For PCOS, chromium effectively improves insulin activity which has been shown to be a significant factor for those diagnosed with this disorder. Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women aged 18 to 44 and is complicated to properly resolve as it has a multitude of contributing factors and symptoms, including impaired glucose metabolism, increased insulin levels, acne, menstrual problems and pain, ovarian cysts, reduced fertility, elevated androgens such as testosterone, and abnormal triglycerides and cholesterol. PCOS causes widespread disruption of a woman’s endocrine system including female and testosterone hormones, and sugar and fat regulation. According to the Mayo Clinic, other possible associated or causative factors for having PCOS include low-grade inflammation and hereditary influences.
It has long been suspected that there is a link between PCOS and elevated blood glucose or type 2 diabetes mellitus; many medical experts believe that these conditions are related. Specifically, insulin resistance may play a part in causing PCOS: the receptors for insulin are disrupted in PCOS sufferers, leading to high levels of insulin being produced by the pancreas.
In women with PCOS, evidence indicates that chromium is effective for improving insulin sensitivity. Taking chromium, especially in the picolinate form, daily for six months along with diet and exercise counseling has been found to decrease body mass index and to improve ovulation rates and the rate of regular menstruation compared to placebo in women with polycystic ovary syndrome.1,2 Chromium is especially effective when taken with the trace mineral vanadium and the herb gymnema.
Researchers in Australia analyzed collected cross-sectional data from over 8,000 women and found that those who had PCOS were 4 to 8.8 times more likely to develop type 2 diabetes than women who didn’t have PCOS. Obesity was an important risk factor.3 A 2017 study of Danish women found that those with PCOS were at higher risk–four times as likely–to develop type 2 diabetes and tended to be diagnosed with diabetes 4 years earlier than women without PCOS.4
To determine the prevalence of PCOS among premenopausal women with type 2 diabetes, a 2001 review conducted a retrospective cross-sectional prevalence study reviewing the medical records of all women seen in the Diabetes Clinic of the Medical College of Virginia Hospitals from January 1995 through February 2000. This review concluded that approximately 27 percent of premenopausal women with type 2 diabetes also have PCOS.5
With several potential causes for PCOS, there are a variety of effective natural therapies: For targeting glucose metabolism, chromium is a well-researched element that decreases fasting glucose levels, improves glucose tolerance and insulin sensitivity, and lowers insulin levels. Chromium can also reduce total cholesterol and triglycerides and boost ‘good’ HDL, all of which can be impaired with PCOS. Chromium is an essential nutrient for human life, and unfortunately the refining of flour and sugar has depleted chromium levels in many diets. Metabolic stress and strenuous exercise can increase chromium needs. People with type 2 diabetes frequently have low body chromium levels, and the same is probably true for women with PCOS.
Chromium is part of glucose tolerance factor (GTF) which also includes niacin. GTF is necessary for insulin to function optimally to move glucose into cells; without chromium, insulin fails and blood sugar levels rise. Evidence shows several ways in which chromium may work: it may increase insulin sensitivity and stimulate insulin receptor sites; similar to metformin, experts believe that chromium decreases insulin resistance; it may increase insulin binding to red blood cells, increase insulin receptor number or enhance receptor proteins, increase insulin internalization in cells, or increase pancreatic beta-cell glucose sensitivity.
Restoring normal insulin activity may boost nitric oxide synthesis and help to open blood vessels and improve blood flow. In non-diabetic people, chromium can also lower total cholesterol by 10%, which translates to a 20% reduction in heart attack or stroke risk.6 Chromium is helpful for PCOS because of the link between polycystic ovaries, insulin resistance, and excessive blood sugar.
Our PCOS patients receive consistently excellent results for insulin resistance and elevated blood sugar, with enduring improvements in fasting glucose and hemoglobin A1C over months and years, with chromium in an absorbable nicotinate or picolinate form. The actions of chromium can be enhanced by vanadium, a trace mineral that helps with blood sugar control, and the classic blood sugar balancing botanical Gymnema sylvestre.
Vanadium can improve glycemic control by enhancing glucose transport into cells, and by improving lipid synthesis and formation of the storage carbohydrate glycogen. Vanadium inhibits gluconeogenesis and lipolysis, so that less glucose is made and less fat broken down or released into the circulation: these actions reduce glucose and fats in the blood. Vanadium may work through activation of several key components of insulin-signaling pathways, and can support insulin’s helpful metabolic effects. According to review data, vanadium doses of 200 to 500mcg may stimulate glucose reduction and the formation of glycogen in the liver.
Gymnema is a plant from India’s tropical forests with a long history of use for high blood sugar and diabetes. Recent scientific investigation confirms history by showing that it stabilizes blood sugar in both type 1 and type 2 diabetes, and reduces glycosylated hemoglobin (HbA1c) levels. Gymnema may support regeneration of beta-cells in the pancreas that make insulin, boosting their number and function to help make more insulin. Clinical observation shows that gymnema can reduce sugar cravings so that patients more easily enjoy a low-carbohydrate diet.
Gymnema may also interact with specific gut hormones so that more insulin is released. Evidence suggests that gymnema enhances the action of insulin for healthy people and those with type 1 and type 2 diabetes increasing glucose utilization, improving blood sugar control, and at times allowing patients to reduce their insulin doses. In clinical studies with type 2 diabetes, gymnema helped patients to reduce their doses of oral hypoglycemic drugs because of better blood sugar balance. There is also early evidence that gymnema can also help lower total cholesterol and triglyceride levels.
Recommendation: Chromium in the absorbable nicotinate or picolinate form, 500 to 1000mcg daily with any meals, or as directed by your physician. Optional gymnema 100-200mg, vanadium 250-500mcg.
- Ashoush S, Abou-Gamrah A, Bayoumy H, Othman N. Chromium picolinate reduces insulin resistance in polycystic ovary syndrome: Randomized controlled trial. J Obstet Gynaecol Res. 2016;42(3):279-85.
- Lydic ML, McNurlan M, Bembo S, et al. Chromium picolinate improves insulin sensitivity in obese subjects with polycystic ovary syndrome. Fertil Steril 2006;86:243-6.
- A. E. Joham, S. Ranasinha, S. Zoungas, L. Moran, H. J. Teede; Gestational Diabetes and Type 2 Diabetes in Reproductive-Aged Women With Polycystic Ovary Syndrome, The Journal of Clinical Endocrinology & Metabolism, Volume 99, Issue 3, 1 March 2014, 447–E452.
- Katrine Hass Rubin, Dorte Glintborg, Mads Nybo, Bo Abrahamsen, Marianne Andersen; Development and Risk Factors of Type 2 Diabetes in a Nationwide Population of Women With Polycystic Ovary Syndrome, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 10, 1 October 2017, Pages 3848–3857.
- Heather R. Peppard, Jennifer Marfori, Maria J. Iuorno, John E. Nestler, “Prevalence of Polycystic Ovary Syndrome Among Premenopausal Women With Type 2 Diabetes.” Diabetes Care Jun 2001, 24 (6) 1050-1052.
- Jamilian M, Asemi Z. Chromium Supplementation and the Effects on Metabolic Status in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. Ann Nutr Metab. 2015;67(1):42-8.
- Azziz R. Polycystic Ovary Syndrome. Obstet Gynecol. 2018 Jul 10.
- Teede HJ et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Clin Endocrinol. 2018 Jul 19.