Manganese

Manganese/Drug Interactions:

  • AntacidsAntacids: According to secondary sources, antacids may interfere with manganese absorption.
  • AntibioticsAntibiotics: Manganese may limit the growth of Enterococcus faecalis (463). In one study, magnesium salts inhibited binding of the AIDS-related pathogen Cryptosporidium parvum's sporozoite membrane antigens to intact, fixed HCT-8 cells and also inhibited parasite development (464). According to secondary sources, manganese may decrease how much antibiotic the body absorbs; taking manganese along with some antibiotics may decrease the effectiveness of these antibiotics. According to secondary sources, the antibiotic tetracycline may reduce the absorption of manganese if taken together.
  • Antidiabetic agentsAntidiabetic agents: In one study, manganese levels were higher in humans with diabetes mellitus compared with nondiabetic controls (465).
  • Anti-inflammatory agentsAnti-inflammatory agents: Intake of manganese has been inversely correlated with the risk of rheumatoid arthritis in women (436). A mechanism of action is unclear.
  • Antilipemic agentsAntilipemic agents: In calcium-deficient ovariectomized rats, supplementation with manganese decreased the rise of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein associated with calcium deficiency (466).
  • Antineoplastic agentsAntineoplastic agents: According to dietary intake calculations, intake of manganese may be inversely correlated with pancreatic cancer (467). However, in another study, no relationship between manganese intake and the incidence of breast cancer was observed (468). Manganese salts have been shown to promote human colon cancer cell adhesion, an effect that could be inhibited by calcium and zinc in vitro (392).
  • Antiparkinson agentsAntiparkinson agents: In human research and review data, chronic increased exposure to manganese has been suggested as a risk factor for the development of Parkinson's disease or parkinsonian-like symptoms (6; 7; 8; 9; 10; 11; 12; 13; 14).
  • AntipsychoticsAntipsychotics: Serum manganese levels have been measured in patients with schizophrenia before and after antipsychotic treatment (469). Additional details are lacking. According to secondary sources, excessive manganese consumption may cause psychosis, mood disturbances, dementia, or "manganese madness," characterized by hallucinations, violent acts, and irritability.
  • Cardiovascular agentsCardiovascular agents: According to a review, manganese exposure may cause cardiovascular dysfunction, as evidenced by sinus tachycardia, sinus bradycardia, sinus arrhythmia, sinister megacardia, and ST-T changes (227). A significant association between manganese and cardiovascular parameters in children with hypertension has been determined (228). In a sample of patients who died three months after a coronary thrombosis, significantly lower concentrations of manganese were found in the heart muscle compared with those who died immediately following ischemic heart disease (470).
  • CNS stimulantsCNS stimulants: A difference in serum manganese levels is lacking in children with attention-deficit hyperactivity disorder between those who were taking methylphenidate and those who were not (471).
  • Fertility agentsFertility agents: According to a review, manganese may affect fertility and may be embryotoxic (391).
  • FluvastatinFluvastatin: In humans, administration of fluvastatin failed to affect serum manganese levels (472).
  • HaloperidolHaloperidol: According to a review, phenothiazine-derivative drugs may potentiate manganese toxicity (238).
  • Hematological agentsHematological agents: Plasma manganese levels were higher in sickle cell anemia patients in crisis compared to those with non-sickle cell anemia or sickle cell anemia subjects in the steady state (142).
  • Hepatic agentsHepatic agents: The role of manganese in acquired hepatolenticular degeneration has been studied (473); additional details are lacking. In calcium-deficient ovariectomized rats, supplementation with manganese decreased low calcium-induced increases in liver weight and serum levels of glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase (GPT) (466).
  • Hormonal agentsHormonal agents: In human research, thyrotropin-releasing hormone (TRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were higher in welders who had occupation exposure to manganese compared with office workers who were not exposed to high levels of manganese (434).
  • ImmunosuppressantsImmunosuppressants: The role of manganese in immune function has been reviewed (474). Additional details are lacking. White blood cell counts were higher in manganese-exposed ferroalloy workers compared with controls (267). Serum lysozyme levels may be increased in workers engaged in the production of iron-manganese alloys (475).
  • Oral contraceptivesOral contraceptives: Use of oral contraceptives prior to pregnancy has been shown to decrease manganese levels in the colostrums at day 3 of lactation following pregnancy (439).
  • PrednisonePrednisone: In patients with rheumatoid arthritis taking prednisone, a statistically significant increase in red cell manganese concentrations has been observed (437).
  • RamiprilRamipril: In patients with congestive heart failure receiving ramipril, manganese failed to induce any negative effects on serum trace element levels (476).
  • Respiratory agentsRespiratory agents: In patients with asthma, sputum manganese levels were increased compared with controls (477). In adults, low intakes of manganese were correlated with an increased risk of bronchial reactivity and bronchial hyperreactivity (478).
  • Sodium iron EDTASodium iron EDTA: In healthy adults, sodium iron EDTA failed to affect absorption and urinary excretion of manganese (479).
  • Wound-healing agentsWound-healing agents: A dressing containing zinc, calcium, and manganese has been shown to stimulate proliferation, growth, collagen biosynthesis, and the migration of fibroblasts (480).

    • Manganese/Herb/Supplement Interactions:

  • Antacid herbs and supplementsAntacid herbs and supplements: According to secondary sources, antacids may interfere with manganese absorption.
  • AntibacterialsAntibacterials: Manganese may limit the growth of Enterococcus faecalis (463). In one study, magnesium salts inhibited binding of the AIDS-related pathogen Cryptosporidium parvum's sporozoite membrane antigens to intact, fixed HCT-8 cells and also inhibited parasite development (464).
  • Anti-inflammatory herbsAnti-inflammatory herbs: Intake of manganese has been inversely correlated with the risk of rheumatoid arthritis in women (436). A mechanism of action is unclear.
  • AntilipemicsAntilipemics: In calcium-deficient ovariectomized rats, supplementation with manganese decreased the rise of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein associated with calcium deficiency (466).
  • AntineoplasticsAntineoplastics: According to dietary intake calculations, intake of manganese may be inversely correlated with pancreatic cancer (467). However, in another study, no relationship between manganese intake and the incidence of breast cancer was observed (468). Manganese salts have been shown to promote human colon cancer cell adhesion, an effect that could be inhibited by calcium and zinc in vitro (392).
  • AntioxidantsAntioxidants: Occupational exposure to manganese has been associated with increases in serum protein, glutathione peroxidase (GPx), aconitase, total antioxidant status (TAS), and isoprostane levels compared with control subjects (304). In workers exposed to fine particulates, manganese exposure was related to urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) concentrations, a biomarker of oxidative DNA damage (390).
  • AntiparkinsoniansAntiparkinsonians: In human research and review data, chronic increased exposure to manganese has been suggested as a risk factor for the development of Parkinson's disease or parkinsonian-like symptoms (6; 7; 8; 9; 10; 11; 12; 13; 14).
  • AntipsychoticsAntipsychotics: Serum manganese levels have been measured in patients with schizophrenia before and after antipsychotic treatment (469). Additional details are lacking.
  • Calcium saltsCalcium salts: The addition of calcium to human milk significantly decreased manganese absorption (481). In another study, high dietary levels of calcium had no significant effect on serum manganese concentrations (482). When combined with either calcium phosphate or calcium carbonate, manganese gluconate increased fecal loss of fat in humans (483).
  • Cardiovascular herbs and supplementsCardiovascular herbs and supplements: According to a review, manganese exposure may cause cardiovascular dysfunction, as evidenced by sinus tachycardia, sinus bradycardia, sinus arrhythmia, sinister megacardia, and ST-T changes (227). A significant association between manganese and cardiovascular parameters in children with hypertension has been determined (228). In a sample of patients who died three months after a coronary thrombosis, significantly lower concentrations of manganese were found in the heart muscle compared with those who died immediately following ischemic heart disease (470).
  • CopperCopper: According to secondary sources, high doses of manganese may inhibit the absorption of copper. However, according to one review, manganese lacked an effect on fecal loss of copper (484). Administration of copper and manganese may affect the vitamin C balance in children (485). Additional details are lacking.
  • Fertility agentsFertility agents: According to a review, manganese may affect fertility and may be embryotoxic (391).
  • FluorideFluoride: Manganese and fluoride when provided in potable water may influence caries resistance (486). Additional details are lacking.
  • Guar gumGuar gum: Supplementation with guar gum in patients with type 2 diabetes failed to change manganese levels (487).
  • Hematological agentsHematological agents: Plasma manganese levels were higher in sickle cell anemia patients in crisis compared to those with non-sickle cell anemia or sickle cell anemia subjects in the steady state (142).
  • Hepatic herbs and supplementsHepatic herbs and supplements: The role of manganese in acquired hepatolenticular degeneration has been studied (473); additional details are lacking. In calcium-deficient ovariectomized rats, supplementation with manganese decreased low calcium-induced increases in liver weight and serum levels of glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase (GPT) (466).
  • Hormonal herbs and supplementsHormonal herbs and supplements: In human research, thyrotropin-releasing hormone (TRH), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were higher in welders who had occupation exposure to manganese compared with office workers who were not exposed to high levels of manganese (434).
  • HypoglycemicsHypoglycemics: In one study, manganese levels were higher in humans with diabetes mellitus compared with nondiabetic controls (465).
  • ImmunosuppressantsImmunosuppressants: The role of manganese in immune function has been reviewed (474). Additional details are lacking. White blood cell counts were higher in manganese-exposed ferroalloy workers compared with controls (267). Serum lysozyme levels may be increased in workers engaged in the production of iron-manganese alloys (475).
  • IronIron: Iron mediated attenuation of mitochondrial manganese uptake-enhanced manganese-dependent superoxide dismutase (MnSOD) and decreased lipid peroxidation in a mouse model of hereditary hemochromatosis (488). In women, manganese absorption was greatest in subjects with low ferritin concentrations when they were consuming the low-manganese diet, and it was least in subjects with high ferritin concentrations (489). According to secondary sources, high doses of manganese may inhibit the absorption of iron. Iron and manganese share common absorption pathways (490; 491). Iron supplementation may exacerbate manganese accumulation in the brain during chronic exposure (225; 226). Low iron stores have been shown to increase blood manganese concentrations in women (492). In women, increasing dietary iron intake of nonheme iron in the diet had negative effects on nutritional status in regard to manganese (serum manganese, urine manganese, and lymphocyte manganese-dependent superoxide dismutase activity) (493). Conversely, a clinical trial in pregnant women found that supplementation with ferrous sulfate and vitamin A did not affect serum manganese levels (494). A high intake of iron in combination with high manganese intake may be related to risk for Parkinson's disease (252). Iron-manganese interactions have been reviewed (495; 496); additional details are lacking. Manganese has been shown to recover levels of iron/sulfur enzymes in yeast cells that are typically decreased in Friedreich's ataxia (497).
  • MagnesiumMagnesium: In postmenopausal women, an ordinary diet deficient in magnesium did not affect manganese balance (498).
  • MolybdenumMolybdenum: When provided in potable water, manganese and molybdenum may influence caries resistance (486). Additional details are lacking.
  • Phytic acidPhytic acid: According to secondary sources, phytic acid may inhibit the absorption of manganese (499).
  • Respiratory herbs and supplementsRespiratory herbs and supplements: In patients with asthma, sputum manganese levels were increased compared with controls (477). In adults, low intakes of manganese were correlated with an increased risk of bronchial reactivity and bronchial hyperreactivity (478).
  • SeleniumSelenium: According to a review, manganese deficiency may potentiate the effect of selenium deficiency on lipid peroxidation (500).
  • TinTin: In healthy humans, supplementation with dietary tin failed to affect fecal and urinary losses of manganese (501).
  • VanadiumVanadium: When provided in potable water, manganese and vanadium may influence caries resistance (486). Additional details are lacking.
  • VitaminsVitamins: Intake of vitamin complexes may increase excretion of manganese through the intestinal tract and kidneys (502).
  • Wound-healing herbs and supplementsWound-healing herbs and supplements: A dressing containing zinc, calcium, and manganese has been shown to stimulate proliferation, growth, collagen biosynthesis, and the migration of fibroblasts (480).
  • ZincZinc: According to secondary sources, high doses of manganese may inhibit the absorption of zinc. Zinc may affect manganese tissue levels (503).

    • Manganese/Food Interactions:

  • FatFat: In human research, low-fat diets inhibited the absorption of manganese (504).
  • FiberFiber: In humans, the addition of carboxymethylcellulose to the diet resulted in a negative manganese balance (505; 506). Isabgol husk supplementation increased fecal excretion of manganese and lowered apparent manganese retention in the body in adolescent girls (507).
  • FructoseFructose: The effect of fructose intake on manganese levels has been examined (508). Additional details are lacking.
  • Fruits and vegetablesFruits and vegetables: Consumption of fruits and vegetables may increase manganese intake (509).
  • Gluten-free dietGluten-free diet: Female patients adhering to a gluten-free diet had lower intakes of manganese (510).
  • MeatMeat: The effect of levels of meat intake on manganese levels has been examined (511). Additional details are lacking.
  • OystersOysters: Increased consumption of oysters failed to affect fecal output of manganese (512).
  • ProteinProtein: In adult males, the consumption of high- or low-protein diets failed to produce an effect on the absorption and retention of manganese (513). In adolescent girls, the addition of milk protein to the diet improved the absorption and retention of manganese (514).
  • Semisynthetic phenylketonuria (PKU) dietSemisynthetic phenylketonuria (PKU) diet: Increased amino acid supplementation as a result of the PKU diet increased retention of manganese in infants (515).
  • StarchStarch: The effect of starch intake on manganese levels has been examined (508). Additional details are lacking.
  • TeaTea: Tea is a major source of dietary manganese, and intakes commonly exceed proposed adequate intake values of 1.8-2.3mg of manganese daily (516; 517).

    • Manganese/Lab Interactions:

  • Cardiovascular parameters:Cardiovascular parameters: Chronic exposure to lead, cadmium, and manganese increased systolic blood pressure and mean blood pressure values compared to those not exposed to these metals (518).
  • CholesterolCholesterol: In calcium-deficient ovariectomized rats, supplementation with manganese decreased the rise of total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein associated with calcium deficiency (466).
  • HemodialysisHemodialysis: In patients undergoing chronic hemodialysis and whose hematocrit levels had been maintained at 30-50% for two years with recombinant human erythropoietin (rHuEPO), serum manganese levels improved (519).
  • Liver enzymesLiver enzymes: In calcium-deficient ovariectomized rats, supplementation with manganese decreased low calcium-induced increases in liver weight and serum levels of glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase (GPT) (466).