Trivalent chromium
Chromium/Drug Interactions:
AlcoholAlcohol: Chronic alcohol use may increase the chance of liver and kidney damage when taken with, or exposed to, hexavalent chromium (133). AntacidsAntacids: According to animal research, the concomitant use of antacids and chromium may reduce chromium absorption (224; 225). Anecdotally, chromium may also decrease the urinary excretion of calcium and hydroxyproline.Anticoagulant/antiplatelets, NSAIDs, aspirinAnticoagulant/antiplatelets, NSAIDs, aspirin: In theory, aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve, Anaprox), may increase chromium levels in the body, which could lead to a tendency for increased side effects. Increased levels of chromium have been reported with aspirin in animal research (224).Antidepressant agents, monoamine oxidase inhibitors (MAOIs)Antidepressant agents, monoamine oxidase inhibitors (MAOIs): Theoretically, chromium may interact with MAOIs. Picolinic acid (found in chromium picolinate) may alter central nervous system (CNS) metabolism of serotonin, dopamine, and norepinephrine (44). In human research, participants with atypical depression administered chromium showed a significantly greater response rate and remission rate vs. placebo (54). Antidepressants selective serotonin reuptake inhibitors (SSRIs)Antidepressants selective serotonin reuptake inhibitors (SSRIs): Theoretically, chromium may interact with SSRIs. Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (44). In human research, participants with atypical depression administered chromium showed a significantly greater response rate and remission rate vs. placebo (54). AntidiabeticsAntidiabetics: In humans, chromium demonstrated hypoglycemic effects in both healthy and diabetic patients (30; 31; 29). In human research, treatment with chromium resulted in a significant increase in acute insulin response to glucose (88) as well as reductions in HbA1c and fasting blood glucose (60; 67; 68; 55; 28; 63; 39; 62; 226; 70) and improvements in postprandial glucose, fasting insulin, postprandial insulin, insulin resistance, insulin sensitivity, whole-body insulin-mediated glucose disposal, glucose area under the curve, and fructosamine (61; 60; 28; 56; 62; 226; 70; 64; 72; 102). However, some studies lacked effects on glucose and insulin parameters or HbA1c (59; 66; 69; 57; 65). In patients with polycystic ovary syndrome, chromium supplementation led to a significant improvement in glucose tolerance (99) and a significant increase in glucose disposal rate (98). In human research, patients with either type 1 or type 2 diabetes treated with 200mcg daily of chromium required lower doses of insulin, sulfonylurea medications, and metformin (227). Chromium has also been used with biotin along with hypoglycemic therapy in randomized controlled trials and may have beneficial effects when used concomitantly (61). In a case report, humans receiving chromium had improved glucose control and decreased insulin requirements (228). AntihypertensivesAntihypertensives: In animal research, rats administered two chromium nicotinate supplements and sugar experienced prevention of an increase in systolic blood pressure (38). In human research, compared to baseline, participants treated with brewer's yeast had a significant reduction in mean systolic blood pressure (39). Anti-inflammatoriesAnti-inflammatories: In theory, some corticosteroids (for example, prednisone) may decrease chromium levels in the body and may interfere with chromium's activity.AntilipemicsAntilipemics: Although some research is inconsistent, many studies suggest that chromium increases high-density lipoprotein (HDL) levels (229; 230; 231; 232; 82; 233; 80; 83; 78; 70). In human research, compared to baseline, participants treated with brewer's yeast or chromium chloride showed significant reductions in mean cholesterol, triglycerides, and low-density lipoprotein (LDL) (39; 70). In other human research, chromium picolinate reduced serum cholesterol compared to placebo in diabetic patients (62). Organic chromium also increased HDL and reduced LDL, triglycerides, and total cholesterol (226). AntineoplasticsAntineoplastics: In human research, treatment with (32)P-chromic phosphate during lung cancer resection for occult lymphatic metastasis treatment resulted in lower rates of supraclavicular lymph node metastasis and increased survival at three and five years (101). AntipsychoticsAntipsychotics: In human research, chromium reduced the number of affective episodes in treatment-resistant, rapid-cycling bipolar disorder patients (50). Anecdotally, chromium and lithium may lead to additive hypoglycemia. Beta-blockersBeta-blockers: Chromium supplementation may increase HDL concentrations in patients taking beta-blockers (231). CNS depressantsCNS depressants: In a review, it was proposed that the biochemical, physiological, and behavioral actions of chromium picolinate may be a consequence of the effects of picolinic acid on the central nervous system (44). Analogs of picolinic acid have been shown to induce profound alterations in the metabolism of serotonin, dopamine, and norepinephrine in the brain. In human research, insomnia was reported as an adverse effect of chromium picolinate supplementation (54). CNS stimulantsCNS stimulants: In a review, it was proposed that the biochemical, physiological, and behavioral actions of chromium picolinate may be a consequence of the effects of picolinic acid on the central nervous system (44). Analogs of picolinic acid have been shown to induce profound alterations in the metabolism of serotonin, dopamine, and norepinephrine in the brain. CorticosteroidsCorticosteroids: Corticosteroids may increase urinary chromium excretion, resulting in chromium deficiency or corticosteroid-induced hyperglycemia. In non-insulin-dependent diabetic patients, oral chromium supplements reversed increases in blood glucose associated with dexamethasone (Decadron?) and prednisone (Deltasone?). Chromium also reduced the insulin dose required by a patient who experienced prednisone-induced diabetes after a kidney transplant (234). Cytochrome P450-metabolized agentsCytochrome P450-metabolized agents: In vitro, cytochrome P450 was involved in the reduction of chromium(VI) (235). Dimercaptosuccinic acid (DMSA)Dimercaptosuccinic acid (DMSA): In children with autism, oral dimercaptosuccinic acid (DMSA) treatment caused increased urinary excretion of chromium (236). Gastrointestinal agentsGastrointestinal agents: Gastric irritation, including nausea, vomiting, and ulcers, has been reported anecdotally. Nausea, vomiting, diarrhea, and gastrointestinal upset have also been reported in human research (66; 59; 94; 97). There were no adverse effects reported in patients who received chromium-containing milk powder (200mcg of chromium and 20g of milk powder), except for mild complaints of constipation (5%) and flatulence (5%) (68). In human research, decreased appetite and constipation were reported with supplementation of brewer's yeast that provided 500mcg of elemental chromium daily (65). Heavy metal antagonists/chelating agentsHeavy metal antagonists/chelating agents: In children with autism, oral dimercaptosuccinic acid (DMSA) treatment caused increased urinary excretion of chromium (236). ImmunostimulantsImmunostimulants: In human research, chromium increased lymphocyte proliferation upon stimulation vs. baseline (87). ImmunosuppressantsImmunosuppressants: In human research, chromium increased lymphocyte proliferation upon stimulation vs. baseline (87). Insulin preparationsInsulin preparations: Patients with either type 1 or type 2 diabetes who were treated with 200mcg daily of chromium required lower doses of insulin, sulfonylurea medications, and metformin (227). In human research, treatment with chromium resulted in a significant increase in acute insulin response to glucose (88), as well as reductions in HbA1c and fasting blood glucose (60; 67; 68; 55; 28; 63; 39; 62; 226; 70) and improvements in postprandial glucose, fasting insulin, postprandial insulin, insulin resistance, insulin sensitivity, whole-body insulin-mediated glucose disposal, glucose area under the curve, and fructosamine (61; 60; 28; 56; 62; 226; 70; 64; 72; 102). However, some studies showed no effects on glucose and insulin parameters or HbA1c (59; 66; 69; 57; 65). In a case report, humans receiving chromium had improved glucose control and decreased insulin requirements (228). LithiumLithium: Anecdotally, chromium and lithium may lead to additive hypoglycemia. In human research, chromium reduced the number of affective episodes in treatment-resistant, rapid-cycling bipolar disorder patients (50). Nicotinic acidNicotinic acid: Concomitant use of chromium and nicotinic acid may produce a synergistic effect with chromium in improving blood glucose (237). Osteoporosis agentsOsteoporosis agents: In humans, chromium picolinate may reduce bone resorption, which may be augmented by the administration of calcium (51). Parkinson's agentsParkinson's agents: Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (60). Proton pump inhibitors and H2 blockersProton pump inhibitors and H2 blockers: Anecdotally, H2 blockers may decrease chromium concentration by inhibiting its absorption.SulfonylureasSulfonylureas: Clinical research demonstrated that CrPic supplementation in subjects with type 2 diabetes taking sulfonylurea agents significantly improved insulin sensitivity and glucose control (60). Thyroid agentsThyroid agents: In humans, ingestion of chromium picolinate with levothyroxine sodium decreased serum thyroxine levels (p<0.05) (43). Patients taking levothyroxine and chromium picolinate should separate ingestion of chromium from thyroid hormones by several hours. Weight loss agentsWeight loss agents: Clinical research has examined the effect of chromium on obesity and weight loss (90; 89; 73; 238; 239; 240; 241; 242; 243; 244; 245; 246; 96). According to a meta-analyses of human research, treatment with chromium supplementation was associated with a 1.1-1.2kg decrease in body weight vs. placebo in participants with an average body mass index of 28-33kg/m2 (93; 94; 91). In a clinical trial, females taking chromium picolinate had a significant weight increase vs. males and placebo, while males increased in the sum of body circumferences and decreased in the sum of skinfolds compared to baseline (96). Chromium/Herb/Supplement Interactions:
AlcoholAlcohol: Chronic alcohol use may increase the chance of liver and kidney damage when taken with, or exposed to, hexavalent chromium (133). AntacidsAntacids: According to animal research, the concomitant use of chromium and antacids may reduce chromium absorption (224; 225). Anecdotally, chromium may also decrease the urinary excretion of calcium and hydroxyproline.Anticoagulant/antiplatelets and NSAIDsAnticoagulant/antiplatelets and NSAIDs: In theory, aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve, Anaprox), may increase chromium levels in the body, which could lead to a tendency for increased side effects. Increased levels of chromium have been reported with aspirin in animal research (224).Antidepressants, monoamine oxidase inhibitors (MAOIs)Antidepressants, monoamine oxidase inhibitors (MAOIs): Theoretically, chromium may interact with MAOIs. Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (44). In human research, participants with atypical depression administered chromium showed a significantly greater response rate and remission rate vs. placebo (54). Antidepressants, selective serotonin reuptake inhibitors (SSRIs)Antidepressants, selective serotonin reuptake inhibitors (SSRIs): Theoretically, chromium may interact with SSRIs. Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (44). In human research, participants with atypical depression administered chromium showed a significantly greater response rate and remission rate vs. placebo (54). Anti-inflammatoriesAnti-inflammatories: In theory, some corticosteroids (for example, prednisone) may decrease chromium levels in the body and may interfere with chromium's activity.AntilipemicsAntilipemics: Although research is inconsistent, most studies suggest that chromium may increase HDL levels (229; 230; 231; 232; 82; 233; 80; 83; 78; 70). In human research, compared to baseline, participants treated with brewer's yeast or chromium chloride showed significant reductions in mean cholesterol, triglycerides, and LDL (39; 70). In other human research, chromium picolinate reduced serum cholesterol compared to placebo in diabetic patients (62). Organic chromium also increased HDL, as well as reduced LDL, triglycerides, and total cholesterol (226). AntiparkinsoniansAntiparkinsonians: Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (60). AntineoplasticsAntineoplastics: In human research, treatment with (32)P-chromic phosphate during lung cancer resection for occult lymphatic metastasis treatment resulted in lower rates of supraclavicular lymph node metastasis and increased survival at three and five years (101). AntipsychoticsAntipsychotics: In human research, chromium reduced the number of affective episodes in treatment-resistant, rapid-cycling bipolar disorder patients (50). BiotinBiotin: Chromium has been used with biotin in randomized controlled trials and may have beneficial effects when used concomitantly (61). CalciumCalcium: In humans, chromium picolinate may reduce bone resorption and may be augmented by the administration of calcium (51). CNS depressantsCNS depressants: In a review, it was proposed that the biochemical, physiological, and behavioral actions of chromium picolinate may be a consequence of the effects of picolinic acid on the central nervous system (44). Analogs of picolinic acid have been shown to induce profound alterations in the metabolism of serotonin, dopamine, and norepinephrine in the brain. In human research, insomnia was reported as an adverse effect of chromium picolinate supplementation (54). CNS stimulantsCNS stimulants: In a review, it was proposed that the biochemical, physiological, and behavioral actions of chromium picolinate may be a consequence of the effects of picolinic acid on the central nervous system (44). Analogs of picolinic acid have been shown to induce profound alterations in the metabolism of serotonin, dopamine, and norepinephrine in the brain. CopperCopper: In human research, chromium increased lymphocyte proliferation upon stimulation vs. baseline, but the increase was suppressed by the addition of copper (87). CorticosteroidsCorticosteroids: Corticosteroids may increase urinary chromium excretion, resulting in chromium deficiency or corticosteroid-induced hyperglycemia. In non-insulin-dependent diabetic patients, oral chromium supplements reversed increases in blood glucose associated with dexamethasone (Decadron?) and prednisone (Deltasone?). Chromium also reduced the insulin dose required by a patient who experienced prednisone-induced diabetes after a kidney transplant (234). Cytochrome P450-metabolized agentsCytochrome P450-metabolized agents: In vitro, cytochrome P450 was involved in the reduction of chromium(VI) (235). Gastrointestinal agentsGastrointestinal agents: Gastric irritation, including nausea, vomiting, and ulcers, has been reported anecdotally. Nausea, vomiting, diarrhea, and gastrointestinal upset have also been reported in human research (66; 59; 94; 97). There were no adverse effects reported in patients who received chromium-containing milk powder (200mcg of chromium and 20g of milk powder), except for mild complaints of constipation (5%) and flatulence (5%) (68). In human research, decreased appetite and constipation were reported with supplementation of brewer's yeast that provided 500mcg of elemental chromium daily (65). GrapeseedGrapeseed: A pilot study evaluating the effects of niacin-bound chromium alone and in combination with grapeseed extract on hyperlipidemic patients found significant reductions in total cholesterol and LDL cholesterol only with the combination of niacin-bound chromium and grapeseed extract (247). Heavy metal antagonists/chelating agentsHeavy metal antagonists/chelating agents: In children with autism, oral dimercaptosuccinic acid (DMSA) treatment caused increased urinary excretion of chromium (236). HypoglycemicsHypoglycemics: In humans, chromium demonstrated hypoglycemic effects in both healthy and diabetic patients (30; 31; 29). In human research, treatment with chromium resulted in a significant increase in acute insulin response to glucose (88), as well as reductions in HbA1c and fasting blood glucose (60; 67; 68; 55; 28; 63; 39; 62; 226; 70) and improvements in postprandial glucose, fasting insulin, postprandial insulin, insulin resistance, insulin sensitivity, whole-body insulin-mediated glucose disposal, glucose area under the curve, and fructosamine (61; 60; 28; 56; 62; 226; 70; 64; 72; 102). However, some studies showed no effects on glucose and insulin parameters or HbA1c (59; 66; 69; 57; 65). In patients with polycystic ovary syndrome, chromium supplementation led to a significant improvement in glucose tolerance (99) and a significant increase in glucose disposal rate (98). In human research, patients with either type 1 or type 2 diabetes treated with 200mcg daily of chromium required lower doses of insulin, sulfonylurea medications, and metformin (227). Chromium has also been used with biotin along with hypoglycemic therapy in randomized controlled trials and may have beneficial effects when used concomitantly (61). People using herbs or other supplements that may alter blood sugar levels, such as bitter melon (Momordica charantia), should be monitored closely by their healthcare professional while using chromium. In a case report, humans receiving chromium had improved glucose control and decreased insulin requirements (228). HypotensivesHypotensives: In animal research, rats administered two chromium nicotinate supplements and sugar did not experience an increase in systolic blood pressure (38). In human research, compared to baseline, participants treated with brewer's yeast had a significant reduction in mean systolic blood pressure (39). ImmunomodulatorsImmunomodulators: In human research, chromium increased lymphocyte proliferation upon stimulation vs. baseline (87). IronIron: Chromium competes with iron for transferrin binding and may affect iron transport (40); however, this has been challenged (41; 42). Nicotinic acidNicotinic acid: Concomitant use of chromium and nicotinic acid may produce a synergistic effect with chromium in improving blood glucose (237). Osteoporosis agentsOsteoporosis agents: In humans, chromium picolinate may reduce bone resorption, which may be augmented by the administration of calcium (51). SalicylatesSalicylates: Increased levels of chromium have been reported with aspirin in animal research (224).Thyroid agentsThyroid agents: In humans, ingestion of chromium picolinate with levothyroxine sodium decreased serum thyroxine levels (p<0.05) (43). Patients taking levothyroxine and chromium picolinate should separate ingestion of chromium from thyroid hormones by several hours. Vitamin C (ascorbic acidVitamin C (ascorbic acid): In animal research, the concomitant use of vitamin C with chromium has been shown to increase chromium excretion and increase serum levels (225). In type 2 DM patients, chromium with vitamins C and E minimized oxidative stress and improved glucose metabolism (248). Vitamin EVitamin E: In type 2 DM patients, chromium with vitamins C and E minimized oxidative stress and improved glucose metabolism (248). Weight loss agentsWeight loss agents: Clinical research has examined the effect of chromium on obesity and weight loss (90; 89; 73; 238; 239; 240; 241; 242; 243; 244; 245; 246; 96). According to a meta-analyses of human research, treatment with chromium supplementation was associated with a 1.1-1.2kg decrease in body weight vs. placebo in participants with an average body mass index of 28-33kg/m2 (93; 94; 91). In a clinical trial, females taking chromium picolinate had a significant weight increase vs. males and placebo, while males increased in the sum of body circumferences and decreased in the sum of skinfolds compared to baseline (96). ZincZinc: Theoretically, the coadministration of chromium and zinc may decrease the absorption of both chromium and zinc.Chromium/Food Interactions:
SugarSugar: Diets high in simple sugars may stimulate chromium losses (249). Complex carbohydratesComplex carbohydrates: Anecdotally, diets high in complex carbohydrates may increase chromium absorption.Chromium/Lab Interactions:
5-HT2A receptors5-HT2A receptors: According to a case series, chromium decreased 5-HT2A receptor sensitivity (250). Blood pressureBlood pressure: In animal research, rats administered two chromium nicotinate supplements and sugar experienced prevention of an increase in systolic blood pressure (38). In human research, compared to baseline, participants treated with brewer's yeast had a significant reduction in mean systolic blood pressure (from 161.5 ? 5 to 141.5 ? 5.33mmHg, p<0.02) (39). Body fatBody fat: In human research, compared to the placebo group, participants administered chromium showed a significant between-group difference regarding change in percentage of body fat (0.39 ? 3.78 vs. -2.84 ? 4.53%, p=0.04), and lean body mass (1.47 ? 5.6 vs. 3.02 ? 3.10kg, p=0.02) (102). Body weightBody weight: Clinical research has examined the effect of chromium on obesity and weight loss (90; 89; 73; 238; 239; 240; 241; 242; 243; 244; 245; 246; 96). According to a meta-analyses of human research, treatment with chromium supplementation was associated with a 1.1-1.2kg decrease in body weight vs. placebo in participants with an average body mass index of 28-33kg/m2 (93; 94; 91). In a clinical trial, females taking chromium picolinate had a significant weight increase vs. males and placebo, while males increased in the sum of body circumferences and decreased in the sum of skinfolds compared to baseline (96). DopamineDopamine: Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (44). Functional magnetic resonance imaging (fMRI)Functional magnetic resonance imaging (fMRI): In humans, participants treated with chromium showed increased brain activity vs. placebo, particularly in the right thalamic, right temporal, bilateral frontal, and right posterior parietal regions (52). GlucoseGlucose: In humans, chromium has demonstrated hypoglycemic effects in both healthy and diabetic patients (30; 31; 29). In human research, treatment with chromium resulted in a significant increase in acute insulin response to glucose (88), as well as reductions in HbA1c and fasting blood glucose (60; 67; 68; 55; 28; 63; 39; 62; 226; 70) and improvements in postprandial glucose, fasting insulin, postprandial insulin, insulin resistance, insulin sensitivity, whole-body insulin-mediated glucose disposal, glucose area under the curve, and fructosamine (61; 60; 28; 56; 62; 226; 70; 64; 72; 102). However, some studies showed no effects on glucose and insulin parameters or HbA1c (59; 66; 69; 57; 65). In patients with polycystic ovary syndrome, chromium supplementation led to a significant improvement in glucose tolerance (99) and a significant increase in glucose disposal rate (98). In a case report, humans receiving chromium had improved glucose control and decreased insulin requirements (228). Hemoglobin (HbA1c)Hemoglobin (HbA1c): In human research chromium reduced HbA1c concentrations (251; 55; 28; 63; 39; 69; 62). For participants with baseline HbA1c levels >10%, this reduction in HbA1c was even greater (1.76%, p=0.001) (55). However, other research has found that chromium lacks an effect on glucose concentrations or HbA1c (252; 69; 57; 65). HOMA-BHOMA-B: In humans, compared to baseline, treatment with chromium resulted in a significant increase in HOMA-B (65). HOMA-IRHOMA-IR: In humans, chromium significantly decreased HOMA-IR values (72; 102; 226). InsulinInsulin: In human research, chromium reduced blood insulin concentrations (251). However, other studies have found that chromium does not affect insulin concentrations (69; 65). In human research, treatment with chromium resulted in a significant increase in acute insulin response to glucose (88). Other human research has shown improvements in fasting insulin, postprandial insulin, and insulin resistance (28; 56; 62; 226; 72) as well as insulin sensitivity and whole-body insulin-mediated glucose disposal (63; 64; 102). In a case report, humans receiving chromium had improved glucose control and decreased insulin requirements (228). IronIron: Iron concentrations may be affected by chromium ingestion. Chromium competes with iron for transferrin binding and may affect iron transport (40), although this has been challenged (41; 42). Lean body massLean body mass: In human research, compared to the placebo group, participants administered chromium showed a significant between-group difference regarding change in percentage of body fat (0.39 ? 3.78 vs. -2.84 ? 4.53%, p=0.04) and lean body mass (1.47 ? 5.6 vs. 3.02 ? 3.10kg, p=0.02) (102). Lipid panelLipid panel: In human research, chromium reduced total cholesterol, LDL, and triglyceride concentrations while increasing HDL (229; 230; 231; 232; 82; 233; 80; 83; 78; 74; 70; 39; 62; 28; 226). In other human research, chromium improved intrahepatic lipid stores (63). Liver function testsLiver function tests: In human research, two subjects with HIV experienced abnormal liver function, and one had elevated blood urea nitrogen (37). Liver damage was reported in a 33 year-old woman taking 1,200mcg of chromium picolinate daily for 4-5 months (32). Neurotransmitter levelsNeurotransmitter levels: Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (44). NorepinephrineNorepinephrine: Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (44). Protein carbonyl levelsProtein carbonyl levels: In human research, chromium dinicocysteinate supplementation significantly lowered tumor necrosis factor (TNF)-alpha and protein carbonyl levels from baseline (56). SerotoninSerotonin: Picolinic acid (found in chromium picolinate) may alter CNS metabolism of serotonin, dopamine, and norepinephrine (44). Thyroid levelsThyroid levels: In humans, ingestion of chromium picolinate with levothyroxine sodium decreased serum thyroxine levels (p<0.05) (43). Patients taking levothyroxine and chromium picolinate should separate ingestion of chromium from thyroid hormones by several hours. Tumor necrosis factor (TNF)-alphaTumor necrosis factor (TNF)-alpha: In human research, chromium dinicocysteinate supplementation significantly lowered tumor necrosis factor (TNF)-alpha and protein carbonyl levels from baseline (56). Urinary calciumUrinary calcium: Anecdotally, chromium may decrease the urinary excretion of calcium and hydroxyproline.Urinary creatinineUrinary creatinine: In human research, participants treated with chromium showed a significantly increased mean urine chromium-to-creatinine ratio (52).