title: Possible Parkinson's Disease Induced by Chronic Manganese Supplement Ingestion.
abstract: OBJECTIVE
  The objective is to report a case of possible neurotoxicity resulting from an incorrect dietary supplement for osteoporosis taken at a toxic dose.
  
  
  CONCLUSIONS
  The case study examined here is a 37-year-old African-American female who consumed excessive manganese over a period of years, resulting in Parkinson's disease (PD). This patient was referred to the pharmacist pharmacotherapy service by a neurology physician. PD has been shown in the medical literature to be caused by chronic exposure to high levels of manganese. It may be concluded that daily doses of manganese well above the upper limit of 9 mg per day were taken by this patient for an extended period of time, possibly causing PD via manganism.
  
  
  CONCLUSIONS
  This case illustrates the unknown risks taken by patients who use excessive amounts of over-the-counter herbals and supplements and how pharmacists can assist patients and physicians in the proper use of these popular products.
  
  
  BACKGROUND
  AI = Adequate intake, EMS = Eosinophilia myalgia syndrome, MTM = Medication therapy management, UL = Tolerable upper limit.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Schuh
mesh_terms: D000328:Adult; D020948:Cat's Claw; D019587:Dietary Supplements / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D005052:Eucalyptus; D005260:Female; D006801:Humans; D008345:Manganese / Q000633:toxicity*; D054539:Medication Therapy Management / Q000458:organization & administration*; D010302:Parkinson Disease, Secondary / Q000139:chemically induced*; D028321:Plant Preparations / Q000008:administration & dosage / Q000009:adverse effects; D012701:Serotonin / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D028321:Plant Preparations; D012701:Serotonin; D008345:Manganese