{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:51:56Z","timestamp":1791942716682,"version":"4.3.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[1998,4,1]],"date-time":"1998-04-01T00:00:00Z","timestamp":891388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To describe a case of toxicity secondary to chronic ingestion of 6\u201312 times the recommended daily allowance of over-the-counter (OTC) chromium picolinate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 33-year-old white woman presented with weight loss, anemia, thrombocytopenia, hemolysis, liver dysfunction (aminotransferase enzymes 15\u201320 times normal, total bilirubin 3 times normal), and renal failure (serum creatinine 5.3 mg\/dL; blood urea nitrogen 152 mg\/dL). She had ingested chromium picolinate 1200\u20132400 \u03bcg\/d for the previous 4\u20135 months to enhance weight loss. The patient had chromium plasma concentrations 2\u20133 times normal. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome were ruled out by clinical findings, peripheral blood smears, and a bone marrow biopsy. The patient was managed with supportive measures and received blood product transfusions and hemodialysis. Hemolysis stabilized and liver function improved over 6 days. Liver function returned to normal prior to discharge. Renal function began to return on day 12 and her serum creatinine on discharge was 1.3 mg\/dL. One year later, all laboratory values were within normal limits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Trivalent chromium is an essential trace element that is considered safe when ingested in normal quantities. Trivalent chromium compounds are used by patients to enhance weight loss, increase lean body mass, and\/or improve glycemic control. Information regarding the toxicity of chromium picolinate is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Chromium supplements may cause serious renal impairment when ingested in excess. Medication histories should include attention to the use of OTC nutritional supplements often regarded as harmless by the public and lay media.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJETIVO:<\/jats:title>\n                    <jats:p>Describir un caso de toxicidad producida por la ingesti\u00f3n cr\u00f3nica de picolinato de cromio, producto que no requiere prescripci\u00f3n m\u00e9dica, en cantidades de 6\u201312 veces mayores que las recomendadas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESUMEN DEL CASO:<\/jats:title>\n                    <jats:p>Una mujer de 33 a\u00f1os presentaba p\u00e9rdida de peso, anemia, trombocitopenia, hem\u00f3lisis, disfunci\u00f3n hep\u00e1tica (aminotranferasas 15\u201320 veces el valor normal, bilirubina total tres veces el valor normal), y fallo renal (creatinina s\u00e9rica = 5.3 mg\/dL, nitr\u00f3geno ure\u00edco sangu\u00edneo = 152 mg\/dL). Esta paciente hab\u00eda ingerido 1200\u20132400 \u03bcg diarios de picolinato de cromio durante los pasados 4\u20135 meses para bajar de peso. La paciente ten\u00eda una concentraci\u00f3n de cromio en el plasma 2\u20133 veces lo normal. Se descartaron los s\u00edndromes de trombocitopenia p\u00farpura tromb\u00f3tica y uremia hemol\u00edtica mediante hallazgos cl\u00ednicos, cultivo de sangre, y biopsia de m\u00e9dula \u00f3sea. La paciente se manej\u00f3 con medidas de apoyo, transfusiones con productos de sangre y hemodi\u00e1lisis. La hem\u00f3lisis se estabiliz\u00f3 y la funci\u00f3n hep\u00e1tica mejor\u00f3 a los 6 d\u00edas de tratamiento. La funci\u00f3n hep\u00e1tica regres\u00f3 a los limites normales antes de ser dada de alta. La funci\u00f3n renal comenz\u00f3 a normalizarse el d\u00eda 12 de la hospitalizaci\u00f3n y la creatinina s\u00e9rica disminuy\u00f3 a 1.3 mg\/dL el d\u00eda que la paciente fue dada de alta. Un a\u00f1o m\u00e1s tarde, todos los valores de laboratorio se encontraban dentro de los l\u00edmites normales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSION:<\/jats:title>\n                    <jats:p>El cromio trivalente es un elemento traza esencial que se considera seguro cuando se ingiere en cantidades recomendadas. En la actualidad, los compuestos de cromio trivalente son utilizados para ayudar en la p\u00e9rdida de peso, aumentar el peso magro y\/o mejorar el control gluc\u00e9mico. La informaci\u00f3n disponible relacionada con la toxicidad del picolinato de cromio es a\u00fan muy limitada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONES:<\/jats:title>\n                    <jats:p>Los suplementos de cromio pueden causar impedimentos renales serios cuando se ingieren en cantidades excesivas. Es importante que el historial m\u00e9dico incluya informaci\u00f3n sobre los suplementos nutricionales que pueda estar utilizando el paciente. Estos productos se adquieren sin prescripci\u00f3n m\u00e9dica y muchas veces el p\u00fablico y los medios de informaci\u00f3n no especializados los consideran inofensivos.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIF:<\/jats:title>\n                    <jats:p>D\u00e9crire un cas de toxicit\u00e9 associee \u00e0 l'ingestion chronique d'un produit de comptoir, le picolinate de chromium, \u00e0 une dose de 6\u201312 fois celle recommand\u00e9e quotidiennement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00c9SUM\u00c9 DU CAS:<\/jats:title>\n                    <jats:p>Une femme \u00e2g\u00e9e de 33 ans se pr\u00e9sente \u00e0 l'urgence o\u00f9 on constate une perte de poids, une an\u00e9mie, une thrombocytop\u00e9nie, une h\u00e9molyse, un probl\u00e8me h\u00e9patique (le taux des aminotransf\u00e9rases est de 15\u201320 fois la normale, le taux de la bilirubine totale est de 3 fois la normale), et une insuffisance r\u00e9nale (cr\u00e9atinine s\u00e9rique = 5.3 mg\/dL, azote ur\u00e9ique sanguine = 152 mg\/dL). Elle a ing\u00e9r\u00e9 1200\u20132400 \u03bcg par jour de picolinate de chromium pendant les 4\u20135 mois pr\u00e9c\u00e9dents pour stimuler une perte de poids. Les concentrations plasmatiques de chromium sont de 2\u20133 fois la normale. Un purpura thrombotique thrombocytop\u00e9nique et un syndrome h\u00e9molytique ur\u00e9mique ont \u00e9t\u00e9 \u00e9limin\u00e9s \u00e0 l'aide des donn\u00e9es cliniques, des pr\u00e9l\u00e8vements sanguins et d'une biopsie de la mo\u00eblle \u00e9pini\u00e8re. Un traitement de support a \u00e9t\u00e9 administr\u00e9 \u00e0 la patiente; elle a re\u00e7u des transfusions sanguines et une h\u00e9modialyse a \u00e9t\u00e9 r\u00e9alis\u00e9e. L'h\u00e9molyse s'est stabilis\u00e9 et la fonction h\u00e9patique s'est am\u00e9lior\u00e9e en 6 jours. La fonction h\u00e9patique s'est normalis\u00e9e avant le d\u00e9part de la patiente. La fonction r\u00e9nale a commenc\u00e9 \u00e0 s'am\u00e9liorer au jour 12 et la cr\u00e9atinine s\u00e9rique \u00e9tait de 1.3 mg\/dL \u00e0 son d\u00e9part. Un an plus tard, toutes les valeurs de laboratoire sont \u00e0 l'int\u00e9rieur de la limite de la normale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Le chromium trivalent est un oligo-\u00e9l\u00e9ment essentiel consid\u00e9r\u00e9 s\u00e9curitaire lorsqu'il est ing\u00e9r\u00e9 en quantit\u00e9 normale. Des produits \u00e0 base de chromium trivalent sont utilis\u00e9s couramment par les patients pour favoriser la perte de poids, pour augmenter la masse maigre et\/ou pour am\u00e9liorer le contr\u00f4le glyc\u00e9mique. Les donn\u00e9es concernant la toxicit\u00e9 du picolinate de chromium sont limit\u00e9es.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Les suppl\u00e9ments de chromium peuvent causer une alt\u00e9ration grave de la fonction r\u00e9nale s'ils sont ing\u00e9r\u00e9s en quantit\u00e9 excessive. Lors des entrevues avec les patients, une attention particuli\u00e8re devrait \u00eatre portee \u00e0 l'utilisation des suppl\u00e9ments nutritionnels disponibles sans ordonnance et consid\u00e9r\u00e9s sans danger par le public et la presse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.17327","type":"journal-article","created":{"date-parts":[[2004,3,11]],"date-time":"2004-03-11T17:08:19Z","timestamp":1079024899000},"page":"428-431","source":"Crossref","is-referenced-by-count":168,"title":["Chromium Picolinate Toxicity"],"prefix":"10.1177","volume":"32","author":[{"given":"Jennifer","family":"Cerulli","sequence":"first","affiliation":[{"name":"Jennifer Cerulli PharmD BCPS, Fellow, Nutrition Support, Division of Pharmacy Practice, Albany College of Pharmacy, Albany, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren W","family":"Grabe","sequence":"additional","affiliation":[{"name":"Darren W Grabe PharmD, Fellow, Nephrology, Division of Pharmacy Practice, Albany College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Gauthier","sequence":"additional","affiliation":[{"name":"Isabelle Gauthier PharmD BCPS, at time of writing, Resident, Oncology, Department of Pharmacy, Albany Medical Center, Albany, NY, and Division of Pharmacy Practice, Albany College of Pharmacy; now, Assistant Clinical Professor, Faculty of Pharmacy, University of Montreal, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Malone","sequence":"additional","affiliation":[{"name":"Margaret Malone PhD FCCP BCNSP, Professor, Division of Pharmacy Practice, Albany College of Pharmacy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Donald","family":"McGoldrick","sequence":"additional","affiliation":[{"name":"M Donald McGoldrick MB FRCP(C), Professor, Department of Medicine, Division of Nephrology, Albany Medical College, Albany, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1998,4,1]]},"reference":[{"key":"bibr1-aph.17327","first-page":"264","volume-title":"Modern nutrition in health and disease","author":"Nielsen FH","year":"1994","edition":"8"},{"key":"bibr2-aph.17327","volume-title":"Recommended dietary allowances","author":"Food and Nutrition Board, National Research Council","year":"1989","edition":"10"},{"key":"bibr3-aph.17327","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-126-5-199703010-00019"},{"key":"bibr4-aph.17327","doi-asserted-by":"publisher","DOI":"10.1002\/jat.2550130314"},{"key":"bibr5-aph.17327","doi-asserted-by":"publisher","DOI":"10.1111\/j.0954-6820.1965.tb01817.x"},{"key":"bibr6-aph.17327","doi-asserted-by":"publisher","DOI":"10.1007\/BF01707671"},{"key":"bibr7-aph.17327","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/30.4.531"},{"key":"bibr8-aph.17327","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03290310036012"},{"key":"bibr9-aph.17327","doi-asserted-by":"publisher","DOI":"10.1007\/BF01318699"},{"key":"bibr10-aph.17327","first-page":"58","volume":"43","author":"McCarty MF","year":"1991","journal-title":"J Appl Nutr"},{"key":"bibr11-aph.17327","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/123.4.626"},{"key":"bibr12-aph.17327","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-127-8_Part_1-199710150-00028"},{"key":"bibr13-aph.17327","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197301182880304"},{"key":"bibr14-aph.17327","first-page":"1743","volume-title":"Harrison's principles of internal medicine","author":"Rosse W","year":"1994","edition":"13"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.17327","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.17327","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:07:12Z","timestamp":1777374432000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.17327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,4]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1998,4]]}},"alternative-id":["10.1345\/aph.17327"],"URL":"https:\/\/doi.org\/10.1345\/aph.17327","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,4]]}}}