Manganese Toxicity
Manganese is an essential trace mineral, and deficiency is almost unheard of. Too much, usually breathed in at work, can build up in the brain and cause a movement disorder called manganism that looks a bit like Parkinson’s disease.
Sources of too much
- Welding, steel and battery manufacturing, and manganese mining (Australia is a major producer)
- Long-term intravenous (IV) feeding with manganese added
- Injecting home-made drugs made with potassium permanganate (ephedrone or methcathinone)
- Severe liver disease, which reduces manganese removal
- Well water with very high natural levels
Symptoms
- Early: irritability, mood changes, poor sleep, sometimes compulsive behaviour (“manganese madness”)
- Later: slowness, stiffness, soft or slurred speech, poor balance, and a strange high-stepping “cock walk”
- Unlike Parkinson’s, tremor is less common and levodopa usually helps little
Parkinson’s that doesn’t respond to levodopa in a welder deserves a work history, not just a bigger dose.
Testing and treatment
- An MRI can show manganese deposits in the brain
- Blood levels help but don’t always reflect brain levels
- The key step is removing the exposure: better ventilation, protective equipment, changing IV feeds
- Some symptoms may persist after exposure stops
At work
- Welding fumes need extraction and respiratory protection
- Workplace exposure limits and health monitoring apply under Australian work health and safety laws
- Tell your GP about your job if you have new movement or mood symptoms
Weird history
- Manganism was first described in 1837 in Scottish workers grinding manganese ore
- Ancient cave painters used manganese oxide for black pigment, about 40,000 years ago
Common questions
What is manganism?
A movement disorder from too much manganese in the brain, usually from workplace exposure, causing slowness, stiffness, speech and balance problems, and mood changes.
Who is at risk of manganese toxicity?
Welders, miners and steel workers, people on long-term IV feeding, people with severe liver disease, and people injecting home-made drugs made with permanganate.
Can you be deficient in manganese?
Deficiency is extremely rare, as manganese is in grains, nuts, tea and many other foods.
Helpful resources
- Safe Work Australia: weldingWorkplace safety guidance. Free.
- Poisons Information Centre: 13 11 26Free advice, 24 hours a day, Australia-wide.
Evidence and more information
maladywise.com/manganese/