Major interaction on record — check this product against your medications before combining. Based on 4 of 5 ingredients. Check your meds →
Dietary supplement

Perna Pro With Lemon Flavoring Ingredients & Drug Interactions

by DaVinci Laboratories

Perna Pro With Lemon Flavoring label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Major
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Perna Pro With Lemon Flavoring against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Major

Perna Pro With Lemon Flavoring is a dietary supplement by DaVinci Laboratories with 5 active ingredients. Its ingredients are commonly taken for bone health support, antioxidant and enzyme support, filling dietary gaps.Based on those ingredients, 1,089 medications have a known interaction with it, the most serious rated major. The ingredients most likely to interact are 5-LOXIN, Glucosamine Sulfate Sodium, Manganese. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Perna Pro With Lemon Flavoring by DaVinci Laboratories

Ask about any prescription or over-the-counter medication and we check it for interactions with Perna Pro With Lemon Flavoring by DaVinci Laboratories — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
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HelloPharmacist Scorecard of Perna Pro With Lemon Flavoring by DaVinci Laboratories

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 5 of its 5 active ingredients.
  • “5-LOXIN” is listed as a grouped ingredient — the label gives one combined amount (50 mg) without saying how much of each component you get.

Perna Pro With Lemon Flavoring has 5 active ingredients. Manganese is a mineral your body needs in small amounts for bone health and metabolism.

Glucosamine sulfate sodium is a compound your joints use to build and repair cartilage, commonly taken for joint comfort. Perna canaliculus (New Zealand green-lipped mussel) is a shellfish-derived ingredient.

The product also contains methylsulfonylmethane (MSM) and 3-acetyl-11-keto-beta-boswellic acid (from Boswellia). Inactive ingredients include hypromellose (a capsule material), lemon juice powder for flavoring, and leucine.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Strong

Clinical evidence supports at least one of this product's ingredients for its stated purpose.

Why this rating?
  • The label markets this product for: joint support supplement.
  • We looked for evidence on: Back pain, Exercise-induced muscle damage, Exercise-induced muscle soreness, Gout, Joint pain, Kashin-Beck Disease — and 4 related terms.
  • The strongest evidence on file: Glucosamine is rated "Likely Effective" for Osteoarthritis (Natural Medicines).
  • Also on file: Manganese is rated "Insufficient Reliable Evidence To Rate" for Osteoarthritis.
  • Also on file: Glucosamine is rated "Insufficient Reliable Evidence To Rate" for Back pain, Rheumatoid arthritis (RA), Joint pain, Gout, and more.

Manganese is effective for manganese deficiency. For the other uses it's marketed for — hay fever, osteoporosis, COPD, obesity, and osteoarthritis — evidence is insufficient to rate it.

Glucosamine sulfate sodium is likely effective for osteoarthritis, but evidence is insufficient for aging skin, back pain, cancer, or metabolic liver disease. Perna canaliculus, methylsulfonylmethane, and 3-acetyl-11-keto-beta-boswellic acid do not have established effectiveness ratings in our data for any condition.

The evidence, ingredient by ingredient Manganese Glucosamine New Zealand Green-lipped Mussel Boswellia Serrata

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 3 of the 3 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 3 of 3.
  • General safety write-ups exist for 3 of 3.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

At appropriate doses, manganese and glucosamine are generally well tolerated. However, high-dose manganese supplements carry serious risk: at very high doses it can cause Parkinson-like neurological symptoms and liver damage; one reported case involved irreversible Parkinson disease after years of 100 mg daily doses.

Glucosamine may cause bloating, constipation, diarrhea, nausea, or heartburn. Rare reports include allergic reactions (including in one case anaphylaxis) and asthma flare-ups.

New Zealand green-lipped mussel is generally well tolerated but may cause abdominal pain, reflux, diarrhea, nausea, or flatulence; rare cases of hepatitis and liver function abnormalities have been reported with a specific extract called Seatone. Anyone with a shellfish allergy should avoid this product.

The safety data advises against this product during pregnancy. For breastfeeding, there is not enough data for manganese, and the safety data advises against glucosamine and New Zealand green-lipped mussel unless your doctor advises otherwise.

Side effects, ingredient by ingredient Manganese Glucosamine New Zealand Green-lipped Mussel Boswellia Serrata

Meds to double-check

Major interaction found
Known Interaction Concern · database check
Major identified

At least one ingredient has a documented Major-severity interaction. Check your medications for a personalized result.

Why this rating?
  • 2 of the 3 matched ingredients can interact with medications — Manganese, Glucosamine.
  • The most serious interaction on file is rated Major.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 253 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Perna Pro With Lemon Flavoring, double-check if you're on warfarin (Major interaction risk), antipsychotic drugs, quinolone or tetracycline antibiotics, cancer chemotherapy drugs like etoposide or doxorubicin (Moderate), or antidiabetes medications or acetaminophen (Minor). No interactions are documented for Perna canaliculus, but we could not check methylsulfonylmethane or 3-acetyl-11-keto-beta-boswellic acid.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Major medication interactions have been identified, and safety information is well characterized.

If you take warfarin or any antipsychotic, antibiotic, or cancer drug, check your exact medications with the tool on this page before starting — these are the main concern. People with shellfish allergies should avoid this product entirely.

Stick to normal doses only, not high-dose manganese. Talk to your pharmacist or doctor before using this if you're pregnant, breastfeeding, or managing diabetes.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 3 of 5 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Dec 14, 2023.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Perna Pro With Lemon Flavoring, straight from the product label.

Brand DaVinci Laboratories
Barcode (UPC) 026664228017
Net contents 120 Capsule(s)
Market status On market
Date entered into DSLD Dec 14, 2023
DSLD ID 304028
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Perna Pro With Lemon Flavoring by DaVinci Laboratories, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
2 Capsule(s)
Maximum serving Sizes:
2 Capsule(s)
Servings per container
60
UPC/BARCODE
026664228017
IngredientAmount% DV
Manganese2.5 mg109%
Methylsulfonylmethane250 mg--
Glucosamine Sulfate Sodium450 mg--
Perna canaliculus750 mg--
5-LOXIN50 mg--
3-Acetyl-11-keto-beta-boswellic acid15 mg--

Other ingredients: Hypromellose, Lemon Juice, Powder, Leucine

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

Truth We pledge total truth in labeling. Our family of products contains only the purest and most potent ingredients. Guaranteed.

Formulation

Color of this product may vary due to color variations of natural ingredients.

A Joint Support Supplement

Gluten free

Precautions

Warning: If pregnant or nursing, consult your healthcare practitioner before taking this product.

Keep out of reach of children.

To obtain product information or report a serious adverse event, call 1-800-325-1776. Not labeled for sale in California.

Contains: Crustacean shellfish (shrimp & crab).

Storage

Store in a cool, dry place.

Brand IP Statement(s)

5-LOXIN is a registered trademark of PL Thomas - Laila Nutra, LLC and is used under license. International patents pending.

FDA Statement of Identity

A Joint Support Supplement

Suggested/Recommended/Usage/Directions

Suggested use: As a dietary supplement, take 2 capsules twice daily, or as directed by your healthcare practitioner.

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Perna Pro With Lemon Flavoring by DaVinci Laboratories label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Perna Pro With Lemon Flavoring label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Perna Pro With Lemon Flavoring by DaVinci Laboratories

These are the 5 active ingredients this product is made of. Select any to open its full monograph.

Serving size2 Capsule(s) Dosage formCapsule Servings per container60 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Manganese

Interacts with
83 drugs
2.5 mg per serving Form: Manganese Citrate

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get...

Manganese monograph & interactions

Methylsulfonylmethane

250 mg per serving

Glucosamine Sulfate Sodium

Interacts with
170 drugs
450 mg per serving

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of...

Glucosamine Sulfate Sodium monograph & interactions

Perna canaliculus

No known
interactions
750 mg per serving

New Zealand green-lipped mussel is a shellfish-derived supplement rich in omega-3 fats that is mostly used for joint pain and arthritis. Some studies...

Perna canaliculus monograph & interactions

5-LOXIN

Interacts with
952 drugs
50 mg per serving Form: Boswellia serrata gum resin extract

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoart...

5-LOXIN monograph & interactions
  • › 3-Acetyl-11-keto-beta-boswellic acid

Other (inactive) ingredients: Hypromellose, Lemon Juice, Powder, Leucine. These complete the product’s ingredient list but are not active constituents.

Interaction report

Perna Pro With Lemon Flavoring by DaVinci Laboratories Drug Interactions

Want to check YOUR meds against Perna Pro With Lemon Flavoring?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,089Drugs
2 Major 1,018 Moderate 69 Minor

Ingredients driving the most interactions

5-LOXIN 952
Glucosamine Sulfate Sodium 170
Manganese 83

Individual Drug Interactions

The ingredients in Perna Pro With Lemon Flavoring interact with 1,089 drugs. Click any drug to see the details.

3 of the 5 ingredients in Perna Pro With Lemon Flavoring interact with drugs. Each result below shows which ingredient is responsible. 5-LOXIN Glucosamine Sulfate Sodium Manganese

Each ingredient & the kinds of drugs it affects

For each ingredient in Perna Pro With Lemon Flavoring with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

5-LOXIN6 drug types · 952 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Likelihood Possible Evidence D
5-LOXIN full monograph & interactions

Glucosamine Sulfate Sodium4 drug types · 170 drugs

Warfarin (Coumadin)

Glucosamine might increase the anticoagulant effects of warfarin and increase the risk of bruising and bleeding.
In two individual case reports, glucosamine/chondroitin combinations were associated with a significant increase in international normalized ratio (INR) in patients previously stabilized on warfarin. In one case, the increase in INR occurred only after tripling the dose of a glucosamine/chondroitin supplement from 500 mg/400 mg daily to 1500/1200 mg daily. Additionally, 20 voluntary case reports to the U.S. Food & Drug Administration (FDA) have linked glucosamine plus chondroitin with increased INR, bruising, and bleeding in patients who were also taking warfarin. There have also been 20 additional case reports to the World Health Organization (WHO) that link glucosamine alone to increased INR in patients taking warfarin. The mechanism of this interaction is unclear. Glucosamine is a small component of heparin, but is not thought to have anticoagulant activity; however, animal research suggests that it might have antiplatelet activity.

Likelihood Probable Evidence D
Topoisomerase Ii Inhibitors

Theoretically glucosamine may induce resistance to topoisomerase II inhibitors.
In vitro research suggests that glucosamine might induce resistance to etoposide (VP16, VePesid) and doxorubicin (Adriamycin) by reducing inhibition of topoisomerase II, an enzyme required for DNA replication in tumor cells. This effect has not been reported in humans.

Likelihood Possible Evidence D
Acetaminophen (Tylenol, Others)

Acetaminophen might interfere with the activity of glucosamine sulfate by interacting with the sulfate portion.
Anecdotal reports suggest that adding glucosamine to an acetaminophen regimen might decrease pain control in patients with osteoarthritis. Some research suggests that the sulfate portion of glucosamine sulfate might contribute to its effect in osteoarthritis. Since acetaminophen metabolism requires sulfur and reduces serum sulfate concentrations, acetaminophen could theoretically interfere with the action of glucosamine sulfate. Conversely, the administration of sulfate could theoretically decrease the effectiveness of acetaminophen in sulfate-deficient people by increasing its clearance.

Likelihood Possible Evidence B
Antidiabetes Drugs

Despite initial concerns, it is unlikely that glucosamine will interfere with the effects of antidiabetes drugs.
In vitro and animal research has suggested that glucosamine might increase insulin resistance or decrease insulin production. This has raised concerns that taking glucosamine might worsen diabetes and decrease the effectiveness of diabetes drugs. However, clinical research suggests that glucosamine does not have adverse effects on blood glucose or glycated hemoglobin (HbA1C) in healthy, obese, or type 2 diabetes patients.

Likelihood Unlikely Evidence B
Glucosamine Sulfate Sodium full monograph & interactions

Manganese3 drug types · 83 drugs

Antipsychotic Drugs

Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.

Likelihood Probable Evidence D
Tetracycline Antibiotics

Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.

Likelihood Probable Evidence D
Manganese full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Perna Pro With Lemon Flavoring, from the product label.

DaVinci Laboratories

See all DaVinci Laboratories products
Name
DaVinci Laboratories a division of FoodScience LLC
Street Address
929 Harvest Lane
City
Williston
State
VT
ZipCode
05495
Phone Number
1-800-325-1776
Web Address
www.davincilabs.com
Pharmacist Counseling Corner

Perna Pro With Lemon Flavoring by DaVinci Laboratories: Common Questions

Does Perna Pro With Lemon Flavoring by DaVinci Laboratories interact with any medications?
Yes. Based on its ingredients, Perna Pro With Lemon Flavoring has a known interaction with 1,089 medications, including 2 rated major. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Perna Pro With Lemon Flavoring contains 5 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Is this safe if I have a shellfish allergy?
No — Perna canaliculus (New Zealand green-lipped mussel) is a shellfish product, so you should avoid this supplement.
Can I take this while pregnant or breastfeeding?
The safety data advises against this product during pregnancy. While breastfeeding, there is not enough safety information for most of its ingredients, so you should avoid it unless your doctor says otherwise. Talk to your pharmacist or doctor for personalized advice.
What side effects might I experience?
Glucosamine commonly causes bloating, constipation, diarrhea, nausea, or heartburn. New Zealand green-lipped mussel may cause abdominal pain, reflux, diarrhea, nausea, or flatulence. At appropriate doses, both are generally well tolerated, but rare allergic reactions and asthma flare-ups have been reported with glucosamine.
Does this actually work for joint pain?
Glucosamine sulfate sodium is likely effective for osteoarthritis. The other ingredients don't have established effectiveness for any condition in our data.
Is this high in manganese, and could that be a problem?
We don't have the dose of manganese per capsule from the label, so you'll want to check it. At normal dietary amounts manganese is safe, but high-dose supplements can cause serious nerve damage (Parkinson-like symptoms) and liver problems. Stick to the label dose and don't take extra.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Perna Pro With Lemon Flavoring is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Perna Pro With Lemon Flavoring label
Go deeper

The Full Monographs Behind Perna Pro With Lemon Flavoring’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Manganese

Interacts with 83 drugs

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...

Read the full Manganese monograph → Herb & supplement monograph

Glucosamine

Interacts with 170 drugs

Glucosamine is a natural compound found in cartilage and joint fluid, and it is one of the most popular supplements for osteoarthritis, especially of the knee. The evidence is mixed, with so...

Read the full Glucosamine monograph → Herb & supplement monograph

New Zealand Green-lipped Mussel

New Zealand green-lipped mussel is a shellfish-derived supplement rich in omega-3 fats that is mostly used for joint pain and arthritis. Some studies suggest a modest benefit for osteoarthri...

Read the full New Zealand Green-lipped Mussel monograph → Herb & supplement monograph

Boswellia Serrata

Interacts with 952 drugs

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...

Read the full Boswellia Serrata monograph →
Sources

Sources & How We Checked

Perna Pro With Lemon Flavoring's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 107 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Manganese 21 references
  1. Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.
  2. Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8. PubMed
  3. Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8. PubMed
  4. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  5. Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9.. PubMed
  6. Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6.. PubMed
  7. McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507.
  8. Gerber, G. B., Leonard, A., and Hantson, P. Carcinogenicity, mutagenicity and teratogenicity of manganese compounds. Crit Rev Oncol Hematol. 2002;42(1):25-34. PubMed
  9. Jiang, Y. and Zheng, W. Cardiovascular toxicities upon manganese exposure. Cardiovasc.Toxicol 2005;5(4):345-354. PubMed
  10. Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14(4):428-430. PubMed
  11. Nemery, B. Metal toxicity and the respiratory tract. Eur Respir.J 1990;3(2):202-219. DOI
  12. Vanek VW, Borum P, Buchman A, et al. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27:440-491.doi: 10.1177/0884533612446706 PubMed
  13. Schuh MJ. Possible Parkinson's disease induced by chronic manganese supplement ingestion. Consult Pharm. 2016;31(12):698-703. doi: 10.4140/TCP.n.2016.698. PubMed
  14. Baker B, Ali A, Isenring L. Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: an analysis of the supporting evidence. Nutr Clin Pract 2016;31(2):180-5. doi: 10.1177/0884533615591600. PubMed
  15. Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15(4). pii: E783. doi: 10.3390/ijerph15040783. PubMed
  16. Yamamoto M, Sakurai K, Eguchi A, et al.; Japan Environment and Children's Study Group: Association between blood manganese level during pregnancy and birth size: the Japan environment and children's study (JECS). Environ Res 2019;172:117-26. PubMed
  17. Li D, Ge X, Liu Z, et al. Association between long-term occupational manganese exposure and bone quality among retired workers. Environ Sci Pollut Res Int 2020;27(1):482-9. PubMed
  18. Martin KV, Sucharew H, Dietrich KN, et al. Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio. Environ Res 2021;202:111644. PubMed
  19. Racette BA, Nelson G, Dlamini WW, et al. Depression and anxiety in a manganese-exposed community. Neurotoxicology 2021;85:222-33. PubMed
  20. Ruiz-Azcona L, Fernández-Olmo I, Expósito A, et al. Impact of environmental airborne manganese exposure on cognitive and motor functions in adults: a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(8):4075. PubMed
  21. Uyar E, Gurkas E, Aksu AU, et al. Can therapeutic plasma exchange be life-saving in life-threatening manganese intoxication?. Transfus Apher Sci 2022;61(4):103417. PubMed

See these in context on the Manganese monograph →

Glucosamine 58 references
  1. Adams ME. Hype about glucosamine. Lancet 1999;354:353-4. PubMed
  2. Balkan B, Dunning BE. Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats. Diabetes 1994;43:1173-9. PubMed
  3. Giaccari A, Morviducci L, Zorretta D, et al. In vivo effects of glucosamine on insulin secretion and insulin sensitivity in the rat: possible relevance to the maladaptive responses to chronic hyperglycaemia. Diabetologia 1995;38:518-24. PubMed
  4. Holmang A, Nilsson C, Niklasson M, et al. Induction of insulin resistance by glucosamine reduces blood flow but not interstitial levels of either glucose or insulin. Diabetes 1999;48:106-11. PubMed
  5. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30.
  6. Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother 1998;32:574-9.
  7. Shankar RR, Zhu JS, Baron AD. Glucosamine infusion in rats mimics the beta-cell dysfunction of non-insulin-dependent diabetes mellitus. Metabolism 1998;47:573-7.
  8. Almada A, Harvey P, Platt K. Effects of chronic oral glucosamine sulfate on fasting insulin resistance index (FIRI) in non-diabetic individuals. FASEB J 2000;14:A750.
  9. Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled trial. Lancet 2001;357:251-6.
  10. Does glucosamine increase serum lipid levels and blood pressure? Pharmacist's Letter/Prescriber's Letter 2001;17(11):171115.
  11. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
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