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Manganese

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Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • Manganese ascorbate, manganese chloride, manganese cofactors, manganese gluconate, manganese metalloproteins, manganese sulfate, manganese-containing polypeptides, Mn.

Background
  • Manganese is an essential trace nutrient. The human body contains about 10 milligrams of manganese, which is stored mainly in the liver, kidneys, pancreas, and bones.In the human brain, manganese is bound to manganese metalloproteins. Manganese activates enzymes responsible for the use of several key nutrients, including B vitamins (biotin, thiamin), vitamin C, and choline. It aids in the synthesis of fatty acids and cholesterol, facilitates protein and carbohydrate metabolism, and may also participate in the production of sex hormones and maintaining reproductive health.
  • Manganese has been examined as a treatment for a variety of conditions, including osteoarthritis and wound healing. However, manganese is often used in combination with other vitamins and/or minerals. Therefore, the effects of manganese alone are difficult to determine.
  • Chronic exposure to excessive manganese levels can lead to a variety of psychiatric and motor disturbances, termed manganism.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


The combination of manganese-cobalt oligosol may have an effect on muscle relaxation. Additional studies are needed in this area.

C


Selenium, manganese, and zinc plasma levels may aid mechanical ventilation in patients with chronic obstructive pulmonary disease (COPD). Additional studies are needed.

C


The effects of toothpaste containing manganese chloride on dental cavities has been studied. However, results are unclear and additional studies are needed.

C


The effects on growth of manganese in combination with other vitamins or minerals have been examined. The role of manganese alone cannot be determined. Additional studies are needed.

C


N-acetyl cysteine, vitamins A-E, biotin, selenium, zinc, manganese, copper, magnesium, folic acid, and coenzyme Q in combination showed a lack of effect on alcoholic hepatitis. Additional studies are needed in this area.

C


Manganese ascorbate in combination with sodium chondroitin sulfate and glucosamine has demonstrated benefit in patients with osteoarthritis. However, the role of manganese alone cannot be determined from these studies. Additional studies are needed.

C


Supplemental calcium and trace minerals (copper, manganese, and zinc) increased bone mineral density in postmenopausal women. However, the effects of manganese alone cannot be determined. More research is needed in this area.

C


A combination of calcium and manganese may alleviate symptoms associated with premenstrual syndrome. However, the effects of manganese alone cannot be determined. Further research is needed.

C


A combination of 7-oxo-DHEA, l-tyrosine, asparagus root extract, choline bitartrate, inositol, copper gluconate, manganese, and potassium iodide has been examined for its effects on weight loss. Additional research is needed in this area.

C


Manganese in combination with calcium and zinc may be beneficial in patients with chronic wounds. Additional research is needed in this area.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Allergies, amyotrophic lateral sclerosis, anemia (microcytic), antibiotic, antioxidant, antiviral, asthma, attention deficit hyperactivity disorder, autoimmune disorders (advanced beta-cell autoimmunity), bone diseases, cancer, cancer (prevention), colorectal cancer, deficiency (manganese), diabetes, epilepsy, gastrointestinal conditions, heart disease, heavy metal/lead toxicity, high cholesterol, immunomodulation, inflammation, learning disabilities, metabolic syndrome (coronary heart disease), multiple sclerosis, myasthenia gravis, neural tube defects, obesity, rheumatoid arthritis, schizophrenia, skin conditions, sprains and strains, vascular disorders (Behçet's disease).

Dosing

Adults (18 years and older)

  • There is no proven effective dose for manganese for any condition in adults.
  • The adequate intake (AI) levels for manganese are as follows: for men 19-70 years old: 2.3 milligrams; for men more than 70 years old: 2.3 milligrams; for women 19-70 years old: 1.8 milligrams; for women more than 70 years old: 1.8 milligrams; for pregnant women 14-50 years old: two milligrams; and for lactating women 14-50 years old: two milligrams.
  • The requirements of manganese for adults from total parenteral nutrition are estimated to be 0.15-0.80 milligrams daily.

Children (under 18 years old)

  • There is no proven effective dose for manganese in children.
  • The adequate intake (AI) levels for manganese are as follows: for those 0-6 months old: three micrograms; for those 7-12 months old: 600 micrograms; for those 1-3 years old: 1.2 milligrams; for those 4-8 years old: 1.5 milligrams; for boys 9-13 years old: 1.9 milligrams; for boys 14-18 years old: 2.2 milligrams; for girls 9-13 years old: 1.6 milligrams; and for girls 14-18 years old: 1.6 milligrams.
  • The requirements of manganese for children from total parenteral nutrition are estimated to be 10 micrograms per kilogram daily.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid with known allergy or hypersensitivity to manganese.

Side Effects and Warnings

  • Use cautiously in patients with ileal pouch-anal anastomosis and malignancies, because blood levels of magnesium may be higher in these individuals.
  • Use cautiously in patients with non-Hodgkin's lymphoma.
  • Use cautiously in total parenteral nutrition in pediatric patients. Increased manganese levels may lead to cholestasis (blockage of bile from the liver).
  • Avoid in patients with chronic liver disease who are receiving parenteral nutrition, due to the potential for increased risk of manganese toxicity.
  • Avoid in patients with iron-deficiency anemia, due to the potential for increased manganese accumulation.
  • Avoid in patients with cardiovascular disease, due to reports of heart rate changes such as arrhythmia.
  • Avoid with known allergy or hypersensitivity to manganese.
  • Avoid chronic exposure to manganese. Chronic exposure to excessive manganese levels can lead to a variety of psychiatric and motor disturbances (termed manganism), such as violent acts, irritability, and decreased neurodevelopment. It may also be a risk factor for the development of neurodegenerative disorders, such as Parkinson's disease or parkinsonian-like symptoms and dementia, as well as decreased results in performance testing. Chronic exposure to manganese may also result in acute bronchitis, cancer cell adhesion, cardiovascular dysfunction (altered heart rate), changes in hormone levels, changes in levels of other biochemical compounds in the blood, decreased fertility, dizziness, hallucinations, headache, hyperactivity, increased blood levels of manganese, liver concerns (hepatic encephalopathy), lung and eye problems, non-Hodgkin's lymphoma, orthostatic hypotension (head rush or dizzy spell), pneumonitis (lung inflammation), or pulmonary edema (swelling in the lungs).

Pregnancy and Breastfeeding

  • Manganese is likely safe in pregnant and lactating women in amounts commonly found in the diet.
  • Manganese may affect fertility, although this has not been well studied in humans.
  • Pregnancy may affect manganese status or metabolism. The maternal diet affects the amount of manganese in milk samples.

Interactions

Interactions with Drugs

  • Manganese may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.
  • Manganese may also interact with antacids, anticancer agents, antidiabetic agents, anti-inflammatory agents, antimicrobials, antipsychotics, cardiovascular agents, drugs that affect the immune system, drugs that lower cholesterol levels, drugs used for Parkinson's disease, drugs used for the liver, fertility agents, fluvastatin, haloperidol, hemological agents, hormonal agents, oral contraceptives, prednisone, ramipril, respiratory agents, sodium iron EDTA, stimulants, and wound-healing agents.

Interactions with Herbs and Dietary Supplements

  • Manganese may cause low blood pressure. Caution is advised in patients taking herbs and supplements that lower blood pressure.
  • Manganese may also interact with antacids, anticancer agents, antidiabetic agents, anti-inflammatory agents, antimicrobials, antioxidants, antipsychotics, calcium, cardiovascular agents, copper, fertility agents, fluoride, guar gum, herbs and supplements that affect the immune system, herbs and supplements that lower cholesterol levels, herbs and supplements used for Parkinson's disease, herbs and supplements used for the liver, hemological agents, high-fat foods, high-fiber foods, hormonal agents, iron, magnesium, molybdenum, phytic acid, respiratory agents, selenium, stimulants, tea, tin, vanadium, vitamins, wound-healing agents, and zinc.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Benevolenskaia LI, Toroptsova NV, Nikitinskaia OA, et al. [Vitrum osteomag in prevention of osteoporosis in postmenopausal women: results of the comparative open multicenter trial]. Ter Arkh. 2004;76(11):88-93.
  2. Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992 Dec 24;327(26):1832-5.
  3. Das A Jr, Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage. 2000 Sep;8(5):343-50.
  4. Davison GW, Hughes CM, Bell RA. Exercise and mononuclear cell DNA damage: the effects of antioxidant supplementation. Int J Sport Nutr Exerc Metab. 2005 Oct;15(5):480-92.
  5. El-Attar M, Said M, El-Assal G, et al. Serum trace element levels in COPD patient: the relation between trace element supplementation and period of mechanical ventilation in a randomized controlled trial. Respirology. 2009 Nov;14(8):1180-7. Epub 2009 Sep 16.
  6. Harrison RL, Cheraskin E, Ringsdorf WM Jr, et al. The effect of multivitamin-trace mineral versus placebo supplementation upon the height-weight ratio (ponderal index). Int Z Vitaminforsch. 1969;39(4):486-91.
  7. Koch G. Comparison and estimation of effect on caries of daily supervised toothbrushing with a dentifrice containing sodium fluoride and a dentifrice containing potassium fluoride and manganese chloride. A three-year clinical test. Odontol Revy. 1972;23(3):341-54.
  8. Leffler CT, Philippi AF, Leffler SG, et al. Glucosamine,chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med. 1999 Feb;164(2):85-91.
  9. Penland JG, Johnson PE. Dietary calcium and manganese effects on menstrual cycle symptoms. Am J Obstet Gynecol. 1993 May;168(5):1417-23.
  10. Rivera JA, González-Cossío T, Flores M, et al. Multiple micronutrient supplementation increases the growth of Mexican infants. Am J Clin Nutr. 2001 Nov;74(5):657-63.
  11. Salducci J, Planche D. [A therapeutic trial in patients with spasmophilia]. Sem Hop. 1982 Oct 7;58(36):2097-100.
  12. Stewart S, Prince M, Bassendine M, et al. A randomized trial of antioxidant therapy alone or with corticosteroids in acute alcoholic hepatitis. J Hepatol. 2007 Aug;47(2):277-83.
  13. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr. 1994 Jul;124(7):1060-4.
  14. Uusitalo L, Kenward MG, Virtanen SM, et al. Intake of antioxidant vitamins and trace elements during pregnancy and risk of advanced beta cell autoimmunity in the child. Am J Clin Nutr. 2008 Aug;88(2):458-64.
  15. Whelan AM, Jurgens TM, Bowles SK. Natural health products in the prevention and treatment of osteoporosis: systematic review of randomized controlled trials. Ann Pharmacother. 2006 May;40(5):836-49.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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