Chromium in combination with diabetes medications?

Chromium in combination with diabetes medications?

Dear Dr. McLeod:

I heard your interview this past Sunday morning. I’m 43 yrs old, 295 lbs. and 5’9″. I’m interested in trying the chromium picolinate supplement, but I have a couple of questions. I take Amaryl (2 mg daily) and Avandia (4 mg daily), I take both in the morning, for Type 2 diabetes. I also take Wellbutrin (150 mg daily) in the morning. I do take a Centrum multi once a day (usually before bed). What concerns should I have about taking the chromium picolinate supplement? Would the supplement have any counter-reaction with the Amaryl and/or Avandia? How would the supplement react with Wellbutrin? And, if I should not have any concerns about taking the supplement, what do you recommend the proper dosage to be? Your “rule of thumb” of 5 mg per pound would mean you would be recommending 1500 mg per day for me. Is that right? But, if each of the multivitamin pill I take contains 100 mg, should I limit myself to 2 500 mg tablets?

Thank you in advance for your attention and response.

Dear Sir,
Thank you for contacting me. First of all, I must tell you that I’m not able to offer personal advice, as that would be a shoddy attempt to practice medicine without meeting with you. So, please consult your healthcare professional.
With that caveat, let me address your several questions in a general way:

Medications for type 2 diabetes can lower blood sugar too much. Because chromium makes the body more sensitive to insulin, it might contribute to low blood sugar. On the other hand, taking chromium might allow a person to take less medications for type 2 diabetes. Again, do so under the careful supervision of your healthcare professional.

I’ve found that people who respond favorably to Wellbutrin also respond well to chromium. You may be able to take less Wellbutrin.

The multivitamin you’re taking may contain chromium chloride, which is difficult to absorb. You may not be absorbing any appreciable amount from your multivitamin. If you decide to take chromium, I suggest you take chromium picolinate, which is readily absorbed.

My “rule of thumb” is to begin by taking 3 micrograms per pound per day, in the morning, and to increase that to 5 micrograms per pound in a week if no improvement.

Please let me know what you and your physician decide to do and the results.

Again, thank you for asking this very important question.

Malcolm McLeod

Thiothixene and chromium?

Thiothixene and chromium?

Q: Dear Doctor, My sister is taking 500 mg of Depakote per day and 4-6 mg of Thiothixene during her psychotic episodes. Recently we started her on 400 mcg of chromium per day. Is that alright?

A: I wish I could be definite, but in truth I don’t know the answer to your question. If I were prescribing thiothixene to a patient,I would warn them that thiothixene can precipitate seizures,especially in people with a history of seizures or who are withdrawing from alcohol. I wonder if the addition of chromium might increase the liklihood of a seizure, but again I don’t know. Please consult, or suggest that your sister consult, her psychiatrist. Please let me know if chromium helps her. Thank you.
Dr. McLeod

Safety of chromium with medications?

Safety of chromium with medications?

Q: I take Zanex and Toprol for high blood pressure. Can I also take chromium?

A: There is no evidence that chromium reacts adversely with Zanex, Toprol, or any other medication, so the answer to your question is “Yes.” You can take chromium with Zanes and Toprol I, however, strongly advise — when taking chromium with any medication — to do so under the close supervision of a physician to monitor for presently unknown, adverse effects that might emerge.

Combination of SSRI and chromium for PMS (PMDD)

Combination of SSRI and chromium for PMS (PMDD)

Q: My sister suffers from the extreme form of PMS a.k.a. PMDD and has tried various antidepressants to treat it with varying but always minimal success (and lots of side effects). Most recently her Dr. prescribed birth control pills to artificially “force” her hormones in line and hopefully relieve some of her PMDD, it’s early with this treatment though and carries its own side effects like headache and nausea. When I read about chromium and your case studies with the women who had depression and severe PMS I immediately thought of my sister. I have been searching for something, anything to help ease her symptoms. I have also noticed that my own PMS is continuing to worsen every year, although not to the extreme (yet) that she has it. I am very excited to try chromium for myself and suggest it to my sister.

May I ask, would chromium be taken every day in the case of PMS/PMDD or just at the time of cycle when the symptoms are ocurring?

A: Thank you for your question. Unfortunately, your sister’s experience is usual. Large-scale, well-designed studies have demonstrated that a class of antidepressant medications – known as selective serotonin reuptake inhibitors or SSRIs for short – is more effective than placebo for relief of symptoms of severe PMS. But, as is the case with your sister, these medications usually causes annoying side effects with the result that many women stop taking them.
In an excellent study of Prozac (fluoxetine) for PMS, 4 out of 10 women dropped out of the study, presumably due to undesirable side effect. In a study of Zoloft for PMS, 2 in 10 women dropped out of the study, again probably due to medication side effects. Dr. Thwe T Htay has written an excellent review article on PMDD.

In my practice, I have given dozens of women combination chromium picolinate and an antidepressant medication. Often they have reported complete and dramatic absence of symptoms of PMS. I have found that regular dosing throughout the month is better than half-cycle dosing.

Dr. Anna L. Stout (Director of Women’s Behavioral Health at Duke University Medical Center) and I decided to test my theory under rigorous scientific conditions. We conducted a small, placebo-controlled, double-blind study in which we administered the combination of 400 micrograms of chromium picolinate per day and 50 mg of Zoloft per day for one month. The next month, we administered Zoloft and a placebo. The results of the study supported my theory that chromium boosts the efficacy of Zoloft and and reduces side effects. We are presently writing up this clinical study.

The Duke study was a pilot study and was too small for calculation of statistical significance. More data is needed.

Please take my general advice to your healthcare professional for further guidance. If you decide to try an SSRI and chromium for sever PMS, please let me know the results. I hope other women will report their experience of combination of chromium and an SSRI for PMS. Perhaps I can use your story and that of other women to support a large study. Thank you.

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