Ms. Western's third visit: "Why do I crave chocolate over other sweets?"

Q: During our third meeting, Ms. Western, to whom I have referred in two earlier blogs, said to me, "Chromax has really curbed my cravings for chocolate and has given me much more energy. No doubt about it. Before I was so tired I couldn't exercise. Now I have enough energy to exercise and am walking a couple of miles a day." Then she added, "I like all sweets, but I prefered chocolate over all other sweets. Why?"

A: I said to Ms. Western, "Consuming sugar often makes people feel better and of course chocolate contains sugar. You probably prefer chocolate because, in addition to sugar, chocolate contains two substances that help mood. One is a mood-enhancing chemical called phenethylamine. The other one is a caffeine-like stimulant named theobromine."

While chocolate may lift your mood and gives you energy over the short time, eating too much chocolate may do more harm that good over the long term. Within an hour or two after eating chocolate, people often crash and are ravenously hungry again. Their body needs more chocolate. Over time, a person puts on weight and blood sugar fluctuations become even more of a problem. More and more chocolate is required for a fix. Yes, many patients refer, as you do, to eating chocolate as a "fix," an addiction.

Ms. Western said she felt so much better that she didn't think more visits with me were necessary. I agreed and told her that my door will always be open to her if she needs to come back. I also told her I would be pleased to receive e-mails from her about how she was doing. Meanwhile, I suggested she continue to take Chromax indefinitely to keep her chocolate cravings in check,and to continue Zoloft and exercise. She thanked me and we said goodbye.

Ms. Western's second visit: follow-up after starting Chromax

Follow-up e-mail and visit from Ms. Western after starting Chromax

Ms. Western send me this email: "Three days ago I started taking Chromax. It has definitely curbed my craving for chocolates. Not completely, but greatly reduced. I'm not losing my starch in the afternoon. My energy level is better, much better. No doubt about it. And my mood is better. See you in a few days."

During our second meeeting, she was emphatic about how much Chromax had helped her energy, mood, and it had greately reducted her cravings for chocolate. Then she added, "One of my daughters has the same problem. I'm going to recommend Chromax to her."

I gave Ms. Western another appointment and advised her to stay the course, that is, to continue Chromax, eat a healthy diet and to continue her two-miles walks every day or two.

Ms. Western's first appointment: sudden sadness, exhaustion and craving for chocolate

Three weeks ago I met with a new patient, a woman in her 50s, whom I'll call Ms. Western.

She said she had had three episodes of uncontrollable crying and agitation over the past six months. She consulted her family physician who prescribed Zoloft, which "helped considerably." But Zoloft did not relieve her exhaustion, and her daily afternoon mood plummets. Due to the persistence of her problems, her family insisted she see a psychiatrist, so she contacted me and we arranged an appointment.

Ms. Western described her daily episodes as follows, "I suddenly lose my starch at 3:30 in the afternoon. I get limp and really tired. I crave chocolates. They give me a boost, a second wind. I call this my 'crave chocolate and tired syndrome.'"

I asked, "What do you mean by 'losing your starch?'" She answered, "That's a phrase mid-westerners use to describe a sudden fall in mood and loss of energy."

I added, "In the South, where I grew up, the sudden onset of depression and exhaustion is referred to as a 'sinking spell.' Other regional descriptions are 'My wheels fell off',' and 'My bucket's got a hole in it.'"

Undoubtedly there are many more phrases that are used to describe this widespread, frequent and troublesome experience. Fortunately such episodes are usually brief. Unfortunately, organized psychiatry has not directed much attention to this problem.

Then I said to Ms. Western, "Here is what I suspect causes you to 'lose your starch.' In almost all people, there are fluctuations in mood and energy during a 24-hour period. All of us have heard people describe themselves as 'a morning person' or 'a night owl.' They are referring to the time of day when they have the most energy and alertness.

"
But the daily swings in your mood and energy have become too wide. That may be caused by low blood sugar in the afternoon.

"Many of my patients — who have been troubled by "losing starch," "sinking spells," and "bucket's got a hole in it," — have benefited enormously from chromium. I think that's because chromium smoothes out fluctuations in blood sugar, which in turn elevates mood.

Therefore I said to Ms. Western, "I certainly think you should also take 500 micrograms a day of Chromax. Chromax is a special brand of chromium. And you should continue to take Zoloft. Please let me know if Chromax helps you."

I gave Ms. Western another appointment and also asked her to send me an email after she started taking Chromax, and tell me if she had any response to it.

What Study Shows Chromium Helps Carb Cravings in Depression

Q: I see in one of your blogs that Medscape is offering CME credits to physicians for the study of chromium's role in appetite and mood regulation. What study is the CME course based on? Will you tell me if there is some place, other than Medscape which requires registration, where I can find a discussion of that study?

A: I'll be happy to. The Science blog contains an excellent discussion of the study that demonstrated that chromium picolinate curbs carbohydrate craving in people with atypical depression.

Physicians Get Credit for Studying Chromium

Q: Dr. McLeod. Are you aware that Webscape WebMD is offering continuing medical education credits to physicians for the study of chromium's role in curbing carb cravings in atypical depression? Congratulations!

A: No I was not aware of that, but it is exciting indeed to see that information about chromium's role in appetite and mood regulation is getting "out there." I did go to the Medscape web site and indeed the CME activity is there. You can find it at Medscape (registration required.)

Recent study on insulin resistance and depression?

Q: In your book, Lifting Depression: The Chromium Connection, you suggest that resistance of the body to the action of insulin is associated with depression. You cite your own case studies as well as studies conducted in the 1980s on which your theory is based. Is there any recent clinical evidence to support your theory?

A: Yes. A group of investigators in Finland, led by Professor Markku Timonen, measured insulin resistance and depression in 491 men who were 55 years old. In their article, published in 2004, they report that subjects with insulin resistance had higher depression scores than people who did not have insulin resistance.

Can chromium help severe depression?

Q: Hi, I have suffered from Severe (Major) Depression Disorder for about 3 years. I have been taking Effexor XR, Lamictal, and also Xanax. I am wondering if Chromium would work for my situation, I know there cannot be a definite answer to my question, but have other people with more severe forms of depression benefited from taking Chromium? These current medications that I have been prescribed are quite expensive and I am looking for more of a natural alternative, but do not want to jeopardize my mental health either. Please give me any information you can on this, as it will be greatly appreciated. Thank you.

A: Thank you for your question. Yes, some of my patients with serious depression have been helped substantially by adding chromium to their medication regimen. And chromium is a natural treatment that is inexpensive.

You are correct. I cannot give a definite answer to you as an individual and I agree with you that you should not jeopardize your mental health by stopping the medications you're now taking. But I would suggest adding chromium, as it is extremely safe and might be of great benefit to you. Please discuss my suggestions with your healthcare provider before taking any action. Please read the FAQs at www.chromiumconnection.com. There you will find more complete responses.I do hope this helps you. Please let me know.