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 -- Judith Richards, London, Ontario, Canada [log in to unmask] Today’s Research... Tomorrow’s Cure