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Table of Contents > Supplements > Manganese
Manganese
Overview
Uses
Dietary Sources
Available Forms
How to Take It
Precautions
Possible Interactions
Supporting Research

Overview

Manganese is a mineral found in large quantities in both plant and animal matter. Only trace amounts of this element can be found in human tissue, however. Manganese is predominantly stored in the bones, liver, kidney, and pancreas. It aids in the formation of connective tissue, bones, blood-clotting factors, and sex hormones and plays a role in fat and carbohydrate metabolism, calcium absorption, and blood sugar regulation. Manganese is also necessary for normal brain and nerve function.

Manganese is a component of the antioxidant enzyme manganese superoxide dismutase (MnSOD). Antioxidants scavenge damaging particles in the body known as free radicals. These particles occur naturally in the body but can damage cell membranes, interact with genetic material, and possibly contribute to the aging process as well as the development of a number of health conditions. Antioxidants such as MnSOD can neutralize free radicals and may reduce or even help prevent some of the damage they cause.

Low levels of manganese in the body can contribute to infertility, bone malformation, weakness, and seizures. Manganese deficiencies are considered rare, however, since it is relatively easy to obtain adequate amounts of manganese through the diet. Interestingly, though, some experts estimate that as many as 37% of Americans do not get the recommended daily amounts of manganese in their diet. This may be due to the fact that whole grains are a major source of dietary manganese, and many Americans consume refined grains more often than whole grains. Refined grains provide half the amount of manganese as whole grains.


Uses

Manganese may be of some benefit for the following illnesses when used in conjunction with conventional medical care:

Arthritis
People with rheumatoid arthritis tend to have low levels of MnSOD (an antioxidant that helps protect the joints from damage during inflammation). Manganese supplementation is thought to increase MnSOD activity. In addition, a few studies of people with osteoarthritis suggest that the combination of manganese supplementation taken along with glucosamine and chondroitin can reduce pain associated with the condition.

Osteoporosis
Manganese and other trace elements are necessary for bone health. Therefore, many experts feel that appropriate balance and intake of manganese and these other nutrients may play a role in preserving bone density and preventing osteoporosis.

Diabetes
Although results have been conflicting, some research suggests that people with diabetes have significantly lower levels of manganese in their bodies than people without diabetes. It is not clear, however, whether this is a cause or effect of the condition. In other words, researchers have yet to determine whether diabetes causes levels of manganese to drop or if deficiencies in this trace element actually contribute to the development of the metabolic disorder. In addition, one study found that diabetics with higher blood levels of manganese were more protected from oxidation of LDL ("bad") cholesterol than those with lower levels of manganese. (LDL oxidation contributes to the development of plaque in the arteries which can lead to heart attack and stroke.) Further studies are needed to determine whether supplementation with manganese helps prevent and/or treat diabetes and its associated complications.

Premenstrual Syndrome (PMS)
In at least one study, women who ate small amounts of manganese (levels below the recommended daily amount) experienced greater mood swings and cramping pain just prior to their periods than women who ate normal to high amounts of manganese. These results suggest that a manganese-rich diet may help reduce symptoms of PMS.

Epilepsy
Several studies suggest that manganese levels may be lower in people with seizure disorders. It is not known, however, whether seizures reduce manganese levels or if low manganese levels make a person more susceptible to convulsions. It is also unclear at this time whether manganese supplements would help reduce the number of seizures in people with epilepsy. In fact, at least one animal study suggests that manganese supplementation does not alter the severity or frequency of seizures in rats.

Other
Low levels of manganese have also been associated with muscle disorders that involve lack of coordination, irregular menstrual cycles, tinnitus (ringing in the ears), hearing loss (even in infants), and poor milk production in lactating women.


Dietary Sources

Rich dietary sources of manganese include nuts and seeds, wheat germ and whole grains (including unrefined cereals, buckwheat, bulgur wheat, and oats), legumes, and pineapples.


Available Forms

Manganese is available in a wide variety of forms including manganese salts (sulfate and gluconate) and manganese chelates (aspartate, picolinate, fumarate, malate, succinate, citrate, and amino acid chelate). Manganese supplements can be taken as tablets or capsules, usually along with other vitamins and minerals.


How to Take It

The estimated safe and adequate daily intakes for dietary manganese established by the Food and Nutrition Board of the National Research Council are listed below.

In the case of epilepsy and joint inflammation, the recommended dose may be increased under the direction of a healthcare professional. Supplements and dietary intake of manganese together should not exceed 11 milligrams per day because of the risk of neurological side effects. Supplementation from non-food sources, particularly for children, should only be undertaken with direction from a healthcare provider.

Pediatric

  • Infants birth to 6 months: 0.3 mg
  • Infants 7 to 12 months: 0.6 mg
  • Children 1 to 3 years: 1.2 mg
  • Children 4 to 8 years: 1.5 mg
  • Males 9 to 13 years: 1.9 mg
  • Males 14 to 18 years: 2.2 mg
  • Females 9 to 18 years: 1.6 mg

Adult

  • Males 19 years and older: 2.3 mg
  • Females 19 years and older: 1.8 mg
  • Pregnant females: 2 mg
  • Breastfeeding females: 2.6 mg

Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider. The amount of manganese ingested in one day (from foods and/or supplements) should not exceed 11 milligrams.

Calcium, phosphorous, and manganese work closely together in the body. For this reason, dietary requirements of manganese may increase as calcium and phosphorous consumption increases.

Manganese rarely causes side effects when taken orally. It is possible, however, for manganese toxicity to occur in those who regularly inhale manganese vapors, such as industrial workers in steel mills and mines. Potential symptoms of such toxicity include loss of appetite, headaches, leg cramps, muscle rigidity, tremors, convulsions, extreme irritability, acts of violence, and hallucinations. Manganese toxicity has also been seen in individuals who received very high amounts of intravenous nutrition (containing manganese) administered over long periods of time.


Possible Interactions

If you are currently being treated with any of the following medications, you should not use manganese supplements without first talking to your healthcare provider.

Haloperidol and other Antipsychotics
There has been at least one report of an interaction between haloperidol and manganese that resulted in hallucinations and behavioral changes in a person with liver disease. In addition, some experts believe that medications for schizophrenia and other forms of psychosis may worsen side effects from manganese supplements. Therefore, individuals taking haloperidol or other antipsychotic medications (particularly a class called phenothiazines which includes chlorpromazine, mesoridazine, perphenazine, prochlorperazine, thioridazine, and trifluoperazine) should use manganese only under the careful supervision of a qualified health professional.

Reserpine
Reserpine, a medication used to treat high blood pressure, may decrease manganese levels in the body.


Supporting Research

Bendich A. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms. J Am Coll Nut. 2000;19(1):3-11.

Carl GF, Keen CL, Gallagher BB, Clegg MS, Littleton WH, Flannery DB, Hurley LS. Association of low blood manganese concentrations with epilepsy. Neurology. 1986;36(12):1584-1587.

ConsumerLab.com 2001. Some supplements for arthritis may exceed newly released safe intake levels for manganese [news release]. PR Newswire; January 29, 2001

Critchfield JW, Carl GF, Keen CL. The influence of manganese supplementation on seizure onset and severity, and brain monoamines in the genetically epilepsy prone rat. Epilepsy Res. 1993;14(1):3-10.

Das A, Hammad TA. Combination of glucosamine and chondroitin in knee OA. Osteoarthritis Cartilage. 2000;8(5):343-350.

Davidson DL, Ward NI. Abnormal aluminum, cobalt, manganese, strontium, and zinc concentrations in untreated epilepsy. Epilepsy Res. 1988;2(5):323-330.

Davis CD, Greger JL. Longitudinal changes of manganese-dependent superoxide dismutase and other indexes of manganese and iron status in women. Am J Clin Nutr. 1992;55:747-752.

Deimling MJ, Schnell C. Interaction between manganese and phenobarbital on hexobarbital hypnosis in the male rat. Res Commun Chem Pathol Pharmacol. 1983;41(1):165-168.

Dendle P. Lupines, manganese, and devil-sickness: an Anglo-Saxon medical response to epilepsy. Bull Hist Med. 2001;75(1):91-101.

Dupont CL, Tanaka Y. Blood manganese levels in children with convulsive disorder. Biochem Med. 1985;33(2):246-255.

Ekmekcioglu C, Prohaska C, Pomazal K, Steffan I, Schernthaner G, Marktl W. Concentrations of seven trace elements in different hematological matrices in patients with type 2 diabetes as compared to healthy controls. Biol Trace Elem Res. 2001;79(3):205-219.

el-Yazigi A, Hannan N, Raines DA. Urinary excretion of chromium, copper, and manganese in diabetes mellitus and associated disorders. Diabetes Res. 1991;18:129-134.

Fell JM, Reynolds AP, Meadows N, et al. Manganese toxicity in children receiving long-term parenteral nutrition. Lancet. 1996;347:1218-1221.

Finley JW, Davis CD. Manganese deficiency and toxicity: are high or low dietary amounts of manganese cause for concern? Biofactors. 1999;10(1):15-24.

Gaby AR. Natural treatments for osteoarthritis. Alt Med Rev. 1999;4(5):330-341.

Hori H, Ohmari O, Shinkai T, Kojima H, Okano C, Suzuki T, Nakamur J. Manganese superoxide dismutase gene polymorphism and schizophrenia: relation to tardive dyskinesia. Neuropsychopharm. 2000;23(2):170-177.

Ingersoll RT, Montgomery EB Jr, Aposhian HV. Central nervous system toxicity of manganese. II: Cocaine or reserpine inhibit manganese concentration in the rat brain. Neurotoxicol. 1999; 20(2-3):467-476.

Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press; 2001. Accessed on February 14, 2002 at http://www4.nas.edu/IOM/IOMHome.nsf.

Johnson MA, Smith MM, Edmonds JT. Copper, iron, zinc, and manganese in dietary supplements, infant formulas, and ready-to-eat breakfast cereals. Am J Clin Nutr. 1998;67(suppl):1035S-1040S.

Komaki H, Maisawa S, Sugai K, Kobayashi Y, Hashimoto T. Tremor and seizures associated with chronic manganese intoxication. Brain Dev. 1999;21(2):122-124.

Leffler CT, Philippi AF, Leffler SG, Mosure JC, Kim PD. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Military Medicine. 1999:164(2):85-91.

Leonhartdt W, Hanefeld M, Muller G, et al. Impact of concentrations of glycated hemoglobin, alpha-tocopherol, copper, and manganese on oxidation of low-density lipoproteins in patients with type I diabetes, type II diabetes, and control subjects. Clin Chim Acta. 1996;254(2):173-186.

Mehta R, Reilly JJ. Manganese levels in a jaundiced long-term total parenteral nutrition patient: Potentiation of haloperidol toxicity?: Case report and literature review. J Parenter Enter Nutr. 1990;14(4):428-430.

Morselli B, Neuenschwander B, Perrelet R, Lippunter K. Osteoporosis diet [in German]. Ther Umsch. 2000;57(3):152-160.

Nielsen FH. Ultratrace minerals: manganese. In: Shils ME, Olson JA, Shihe M, Ross RC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore, Md: Williams & Wilkins; 1999:289-291.

Pasquier C, Mach PS, Raichvarg D, Sarfati G, Amor B, Delbarre F. Manganese-containing superoxide-dismutase deficiency in polymorphonuclear leukocytes of adults with rheumatoid arthritis. Inflammation. 1984;8:27-32.

Penland JG, Johnson PE. Dietary calcium and manganese effects on menstrual cycle symptoms. Am J Obstet Gynecol. 1993;168(5):1417-1423.

Saltman PD, Strause LG. The role of trace minerals in osteoporosis. J Am Coll Nutr. 1993;12:384-389.

Walter RM Jr, Uriu-Hare JY, Olin KL, Oster MH, Anawalt BD, Critchfield JW, Keen CL. Copper, zinc, manganese, and magnesium status and complications of diabetes mellitus. Diabetes Care. 1991;14(11):1050-1056.


Review Date: April 2002
Reviewed By: Participants in the review process include: Ruth DeBusk, RD, PhD, Editor, Nutrition in Complementary Care, Tallahassee, FL; Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's Administrative Hospital, Londonderry, NH. All interaction sections have also been reviewed by a team of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant Professor, University of Maryland School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu, HI.

Copyright © 2004 A.D.A.M., Inc

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

 
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