 to 25 times better than “inorganic chromium”. See quote below:
“Chromium is not naturally found in the body in the commonly supplemented forms such as chromium picolinate, chromium chloride, or chromium chelate. Only 1% or less of inorganic chromium is absorbed vs. 10-25% of chromium GTF.”
Would it be best to take the GTF form? If not, why not?
Thank you!
B.J.

I responded as follows:

Hello B.J.,

Thank you for contacting me.

It is quite true that inorganic forms of chromium, such as chromium chloride, are very poorly absorbed. The two organic forms of chromium -- chromium picolinate and chromium polynicotinate (aka GTF) -- are both well absorbed. I prefer CHROMAX chromium picolinate (which is chelated with picolinic acid) over the polynicotinate preparation (chelated with niacin). Although chromium polynicotinate is well absorbed, I do not recommend it because it causes flusing, dizziness and hyperpigmentation is some patients. These undesirable side effects are caused by niacin.

Please let me know if this helps.

Malcolm McLeod, MD

I received the following e-mail:

The results of the tiny study (on the role of chromium in the treatment of depression), done in 2000, look so promising. Why is it that the http://www.chromiumconnection.com/ has no reference to newer and larger studies?

Did such studies ever occur? I am interested in participating in such a study if one exists. I have been diagnosed under DSM IV with dysthmia and sever depression. I also fit the description for atypical depression. I have been off work for the last year and a half with severe depression. I have tried 6 different MAOI drugs and am currently using Mannerix as I tolerate it well and it provides some relief.

My answer follows:

Thank you for writing to me. There has been a more recent study on the role of chromium picolinate in the treatment of atypical depression.

In 2005, the results of a study of 113 patients, conducted by Comprehensive Neuroscience, were published. This double-blind study further demonstrated chromium's role in reducing crbohydrate cravings in people with the most common type of depression.

I certainly would refer you to a study if one existed, but I don't know of any. Moreover, it is unlikely that very large studies will be conducted further to substantiate chromium's role in depression, as there is not enough profit in neutraceuticals to support the type of large studies funded by pharmaceutical companies.

I hope these comments help.

Malcolm McLeod

Below in italics is a question I received:

I'm curious to know if Chromium Polynicotinate GTF with the trademark ChromeMate would work for depression and Diabetes just as well as Picolinate.

Thanks,

Jenny

Dear Jenny,
I recommend Chromax®chromium picolinate. It the best preparation of chromium, in my experience, and it has no known side effects.

Years ago, soon after I accidentally discovered chromium's benefits in depression, I learned that there is great variation in quality among distributors of chromium products. Some chromium products didn't work, other tasted awful and some caused a total body rash. Gradually I narrowed the two most effective preparations down to chromium picolinate and chromium polynicotinate. Both helped lift depression, gave more energy, and curbed appetite. Not long thereafter, however, I learned that chromium polynicotinate, which is chelated with niacin, can cause dizziness, I sent several patients to neurologists for dizziness and fainting, and no cause was found. I began to suspect the culprit was the niacin in chromium polynicotinate. After the patients switched from chromium polynicotinate to chromium picolinate, their dizziness disappeared. Other side effect associated with the polynicotinate chromium preparation are flushing, rashes, and skin hyperpigmentation.

In summary, both chromium picolinate and chromium polynicotinate improve insulin sensitivity and help associated symptoms, but chromium polynicotinate causes unwanted side effects. So I recommend Chromax®chromium picolinate, distributed by Nutrition 21.

Q: I think that maybe chromium brings my blood sugar TOO far down (I am a normal-not insulin resistant-individual, and am extremely drug sensitive to even very small doses of just about everything)?

A: That's a good question. I'm not aware that chromium causes blood sugar to fall too low. There are many causes of low blood sugar. One of the most frequent causes is eating sugar and rapidly absorbed carbohydrates. Caffeine can cause low blood sugar in some people.

Before concluding that chromium causes low blood sugar, I suggest eating a healthy diet free of sugar, white bread and potatoes and reduce caffeine intake while taking chromium. Please let me know your response.
MM

Q: I have read your book Lifting Depression and I am about to start on Chromax for myself.

I have a 15-year-old (will be 16 in July) son who is depressed, lethargic, has loss of focus, non-motivated, and constantly wants sweets. He refuses to take prescription meds, such as antidepressants. Do you think the Chromax could help him, and if so, what dosage? He weighs approximately 165 pounds, about 5’7” tall. His mood problems are severely affecting his life.

Thank you for your time.

A: Good luck to you. I hope Chromax helps you.

From your description of your son's symptoms, it sounds as if he is suffering from atypical depression. That's the type of depression associated with excessive appetite and unexplained exhaustion. Chromax(R) chromium picolinate has been demonstrated to decrease carbohydrate craving in people with this type of depression. So, yes, I think you should suggest your son take Chromax. You might explain that Chromax is not a man-made, pharmaceutical drug, but is a natural substance. Chromium is an essential trace mineral, just like iron, that is necessary for the body to function normally. Eating a diet high in sweets can cause loss of chromium.

In addition to taking Chromax, I would continue to suggest he consult a mental health professional. You might explain that depression is a medical disorder and there is a treatment for it.

Regarding the amount to take, I recommend a starting dose of between 3 to 5 micrograms per body weight per day, taken in the morning. For your son that would translate into a beginning dose of approximately 500 micrograms per day. If he doesn't respond favorably within a week, I would increase the dosage to 800 micrograms per day.

In addition to taking Chromax, I suggest you encourage your son to follow the other treatment recommendations found in Lifting Depression: The Chromium Connection. These include exercis and supplementation of his diet with omega-3 fatty acids (fish oil). Fish oil is widely available. Many of my patients with atypical depression were too tired to exercise, so they got into a cycle of overeating, weight gain and less exercise. After beginning Chromax, many of them had enough energy to exercise. And, by controlling their craving for carbs, Chromax helped them fight weight gain.

Please let me know how you and your respond to Chromax.

I wish you best.

Malcolm McLeod, MD

Q: In one of your blogs you recommend Chromax(R) chromium picolinate, but I haven't been able to find it. Where can I find it?

A: By the late summer of this year (2006), you'll be able to find Chromax(R) chromium picolinate in 90 Percent of drug, food and mass retail chains. These include Wal-Mart, Rite Aid, Albertsons, Kroger and Duane Reade.

Yes, I do recommend Chromax(R) chromium picolinate. Just as there is variation in the quality of generic prescription drugs, there is variation in neutraceuticals, which include chromium picoliate.