Does Chromium Help Tryptophan Enter the Brain?

Dear Dr. McLeod

Thank you so much for your work on chromium and depression.  Here is my question: I know that tryptophan is a precursor of serotonin, and that brain levels of serotonin are involed in depression.  Has any research been conducted to answer the question whether chromium helps tryptophan enter the brain?

ANSWER:

Yes. Research on this topic has been conducted by a group on splendid investigators in the Department of Psychiatry at Warneford Hospital in Oxford, England.  They concluded that “Chromium can modify brain 5-HT function in humans and animals, perhaps by altering the sensitivity of central 5-HT(2A) receptors.”  This may be the mechanism whereby chromium helps some people.  I would certainly like to see more research on this topic.

Thank you for  your question.

Malcolm N. McLeod, MD

Analysis of Study of 113 Patients

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

Why no further research on CrPic in AD?

Why no further research on CrPic in AD?

QUESTION:

Hi Doctor,
I read several articles related to the Duke University research on Chromax® chromium picolinate. I was excited at beginning and then disappointed when I could not find any further research on the subject. I looked through your site and failed to see proofs of patients that can testify sustained recovery or relief. Then I found Nutrition 21, the company makes Chromax is in deep red financially. Can you please tell me if Chromax can achieve sustained benefit to atypical depression? Why there are no extensive reports on these lately?
Thanks,
CF

ANSWER

There has been a further study on chromium picolinate in atypical depression. The conclusions reached from the study were that in adults with atypical depression, 600 micrograms per day of Chromax chromium picolinate helped control appetite and excessive eating, it reduced carbohydrate craving, and it “smoothed out” diurnal variation of feelings (daily mood fluctuations). In those patients with high carbohydrate craving, chromium picoliante improved overall HAM-D-29 depression scores.

Several of my patients have taken chromium picolinate for a decade and have been depression free.

I wish there were a study in which depressed patients with carbohydrate craving and increased appetite were given chromium picolinate. Will this happen? I’m afraid not. It’s a matter of money. Because chromium picolinate is readily available and is inexpensive, pharma companies are not interested in supporting such research.

Thank you so much for your question.

MM

Recent studies on chromium in atypical depression

Recent studies on chromium in atypical depression

I received the following e-mail:

The results of the tiny study (on the role of chromium in the treatment of depression), done in 2000, look so promising. Why is it that the http://www.chromiumconnection.com/ has no reference to newer and larger studies?

Did such studies ever occur? I am interested in participating in such a study if one exists. I have been diagnosed under DSM IV with dysthmia and sever depression. I also fit the description for atypical depression. I have been off work for the last year and a half with severe depression. I have tried 6 different MAOI drugs and am currently using Mannerix as I tolerate it well and it provides some relief.

My answer follows:

Thank you for writing to me. There has been a more recent study on the role of chromium picolinate in the treatment of atypical depression.

In 2005, the results of a study of 113 patients, conducted by Comprehensive Neuroscience, were published. This double-blind study further demonstrated chromium’s role in reducing crbohydrate cravings in people with the most common type of depression.

I certainly would refer you to a study if one existed, but I don’t know of any. Moreover, it is unlikely that very large studies will be conducted further to substantiate chromium’s role in depression, as there is not enough profit in neutraceuticals to support the type of large studies funded by pharmaceutical companies.

I hope these comments help.

Malcolm McLeod

Alzheimer's response to chromium

Alzheimer’s response to chromium

Some months ago, the daughter of a man who suffers from Alzheimer’s disease, wrote to me that she had read Lifting Depression: The Chromium Connection and was intrigued by my discussion of insulin resistance and its symptoms. Her father and other family members were troubled by insulin resistance, especially carbohydrate craving and a tendency to develop type 2 diabetes. She suspected a connection between type 2 diabetes and Alzheimer’s disease and wondered if chromium might help people suffering from Alzheimer’s disease. I replied that people with type 2 diabetes are at increased risk of developing Alzheimer’s disease, but I didn’t know whether chromium would help her father. I asked her to let me know whether he responded to chromium. Recently she answered:

Hello Dr. McLeod,

Yes, I do think that chromium seems to have helped my father. Several months ago, when I first mentioned the possible benefits of chromium for Alzheimer’s to him, he agreed to try it, but at that point I knew it was probably beyond his capability to remember to actually go out and buy it for himself. So, I bought a few bottles of chromium picolinate and mailed them to him. About a week later I asked him if he was actually taking the tablets that I sent him, and found out that he had completely forgotten about it. It turns out, he had put the bottle of chromium on the kitchen counter, and had somehow gotten it mixed up in his mind and thought he was supposed to take it in case of bird flu! I finally convinced him to start taking the tablets and explained all over again how it could help him, and at that point, with additional coaxing on my part, he did start to take chromium every day, both morning and afternoon.

These seem like subtle but very definite improvements in his memory and ability to execute tasks. I am very grateful to you for writing the book on the benefits of chromium, and explaining the scientific reasons of why it works. I see more and more information in the press lately about the link between insulin resistance and Alzheimer’s, and the latest research demonstrates a link between obesity and Alzheimer’s. I think that you are far ahead of most physicians in your knowledge of the benefits of chromium and how it is a key component of the puzzle of atypical depression, insulin resistance, diabetes, and now possibly Alzheimer’s.

Thank you very much,
PS

What Study Shows Chromium Helps Carb Cravings in Depression

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

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?

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.

Studies Shows Chromium Reduces Carb Cravings

Studies proves chromium reduces carb cravings

Q: I recently read that chromium reduces carb cravings in people with depression. Is there any evidence to support this?

A: Yes. I first made this observation in the early 1990s.

In 1999 my finding—that chromium controls appetite in some patients—first appeared in the Journal of Clinical Psychiatry .

In the year 2000—after the appetite of more patients in my practice had responded to chromium—Dr. Robert Golden and I wrote an article in which we stated, “Most of the patients [who responded to chromium) described carbohydrate craving . . . " (p 312). And we commented on chromium's "dramatic impact on normalizing appetite" (p 313).

In 2002, a report of a double-blind, placebo-controlled study, conducted at Duke University Medical Center was published. In that article we reported that "Of the eight patients who were overeating at baseline [and who received chromium picolinate], four experienced complete disappearance of the symptom” (p. 262).

In 2005, the results of a study of 113 patients, conducted by Comprehensive Neuroscience, were published. This double-blind study further demonstrated chromium’s role in reducing crbohydrate cravings in people with the most common type of depression.