Chromium Deficiency

Excerpt

Dietary minerals are naturally occurring elements required for normal health and function. Some dietary minerals are called trace elements because they are required in minimal quantities to maintain the normal function of their respective metabolic pathways. Trace dietary elements include cobalt, copper, fluoride, iodine, manganese, molybdenum, selenium, zinc, and chromium.

Chromium exists in several valence forms. The trivalent form is considered an essential trace element for metabolizing lipids and carbohydrates. The tetravalent, pentavalent, and hexavalent forms are toxic and carcinogenic. Trivalent chromium can be found in various grains, meats, and high-bran cereals. This form enhances the effect of insulin in peripheral tissues and is believed to be an essential component of metalloenzymes in the metabolism of carbohydrates, proteins, and fats. Therefore, it is recommended as a vital component of a regular diet in most individuals and an essential supplement for those on total parenteral nutrition.

However, emerging data question the status of trivalent chromium as an essential element. Recent studies in animal models suggest that trivalent chromium is beneficial, but it may not be necessary for normal physiological functions. Case studies initially indicating chromium deficiency as the cause of glucose intolerance and insulin resistance suggest that chromium may have a therapeutic role in treating these conditions. However, it is unlikely that chromium is the cause of these complications. This view was supported by the European Food and Safety Authority in 2014 when they concluded that an essential function of chromium could not be substantiated.

To ensure adequate use of chromium replacement therapy, a team of healthcare professionals, including clinicians, pharmacists, and dieticians, must become aware of current recommendations regarding the status of chromium as an essential element. Understanding chromium's role in the normal physiology of the human body and developing appropriate chromium supplementation guidelines for individuals on total parenteral nutrition are essential. In addition, clinicians must understand the role of chromium replacement therapy in health conditions marketed to benefit from it. This activity provides an up-to-date review of the current literature regarding chromium as a dietary trace element, its role in normal physiological functions, the postulated clinical consequences of its deficiency, and the recommended replacement thresholds in individuals receiving total parenteral nutrition.