Iron & Manganese
The information presented is based on Cellular trace mineral analysis - not Serum / Blood measurements.
RDA / DRI, synergists, antagonists, and additional deficiency / overdose / toxicity symptoms are listed at the bottom of the page.
Iron (Fe) and Manganese (Mn) are associated trace elements considered essential to human health.
As is the case with most other associated mineral pairs, the absorption of iron is dependent on manganese,
however with manganese levels being frequently lower than iron levels, and with many forms of iron causing
constipation or gastric upsets when supplemented, the addition of manganese, when low, is vitally important.
This not only prevents further ratio conflicts between the two elements, but also substantially reduces the
amount of iron needed when manganese is supplemented at the same time.
While some sources claim that manganese lowers iron levels, this is mostly a theoretical consideration that
would only happen under unusual circumstances. In actual clinical settings, I have not seen a single case of
a patient's iron (ferritin) levels decline as a result of taking manganese, even when doses as high as 150 mg
per day were supplemented on an ongoing basis. In fact, most minor iron-deficiency situations can be dealt
with by using manganese alone - without any iron - which reduces any potential adverse effects that can be
part of routine iron supplementation.
In contrast to Acu-Cell Analysis, routine blood tests do not include
manganese measurements, but use a number of iron determinations
alone, none of which are very reliable to assess true iron requirements
in a patient, with only ferritin levels being more useful, and being closer
to actual intracellular values. As a result, patients are given far too
many false positive and false negative recommendations (especially with
polycythemia or thalassemia issues) to take - or not to take extra iron
supplements, to the detriment of the patient.
Pregnant women are the most vulnerable targets for either insufficient,
or excessive iron supplementation, with the latter being able to trigger
'Toxemia of Pregnancy' (high iron causes excessive sodium retention),
and in which case higher amounts of Folic acid should have been supple-
Likewise, blood loss, or malabsorption are considered to be the main causes for low iron after ruling out any
of a number of blood disorders, however low iron can very easily result from manganese levels having been
low for a long period of time, or from other factors such as excessive calcium, zinc, or magnesium levels
reducing iron values. Cellular levels of iron best correspond to actual symptoms of excess or deficiency,
in contrast to blood levels, which unfortunately fluctuate considerably under various medical situations,
particularly with infections. Following are some interactions of iron and manganese with other elements:
There is also a synergistic and antagonistic interaction between Iron + Manganese and B-Vitamins, whereby
these interactions will change under various medical situations as well. For instances, with kidney disease, a
fine balance needs to be maintained between folate and iron levels since one will otherwise inhibit the other.
The same applies with adrenal disturbances, except they will affect the balance between iron and Vitamin B1.
Stomach acid levels heavily interact synergistically with iron & manganese, whereby the absorption of both
elements is enhanced by higher HCl acid levels, while an increase in iron or manganese will generally, but not
always, result in raised stomach acid levels. Since Calcium and Magnesium have the exact opposite effect on
stomach acid levels, their interaction with iron and manganese have a major impact on medical situations that
are associated with raised or lowered stomach acid levels (for details see "Calcium & Magnesium").
Excessive manganese and/or iron storage can set the stage for tumor development as much as 10 or 20 years
before a benign or malignant growth develops - subsequent to the exposure or intake of substances that have
an adverse effect on Liver Chemistry, which includes:
• Marijuana / cannabis,
• Antifungal medications,
• Acetaminophen (Tylenol),
• Viral infections (e.g. hepatitis),
• Cholesterol-lowering (statin) drugs,
• Food-related mold / mycotoxins (aflatoxin),
• Proton pump inhibitors (Nexium, Prilosec, Prevacid...),
• Hormones (e.g. estrogen, androgen, anabolic steroids),
• Heavy metal / toxic exposure (PVC, arsenic, pesticides),
• Dry cleaning chemicals (tetrachloroethylene / perchloroethylene),
• Genetic disposition (alpha-1 antitrypsin deficiency, hemochromatosis),
• Foods / beverages heated in plasticware containing Bisphenol A (BPA).
• Herbal / nutritional supplements (Lakota, kava, devil's claw, celandine, comfrey, chaparral).
• Evening primrose oil [EPO] (impairs liver functions in some individuals. Symptoms include
mild, but chronic nausea).
Many other factors or medications (certain antibiotics, anesthetics, antihypertensive, antiviral, tricyclic
antidepressants, anti-seizure... drugs) can result in higher manganese (and some in excessive iron) storage,
regardless of actual manganese or iron consumption. In addition, certain foods or beverages (grapefruit or
grapefruit juice) can alter the liver's ability to metabolize many toxins and drugs, resulting in higher iron
and/or manganese retention as well.
By the time a tumor develops, patients don't always exhibit liver storage of these elements any longer, or
they may have dropped below normal as a result of perimenopausal or postmenopausal hormone changes,
along with reduced stomach acid levels.
From many years of following patients with a similar medical history, it appears that if stomach acid levels
and liver functions are normalized in time, patients remain largely tumor-free. That approach is also helpful
after cancer has developed, where following successful therapy, cancer is more likely to stay in remission.
High manganese levels are linked to estrogen receptor-positive, while low manganese levels are linked to
estrogen receptor-negative cancers.
11-18 years males
19 + years males
11-18 years females
19-50 years females
50 + years females
7mg - 10mg
8mg - 11mg
8mg - 15mg
9mg - 10mg
11-18 years males
19 + years males
11-18 years females
19-50 years females
50 + years females
Cellular / Intracellular Attributes and Interactions:
Phosphorus, bismuth, germanium,nickel, manganese,
Vitamin A, Vitamin B1, Vitamin C, Vitamin D, folate,
niacin, niacinamide, lecithin, protein.
Zinc, calcium, magnesium, tin, cobalt, gallium,
Vitamin B2, B5, B12, Vitamin E, [folate], caffeine,
insoluble fiber, rice (phytates), tea (tannic acid),
soy protein, dairy (casein), oxalic acid, curcumin.
Sodium, lithium, silicon / silica, cobalt, PABA,
biotin, niacin / niacinamide, Vitamin E, choline,
Potassium, magnesium, calcium, iodine, nickel,
boron, Vitamin B1, Vitamin B6, Vitamin B15,
Vitamin C, [iron], sugar,* alcohol.*
* These can have synergistic or antagonistic action, depending on hypoglycemic or hyperglycemic tendencies.
Low Levels / Deficiency - Symptoms and/or Risk Factors:
Fatigue, anemia, depression, dizziness, asthma,
gastrointestinal disorders, pale skin, miscarriage,
amenorrhea (failure to menstruate), dysmenorrhea,
(painful periods), migraine-headaches, Ménière's
disease, learning difficulties, weak immune system,
restless leg / legs syndrome, ovarian cysts (left),
delayed development in infants and children.
Fatigue, depression, hypoglycemia / low blood
sugar, joint dislocations (particularly knees),
high cholesterol, asthma, migraine-headaches,
osteoporosis, gastrointestinal disorders, PMS,
infrequent menstrual cycles, ovarian cysts (right).
Hemochromatosis, migraine-headaches, arthritis,
high blood pressure, heart disease, liver disease,
dizziness, gastrointestinal disorders, nausea,
higher risk for several cancers, fibroid tumors,
benign prostatic hypertrophy (BPH), edema,
constipation (high supplementation), diabetes,
preeclampsia, lowered IQ in children.
High levels / Overdose / Toxicity / Negative Side Effects - Symptoms and/or Risk Factors:
Migraine-headaches, PMS, frequent menstrual
cycles, endometriosis, dizziness, depression,
mental illness, learning disabilities, hypothyroid,
higher risk for several cancers, fibroid tumors,
insomnia, osteoporosis, edema, liver disease,
chronic nausea, colitis, muscle tremors, diabetes,
hypothyroid, higher risk for tendon / ligament tears.
Meat, fish, shellfish, nuts, seeds, eggs, molasses,
wheat germ, whole-grain products, raisins, beans.
Nuts, seeds, whole-grain products, wheat germ,
seaweed, beans, peas, ginger, coffee. ¤
The primary function of Iron in the body is the formation of hemoglobin, the essential oxygen-carrying compo-
nent of the red blood cell (RBC). In combination with protein, iron is carried in the blood to the bone marrow,
where with the help of copper, it forms hemoglobin. Red blood cells pick up oxygen from the lungs and distri-
bute it to the rest of the tissues, all of which need oxygen to survive. Iron absorbed into the blood is usually
bound to the protein transferrin and goes mainly to the bone marrow, where it can be used to make red blood
Myoglobin is a red, iron-containing protein, which stores oxygen for muscle contraction. There are about 3 mg
to 5 gm of iron in the body, of which hemoglobin represents 65%, while about 30% occurs as ferritin, which is
the iron storage complex found in the liver, spleen and bone marrow. Neutrophils (white blood cells) depend
on iron to help generate superoxide to function as a bacteria-destroying agent, whereby inadequate iron levels
reduce the effectiveness of the immune system. With severe iron deficiency, hemoglobin levels decline and
the packed volume of red blood cells, the hematocrit, declines.
Heme Iron from meat is about 10 times more absorbable than iron from
all plant / vegetable sources. Many vegans have trouble obtaining sufficient
iron from the diet alone since phytates present in whole grains and oxalates
found in certain vegetables may bind to some of the iron and reduce
Iron deficiency is more common during infancy, childhood,
adolescence, pregnancy, menstruation, chronic infections,
low stomach acid (sometimes from low salt intake), chronic
diarrhea, impaired absorption (celiac disease), or bleeding.
The elderly may become iron deficient due to inadequate
dietary intake or poorer absorption of iron. Vitamin C, protein,
niacinamide and sufficient stomach acid all help iron absorption.
Iron Toxicity (high organ storage of iron) and/or high blood levels of iron are associated with an increased
risk of free radical damage and cancer. Ferritin levels are a good indication of iron storage levels. Normal
values for females range from 18 - 180 ng/ml (mcg/L), and 18 - 270 ng/ml for males. Levels below 15 ng/ml
suggest very depleted iron reserves, and higher ferritin (> 350 ng/ml) can be a risk factor for cardiovascular
disease and diabetes. Free radicals formed as a result of high iron can attack low-density lipoproteins (LDL)
and subsequently lead to fatty plaque buildup, damage to the walls of arteries, as well as heart muscle tissue.
Iron supplements frequently cause constipation or stomach complaints, which may result from the use of
ferrous sulfate, or similar hard-to-digest forms of iron. Other types of iron such as ferrous gluconate, ferrous
fumarate, or ideally Chelated Iron Supplements are generally better tolerated, and there are also water-
soluble iron products that are probably the least problematic on the body, and cause less of these effects.
Manganese is a much neglected, but important element when trying to stabilize blood sugar with diabetic
and hypoglycemic individuals, and for lowering total cholesterol (cholesterol-lowering drugs frequently raise
It has strong estrogenic properties, and as a result is the most important element when nutritionally treating
menopausal symptoms, menstrual problems, osteoporosis, and postpartum depression, for which manganese,
along with Vitamin B1, is most effective. Manipulating manganese (or DHEA) levels can be an effective way
to delay, or (sometimes) hasten menopause, trigger the menstrual cycle again after starting menopause, or
along with iron and iodine levels, affect the frequency, duration and heaviness of the menstrual cycle.
Like iron, manganese can be helpful with some types of asthma, where lung capacity measurably improvers
proportional to manganese intake. Extra supplementation of manganese may be helpful in some cases of
carpal tunnel syndrome, deafness, epilepsy, infertility, and lack of libido in both sexes. In addition, individuals
who regularly dislocate joints (particularly knee joints), frequently present with insufficient manganese levels,
so normalizing manganese in those cases will permanently resolve that problem. On the other hand, high
manganese levels increase the risk for tendon / ligament tears.
Manganese is important to many enzyme systems such as protein metabolism, bone formation, and the
synthesis of L-dopamine and cholesterol, as well as carbohydrate metabolism, where it is required for the
synthesis of glucose from non-carbohydrate substances (gluconeogenesis). As a co-factor in glycolysis,
manganese aids glucose metabolism.
It is also needed for normal muscle and brain function, blood clotting, and DNA and RNA synthesis, and
it activates the enzyme responsible for the formation of urea. Manganese may help with some symptoms
of Parkinson's disease such as muscle rigidity and twitching, although an excessive level of manganese can
in itself produce Parkinsonian syndrome from a loss of dopamine in the brain cells. L-dopa, which converts
to dopamine in the brain, is used in the treatment of manganese toxicity to reduce the symptoms.
High levels of manganese can produce violence and other mental changes, including a psychiatric disorder
When people supplement certain herbs to "cleanse" their liver, they will always affect manganese and iron
status. For instance, by taking Devil's Claw on an ongoing basis, they will eventually raise manganese and
iron levels. On the other hand, taking higher amounts of Milk Thistle will in time decrease manganese and
iron stores, which can be an advantage with hemochromatosis (excess iron storage disease), where
regular consumption of milk thistle, RNA / DNA, zinc, magnesium and Vitamin B2 - as individually matched -
will return iron levels closer to normal, and frequently eliminate the need for phlebotomies. ¤
UL: 40mg - 45mg
Therapeutic Range: 10mg - 900mg +
Best time to take Iron: Morning - afternoon, with
sufficient food to prevent stomach irritation. Include
synergists such as Vitamin C (optional), but avoid
taking iron antagonists at the same time listed below:
1.2 - 1.9mg AI
1.9 - 2.2mg AI
UL: 2mg - 11mg
Therapeutic Range: 10mg - 200mg +
Best time to take Manganese: Morning - evening,
with sufficient food to prevent stomach upsets, but
avoid taking manganese antagonists at the same time
2013 Dietary Reference Intake (DRI) - Recommended Dietary Allowance / Intake (RDA / RDI) for
Adults, Children, Pregnancy & Nursing - Adequate Intake (AI) - Tolerable Upper Intake Level (UL)
General recommendations for nutritional supplementation: To avoid stomach problems and improve tolerance,
supplements should be taken earlier, or in the middle of a larger meal. When taken on an empty stomach or
after a meal, there is a greater risk of some tablets causing irritation, or eventually erosion of the esophageal
sphincter, resulting in Gastroesophageal Reflux Disease (GERD). It is also advisable not to lie down right after
taking pills. When taking a large daily amount of a single nutrient, it is better to split it up into smaller doses
to not interfere with the absorption of other nutrients in food, or nutrients supplemented at lower amounts.
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