Manganese

Manganese is an essential trace mineral in animal nutrition and is believed to be an essential trace mineral in human nutrition, as well.
Manganese supports many enzymatic reactions. It plays an essential role in GAGs' (glicosaminoglycans) synthesis and, therefore, in the making up of connective tissue, bones, sexual hormones, and in blood clotting.

Dietary manganese-deficiency in animals results in a wide variety of structural and physiological defects, including growth retardation, skeletal and cartilage malformations, impaired reproductive function, congenital ataxia due to abnormal inner ear development, optic nerve abnormalities, impaired insulin metabolism and abnormal glucose tolerance, alterations in lipoprotein metabolism and an impaired oxidant defense system.

Manganese deficiency states have not been well documented in humans. There is one report of a man maintained for four months on a manganese-deficient diet and also given magnesium-containing antacids. The symptoms which occurred included a decrease in serum cholesterol, depressed growth of hair and nails, scaly dermatitis, weight loss, reddening of his black hair and beard and impaired blood clotting. He responded to a diet containing manganese. In another report, men fed a low-manganese diet manifested low serum cholesterol levels and dermatitis. Short-term manganese supplementation did not reverse these symptoms.

In still another report, young women fed a manganese-poor diet were found to have mildly abnormal glucose tolerance and increased menstrual losses of manganese, calcium, iron and total hemoglobin. Finally a child on long-term total parenteral nutrition (TPN) lacking manganese manifested bone demineralization and impaired growth that were corrected by supplementation with manganese.

Manganese may have an antioxidant activity.

Manganese has putative anti-osteoporotic and anti-arthritic activities. It is thought that this is due to decreased activity of the manganese-dependent glycosyltransferases which, among other things, are involved in the synthesis of glycosaminoglycans or GAGs. GAGs are crucial for healthy cartilage and bone. However, there is as yet only very preliminary evidence that supplemental manganese has any effect on the promotion of bone or cartilage formation in humans who are not manganese-deficient. One study reported that manganese when taken in combination with calcium, copper and zinc may improve bone mineral density in postmenopausal women with osteoporosis.

Manganese supplementation, in combination with calcium, zinc and copper, showed some efficacy in postmenopausal osteoporosis. Manganese ascorbate, in combination with glucosamine hydrochloride and chondroitin sulfate, was helpful in treating knee osteoarthritis pain in a recent randomized, double-blind, placebo-controlled pilot study. Followup on these studies is needed. Similarly, there is an isolated study needing followup that suggested some possible benefit from manganese in alleviating some PMS symptoms, including anxiety, depression, irritability and mood swings.

MANGANESE

Main Actions:	anti-oxidant, anti-osteoporosis, anti-arthritis, anti-PMS
Main Uses:	promotes connective tissues and bones formation improves bone mineral density in postmenopausal women with osteoporosis relieves symptoms of PMS promotes sexual hormones formation promotes blood clotting
Standard Dosage:	2-5 mg daily
Contraindications:	Manganese supplements are contraindicated in those with liver failure. Manganese supplements are contraindicated in those hypersensitive to any component of a manganese-containing supplement Pregnant women and nursing mothers should avoid intakes of manganese above the upper limit of the estimated safe and adequate daily dietary intake
Drug Interactions:	Magnesium-containing antacids and laxatives may decrease the absorption of manganese if taken concomitantly Tetracycline may reduce the absorption of manganese if taken concomitantly Calcium, non-heme iron, and magnesium supplements may decrease the absorption of manganese if taken concomitantlt Concomitant intake of manganese with foods rich in phytic acid (unleavened bread, raw beans, seeds, nuts and grains and soy isolates) or oxalic acid (spinach, sweet potatoes, rhubarb and beans) may depress the absorption of manganese

Bibliography

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Fell JME, Reynolds AP, Meadows N, et al. Manganese toxicity in children receiving long-term parenteral nutrition. Lancet. 1996; 347:1218-1221.
Gong H, Amemiya T. Optic nerve changes in manganese-deficient rats. Exp Eye Res. 1999; 68:313-320.
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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; 162:102-105.
Nielsen FH. Ultratrace minerals. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease, 9th ed. Baltimore, MD: Williams and Wilkins; 1999:283-303.
Strause L, Saltman P, Glowacki J. The effect of deficiencies of manganese and copper on osteo-induction and on resorption of bone particles in rats. Calcif Tissue Int. 1987; 41:145-150
Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr. 1994; 124:1060-1064.
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