Suggested Daily Intravenous Intake of Essential Trace Elements




Acute Catabolicb

Gl Lossesb



2.5 to 4 mg Additional 2 mg Add 12.2 mg/l small bowel fluid lost; 17.1 mg/kg of stool or ileostomy outpute

Copper 20

Chromium 0.14 to 0.2 Manganese 2

20 |g a Limited data are available for infants weighing less than 1500 g. Their requirements may be more than the recommendations because of their low body reserves and increased requirements for growth. b Frequent monitoring of blood concentrations in these patients is essential to provide proper dosage. c Premature infants (weight less than 1500 g) up to 3 kg of body weight. Thereafter, the recommendation for full-term infants applies.

d Values derived by mathematical fitting of balance data from a 71-patient-week study in 24 patients. e Mean from balance study.

Source: From Nutrition Advisory Group, American Medical Association, J. Parenter. Enteral. Nutr., 3, 263, 1979. With permission.

can lead to cognitive, perceptual, and motor dysfunction at doses of 200 to 400 mcg/d. It can also cause anemia, thrombocytopenia, hemolysis, hepatic dysfunction, and renal failure when given in dosages of 1200 to 2400 mcg/d.70 Chromium picolinate might affect dopamine, serotonin, and norepinephrine metabolism in the brain, due to the picolinic acid component.71

Studies show that people with type 2 diabetes have lower blood levels of chromium than those without the disease. Insulin resistance is the common denominator in a cluster of cardiovascular disease risk factors. One out of every five Americans has metabolic syndrome. It affects 40% of people in their 60s and 70s. Insulin resistance, with or without the presence of metabolic syndrome, significantly increases the risk of cardiovascular disease. Insulin resistance is present in two serious health problems in women — polycystic ovarian syndrome (PCOS) and gestational diabetes. Several studies have demonstrated that chromium supplements enhance the metabolic action of insulin and lower some of the risk factors for cardiovascular disease, particularly in overweight individuals. Chromium picolinate, specifically, has been shown to reduce insulin resistance and to help reduce the risk of cardiovascular disease and type 2 diabetes. It must be remembered that dietary chromium is poorly absorbed, and chromium levels decrease with age. Supplements containing 200 to 1000 mcg chromium as chromium picolinate taken each day have been found to improve blood glucose control. Chromium picolinate appears to be the most efficacious form of chromium supplementation.72

Chromium is of particular importance in wound healing. Chromium can alter the immune response by immunostimulatory or immunosuppressive processes, as shown by its effects on T and B lymphocytes, macrophages, cytokine production, and the immune response that may induce hypersensitivity reactions.73

More recently, researchers conducting a randomized, placebo-controlled, doubleblind study of supplementation in patients with impaired glucose tolerance suggested that chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile.74

Further, a meta-analysis from 15 randomized, controlled trials showed no effect of chromium on glucose or insulin concentrations in nondiabetic subjects.75

Therefore, the role of chromium (as part of glucose tolerance factor in insulin, the chief anabolic hormone in humans) in wound healing remains somewhat unclear. Yet, particularly in type 2 diabetics, there are suggestions that chromium supplementation may serve to avoid hyperglycemia and associated glycation that leads to complement fixation compromise and infection.

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