Chromium supplementation has therapeutic effects in PCOS

PCOS (polycystic ovary syndrome) is the most common cause of involuntary infertility. Women with PCOS often have elevated blood glucose levels due to insulin resistance, which contributes to the development of the condition. However, evidence now suggests that chromium supplementation may have therapeutic effects on insulin sensitivity, blood glucose control, ovulation, and the chance of becoming pregnant. Remarkably, this effect appears to be just as effective as the diabetes drug metformin - yet without side effects. These findings are reported in a meta-analysis published in Endocrinologica, Diabetes and Nutrition. As part of PCOS treatment and blood sugar regulation, it is also recommended to limit carbohydrate intake and place greater emphasis on getting adequate protein and healthy fats with all main meals.

PCOS is characterized by enlarged ovaries with multiple cysts (polycystic ovaries, PCO), where the ovaries contain many small follicles. The associated syndrome, PCOS, involves a wide range of symptoms caused by multiple hormonal imbalances, including irregular menstrual cycles, sugar cravings, overweight, fatigue, and involuntary infertility. Acne and male-pattern hair growth (hirsutism) are due to elevated levels of male sex hormones.
One of the underlying causes of PCOS is insulin resistance - a condition in which cells have a reduced ability to absorb glucose from the bloodstream. As a result, satiety is impaired, and one easily tends to consume excessive amounts of fast carbohydrates, which are converted into fat stores, typically around the abdomen. Insulin resistance also leads to elevated blood glucose and insulin levels, increasing the risk of chronic inflammation, oxidative stress, metabolic syndrome, type 2 diabetes, and cardiovascular disease.
Because insulin resistance plays a central role in the development of PCOS, the condition is often treated with metformin, which reduces insulin resistance and weight gain. However, this treatment does not address the underlying cause of PCOS and is associated with side effects such as vitamin B12 deficiency. Since the trace element chromium is also known to enhance insulin action, the researchers behind the new meta-analysis set out to investigate whether chromium supplementation is as effective as metformin in women with PCOS.
The researchers therefore collected a number of relevant studies from databases such as PubMed, Scopus, Embase, and Google Scholar. The new meta-analysis included 10 randomized, placebo-controlled trials involving a total of 683 women with PCOS. Compared with the placebo groups, the studies showed that women who received a daily supplement of 200 micrograms of chromium experienced the following benefits:

• A significant reduction in fasting insulin
• Improved insulin sensitivity, indicating better glucose uptake
• A significant reduction in triglycerides, where elevated levels increase the risk of cardiovascular disease
• A significant reduction in total cholesterol and LDL cholesterol
• A significant reduction in C-reactive protein (CRP), a marker of chronic inflammation
• A significant reduction in malondialdehyde (MDA), a marker of oxidative stress
• A significant reduction in follicle-stimulating hormone (FSH), prolactin, and luteinizing hormone (LH), which are typically elevated in PCOS
• More frequent ovulation and menstrual cycles, indicating improved fertility

The researchers therefore conclude that a daily chromium supplement of 200 micrograms can improve insulin sensitivity just as effectively as metformin. The beneficial effects of chromium supplementation are also associated with improved sex hormone balance and a greater chance of becoming pregnant. Unlike metformin, chromium supplementation is not associated with side effects.

• In insulin resistance, PCOS, metabolic syndrome, and type 2 diabetes, the liver functions almost like a “fat factory,” producing excessive triglycerides and LDL cholesterol from surplus carbohydrates.

How does chromium enhance the effect of insulin?

After ingestion, carbohydrates are broken down into blood sugar (glucose), which enters the bloodstream. At the same time, the pancreas produces the hormone insulin, which is released into circulation. Insulin then binds to insulin receptors on the surface of cells. Subsequently, chromium must also be transported into the cells, where it is converted into chromodulin, which binds to the inner portion of the cell’s insulin receptor. This process - requiring both insulin and chromium - opens the pathway for glucose uptake into the cells, supplying them with energy. Overall, chromium helps cells absorb more glucose, which can be compared to a car that gets much better fuel efficiency.

The effect of chromium supplementation is enhanced by a low-glycemic diet

In the introduction to the new meta-analysis, the authors also emphasize that primary therapy should focus on establishing appropriate dietary habits, including limiting carbohydrate intake - especially refined carbohydrates with a high glycemic index that rapidly enter the bloodstream. It’s a good idea to get inspiration from the Mediterranean diet, paleo-style diets, and other dietary patterns with a low glycemic index. It is also important to place greater emphasis on adequate protein, healthy fats, and fiber from vegetables, which help lower the glycemic impact of meals.

Reference:

Mohammed Hamsho et al. Therapeutic effects of chromium supplementation on women with polycystic ovarian syndrome: A systematic review and meta-analysisEfectos terapéuticos de la suplementación con cromo en mujeres con síndrome de ovario poliquístico: una revisión sistemática y metaanálisis. Endocrinologica, Diabetes y Nutrition 2025.

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