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
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
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.
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.
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
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.
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
Males 19 years and older: 2.3 mg
Females 19 years and older: 1.8 mg
Pregnant females: 2 mg
Breastfeeding females: 2.6
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.
If you are currently being treated with any of the following medications, you
should not use manganese supplements without first talking to your healthcare
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
Reserpine Reserpine, a medication used to treat high blood
pressure, may decrease manganese levels in the body.
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.
ConsumerLab.com 2001. Some supplements for arthritis may exceed newly
released safe intake levels for manganese [news release]. PR Newswire; January
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.
Davis CD, Greger JL. Longitudinal changes of manganese-dependent superoxide
dismutase and other indexes of manganese and iron status in women. Am J Clin
Deimling MJ, Schnell C. Interaction between manganese and phenobarbital on
hexobarbital hypnosis in the male rat. Res Commun Chem Pathol Pharmacol.
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.
Fell JM, Reynolds AP, Meadows N, et al. Manganese toxicity in children
receiving long-term parenteral nutrition. Lancet.
Finley JW, Davis CD. Manganese deficiency and toxicity: are high or low
dietary amounts of manganese cause for concern? Biofactors.
Gaby AR. Natural treatments for osteoarthritis. Alt Med Rev.
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
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.
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.
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.
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.
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