Manganese

Uses

Manganese is an essential trace mineral needed for healthy skin, bone, and cartilage formation, as well as glucose tolerance. It also helps activate superoxide dismutase (SOD)—an important antioxidant enzyme.

What Are Star Ratings?

This supplement has been used in connection with the following health conditions:

Used for Why
2 Stars
Tardive Dyskinesia
For prevention: 15 mg daily while taking anti-psychotic medication; treat under a doctor's supervision: 60 mg daily
Supplementing with manganese may prevent onset or help reverse the condition.

One doctor has found that administering the trace mineral (15 mg per day) can prevent the development of TD and that higher amounts (up to 60 mg per day) can reverse TD that has already developed. Other researchers have reported similar improvements with manganese.
1 Star
Goiter
800 IU daily
Deficiencies of manganese can contribute to iodine-deficiency goiter. Supplementing with manganese may help.

When iodine deficiency is present, other nutrient levels become important in the development of goiter. Deficiencies of zinc and can both contribute to iodine-deficiency goiter; however, an animal study found that manganese excess can also be goitrogenic. It has been suggested that selenium deficiency may contribute to goiter. However, when selenium supplements were given to people deficient in both iodine and selenium, thyroid dysfunction was aggravated, and it has been suggested that selenium deficiency may provide some protection when there is iodine deficiency. A study of the effects of selenium supplementation at 100 mcg daily in women without selenium deficiency but with slightly low iodine intake found no effect on thyroid function. The authors concluded that selenium supplementation seems to be safe in people with only iodine deficiency but not in people with combined selenium and iodine deficiencies. In those cases, iodine supplementation has been shown to be most useful. No studies have been done to evaluate the usefulness of supplementation with zinc or manganese to prevent or treat goiter.
1 Star
Hypoglycemia
Refer to label instructions
Manganese helps control blood sugar levels in people with diabetes, and since there are similarities in the way the body regulates high and low blood sugar levels, it might be helpful for hypoglycemia as well.

Research has shown that supplementing with chromium (200 mcg per day) or magnesium (340 mg per day) can prevent blood sugar levels from falling excessively in people with hypoglycemia. Niacinamide (vitamin B3) has also been found to be helpful for hypoglycemic people. Other nutrients, including vitamin C, vitamin E, zinc, copper, , and vitamin B6, may help control blood sugar levels in diabetics. Since there are similarities in the way the body regulates high and low blood sugar levels, these nutrients might be helpful for hypoglycemia as well, although the amounts needed for that purpose are not known.
1 Star
Osgood-Schlatter Disease (Vitamin B6, Zinc)
Refer to label instructions
Some doctors have reported good results using a combination of zinc, manganese, and vitamin B6 for people with Osgood-Schlatter disease.

Another group of doctors has reported good results using a combination of zinc, , and vitamin B6 for people with Osgood-Schlatter disease; however, the amounts of these supplements were not mentioned in the report. Most physicians would consider reasonable daily amounts of these nutrients for adolescents to be 15 mg of zinc, 5 to 10 mg of manganese, and 25 mg of vitamin B6. Larger amounts might be used with medical supervision.
1 Star
Osteoporosis
Refer to label instructions
A combination of minerals including manganese was reported to halt bone loss in one study. Some doctors recommend manganese to people concerned with bone mass maintenance.

Interest in the effect of and bone health began when famed basketball player Bill Walton’s repeated fractures were halted with manganese supplementation. A subsequent, unpublished study reported manganese deficiency in a small group of osteoporotic women. Since then, a combination of minerals including manganese was reported to halt bone loss. However, no human trial has investigated the effect of manganese supplementation alone on bone mass. Nonetheless, some doctors recommend 10 to 20 mg of manganese per day to people concerned with maintenance of bone mass.

One trial studying postmenopausal women combined hormone replacement therapy with magnesium (600 mg per day), calcium (500 mg per day), vitamin C, B vitamins, vitamin D, zinc, copper, manganese, boron, and other nutrients for an eight- to nine-month period. In addition, participants were told to avoid processed foods, limit protein intake, emphasize vegetable over animal protein, and limit consumption of salt, sugar, alcohol, coffee, tea, chocolate, and tobacco. Bone density increased a remarkable 11%, compared to only 0.7% in women receiving hormone replacement alone.

1 Star
Sprains and Strains
Refer to label instructions
Trace minerals, such as manganese, are known to be important in the biochemistry of tissue healing.

Zinc is a component of many enzymes, including some that are needed to repair wounds. Even a mild deficiency of zinc can interfere with optimal recovery from everyday tissue damage as well as from more serious trauma. Trace minerals, such as , copper, and silicon are also known to be important in the biochemistry of tissue healing. However, there have been no controlled studies of people with sprains or strains to explore the effect of deficiency of these minerals, or of oral supplementation, on the rate of healing.
1 Star
Type 1 Diabetes
Refer to label instructions
Supplementing with manganese may increase antioxidant defenses and improve blood sugar control in those with type 1 diabetes.
Manganese is involved in the activity of an important antioxidant enzyme system in the body. A genetic variant linked to reduced activity of this enzymes system has been implicated as a factor in the development of type 1 diabetes and its complications. Low blood levels of manganese have been reported in people with type 1 and type 2 diabetes. Animal research suggests that manganese supplementation can improve the functioning of this enzyme system, increase insulin secretion, and improve glucose metabolism. One team of researchers reported on a case of a young adult with insulin-dependent diabetes who received oral manganese (3 to 5 mg per day as manganese chloride) and experienced a significant fall in blood glucose, sometimes to dangerously low levels; however, three other people with type 1 diabetes they treated with manganese supplementation had no change in blood glucose levels. People with type 1 diabetes wishing to supplement with manganese should do so only with a doctor’s close supervision.
1 Star
Type 2 Diabetes
1.8 to 2.6 mg daily
Manganese is important as an antioxidant and metabolic regulator. Supplementation to prevent deficiency may be helpful for people with type 2 diabetes.
Manganese is an important nutrient for the activation of antioxidant and metabolic enzyme systems. Both high and low manganese levels can contribute to increased oxidative stress and the development and progression of type 2 diabetes. Animal and laboratory research suggest manganese supplementation might improve insulin sensitivity and protect blood vessels from damage due to high glucose levels in people with type 2 diabetes. Although clinical trials are lacking, taking a multivitamin/mineral supplement to ensure adequate manganese intake is a reasonable precautionary measure for people with type 2 diabetes.

How It Works

How to Use It

Whether 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.1 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 It

Nuts and seeds, wheat germ, wheat bran, leafy green vegetables, beet tops, tea, and pineapple are all good sources of manganese.

Possible Deficiencies

Many 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.2

Interactions

Interactions with Supplements, Foods, & Other Compounds

Several minerals, such as calcium and iron, and possibly zinc, reduce the absorption of manganese.3 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.4 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.5 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 Medicines

Certain medicines interact with this supplement.

What Are Drug Interactions
Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

Reduce Side Effects

  • none

Support Medicine

  • none

Reduces Effectiveness

  • Ciprofloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Ciprofloxacin in D5W

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Delafloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Gatifloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Gatifloxacin in D5W

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Gemifloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Levofloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Levofloxacin in D5W

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Moxifloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Moxifloxacin in Saline

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Norfloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

  • Ofloxacin

    Minerals such as aluminum, calcium, copper, iron, magnesium, , and zinc can bind to ciprofloxacin, greatly reducing the absorption of the drug. Because of the mineral content, people are advised to take ciprofloxacin two hours after consuming dairy products (milk, cheese, yogurt, ice cream, and others), antacids (Maalox®, Mylanta®, Tums®, Rolaids®, and others), and mineral-containing supplements.

Potential Negative Interaction

  • none

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 Effects

Side Effects

Amounts 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 intravenously6, 7, 8 and pesticides containing manganese in agricultural workers who have been exposed.9

Preliminary research suggests that people with cirrhosis10 or cholestasis (blocked bile flow from the gall bladder)11 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.12 People with diabetes who want to take manganese should consult their doctor.

References

1. National Research Council. Recommended Dietary Allowances. 10th ed. Washington, DC: National Academy Press, 1989.

2. Raloff J. Reasons for boning up on manganese. Science News 1986;Sep 27:199 [review].

3. Freeland-Graves JH. Manganese: an essential nutrient for humans. Nutr Today 1989;23:13-9 [review].

4. Finley JW. Manganese absorption and retention by young women is associated with serum ferritin concentration. Am J Clin Nutr 1999;70:37-43.

5. 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.

6. 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.

7. Ejima A, Imamura T, Nakamura S, et al. Manganese intoxication during total parenteral nutrition. Lancet 1992;339:426 [letter].

8. Fell JM, Reynolds AP, Meadows N, et al. Manganese toxicity in children receiving long-term parenteral nutrition. Lancet 1996;347:1218-21.

9. 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.

10. Krieger D, Krieger S, Jansen O, et al. Manganese and chronic hepatic encephalopathy. Lancet 1995;346:270-4.

11. Staunton M, Phelan DM. Manganese toxicity in a patient with cholestasis receiving total parenteral nutrition. Anaesthesia 1995;50:665.

12. Rubenstein AH, Levin NW, Elliott GA. Hypoglycaemia induced by manganese. Nature (London) 1962;194:188-9.

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