Germanium

Category

Herbs & Supplements

Synonyms

Azaspirane compounds, carboxyethyl germanium sesquioxide, Ge-132, germanium citrate lactate, germanium dioxide (GeO2), germanium elixir, germanium lactate citrate, germanium salts, inorganic germanium, lactate-citrate-germanate, Mu-trioxo-bis [betacarboxyethyl] germanic anhydride, organogermanium compound, poly-trans-(2-carboxyethyl) germansesquioxane, propagermanium (3-oxygermylpropionic acid polymer), proxigermanium, proxygermanium, repagermanium, S 99 A, sanumgerman, Serocion, SG, Spiro 32, spirogermanio (Spanish), Spirogermanium 32, Spirogermanium dihydrochloride, spirogermanium hydrochloride, vitamin O.

Note: This monograph reviews the therapeutic benefit of organic germanium compounds, specifically spirogermanium and carboxyethyl germanium sesquioxide. Inorganic germanium compounds (germanium dioxide, germanium citrate lactate, and elemental germanium) are potentially toxic and should not be confused with organic germanium.

Background

There are two general forms of germanium: organogermanium compounds, which are carbon-containing compounds (carboxyethyl germanium sesquioxide, spirogermanium, propogermanium, Ge-132); and inorganic (non-carbon containing) germanium compounds (Ge, germanium citrate lactate, germanium dioxide). In this monograph, elemental germanium is classified as inorganic. Inorganic germanium is present in all living plant and animal matter in micro-trace quantities.

In recent years, inorganic germanium salts and novel organogermanium compounds have been sold as nutritional supplements in some countries for their purported immunomodulatory effects or as health-producing elixirs. Bis (2-carboxyethyl germanium sesquioxide), simply called germanium sesquioxide, has been shown in animal studies to have anti-viral and immunological properties including the induction of gamma-interferon, macrophages, T-suppressor cells and augmentation of natural killer cell activity. Another organic germanium, spirogermanium (3-(8,8-diethyl-3-aza-8-germaspiro[4.5]dec-3-yl)-N,N-dimethyl-propan-1-amine), is a heavy metal compound in which germanium has been substituted in an azaspirane ring structure. The supposed therapeutic attributes of organogermaniums include: immunoenhancement, oxygen enrichment, free radical scavenging, analgesia and heavy metal detoxification. However, because of the possibility of contaminated organic germanium products on the market and several unclear and poor-quality scientific reviews, all types of germanium are currently thought of as unsafe.

The National Nutritional Foods Association continues to support a voluntary ban on the sale of germanium. Based on information accessed on February 2, 2007, the import alert against germanium products (see related terms) remains in effect. This import alert was created in 1988, and amended in 1995 to prevent the importation of germanium-containing products that are deemed as "poisonous and deleterious substances (PSNC)" or "unapproved new drugs (DRND)" by the U.S. Food and Drug Administration (FDA).

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Hepatitis B: There is early evidence for the use of propagermanium (an organogermanium) in the treatment of hepatitis B. Additional research is warranted in this area.
Grade: C

Multiple myeloma: There is early evidence for the use of propagermanium (an organogermanium) in the treatment of multiple myeloma. Additional research is warranted in this area.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Amyloidosis (disease), analgesia, angina, antioxidant, antiviral, arteriosclerosis (hardening of arteries), arthritis, asthma, Behcet's disease, breast cancer, burns, cancer, cancer (intestinal), carcinoma (renal cell), cardiac abnormalities, cataracts, cerebral sclerosis, cervical cancer, chemotherapy (adjuvant), chronic fatigue syndrome, circulatory disorders, corns, depressive symptoms, detoxification, diabetes, digestion disorders, eczema, epilepsy, Epstein-Barr virus, eye diseases, gastritis, glaucoma, heart attack (acute myocardial infarction), heart disease, herpes, HIV/AIDS, hypertension (high blood pressure), immune stimulant, inflammation (retina and optic nerves), influenza, leukemia, lung cancer, lupus erythematosus, lymphoma, malaria, mental disorders, neuropathy, non-Hodgkin's lymphoma, osteoporosis, ovarian cancer, Parkinson's disease, prostate cancer, radiation toxicity, Raynaud's disease, rheumatoid arthritis, schizophrenia, skin eruptions, stress, tumors, ulcers, warts.

Dosing

Adults (over 18 years old)

There is no proven safe or effective dose for germanium. For cancer, intermittent administration of germanium sesquioxide (trade name: Ge-132) 1,000 milligrams has been shown to augment natural killer cell activity for up to ten days. For Epstein-Barr virus syndrome, 150-500 milligrams daily of Ge-132 (germanium sesquioxide) has caused marked symptom relief. For advanced malignant neoplasms, spirogermanium, one type of organogermanium, had limited and acceptable toxicity in utilizing a dose of 120 milligrams per m² infused over two hours, three times weekly however, the benefits of this dosing remain unclear.

Children (under 18 years old)

There is no proven safe or effective dose for germanium, and use in children is not recommended.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to germanium. Skin rash occurred in a patient taking a germanium preparation (main component was germanium dioxide with some organic compound present). There have been no available reports of allergy to germanium sesquioxide, spirogermanium or other pure organogermanium compounds.

Side Effects and Warnings

Pure organic germanium (germanium sesquioxide, Ge-132) is possibly safe when used at recommended doses and monitored by a qualified healthcare professional, including a pharmacist. However, more study is needed to make a firm recommendation. To date, there have been no clinical trials studying germanium sesquioxide but one available case report indicated no side effects.

Most trials have been conducted on spirogermanium and have reported neurotoxicity and neurologic adverse effects; although there is at least one trial that has reported no adverse effects at all. Lethargy, dizziness, ataxia, lightheadedness, visual blurring, partial loss of taste, extreme weakness, ataxia, paresthesia, nausea and grand mal seizure have occurred. Rash and diarrhea have also been reported in patients taking spirogermanium, although it is unclear whether spirogermanium was the cause. There are relatively few reports of hepatic (liver) or renal (kidney) adverse effects with spirogermanium. However, hematologic (blood) toxicity and pulmonary (lung) toxicity have been observed in patients taking spirogermanium and 5-fluorouracil. Spirogermanium is likely unsafe when taken long-term or at high doses.

Depression was observed in two patients receiving propagermanium.

Peripheral neuropathy, anemia, kidney dysfunction, kidney tubular degeneration, myopathy (muscle disease), and germanium accumulation have occurred in those who ingested marketed organic germanium contaminated with germanium dioxide, carboxyethyl germanium sesquioxide, germanium lactate citrate, and/or unspecified forms. Avoid inorganic germanium products because of potential toxic effects. Also avoid ingesting organic germanium from unregulated sellers as it may be contaminated with toxic inorganic germanium.

Pregnancy & Breastfeeding

High doses of germanium may result in an increased embryonic resorption, but possible malformations have been reported only after administration of dimethyl germanium oxide (GeO₂; inorganic germanium) to pregnant animals. Inorganic germanium should be avoided during pregnancy, and organic germanium is not recommended because of insufficient scientific evidence. Not recommended during breastfeeding due to insufficient available scientific evidence.

Interactions

Interactions with Drugs

Two toxic deaths, both attributable to neutropenia and sepsis, were reported in a phase II trial studying spirogermanium in combination with 5-fluorouracil. Significant toxicity has occurred and caution is advised.

Ge-132 (germanium sesquioxide) may enhance morphine analgesia in humans following both oral and intraperitoneal injection. Caution is advised.

Interactions with Herbs & Dietary Supplements

Insufficient available evidence.

Attribution

This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Tracee Rae Abrams, PharmD (University of Rhode Island); Ethan Basch, M.Sc (Memorial-Sloan-Kettering Cancer Center); Heather Boon, BScPhm, PhD (University of Toronto); Mary Giles, PharmD (University of Rhode Island); Nicole Giese, MS (Natural Standard Research Collaboration); Dana A. Hackman, BS (Northeastern University); David Kiefer, MD (Bastyr University, University of Washington); Cathy DeFranco Kirkwood, MPH, CCCJS-MAC (MD Anderson Cancer Center); Lisa Scully, PharmD (Massachusetts College of Pharmacy); Kristopher Swinney, PharmD (Massachusetts College of Pharmacy - Worcester); Isabell Sylesky, PharmD (Northeastern University); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA (Natural Standard Research Collaboration); Shannon Welch, PharmD (Northeastern University).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Asaka T, Nitta E, Makifuchi T, et al. Germanium intoxication with sensory ataxia. J.Neurol.Sci. 1995;130(2):220-223.

Gerber GB, Leonard A. Mutagenicity, carcinogenicity and teratogenicity of germanium compounds. Mutat.Res. 1997;387(3):141-146.

Hirayama C, Suzuki H, Ito M, et al. Propagermanium: a nonspecific immune modulator for chronic hepatitis B. J Gastroenterol. 2003;38(6):525-532.

Ishiwata Y, Yokochi S, Hashimoto H, et al. Protection against concanavalin A-induced murine liver injury by the organic germanium compound, propagermanium. Scand.J Immunol. 1998;48(6):605-614.

Kaplan BJ, Andrus GM, Parish WW. Germane facts about germanium sesquioxide: II. Scientific error and misrepresentation. J.Altern.Complement Med. 2004;10(2):345-348.

Kaplan BJ, Parish WW, Andrus GM, et al. Germane facts about germanium sesquioxide: I. Chemistry and anticancer properties. J.Altern.Complement Med. 2004;10(2):337-344.

Kuwabara M, Ohba S, Yukawa M. Effect of germanium, poly-trans-[2-carboxyethyl] germasesquioxane on natural killer (NK) activity in dogs. J Vet.Med.Sci. 2002;64(8):719-721.

Long QC, Zeng GX, Zhao XL. Pharmacokinetics of germanium after po beta-carboxyethylgermanium sesquioxide in 24 Chinese volunteers. Zhongguo Yao Li Xue.Bao. 1996;17(5):415-418.

Luck BE, Mann H, Melzer H, et al. Renal and other organ failure caused by germanium intoxication. Nephrol.Dial.Transplant. 1999;14(10):2464-2468.

Mainwaring MG, Poor C, Zander DS, et al. Complete remission of pulmonary spindle cell carcinoma after treatment with oral germanium sesquioxide. Chest 2000;117(2):591-593.

Ming X, Yin H, Zhu Z. [Effect of dietary selenium and germanium on the precancerous lesion in rat glandular stomach induced by N-methyl-N'-nitro-N-nitrosoguanidine]. Zhonghua Wai Ke.Za Zhi. 1996;34(4):221-223.

Shamir M, Sprung CL. [Fatal multiple organ system dysfunction associated with germanium metal used in complementary therapy]. Harefuah 11-16-1997;133(10):446-7, 502.

Tao SH, Bolger PM. Hazard assessment of germanium supplements. Regul.Toxicol.Pharmacol. 1997;25(3):211-219.

Tsutsumi Y, Tanaka J, Kanamori H, et al. Effectiveness of propagermanium treatment in multiple myeloma patients. Eur.J Haematol. 2004;73(6):397-401.

Unakar NJ, Tsui J, Johnson M. Effect of pretreatment of germanium-132 on Na(+)-K(+)-ATPase and galactose cataracts. Curr Eye Res. 1997;16(8):832-837.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.