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Manganese

essential trace mineral for bone health and metabolism

Evidence · Grade C
Meta-analysis availableSystematic review availableHuman trial evidenceTraditional useInteraction risk

Manganese is an essential trace mineral vital for bone health, metabolism, and antioxidant function.

Manganese is an essential trace element that plays a crucial role in bone health. It is involved in the formation and maintenance of bone structure and may contribute to bone mineral density.

Quick answer

What it is: Manganese is an essential trace element that plays a crucial role in bone health.

May support:Osteoporosis

Evidence:Evidence · Grade C

Evidence Summary

Evidence · Grade C

The role of manganese in human health, particularly in bone metabolism, is established through its biochemical functions and observations of deficiency states. However, direct clinical trial evidence specifically linking manganese supplementation to improved outcomes for conditions like osteoporosis is limited in the provided studies. Its classification as an essential nutrient is based on decades of nutritional science.

Last reviewed · Jun 2026

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Why It Works

Manganese acts as a cofactor for several enzymes, including glycosyltransferases and alkaline phosphatase, which are essential for the synthesis of proteoglycans in cartilage and bone. It also participates in collagen synthesis, a primary component of the bone matrix, thereby supporting bone formation and elasticity.

How it works in more detail

Manganese is a required cofactor for glycosyltransferases, enzymes crucial for the synthesis of proteoglycans, which are major components of bone and cartilage. It also activates enzymes involved in carbohydrate and lipid metabolism. Furthermore, manganese is an integral part of manganese superoxide dismutase (MnSOD), a powerful antioxidant enzyme located in the mitochondria, which converts superoxide radicals into less harmful molecules, thereby protecting cells from oxidative stress.

How to use

Always consult a qualified clinician.

Editorial guidance

Suggested dosage
Dietary Reference Intakes for adults are 1.8-2.3 mg/day. Therapeutic dosages for bone health, when considered, are often in the range of 5-10 mg/day, but should be advised by a healthcare professional.
Research dosage range
Not applicable due to lack of specific clinical trials in the provided evidence.
Typical forms
capsule, tablet, multivitamin, mineral complex
Quality markers
Look for products from reputable manufacturers that adhere to Good Manufacturing Practices (GMP). Check for third-party testing for purity and accurate dosage.
Medication interactions
  • Iron supplements (may compete for absorption)
  • Antacids (may reduce absorption)
Avoid if
  • Liver disease (risk of toxicity)
  • Manganism (pre-existing condition)

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Suggested dosage

Dietary Reference Intakes for adults are 1.8-2.3 mg/day. Therapeutic dosages for bone health, when considered, are often in the range of 5-10 mg/day, but should be advised by a healthcare professional.

General guidance — discuss specifics with a clinician.

Active medicinal compounds

Manganese (as an elemental mineral)

Traditional use

Manganese is an essential nutrient, and its importance has been recognized through modern nutritional science rather than traditional medicine systems. Traditional practices may have included manganese-rich foods, but not as a distinct remedy.

Safety

Safety warnings

At high doses (above 11 mg/day for adults), manganese can be toxic, particularly affecting the nervous system, leading to symptoms similar to Parkinson's disease. Toxicity is rare from dietary intake but can occur from occupational exposure or excessive supplementation.

Avoid if

  • Liver disease (risk of toxicity)
  • Manganism (pre-existing condition)

Medication interactions

  • Iron supplements (may compete for absorption)
  • Antacids (may reduce absorption)

Reported side effects

  • Nausea
  • Vomiting
  • Abdominal pain
  • Neurological symptoms (with excessive intake)

General guidance — discuss specifics with a clinician.

Evidence ecosystem

Scientific literature, clinical guidance, government sources, ongoing research, traditional use, and lived experience — grouped by source type and quality.

Overall grade (C)

The role of manganese in human health, particularly in bone metabolism, is established through its biochemical functions and observations of deficiency states. However, direct clinical trial evidence specifically linking manganese supplementation to improved outcomes for conditions like osteoporosis is limited in the provided studies. Its classification as an essential nutrient is based on decades of nutritional science.

Filter by source type

Meta-Analyses(3)

Pooled analyses across multiple human trials.

Very High Quality
  • Serum trace elements and osteoarthritis: A meta-analysis and Mendelian randomization study.

    Shi H, Wang H, Yu M, Su J, Zhao Z, Gao T · Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) · 2024

    This study aims to establish the correlation between shifts in serum trace element (TE) levels and the progression of osteoarthritis (OA), while also exploring the underlying causal relationship between these variables. An investigation was conducted, which included a systematic review, a meta-analysis of observational studies, and a two-sample Mendelian randomization (MR) study. This meta-analysis revealed significant differences in serum levels of copper, manganese, cadmium, and selenium between OA patients and healthy controls, after adjusting for heterogeneity. Specifically, significant disparities were observed for copper (SMD 0.118 [95 % CI: 0.061 ∼ 0.175], P < 0.001), manganese (SMD -0.180 [95 % CI: -0.326 ∼ -0.034], P = 0.016), cadmium (SMD 0.227 [95 % CI: 0.131 ∼ 0.322], P < 0.001), and selenium (SMD -0.138 [95 % CI: -0.209 ∼ -0.068], P < 0.001), while zinc levels did not show a significant difference (SMD -0.0

    Meta-AnalysisPubMedVery High Quality
  • Manganese Exposure and Metabolic Syndrome: A Systematic Review and Meta-Analysis.

    Wong MMH, Chan KY, Lo K · Nutrients · 2022

    Manganese (Mn) is an essential element acting as a co-factor of superoxide dismutase, and it is potentially beneficial for cardiometabolic health by reducing oxidative stress. Although some studies have examined the relationship between Mn and metabolic syndrome (MetS), no systematic review and meta-analysis has been presented to summarize the evidence. Therefore, the present review examined the association between dietary and environmental Mn exposure, and MetS risk. A total of nine cross-sectional studies and three case-control studies were included, which assessed Mn from diet, serum, urine, and whole blood. The association of the highest Mn level from diet (three studies, odds ratio (OR): 0.83, 95% confidence interval (C.I.) = 0.57, 1.21), serum (two studies, OR: 0.87, 95% C.I. = 0.66, 1.14), urine (two studies, OR: 0.84, 95% C.I. = 0.59, 1.19), and whole blood (two studies, OR: 0.92, 95% C.I. = 0.53, 1.60) were insignificant, but some included studies have suggested a non-linear r

    Meta-AnalysisPubMedVery High Quality
  • Micronutrient status in type 2 diabetes: a review.

    Kaur B, Henry J · Advances in food and nutrition research · 2014

    Type 2 diabetes is characterized by significant losses of important micronutrients due to metabolic basis of the disease and its complications. Evidence of changes in trace mineral and vitamin metabolism as a consequence of type 2 diabetes is reviewed in this chapter. This review is not a meta-analysis but an overview of the micronutrient status, metabolic needs, and potential micronutrient requirements in type 2 diabetics. This chapter will not concentrate on vitamin D and type 2 diabetes as this is a topic that has been extensively reviewed before. The less well-known micronutrients notably zinc, magnesium, chromium, copper, manganese, iron, selenium, vanadium, B-group vitamins, and certain antioxidants are assessed. While some evidence is available to demonstrate the positive influence of micronutrient supplementation on glycemic control, much remains to be investigated. Additional research is necessary to characterize better biomarkers of micronutrient status and requirements in ty

    Meta-AnalysisPubMedVery High Quality

Systematic Reviews(2)

Structured reviews of the full body of evidence (incl. Cochrane).

Very High Quality
  • Micronutrients and Androgenetic Alopecia: A Systematic Review.

    Wang R, Lin J, Liu Q, Wu W, Wu J, Liu X · Molecular nutrition & food research · 2024

    Hair loss is a common problem that can negatively impact individuals' psychological well-being. Androgenetic alopecia (AGA) is one of the most prevalent types of nonscarring hair loss. This review summarizes the existing evidence on the relationship between AGA and various micronutrients, including vitamin B, vitamin D, vitamin A, vitamin C, iron, selenium, zinc, manganese, and copper. A literature search was conducted to identify relevant articles published between 1993 and 2023. The search identified 49 relevant articles. The findings suggest that deficiencies or imbalances in these micronutrients may contribute to the pathogenesis of AGA and represent modifiable risk factors for hair loss prevention and treatment. Vitamin B, vitamin D, iron, and zinc appear to play critical roles in hair growth and maintenance. Deficiencies in these micronutrients have been associated with increased risk of AGA, while supplementation with these nutrients has shown potential benefits in improving h

    Systematic ReviewPubMedVery High Quality
  • Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Review.

    Woolhiser E, Keime N, Patel A, Weber I, Adelman M, Dellavalle RP · JMIR dermatology · 2024 · n=906

    Pathogenesis of seborrheic dermatitis involves lipid secretion by sebaceous glands, Malassezia colonization, and an inflammatory response with skin barrier disruption. Each of these pathways could be modulated by diet, obesity, and nutritional supplements. Current treatment options provide only temporary control of the condition; thus, it is essential to recognize modifiable lifestyle factors that may play a role in determining disease severity. This study aimed to summarize published evidence on diet, nutritional supplements, alcohol, obesity, and micronutrients in patients with seborrheic dermatitis and to provide useful insights into areas of further research. A literature search of Scopus, PubMed, and MEDLINE (Ovid interface) for English language papers published between 1993 and 2023 was conducted on April 16, 2023. Case-control studies, cohort studies, and randomized controlled trials with 5 or more subjects conducted on adult participants (>14 years) were included, case rep

    Systematic ReviewPubMedVery High Quality

Observational Studies(1)

Cohort, case-control, and cross-sectional human studies.

Moderate Quality
  • Trace elements and the thyroid.

    Zhou Q, Xue S, Zhang L, Chen G · Frontiers in endocrinology · 2022

    Trace elements, such as iodine and selenium (Se), are vital to human health and play an essential role in metabolism. They are also important to thyroid metabolism and function, and correlate with thyroid autoimmunity and tumors. Other minerals such as iron (Ir), lithium (Li), copper (Co), zinc (Zn), manganese (Mn), magnesium (Mg), cadmium (Cd), and molybdenum (Mo), may related to thyroid function and disease. Normal thyroid function depends on a variety of trace elements for thyroid hormone synthesis and metabolism. These trace elements interact with each other and are in a dynamic balance. However, this balance may be disturbed by the excess or deficiency of one or more elements, leading to abnormal thyroid function and the promotion of autoimmune thyroid diseases and thyroid tumors.The relationship between trace elements and thyroid disorders is still unclear, and further research is needed to clarify this issue and improve our understanding of how trace elements mediate thyroid fun

    Observational StudyPubMedLow Quality

Clinical Trial Registries(2)

Registered ongoing or completed trials (ClinicalTrials.gov).

Moderate Quality
  • Efficacy of Oral Hyaluronic Acid and Collagen Supplementation Compared With Hyaluronic Acid Infiltration Treatment in Rotator Cuff Tendinopathies: A Prospective Study

    n=50 · NCT06379997 · RECRUITING · RECRUITING

    The present study aims to investigate the effectiveness of oral supplementation with a nutraceutical containing Collagen, Hyaluronic Acid, Vitamin C, and Manganese in functional outcome and pain reduction in cases of shoulder rotator cuff tendinopathy compared to a cycle of intra-articular hyaluronic acid injections. The project involves the recruitment of 50 adult individuals presenting with shoulder pain and instrumental evidence of rotator cuff tendinopathy. All participants will receive one intra-articular injection of 1 ml of triamcinolone acetonide 40 mg. After the injection, participants will be divided into two groups according to Good Clinical Practice guidelines. One group will begin taking one vial per day for 56 days of an oral supplement containing Hyaluronic Acid, Collagen, Vitamin C, and Manganese (HA-COL) (Tendogenial®, B2Pharma) starting from the day following enrollment (Group 1). The other group will undergo a cycle of 3 intra-articular injections with hyaluronic acid (HA) (Hyalotend®, Fidia) (Group 2). The hypothesis is that oral supplementation with HA-COL may have the same efficacy as intra-articular hyaluronic acid treatment in reducing pain and improving shoulder functionality. Functional assessments will be conducted by a clinician unaware of the participants' group assignment. The following assessment scales will be used: Numeric Rating Scale (NRS) for pain (from 0 to 10), evaluating 3 aspects of pain: 1) pain at rest, 2) nocturnal pain, 3) pain during movement. Shoulder Disability Questionnaire (SDQ) for functionality. Assessments will be conducted at the following time points: T0) Before the administration of corticosteroid intra-articular injection (baseline). T1) Seven days after the start of HA-COL intake for Group 1 and before the first intra-articular HA injection for Group 2 (T1, seven days from T0). T2) At mid-cycle of oral HA-COL supplementation for Group 1 (28 days of intake) and seven days after the last HA injection for Group 2 (T2, 21 days from T1). T3) Follow-up at 28 days from T2, at the end of the 56-day oral treatment cycle for Group 1, and 28 days after the last injection for Group 2 (T3, 56 days from T0).

    Clinical TrialClinicalTrials.govModerate Quality
  • The NAGIC Study: Multi-center, Randomized, Double-blind, Placebo-controlled Cross-over Study of Oral N-acetylglucosamine in Ileal/Ileocolonic Crohn's Disease

    n=40 · NCT07225998 · NOT_YET_RECRUITING · NOT_YET_RECRUITING

    Protein glycosylation is a critical post-translational modification that regulates protein trafficking and protein-protein interactions impacting a host of physiological processes. There is a growing appreciation of glycosylation defects in chronic human diseases, including Crohns disease. Crohns disease (CD), and the related condition of ulcerative colitis, are chronic inflammatory bowel diseases (IBD) that impact 3.1 million Americans. While the development of medications has revolutionized care of CD patients, clinical remission is only achieved in \~40% of patients a therapeutic ceiling that has not changed in 20 years. These data underscore the need for new CD treatment strategies. The investigators are focused on understanding the role of defective N-glycosylation in CD, as an innovative strategy to identify and develop new therapeutics. Depending on ancestral background, 7-25% of CD patients carry a pathogenic, missense mutation in the manganese (Mn) transporter ZIP8 (rs13107325; ZIP8 A391T). ZIP8 regulates systemic Mn homeostasis with ZIP8 391-Thr causing a relative Mn insufficiency. Mn is a required metal cofactor for enzymes regulating key cellular processes, like N-glycosylation. In the gut, protein N-glycosylation plays key roles in host-pathogen interactions, inflammation, and cell-cell interactions. The investigator's central hypothesis is that in patients carrying ZIP8 391-Thr - CD is exacerbated by aberrant N-glycosylation and that this defect can be targeted by specific, safe therapy. Supporting this hypothesis, Mn levels are reduced (\~15%) in ZIP8 391-Thr allele carriers and this is associated with a decrease in complex N-glycan branching in plasma. Further, the investigators uncovered a microbiota signature in the ileal mucosa that implicated altered bile acid homeostasis in ZIP8 391-Thr carriers. To better understand CD in ZIP8 391 carriers, the investigators generated a knock-in mouse model of ZIP8 391-Thr (Zip8393T/393T). Like patient data, the investigators observe reduced branching of N-glycans and disrupted bile acid homeostasis in the Zip8393T/393T mice. Promising human trials have shown that defects in N-glycan branching can be safely restored by raising levels of the rate-limiting metabolite UDP-N-acetylglucosamine (GlcNAc) via supplementation with free GlcNAc. The investigator's preliminary data in Zip8393T/393T mice have demonstrated that GlcNAc supplementation restores N-glycan branching deficits, rescues the defect in bile acid homeostasis, and ameliorates colitis susceptibility. Thus, the objective of the proposed research is to test a safe and effective therapy for patients carrying ZIP8 391-Thr and others who may have underlying changes in N-glycosylation. The investigators will perform a multi-center, randomized, double-blind, placebo-controlled cross-over study to test the safety and tolerability of oral GlcNAc as a proof-of-concept study. The investigators will use two cohorts stratified by ZIP8 391-Thr genotype status (carriers and non-carriers, n= 20 participants in each cohort, total= 40 participants).

    Clinical TrialClinicalTrials.govModerate Quality

Limitations: The current evidence base lacks specific PubMed studies directly evaluating manganese for osteoporosis, necessitating reliance on general nutritional understanding and its known biochemical roles. There is an absence of clinical trials assessing the efficacy and optimal dosing of manganese supplementation for this specific condition.

This page is educational. Statements use phrases like "may support" and "has been studied for"because no remedy here is approved to cure, treat, or reverse any condition. Discussion happens on the ailment pages — community statistics here are derived from those reports. Always consult a qualified clinician.

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