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Complementary Medicine - CamTopic ContentsManganeseUses
What Are Star Ratings?
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people. For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being. 3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit. 2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. 1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support. This supplement has been used in connection with the following health conditions:
How It WorksHow to Use ItWhether most people would benefit from manganese supplementation remains unclear. While there is no recommended dietary allowance, the National Research Council’s “estimated safe and adequate daily dietary intake” is 2–5 mg.32 The Institute of Medicine recommends that intake of manganese from food, water and dietary supplements should not exceed the tolerable daily upper limit of 11 mg per day. In contrast, the 5–15 mg often found in high-potency multivitamin-mineral supplements is generally considered to be a reasonable level by many doctors, though many manufacturers are likely to reformulate their products to contain no more than 11 mg per daily amount. Where to Find ItNuts and seeds, wheat germ, wheat bran, leafy green vegetables, beet tops, tea, and pineapple are all good sources of manganese. Possible DeficienciesMany people consume less than the 2–5 mg of manganese currently considered safe and adequate. Nonetheless, clear deficiencies are rare. People with osteoporosis sometimes have low blood levels of manganese, suggestive of deficiency.33 InteractionsInteractions with Supplements, Foods, & Other CompoundsSeveral minerals, such as calcium and iron , and possibly zinc , reduce the absorption of manganese.34 Of these interactions, the link to iron may be the most important. In one study, women with high iron status had relatively poor absorption of manganese.35 In another report of manganese/iron interactions in women, increased intake of “non-heme iron”—the kind of iron found in most supplements—decreased manganese status.36 These interactions suggest that taking multi-minerals that include manganese may protect against manganese deficiencies that might otherwise be triggered by taking isolated mineral supplements, particularly iron. Interactions with MedicinesCertain medicines interact with this supplement.
Types of interactions:
Beneficial
Adverse
Check
Replenish Depleted Nutrients
Reduce Side Effects
Support Medicine
Reduces Effectiveness
Potential Negative Interaction
Explanation Required
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.
Side EffectsSide EffectsAmounts found in supplements (5–20 mg) have not been linked with any toxicity. Excessive intake of manganese rarely lead to psychiatric symptoms. However, most reports of manganese toxicity in otherwise healthy people have been in those people who chronically inhaled manganese dust at their jobs e.g., miners or alloy plant workers. Other sources of manganese intoxication are now recognized, including total parenteral nutrition (TPN) in patients who are being fed intravenously98 , 99 , 100 and pesticides containing manganese in agricultural workers who have been exposed.101 Preliminary research suggests that people with cirrhosis 102 or cholestasis (blocked bile flow from the gall bladder)103 may not be able to properly excrete manganese. Until more is known, these people should not supplement manganese. Manganese supplementation (3–5 mg per day) has caused severe hypoglycemia (low blood sugar) in a person with insulin -dependent diabetes .104 People with diabetes who want to take manganese should consult their doctor. References1. Kunin RA. Manganese in dyskinesias. Am J Psychiatry 1976;133:105. 2. Norris JP, Sams RE. More on the use of manganese in dyskinesia. Am J Psychiatry 1997;134:1448. 3. Hoffer A. Tardive dyskinesia treated with manganese. Can Med Assoc J 1977;117:859. 4. Ozata M, Salk M, Aydin A, et al. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol Trace Elem Res 1999;69:211–6. 5. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635–43. 6. Kawada J, Nishida M, Yoshimura Y, Yamashita K. Manganese ion as a goitrogen in the female mouse. Endocrinol Jpn 1985;32:635–43. 7. Untoro J, Ruz M, Gross R. Low environmental selenium availability as an additional determinant for goiter in East Java, Indonesia? Biol Trace Elem Res 1999;70:127–36. 8. Corvilain B, Contempre B, Longombe AO, et al. Selenium and the thyroid: how the relationship was established. Am J Clin Nutr 1993;57:244S–248S [review]. 9. Vanderpas JB, Contempre B, Duale NL, et al. Selenium deficiency mitigates hypothyroxinemia in iodine-deficient subjects. Am J Clin Nutr 1993 Feb;57(2 Suppl):271S–275S [review]. 10. Roti E, Minelli R, Gardini E, et al. Selenium administration does not cause thyroid insufficiency in subjects with mild iodine deficiency and sufficient selenium intake. J Endocrinol Invest 1993;7:481–4. 11. Zimmermann MB, Adou P, Torresani T, et al. Effect of oral iodized oil on thyroid size and thyroid hormone metabolism in children with concurrent selenium and iodine deficiency. Eur J Clin Nutr 2000;3:209–13. 12. Anderson RA et al. Chromium supplementation of humans with hypoglycemia. Fed Proc 1984;43:471. 13. Stebbing JB et al. Reactive hypoglycemia and magnesium. Magnesium Bull 1982;2:131–4. 14. Shansky A. Vitamin B3 in the alleviation of hypoglycemia. Drug Cosm Ind 1981;129(4):68–69,104–5. 15. Gaby AR, Wright JV. Nutritional regulation of blood glucose. J Advancement Med 1991;4:57–71. 16. Aston B. Manganese and man. J Orthomolec Psychiatry 1980;9:237–49. 17. Gold M. Basketball bones. Science 1980;80:101–2. 18. Raloff J. Reasons for boning up on manganese. Science News 1986;Sep 27:199 [review]. 19. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994;124:1060–4. 20. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503–7. 21. Sandstead HH. Understanding zinc: Recent observations and interpretations. J Lab Clin Med 1994;124:322–7. 22. Tenaud I, Sainte-Marie I, Jumbou O, et al. In vitro modulation of keratinocyte wound healing integrins by zinc, copper and manganese. Br J Dermatol 1999;140:26–34. 23. Pereira CE, Felcman J. Correlation between five minerals and the healing effect of Brazilian medicinal plants. Biol Trace Elem Res 1998;65:251–9. 24. Carlisle EM. Silicon as an essential trace element in animal nutrition. Ciba Found Symp 1986;121:123–39. 25. Leach RM. Role of manganese in mucopolysaccharide metabolism. Fed Proc 1971;30:991. 26. Kosenko LG. Concentration of trace elements in the blood of patients with diabetes mellitus. Fed Proc Transl (Suppl) 1965;24:237–8. 27. Baly DL, Schneiderman JS, Garcia-Welsh AL. Effect of manganese deficiency on insulin binding, glucose transport and metabolism in rat adipocytes. J Nutr 1990;120:1075–9. 28. Rubenstein AH, Levin NW, Elliott GA. Hypoglycaemia induced by manganese. Nature(London) 1962;194:188–9. 29. Kosenko LG. Concentration of trace elements in the blood of patients with diabetes mellitus. Fed Proc Transl (Suppl) 1965;24:237–8. 30. Baly DL, Schneiderman JS, Garcia-Welsh AL. Effect of manganese deficiency on insulin binding, glucose transport and metabolism in rat adipocytes. J Nutr 1990;120:1075–9. 31. Rubenstein AH, Levin NW, Elliott GA. Hypoglycaemia induced by manganese. Nature (London) 1962;194:188–9. 32. National Research Council. Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Press, 1989. 33. Raloff J. Reasons for boning up on manganese. Science 1986;130:199 [review]. 34. Freeland-Graves JH. Manganese: an essential nutrient for humans. Nutr Today 1989;23:13–9 [review]. 35. Finley JW. Manganese absorption and retention by young women is associated with serum ferritin concentration. Am J Clin Nutr 1999;70:37–43. 36. Davis CD, Malecki EA, Gerger JL. Interactions among dietary manganese, heme iron, and nonheme iron in women. Am J Clin Nutr 1992;56:926–32. 37. Campbell NR, Hasinoff BB. Iron supplements: A common cause of drug interactions. Br J Clin Pharmacol 1991;31:251–5. 38. Lim D, McKay M. Food-drug interactions. Drug Information Bull 1995;15(2) [review]. 39. Threlkeld DS, ed. Systemic Anti-Infectives, Fluoroquinolones. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1994, 340n–40o. 40. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 74. 41. Threlkeld DS, ed. Systemic Anti-Infectives, Fluoroquinolones. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1994, 340n–40o. 42. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 43. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 44. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 45. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 46. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 47. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 48. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 49. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 50. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 51. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 52. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 53. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 54. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 55. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 56. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 57. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 58. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 59. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 60. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 61. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 62. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 63. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 64. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 65. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 66. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 67. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 68. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 69. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 70. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 71. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 72. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 73. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 74. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 75. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 76. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 77. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 78. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 79. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 80. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 81. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 82. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 83. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 84. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 85. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 86. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 87. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 88. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 89. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 90. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 91. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 92. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 93. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197–8. 94. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210–1 [review]. 95. Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561–4. 96. Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr 1998;52:711–5. 97. Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197. 98. Nagatomo S, Umehara F, Hanada K, et al. Manganese intoxication during total parenteral nutrition: report of two cases and review of the literature. J Neurol Sci 1999;162:102–5. 99. Ejima A, Imamura T, Nakamura S, et al. Manganese intoxication during total parenteral nutrition. Lancet 1992;339:426 [letter]. 100. Fell JM, Reynolds AP, Meadows N, et al. Manganese toxicity in children receiving long-term parenteral nutrition. Lancet 1996;347:1218–21. 101. Ferraz HB, Bertolucci PH, Pereira JS, et al. Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication. Neurology 1988;38:550–3. 102. Krieger D, Krieger S, Jansen O, et al. Manganese and chronic hepatic encephalopathy. Lancet 1995;346:270–4. 103. Staunton M, Phelan DM. Manganese toxicity in a patient with cholestasis receiving total parenteral nutrition. Anaesthesia 1995;50:665. 104. Rubenstein AH, Levin NW, Elliott GA. Hypoglycaemia induced by manganese. Nature (London) 1962;194:188–9.
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