Chromium, sold mainly as chromium picolinate, is taken to improve how the body handles sugar. Benefit appears only where blood sugar control is already impaired; where sugar handling is normal, trials show nothing, and one study suggests high accumulated exposure moves insulin sensitivity the wrong way. Harms at usual intakes are minor. Contamination of many products is unresolved. (Full Review)
| Marker | Target | Why |
|---|---|---|
| HbA1c | 4.8–5.3% | Primary efficacy endpoint; average glucose over ~3 months |
| Fasting plasma glucose | 75–86 mg/dL | Earliest endpoint to move; largest pooled effect |
| Fasting insulin | 2–5 µIU/mL | Insulin-sensitivity change underlying any glucose effect |
| HOMA-IR | Below 1.0 | Combines fasting glucose and insulin; used in the pooled trials |
| hs-CRP | Below 0.8 mg/L | Tracks the inflammation signal reported to fall in trials |
| eGFR with creatinine | Above 90 mL/min/1.73 m² | Safety endpoint; kidney injury is the most serious harm |
| ALT and AST | ALT below 25 U/L in men, below 20 U/L in women | Safety endpoint; hepatotoxicity reported from 200 µg/day |
| Ferritin with transferrin saturation | Ferritin 30–100 ng/mL; saturation 20–35% | Iron status modifies delivery via shared transferrin carrier |
| TSH | 0.5–2.0 mIU/L | Detects the levothyroxine absorption interaction early |
| Lipid panel (total cholesterol, triglycerides, HDL, LDL) | Triglycerides below 80 mg/dL; HDL above 55 mg/dL | Secondary efficacy endpoint; small pooled effect claimed |
| Serum or urinary chromium | No target; track change from own baseline | Only exposure marker; detects accumulation, not sufficiency |
Cadence: Fasting baseline; glucose, insulin and thyroid at 12 weeks; kidney and liver at 12 weeks, then every 6–12 months if continuing; full panel annually.