What is it?
Manganese is taken by mouth for manganese deficiency. It is also used for weak and brittle bones (osteoporosis), osteoarthritis, and other conditions.
Manganese is given intravenously (by IV) for manganese deficiency and as a trace element in a nutrition preparation that is given by IV called total parenteral nutrition (TPN).
Manganese is applied to the skin for wound healing.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for MANGANESE are as follows:
- Manganese deficiency. Taking manganese by mouth or giving manganese intravenously (by IV) helps to treat or prevent low manganese levels in the body. Also, taking manganese by mouth along with other vitamins and minerals can promote growth in children who have low levels of manganese in developing countries.
Insufficient evidence to rate effectiveness for...
- Hay fever. Using a salt-water nasal spray with added manganese seems to reduce episodes of acute hay fever, but a plain salt-water spray may work just as well.
- A lung disease that makes it harder to breathe (chronic obstructive pulmonary disease or COPD). Early research shows that giving manganese, selenium, and zinc intravenously (by IV) may help people with worsened COPD to breathe on their own without help from a machine sooner.
- Obesity. Early research shows that taking a specific product containing manganese, 7-oxo-DHEA, L-tyrosine, asparagus root extract, choline bitartrate, inositol, copper gluconate, and potassium iodide by mouth for 8 weeks can slightly reduce weight in overweight people. It is unclear if taking manganese alone has an effect on weight.
- Osteoarthritis. Taking a specific product containing manganese, glucosamine hydrochloride, and chondroitin sulfate by mouth for 4 months improves pain and the ability to do normal activities in people with osteoarthritis of the knee and the lower back. However, many studies show that taking glucosamine plus chondroitin without manganese might help treat osteoarthritis. Therefore, the effects of manganese are unclear.
- Weak and brittle bones (osteoporosis). Taking manganese by mouth in combination with calcium, zinc, and copper reduces spinal bone loss in older women. Also, taking a specific product containing manganese, calcium, vitamin D, magnesium, zinc, copper, and boron for one year seems to improve bone mass in women with weak bones. However, many studies show that taking calcium plus vitamin D without manganese can help treat osteoporosis. Therefore, the effects of manganese are unclear.
- Premenstrual syndrome (PMS). Early research shows that taking manganese along with calcium helps improve symptoms of PMS, including pain, crying, loneliness, anxiety, restlessness, irritability, mood swings, depression, and tension. Researchers aren't sure whether the improvement is due to the calcium, manganese, or the combination.
- Wound healing. Early research shows that applying a dressing containing manganese, calcium, and zinc to chronic skin wounds for 12 weeks may improve wound healing.
- Other conditions.
How does it work?
Are there safety concerns?
When given by IV: Manganese is LIKELY SAFE when given by IV as part of parenteral nutrition under the supervision of a health care provider. It's generally recommended that parenteral nutrition provides no more than 55 mcg of manganese per day, especially when used long-term. Receiving more than 55 mcg of manganese per day by IV as part of parenteral nutrition is POSSIBLY UNSAFE for most adults.
When inhaled: Manganese is LIKELY UNSAFE when inhaled by adults for long periods of time. Excess manganese in the body can cause serious side effects, including symptoms resembling Parkinson disease, such as shaking (tremors).
Special precautions & warnings:Children: Taking manganese by mouth is LIKELY SAFE for children 1 to 3 years in amounts less than 2 mg per day; for children 4 to 8 years in amounts less than 3 mg per day; for children 9 to 13 years in amounts less than 6 mg per day; and for children 14 to 18 years in amounts less than 9 mg per day. Manganese in higher doses than described is POSSIBLY UNSAFE. Talk with your health care provider before giving manganese to children. High doses of manganese might cause serious side effects. Manganese is LIKELY UNSAFE when inhaled by children.
Pregnancy and breast-feeding: Manganese is LIKELY SAFE in pregnant or breast-feeding adult women aged 19 or older when taken by mouth in doses of less than 11 mg per day. However, pregnant and lactating women under age 19 should limit doses to less than 9 mg per day. Manganese is POSSIBLY UNSAFE when taken by mouth in higher doses. Doses over 11 mg per day are more likely to cause serious side effects. Manganese is LIKELY UNSAFE when inhaled by women who are pregnant or breast-feeding.
Long-term liver disease: People with long-term liver disease have trouble getting rid of manganese. Manganese can build up in these people and cause shaking, mental problems such as psychosis, and other side effects. If you have liver disease, be careful not to get too much manganese.
Iron-deficiency anemia: People with iron-deficiency anemia seem to absorb more manganese than other people. If you have this condition, be careful not to get too much manganese.
Nutrition that is given intravenously (by IV). People who receive nutrition intravenously (by IV) are at an increased risk of side effects due to manganese.
Are there interactions with medications?
- Antibiotics (Quinolone antibiotics)
- Manganese can attach to quinolones in the stomach. This decreases the amount of quinolones that can be absorbed by the body. Taking manganese along with some quinolones might decrease their effectiveness. To avoid this interaction, take manganese supplements at least one hour after quinolone antibiotics.
Some quinolones include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), and others.
- Antibiotics (Tetracycline antibiotics)
- Manganese can attach to tetracyclines in the stomach. This decreases the amount of tetracyclines that can be absorbed by the body. Taking manganese with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction, take manganese two hours before or four hours after taking tetracyclines.
Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).
- Medications for mental conditions (Antipsychotic drugs)
- Antipsychotic drugs are taken by some people to treat mental illnesses. Some researchers believe that taking certain antipsychotic drugs along with manganese might worsen side effects of manganese in some people.
Are there interactions with herbs and supplements?
- Taking calcium along with manganese can decrease the amount of manganese that the body can take in.
- IP-6 (Phytic acid)
- IP-6 found in foods, such as cereals, nuts, and beans, and in supplements can decrease the amount of manganese that the body takes in. Take manganese at least two hours before or two hours after eating foods that contain IP-6.
- Taking iron along with manganese can decrease the amount of manganese that the body can take in.
- Taking zinc along with manganese can increase the amount of manganese that the body can take in. This may increase the side effects of manganese.
Are there interactions with foods?
- Eating low amounts of fat might decrease how much manganese the body can absorb.
- Milk protein
- Adding milk protein to the diet might increase the amount of manganese the body can absorb.
What dose is used?
- General: No recommended dietary allowances (RDA) for manganese have been established. When there are no RDAs for a nutrient, the Adequate Intake (AI) is used as a guide. The AI is the estimated amount of the nutrient that is used by a group of healthy people and assumed to be adequate. The daily Adequate Intake (AI) levels for manganese are: men age 19 and older, 2.3 mg; women 19 and older, 1.8 mg; pregnant women age 14 to 50, 2 mg; breastfeeding women, 2.6 mg.
- Tolerable Upper Intake Levels (UL), the highest level of intake at which unwanted side effects are not expected, for manganese have been established. The daily ULs for manganese are: for adults 19 years and older (including pregnant and breast-feeding women), 11 mg.
- For low manganese levels in the body (manganese deficiency): For preventing manganese deficiency in adults, total parenteral nutrition containing up to 200 mcg of elemental manganese per day has been used. The recommended daily dose of manganese in long-term use of total parenteral nutrition is ≤ 55 mcg per day.
- General: No recommended dietary allowances (RDA) for manganese have been established. When there are no RDAs for a nutrient, the Adequate Intake (AI) is used as a guide. The AI is the estimated amount of the nutrient that is used by a group of healthy people and assumed to be adequate. In infants and children, the daily Adequate Intake (AI) levels for manganese are: infants birth to 6 months, 3 mcg; 7 to 12 months, 600 mcg; children 1 to 3 years, 1.2 mg; 4 to 8 years 1.5 mg; boys 9 to 13 years, 1.9 mg; boys 14 to 18 years, 2.2 mg; and girls 9 to 18 years, 1.6 mg. Tolerable Upper Intake Levels (UL), the highest level of intake at which unwanted side effects are not expected, for manganese have been established. The daily ULs for manganese for children are: children 1 to 3 years, 2 mg; 4 to 8 years, 3 mg; 9 to 13 years, 6 mg; and 14 to 18 years (including pregnant and breastfeeding women), 9 mg.
- For low manganese levels in the body (manganese deficiency): For preventing manganese deficiency in children, total parenteral nutrition containing 2-10 mcg or up to 50 mcg of elemental manganese per day has been used.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- Kresovich JK, Bulka CM, Joyce BT, et al. The inflammatory potential of dietary manganese in a cohort of elderly men. Biol Trace Elem Res 2018;183:49-57. doi: 10.1007/s12011-017-1127-7. View abstract.
- Grasso M, de Vincentiis M, Agolli G, Cilurzo F, Grasso R. The effectiveness of long-term course of Sterimar Mn nasal spray for treatment of the recurrence rates of acute allergic rhinitis in patients with chronic allergic rhinitis. Drug Des Devel Ther 2018;12:705-9. doi: 10.2147/DDDT.S145173. View abstract.
- . Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15. pii: E783. doi: 10.3390/ijerph15040783. View abstract.
- Baker B, Ali A, Isenring L. Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: an analysis of the supporting evidence. Nutr Clin Pract 2016;31:180-5. doi: 10.1177/0884533615591600. View abstract.
- Schuh MJ. Possible Parkinson's disease induced by chronic manganese supplement ingestion. Consult Pharm. 2016;31:698-703. doi: 10.4140/TCP.n.2016.698. View abstract.
- Vanek VW, Borum P, Buchman A, et al. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27:440-491.doi: 10.1177/0884533612446706 View abstract.
- Sayre EV, Smith RW. Compositional categories of ancient glass. Science 1961;133:1824-6. View abstract.
- Chalmin E, Vignaud C, Salomon H, et al. Minerals discovered in Paleolithic black pigments by transmission electron microscopy and micro-X-ray absorption near-edge structure. Applied Physics A 2006;83:213-8.
- Zenk, J. L., Helmer, T. R., Kassen, L. J., and Kuskowski, M. A. The effect of 7-KETO NATURALEAN on weight loss: a randomized, double-blind, placebo-controlled trial. Current Therapeutic Research (CURR THER RES) 2002;63:263-272.
- Wada, O. and Yanagisawa, H. [Trace elements and their physiological roles]. Nippon Rinsho 1996;54:5-11. View abstract.
- Salducci, J. and Planche, D. [A therapeutic trial in patients with spasmophilia]. Sem.Hop. 10-7-1982;58:2097-2100. View abstract.
- Kies, C. V. Mineral utilization of vegetarians: impact of variation in fat intake. Am J Clin Nutr 1988;48(3 Suppl):884-887. View abstract.
- Saudin, F., Gelas, P., and Bouletreau, P. [Trace elements in artificial nutrition. Art and practice]. Ann Fr.Anesth.Reanim. 1988;7:320-332. View abstract.
- Nemery, B. Metal toxicity and the respiratory tract. Eur Respir.J 1990;3:202-219. View abstract.
- Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14:428-430. View abstract.
- Janssens, J. and Vandenberghe, W. Dystonic drop foot gait in a patient with manganism. Neurology 8-31-2010;75:835. View abstract.
- El-Attar, M., Said, M., El-Assal, G., Sabry, N. A., Omar, E., and Ashour, L. 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;14:1180-1187. View abstract.
- Davidsson, L., Cederblad, A., Lonnerdal, B., and Sandstrom, B. The effect of individual dietary components on manganese absorption in humans. Am J Clin Nutr 1991;54:1065-1070. View abstract.
- Kim, E. A., Cheong, H. K., Joo, K. D., Shin, J. H., Lee, J. S., Choi, S. B., Kim, M. O., Lee, IuJ, and Kang, D. M. Effect of manganese exposure on the neuroendocrine system in welders. Neurotoxicology 2007;28:263-269. View abstract.
- Jiang, Y. and Zheng, W. Cardiovascular toxicities upon manganese exposure. Cardiovasc.Toxicol 2005;5:345-354. View abstract.
- Ziegler, U. E., Schmidt, K., Keller, H. P., and Thiede, A. [Treatment of chronic wounds with an alginate dressing containing calcium zinc and manganese]. Fortschr.Med Orig. 2003;121:19-26. View abstract.
- Gerber, G. B., Leonard, A., and Hantson, P. Carcinogenicity, mutagenicity and teratogenicity of manganese compounds. Crit Rev Oncol Hematol. 2002;42:25-34. View abstract.
- Finley, J. W. Manganese absorption and retention by young women is associated with serum ferritin concentration. Am J Clin Nutr 1999;70:37-43. View abstract.
- McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507. View abstract.
- Benevolenskaia, L. I., Toroptsova, N. V., Nikitinskaia, O. A., Sharapova, E. P., Korotkova, T. A., Rozhinskaia, L. I., Marova, E. I., Dzeranova, L. K., Molitvoslovova, N. N., Men'shikova, L. V., Grudinina, O. V., Lesniak, O. M., Evstigneeva, L. P., Smetnik, V. P., Shestakova, I. G., and Kuznetsov, S. I. [Vitrum osteomag in prevention of osteoporosis in postmenopausal women: results of the comparative open multicenter trial]. Ter.Arkh. 2004;76:88-93. View abstract.
- Randhawa, R. K. and Kawatra, B. L. Effect of dietary protein on the absorption and retention of Zn, Fe, Cu and Mn in pre-adolescent girls. Nahrung 1993;37:399-407. View abstract.
- Rivera JA, González-Cossío T, Flores M, et al. Multiple micronutrient supplementation increases the growth of Mexican infants. Am J Clin Nutr. 2001 Nov;74:657-63. View abstract.
- Dobson AW, Erikson KM, Aschner M. Manganese neurotoxicity. Ann N Y Acad Sci 2004;1012:115-28. View abstract.
- Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6.. View abstract.
- Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9.. View abstract.
- 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;8:343-50. View abstract.
- Food and Nutrition Board, 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, 2002. Available at: www.nap.edu/books/0309072794/html/.
- 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;164:85-91. View abstract.
- Freeland-Graves JH. Manganese: an essential nutrient for humans. Nutr Today 1988;23:13-9.
- Freeland-Graves JH, Turnlund JR. Deliberations and evaluations of the approaches, endpoints and paradigms for manganese and molybdenum dietary recommendations. J Nutr 1996;126:2435S-40S. View abstract.
- Penland JG, Johnson PE. Dietary calcium and manganese effects on menstrual cycle symptoms. Am J Obstet Gynecol 1993;168:1417-23. View abstract.
- Moghissi KS. Risks and benefits of nutritional supplements during pregnancy. Obstet Gynecol 1981;58:68S-78S. View abstract.
- O'Dell BL. Mineral interactions relevant to nutrient requirements. J Nutr 1989;119:1832-8. View abstract.
- Krieger D, Krieger S, Jansen O, et al. Manganese and chronic hepatic encephalopathy. Lancet 1995;346:270-4. View abstract.
- Freeland-Graves JH, Lin PH. Plasma uptake of manganese as affected by oral loads of manganese, calcium, milk, phosphorus, copper, and zinc. J Am Coll Nutr 1991;10:38-43. View abstract.
- 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. View abstract.
- Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8. View abstract.
- Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8. View abstract.
- Zhou JR, Erdman JW Jr. Phytic acid in health and disease. Crit Rev Food Sci Nutr 1995;35:495-508. View abstract.
- Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.
- Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.
- Drug Facts and Comparisons. Olin BR, ed. St. Louis, MO: Facts and Comparisons. (updated monthly).
- McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.