WHAT IS THE PROPER DOSAGE OF CrPic?

COMMENT:

Dr. McLeod:

After reading your book, I started taking chromium almost five years ago. It had a profound impact. I am wondering about dosage. I believe I have been taking 200 mcg after breakfast, and then again, at around 10:30 am. Odd as this might sound, I wonder if I initailly was taking 500 mcg, and then somehow purchased the 200 mcg. What is the proper dose? If I should increase, what is the best way to build up to the higher dose? I have gained weight in the last year, and wonder if that is because I changed accidentally from 500 to 200.

Thanks!

Best,

R H

ANSWER:

Dear RH

I usually recommend that people start taking 3 micrograms per pound of body weight of chromium picolinate daily. If that dosage does not curb appetite, give more energy, and lift depression within one week, I suggest increasing the dosage to 5 micrograms per pound of body weight daily. That 'translates" to a maximum dosage of 1000 micrograms per day for a person who weighs 200 pounds.

If increasing the dosage does not achieve the desired effect, you may want to consider switching to another brand of chromium picolinate. Not all formulations are made with equal atttention to quality control.

Thank you for contacting me. Please let me know if increasing the dosage helps.

Malcolm N. McLeod, MD

CrPic in Canada

Dr. McLeod,

I have just finished reading your book Lifting Your Depression and am interested in adding chromium picolinate to my diet to see what effect, if any, it may have on my depression. However, I'm a young woman located in Canada and am wondering if there is a brand that I can purchase here that you know is similar in effectiveness as the one you recommend. Is there a product that can be purchased from a Canadian retailer? I do not make much of a salary and would so appreciate your advice.

Thank you for your time,

Sincerely,

N V

ANSWER
CHROMIUM PICOLINATE (CrPic) is still pending approval in Canada. So you will not be able to buy it in Canada. I, however, have contacted Nutrition21, US maker of CHROMAX, a reliable brand of CrPic, and they have agreed to send you some bottles. Simply send me your physical mailing address and I will forward it to Nutrtion21, Inc.

Thank you for contacting me. Please let me know what effect CrPic has.

Malcolm N. McLeod, MD

Analysis of Study of 113 Patients

QUESTION:

Dear Dr. McLeod,

I read about the study of 113 depressed patients who received either chromium or placebo for 8 weeks. Why didn’t more of them benefit from from chromium? I find this surprising since chromium has helped curb my appetite, has allowed me to lose weight (because I have more energy to exercise), and it has lifted my depression. It has been wonderful for me. Will you explain why more people in the study didn't benefit from chromium?

ANSWER:

Yes, I'll certainly try to.

Dr. John P. Docherty was the lead investigator of the study to which you are referring. At the time he was CEO of Comprehensive NeuroScience Inc., and Professor of Psychiatry at Weill Medical College of Cornell University in New York, NY.

One hundred thirteen patients were enrolled in study, which was double-blinded. It was conducted at multiple centers across the US, and lasted for 8 weeks. The plan was to give 600 micrograms daily of chromium picolinate (CrPic) to 75 of the patients; 38 were to receive a placebo or “dummy” pill. The patients’ responses were to be assessed by the 29-item Hamilton Depression Rating Scale (HAM-D-29) and the Clinical Global Impressions Improvement Scale (CGI-I).

Of the 113 patients who were enrolled in the study, 3 dropped out before taking a single dose of the capsules that contained either CrPic or placebo. Another 35 did not comply with the study design, that is, they failed to take at least 80% of the capsules, and therefore were excluded from analysis of the data. This left only 75 of the original 113 who completed the study. Of the 75 who completed the study, only fifty (50) received CrPic, while 25 received placebo.

TheCrPic group reported more benefit than placebo in reducing appetite, reducing eating, decreasing carbohydrate craving, and “smoothing out” daily mood swings. As measured by the overall HAM-D-29 scores, both groups improved. However, CrPic was no better than placebo. This may have been because not everyone is this group craved carbohydrates and not everyone was overweight. In other words, not all patients suffered from atypical depression.

Let us look at only those 41 patients who were overweight and who craved carbohydrates: twenty six, (26) received CrPic and 15 received placebo. Those who received CrPic had significantly greater improvement, as measured by the total HAM-D-29 scores, than did those receiving placebo (65% vs 33%). Moreover, those receiving CrPic reported significantly greater improvement in terms of appetite control, reduced eating, and reduced carbohydrate craving.

To look at the results in round numbers, analysis of the study results suggests that 2 in 3 depressed people who are overweight and chronically hungry will respond to chromium while only 1 in 3 will respond to placebo. This analysis of the data supports my observation that chromium lifts depression and curbs appetite in overweight, depressed people.

Thank you very much for your question.

Malcolm N. McLeod, MD

Does Chromium Reduce Craving for Alcohol?

Dear Dr. McLeod,

I take chromium for 2 weeks as part of my diet to avoid crave for sugar.
Everything works fine but yesterday when I went for a party and had 5 pear ciders I started be aggressive like never before.
I do not understand the symptoms and my friends are not very happy about that what happened.
Could it be because any alcohol connection with chromium?
Could it be a sugar-chromium side effect?
Pear cider has got 210 kcal.

Regards
M.J.

Dear M.J.,

My knowledge of chromium's effects on metabolism of alcohol by the human body is very limited, but I can tell you this. I posted a blog in December of 2005 on this topic. George, the first patient I described in Lifting Your Depression, reported that chromium definitely changed the way his body responded to alcohol.

To briefly summarize George's response, in his own words, to alcohol after he started taking chromium:
"Both my parents were alcoholics. I saw the harm alcohol did to them and to our family, so I have always been very careful to limit my consumption of alcohol. In the past - on those rare occasions when I drink - I gulp alcohol, get drunk very fast, and have a terrible hangover the next day. As you know I started taking chromium picolinate about a month ago. This past weekend my reaction to alcohol was very different. I drank two beers, slowly, and got pleasantly tipsy. I didn't feel a need to gulp alcohol as I have in the past, and I didn't drink too much. When I woke the next morning, I did not have any trace of a hangover. Chromium has definitely changed the way my body reacts to alcohol."

Thank you for contacting me, M.J. I wish I could offer more case histories, but my experience with alcohol and chromium is limited. Please let me know if you have any further observations and thoughts.

By the way, do you think pear cider might contain any toxins that contributed to the change in your behavior? Or might pear cider contain too much sugar?


Malcolm N. McLeod, MD

Does the combination of an SSRI and chromium help PMS?

QUESTION:

Hi Dr. McLeod,
I was taking 10 mg. of Prozac for approximately 4 1/2 years for what I thought was difficult PMS. Even with this small dose, I benefited quit a bit and even experienced benefits in areas that surprised me (overall confidence increased dramatically) I went off in January because I started an In Vitro Fertilization (IVF) cycle. IVF ended in April and I hit rock bottom. It has taken the last three months to allow the hormones from the IVF to leave my system, and I have to say I feel much better. However, I am still somewhat irritable, blue and am experiencing chronic insecurity. I've come to the conclusion that perhaps I do in fact have low serotonin and perhaps always have. I went back on 10 mg. of Prozac this week.
Here are my questions:
1. Over the long term I gained 10-15 lbs on the Prozac. That was my only side effect but it is a big one and I am very concerned this will happen again. I bought Solgar brand Chromium Picolinate (500 mcg) after reading that it can help with this side effect of an SSRI. Is it safe to take long term along side the Prozac?
2. Are there any other supplements that should be avoided? I also take Asacol for mild ulcerative colitis, is this okay to take with the Chromium Picolinate?
I look forward to reading your answer on the blog.
Sincerely,
R. K.


ANSWER:

Dear Ms. K,

Thank you for contacting me with your interesting and important questions.

Not only is it safe to add chromium, the combination of chromium and Prozac (and other SSRIs) seems to work better than SSRIs alone for PMS and atypical depression. I do not know of any long term ill effects. Some of my patients have taken chromium along with an SSRIs for over a decade with great benefit and no side effects. In some cases, they have NEVER had another difficult period.

There are no reported interactions among chromium, Asacol and Prozac.

In case you don’t already know, women with severe PMS tend to relapse after discontinuing treatment with antidepressant medications, according to a recent study published in the May issue of the Archives of General Psychiatry.

Dr. Dr. Ellen W. Freeman and colleagues at the University of Pennsylvania School of Medicine in Philadelphia studied 174 women with severe PMS, known as premenstrual dysphoric disorder (PMDD). Some of the women took the antidepressant medication, sertraline, for 4 months and were then switched to a placebo or dummy pill. Other women took sertraline for 12 months and were then switched to placebo. (Sertraline and Prozac are both selective serotonin reuptake inhibitors.)

Although 72 percent of the 174 women improved while taking sertraline, symptoms returned in roughly half of the women after discontinuation of sertraline.

This study suggests that the more severe your symptoms are before treatment, the greater your likelihood of relapse (return of symptoms) after discontinuation of treatment.

If you decide to add chromium, please let me know if it helps or not. Again, thank you for contacting me.

Malcolm McLeod, MD

Chromium for Asperger's Syndrome?

QUESTION:

Dear Dr McLeod,

My son has Asperger's Syndrome, and his most troublesome symptoms are disordered sleep patterns, depression and anxiety, particularly anxiety. He is underweight, because often he is so anxious he feels nauseous, and doesn't want to eat. He sees a psychologist and talks about the issues that make him anxious and depressed, but talking is not enough and he needs more help. I read somewhere that chromium can help with sleep problems because of its effect on tryptophan, serotonin and melatonin, and also that it can help stressed adrenal glands. Do you think he should try chromium for these reasons, even though he is not overweight? He is reluctant to try antidepressants and anti-anxiety medication because he is frightened of side effects, and fears they might sedate him so much he loses his creativity (he is an artist).

Thank you,
E

ANSWER:
Before making any decision, I suggest you consult your son's physician and run your questions by him or her.

I did have one patient who had a mild case of Asperger's Syndrome: his anxiety and depression did seem to benefit from taking chromium picolinate. I doubt, however, that it helped his underlying Asperger's Syndrome. Like your son, he was thin, very brightand creative. He, too, refused to take antidepressants or anti-anxiety medications for fear they would dull his thinking.

You must not view this one case I am citing as anything other than anecdotal. Moreover, the use of chromium for Asperger's has not been evaluated by the FDA. Chromium is, however, very safe, so that the potential benefits might far outweight any risk.

If you decide to give your son chromium, please let me know the results.

Thank you
Malcolm McLeod, MD

Combination Chromium and Prozac

Hello again, Dr. McLeod.

I wrote you about a year and a half ago when I started taking chromium. I'm still on it and doing very well. The difference still astonishes me in how much better I am on the combination of Prozac and chromium. The carb cravings are a lot less and my energy level stays stable through the day. I've been able to lose 25 pounds so far, hopefully with more to come. I still need to lose another 30-50 pounds, but the chromium has been a big help so far. My blood pressure has dropped significantly as the result of the weight loss, my blood pressure has dropped from 130/90 to 118/80. I will have to stay disciplined, as even with the carb cravings diminished, I do still love to eat. My GP is pleased that I'm on chromium with my family history of type 2 diabetes, even though I show no clinical symptoms yet. He also treats both of my parents' type 2 diabetes. We've talked about possibly starting me on a low dose of glucophage as a preventive, as since I'm already responding to the chromium, there's already insulin resistance present. One of my friends who has similar depression to mine has started taking it and has had good results and I finally got my dad to start taking it. We both come from a long line of people with depression. He is feeling better too, and our doctor was ecstatic at his last checkup for his type 2 diabetes at his blood sugar and A1C levels. They've dropped significantly since he's been on the chromium.Thanks again for all of your research and work to publicize this treatment. It has made such a big difference in my life.
E.L.