Peter Dawkins wrote:
>Has anyone had any experience with treatment with additional manganese, which evidently has good effect on tremor.  My wife is convinced that it would help my creaking joints. Any takers?<

        Be careful, be very careful. jmr

Supplements May Have Too Much Manganese
By Keith Mulvihill

NEW YORK, February 1, 2001  (Reuters Health) - The levels of manganese
in some over-the-counter dietary supplements--most touted as treatments
for joint and muscle problems--exceed government recommended levels for
safe consumption of the element.
        Consuming too much manganese may cause abnormal neurological
symptoms, such as tremors, similar to those seen in Parkinson’s disease
patients, according to a report issued by the Institute of Medicine,
part of The National Academy of Sciences.
        On January 9th, the Institute of Medicine (IOM) announced that daily
consumption of manganese from food, water and dietary supplements should
not exceed the tolerable upper intake levels (UL) of 11 milligrams (mg)
per day. ULs are now being calculated for many nutrients to help people
avoid taking too much of otherwise essential, health promoting
nutrients.
        Of five dietary supplements purchased by Reuters Health, all exceed the
UL for manganese.
        For example, Super Flex Joint Formula manufactured by Natural Balance
in Castle Rock, Colorado, instructs consumers to ingest 40.2 mg of
manganese per day (two tablets containing 6.7 mg, 3 times a day) for the
first week or for maximum strength, nearly four times the UL. They
suggest a “maintenance dose” of 20.1 mg per day (3 tablets per day).
        Two brands--Extra Strength Glucosamine Chondroitin Complex by Solgar in
Leonia, New Jersey and CSA Joint Formula with Chondroitin Sulfate by
Natural Balance--each recommend daily consumption of 20 mg of manganese
per day, almost twice the UL.
        Finally, Joint Support by Now Foods in Bloomingdale, Illinois, calls
for 5 to 15 mg per day of manganese, and Arthro-Joint and Muscle Relief
Factors by Country Life in Hauppauge, New York instructs persons
weighing 200 pounds or more to take 15 mg of manganese per day.
        All the companies were contacted and none were available to comment by
deadline. Liver Disease Ups Risk
        People who consume high amounts of certain nutrients, such as
manganese, on a daily basis for long periods of time may put their
health at risk, according to Dr. Paula R. Trumbo, Food and Nutrition
Board, Institute of Medicine in Washington, DC. Excess manganese can
result in “high concentrations of manganese in the brain,'” she told
Reuters Health.
        The neurological problems associated with too much manganese “have most
often been reported in patients with liver disease, miners inhaling
manganese dust, and people who consumed water with very high manganese
concentrations,” she said.
        While the health effects of consuming lower doses is somewhat
controversial, studies in animals and humans with liver disease suggest
that chronic doses can cause nervous system changes.
        Consuming too much manganese may be particularly hazardous to those
with liver disease, including cirrhosis, a disease often associated with
high alcohol consumption.
        The liver plays an important role in the breakdown of manganese, and
reduced liver function means that more of the element may accumulate in
the brain. The accumulation of manganese in the brain may cause people
to develop tremors, abnormal walking and rigidity, Trumbo explained.
        Many people taking such manganese-containing supplements should realize
that they are already getting manganese from their diets. The average
intake of dietary manganese for adults is approximately 2 mg per day,
according to Trumbo, and the element can be found in nuts, legumes, tea
and whole grains.
        Manganese is an essential nutrient involved in the formation of bone
and the metabolism of amino acids, lipids and carbohydrates. A
deficiency in manganese can cause impaired growth and problems with
reproductive function, and decreased blood levels have been seen in
women with osteoporosis, according to the IOM report.
        The adequate intake (AI) level for manganese, based on the median
intake reported from a Food and Drug Administration diet study, is 2.3
mg per day for men over age 19 and 1.8 mg per day for women over age 19,
the report states.
        Reuters Health was prompted to conduct its investigation after
ConsumerLab.com of White Plains, New York posted a notice on its Web
site on January 29th, stating that one of the products that it evaluates
exceeded the UL for manganese.
        The product, CosaminDS, manufactured by Nutramax Laboratories Inc. in
Edgewood, Maryland, contains 10 mg of manganese per tablet and called
for users to ingest three tablets every day for 60 days--making the
daily intake of manganese 30 mg.
        After the 60-day dose, the product tells the user to lower the intake
to one to two tablets--10 to 20 mg of manganese per day, according to
ConsumerLab.com.
        Subsequently, Nutramax Laboratories Inc. informed ConsumerLab.com that
they have had a reformulated CosaminDS product on the market since
August. Tablets in this new formulation contain 5 mg of manganese and
although the first 60 days of treatment exceed recommended daily intake
levels (three tablets a day), the product calls for a dose
of 5 mg to 10 mg per day after the first 60 days.
        “CosaminDS loading dose is 60 days at most. All CosaminDS formulas thus
comply with the UL for manganese which is established for chronic
(long-term) consumption,” Nutramax Laboratories said in a statement to
Reuters Health.
        U.S. consumers are spending an estimated $15.7 billion this year on
herbal and dietary supplements, according to experts. However, the Food
and Drug Administration does not regulate ingredients in supplements or
dosage levels.
Copyright © 2001 Yahoo! Inc., and Reuters Limited


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Judith Richards, London, Ontario, Canada
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