Bastyr Center for Natural Health
Dr. Alan R. Gaby
Chromium supplementation may relieve symptoms in people with a mood disorder known as atypical depression, according to the Journal of Psychiatric Practice (2005;11:302ˆ14). These findings are good news for the many people who suffer from this often difficult to treat condition.
Atypical depression, the most common form of depression in outpatients, is characterized by increased appetite, excessive sleepiness, sluggishness, and increased sensitivity to being rejected by another person and improved mood when something good happens (mood reactivity). Compared with other forms of depression, atypical depression tends to be more chronic and is associated with more suicidal thoughts and greater disability. Medical therapy usually consists of a specific type of antidepressant drug (monoamine oxidase inhibitors).
The symptoms of atypical depression resemble those of a blood sugar regulation disorder commonly called reactive hypoglycemia or dysinsulinism. This metabolism abnormality results in a wide range of physical and mental symptoms and may be relieved by changes to the diet, such as avoiding refined sugar, caffeine, and alcohol, and eating small meals six times a day.
Chromium is an essential trace mineral that plays a key role in blood sugar regulation by facilitating the action of insulin. Chromium deficiency in animals leads to insulin resistance and diabetes, and chromium supplementation has improved blood sugar control in people with either diabetes or reactive hypoglycemia. It is possible that, in some cases, atypical depression is a manifestation of reactive hypoglycemia or dysinsulinism. If so, chromium supplementation might relieve symptoms by improving blood sugar regulation.
In the new study, adults with atypical depression were randomly assigned to receive 600 mcg of chromium per day (in the form of chromium picolinate) or a placebo for eight weeks. In the chromium group, 54% experienced a clinically significant improvement in depression compared with 36% in the placebo group. While this difference was not statistically significant, the chromium group showed significant improvements in four depression-related symptoms: appetite increase, increased eating, carbohydrate craving, and daily fluctuations of feelings. Because chromium was effective for those specific symptoms, the participants who suffered from carbohydrate cravings at the start of the study were analyzed separately. In that subset, 65% of those receiving chromium but only 33% of those receiving placebo responded to treatment, a statistically significant difference. Chromium treatment did not cause any serious side effects.
The results of this study suggest that chromium supplementation relieves certain symptoms in people with atypical depression and also severe carbohydrate craving. If chromium works by improving blood sugar regulation, then its effects might be enhanced by appropriate dietary modifications and by supplementing with other blood sugarˆstabilizing nutrients, including B vitamins, magnesium, zinc, and copper. It is also possible that chromium works by a separate mechanism: by altering the way in which the chemical messenger serotonin functions in the brain. Additional research is needed to further clarify which depressed patients are most likely to respond to chromium, what is the optimal dose, and what dietary modifications and other nutritional supplements would maximize its benefits.
An expert in nutritional therapies, Chief Medical Editor Alan R. Gaby is a former professor at Bastyr University of Natural Health Sciences, where he served as the Endowed Professor of Nutrition. He is past-president of the American Holistic Medical Association and gave expert testimony to the White House Commission on Complementary and Alternative Medicine on the cost-effectiveness of nutritional supplements. Dr. Gaby has conducted nutritional seminars for physicians and has collected over 30,000 scientific papers related to the field of nutritional and natural medicine. In addition to editing and contributing to The Natural Pharmacy (Three Rivers Press, 1999), and the AˆZ Guide to Drug-Herb-Vitamin Interactions (Three Rivers Press, 1999), Dr. Gaby has authored Preventing and Reversing Osteoporosis (Prima Lifestyles, 1995) and B6: The Natural Healer (Keats, 1987) and coauthored The Patient's Book of Natural Healing (Prima, 1999).