Chromium in PCOS: who it helps (and who it won’t)
A research breakdown
Hello everyone,
How is your January going? This month can be both busy and empowering, or a bit low and confusing. Wherever you are, I hope you are taking life as it comes and surrendering to what comes your way. I am personally very deep into labour research and getting myself ready to give birth. I will share more towards the end of February, but the little girl is coming in early March.
I am doing some research on PCOS supplements. Would love to get your anonymous opinion on them in a quick 2 min survey:
Your help would be extremely useful for the next steps of The PCOS Newsletter.
Today, we discuss a popular compound in PCOS supplementation: Chromium. This little substance has quite a bit of research on it and some very positive results.
What is Chromium?
Chromium is a trace element found naturally in foods like meat, whole grains, vegetables and grapes. In the body, it exists mainly as trivalent chromium (Cr³⁺), the form involved in glucose metabolism.
We don’t fully understand its mechanism, but we do understand enough to move beyond vague “blood sugar support” claims.
At a cellular level, chromium seems to:
Enhance insulin signalling
Improve how responsive insulin receptors are
Amplify downstream signalling once insulin binds
Importantly, chromium does not act like insulin. It makes existing insulin work better.
One proposed mechanism is the formation of chromodulin, a chromium-binding oligopeptide that enhances insulin receptor activity and glucose uptake. Chromium may also inhibit negative regulators of insulin signalling, essentially removing some of the “brakes” on insulin action.
That’s why chromium works better in people with moderate insulin resistance and often does nothing in metabolically healthy individuals and is less effective in advanced diabetes. This is why, when people take supplements that don’t work, it might be the case that you don’t have insulin resistance. I was convinced for a long time that I had it despite nothing showing up on CGM or other tests. You can have PCOS without insulin resistance.
What does research say?
Interest in chromium really took off after a landmark 1997 RCT showed that 1,000 μg/day reduced fasting glucose and HbA1c in people with type 2 diabetes over four months.
Since then, results have been mixed, with some trials showing improvements in fasting glucose, HbA1c, triglycerides, and HDL, while others show very small or statistically insignificant effects. There is a reason for it; not everyone responds, and the response is dependent on your starting point. People with worse insulin sensitivity, higher fasting glucose, and higher HbA1c were far more likely to respond, whereas those with relatively normal insulin sensitivity often saw no effect. In one study, baseline insulin sensitivity accounted for ~40% of the variation in response to chromium. This makes a lot of sense, if there is no problem to begin with, of course it won’t work.
What about for PCOS specifically?
Across multiple RCTs and meta-analyses, chromium supplementation (usually as chromium picolinate) has been associated with reduced fasting insulin, improved glucose metabolisim and some improvemetns in cholesterol levels. It has also shown benefits for inflammation, acne and hirsutism scores in some trials. I think Chromium deserves a place in the PCOS management tool-kit for those with confirmed insulin resistance.
However, it’s important to note that just because it improves some of these markers, it doesn’t mean it will improve symptoms so let’s see how it does on ovulation.
What about the effect on ovulation?
A nice 6-month trial with 1,000 μg chromium picolinate saw that ovulation became more common after 5 months and 6 months compared to placebo. This is why you need to take these supplementation for much longer then expected to see a difference. They are not medication so they work much slower. This was also confirmed by meta-analysis published in 2025.
What it doesn’t help with?
Chromium does not significantly affect other reproductive hormones including follicle-stimulating hormone (FSH), luteinizing hormone (LH), or sex hormone-binding globulin (SHBG) and it has shown mixed results for testosterone levels.
How much do I need to take?
Clinical trials in PCOS have utilized chromium picolinate dosages ranging from 200 to 1,000 μg per day, with intervention durations from 8 weeks to 6 months. The most commonly studied and recommended dosage is 200 μg daily, which has demonstrated efficacy in multiple randomized controlled trials. I would be careful wtih 1,000 ug/per day and take them under the supervision of a nutrionist.
Safety
Chromium supplementation is contraindicated in individuals with kidney or liver disease, as these organs may have increased susceptibility to chromium-induced toxicity. Chromium can enhance insulin's blood glucose-lowering effects, needing caution in individuals taking sulfonylureas or insulin to prevent hypoglycemia.
In terms of dosaged the European Food Safety Authority (EFSA) concluded that chromium picolinate can be used safely based on a No Observed Adverse Effect Level (NOAEL) of 2,400 mg/kg body weight/day from long-term National Toxicology Program studies, so the dosages you see in studies are fine.
With any supplementation, I don’t recommed long-term usage and working with someone who has training in this is advisable.
Conclusion
I would say Chromium has enough evidence to make into the PCOS management toolkit if you have insulin resistance and feel like you need support with glucose metabolism. If you don’t, it won’t do much and it will be a waste of money and time.
If you need personalised support for your PCOS, please don’t hesistate to drop me an email at francesca.abalasei@gmail.com. I am qaulified Nutrional Therapist and can help with supplements protocols and support you PCOS management.
See you the following Sunday with another insightful conversation!
Francesca
Amiri Siavashani, M., Heidari, Z., Maktabi, M., Mahjoob, M., Hashemi, T. and Asemi, Z., 2018. The effects of chromium supplementation on gene expression of insulin, lipid, and inflammatory markers in infertile women with polycystic ovary syndrome candidate for in vitro fertilization: A randomized, double-blinded, placebo-controlled trial. Frontiers in Endocrinology, 9, p.726.
Amooee, S., Parsanezhad, M.E., Shiva, M., Alborzi, S., Samsami, A. and Zare, N., 2013. Metformin versus chromium picolinate in clomiphene citrate-resistant patients with polycystic ovary syndrome: A double-blind randomized clinical trial. Journal of Research in Medical Sciences, 18(7), pp.621–626.
Jamilian, M., Asemi, Z., Taghizadeh, M., Akbari, M., Jafari, P. and Memarzadeh, M.R., 2015. Chromium supplementation and the effects on metabolic status in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. Annals of Nutrition and Metabolism, 67(1), pp.42–48.
Rashidi, H., Ghazanfarpour, M., Khadivzadeh, T., et al., 2016. Chromium picolinate reduces insulin resistance in polycystic ovary syndrome: Randomized controlled trial. Journal of Obstetrics and Gynaecology Research, 42(3), pp.279–285.
Rashidi, H., Ghazanfarpour, M., Khadivzadeh, T., et al., 2016. Chromium picolinate reduces insulin resistance in polycystic ovary syndrome: Randomized controlled trial. Journal of Obstetrics and Gynaecology Research, 42(3), pp.279–285. (Report emphasising ovulation and menstrual regularity outcomes over six months).
Kazemi, M., Shidfar, F., Jazayeri, S., et al., 2019. Effects of chromium picolinate supplementation on acne, hirsutism, hs-CRP, TAC, and MDA in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. [Journal name as per full article – dermatology/endocrinology journal], 2019; volume(issue), pages.
Kazemi, M., Shidfar, F., Jazayeri, S., et al., 2019. Eight weeks of chromium picolinate supplementation and metabolic/clinical features in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. Annals of Nutrition and Metabolism, 2019; volume(issue), pages. (Summary reported in secondary sources).
Jamilian, M., Tabassi, Z., Rezaei, A., et al., 2016. Effects of chromium and carnitine co-supplementation on metabolic status in women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled trial. [Journal name – nutrition/endocrine journal], 2016; volume(issue), pages.
Jamilian, M., Foroozanfard, F., Bahmani, F., Talaee, R. and Asemi, Z., 2018. The effects of supplementation with chromium on insulin resistance indices in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized clinical trials. Experimental and Clinical Endocrinology & Diabetes, 126(7), pp.397–404.
Kazemi, M., Jamilian, M., Asemi, Z. and Esmaillzadeh, A., 2018. Chromium supplementation in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Journal of Obstetrics and Gynaecology Research, 44(1), pp.89–97.
Al-Jefout, M., et al., 2025. Therapeutic effects of chromium supplementation on women with polycystic ovarian syndrome: A systematic review and meta-analysis.
Zhang, L., Wang, J., Chen, Y., et al., 2025. The effects of trace element supplementation on glycolipid metabolism in women with polycystic ovary syndrome: A systematic review and meta-analysis. Frontiers in Nutrition, 8, article 1683556.
Serrano, F., Morales, E., and Castillo, A., 2022. The impact of mineral supplementation on polycystic ovary syndrome: A systematic review. Nutrients, 14(7), article 1458.
Benelli, E., Del Ghianda, S., Di Cosmo, C. and Tonacchera, M., 2024. Dietary supplements in polycystic ovary syndrome – current evidence. Nutrients, 16(18), article 3937.