[Aurornis]

> So I'm guessing that you could survive weeks in a severe-manganese-deficiency situation before you noticed any ill effects.

Your guess would be wrong. Your body needs manganese for similar reasons that Lyme disease needs it. You also produce MnSOD.

If you starved your body of manganese sufficiently (which I doubt you could do without eating a completely synthetic diet for months) then you'd be killing yourself in parallel with the Lyme disease.

[btilly]

The idea is not trivially wrong. It's the same idea as chemotherapy. Sure, it is a poison for you. But it hits the cancer harder than you, and so can also be an effective treatment.

That said, it is very unlikely that simply reducing manganese is preferable to existing antibiotics. But that doesn't rule out the potential effectiveness of a combination therapy.

Here is how we'd do that combination therapy. We'd mix a standard antibiotic with oral para-Aminosalicylic acid (PAS). Orally delivered PAS is the the standard treatment for treating excess manganese in humans. (Sorry, but you're dead wrong about needing a completely synthetic diet for months.) While PAS does harm a few kinds of stomach bacteria, it is far better than a broad spectrum antibiotic. And if the target disease is under stress already, then you need less antibiotic to finish them off.

Sure, a medicine that targets manganese in Lyme disease bacteria would be even better than this combination. But that medicine does not exist. And the combination in question is something that can be experimented with today, using drugs that have already been approved by the FDA.

Furthermore this is a combination that we already have a lot of experience with. Back in the 1950s, a variation on this, working on the same principles, was the standard treatment for tuberculosis. It was abandoned not because it was ineffective, but because we developed treatments with fewer side effects.

[Aurornis]

> Here is how we'd do that combination therapy. We'd mix a standard antibiotic with oral para-Aminosalicylic acid (PAS).

I responded to your comment above with this same claim. I cannot find any sources that say reducing manganese was the mechanism of PAS in TB.

A recent research paper on PAS in TB doesn't even mention manganese once. It identifies Dihydrofolate Reductase related actions as the mechanism against TB: https://pmc.ncbi.nlm.nih.gov/articles/PMC5395024/

> orally delivered PAS is the the standard treatment for treating excess manganese in humans.

EDTA has been the standard treatment. PAS has been explored and trialed. It can be used, but I don't know if I'd call it the "standard" treatment.

> (Sorry, but you're dead wrong about needing a completely synthetic diet for months.)

I was talking about a low-manganese diet, which the comment above me suggested. I don't know why you're so set on calling me "dead wrong" so much when you can't provide sources and aren't even reading what I'm writing.

> While PAS does harm a few kinds of stomach bacteria, it is far better than a broad spectrum antibiotic. And if the target disease is under stress already, then you need less antibiotic to finish them off.

You're really going to have to provide sources for PAS reducing manganese as a mechanism for fighting TB.

As I pointed out in my other comment, manganese is an essential cofactor for one of the other anti-TB drugs in the triple combination that was used in the past.

[kragen]

This is fascinating, thanks!

[kragen]

You could probably add enough phosphate to all your food to prevent you from absorbing any manganese, then inject iron, calcium, and magnesium? Just guessing here.

How long would it take you to die on a zero-manganese diet? If it's longer than it takes Borrelia, you still win!

[btilly]

As noted in my sibling comment, the standard of care for eliminating manganese is para-Aminosalicylic acid (PAS).

Plenty of other treatments can remove manganese. But they all are biologically active in other unwanted ways.

[butvacuum]

You would die. Immediately, and screaming in agony.

[btilly]

That's stupidly wrong.

I regularly find myself on a zero manganese diet for hours at a time, and I've yet to experience immediate death, screaming in agony.

Furthermore we have lots of data on how well humans can tolerate extended low manganese regimens. The standard treatment course for TB in the 1950s resulted in humans having low manganese for 1-2 years. This was unpleasant, but not lethal.

[Aloisius]

Source? I can't find anything about the standard treatment course for TB in the 1950s resulting in low manganese.

[btilly]

See https://pmc.ncbi.nlm.nih.gov/articles/PMC4407437/ to verify that PAS was used.

Any google search on PAS and manganese will show that it eliminates manganese from the body by chelating it, and is therefore used for treating manganese toxicity.

I don't have a specific reference for manganese levels in people undergoing the old TB treatment. But I'm sure that it should exist somewhere.

[Aurornis]

> I don't have a specific reference for manganese levels in people undergoing the old TB treatment. But I'm sure that it should exist somewhere.

You've spread this claim throughout the comment section and called others "dead wrong", yet even you can't find a reference to support it?

The mechanism of PAS in TB is not manganese reduction: https://pmc.ncbi.nlm.nih.gov/articles/PMC5395024/

[Aurornis]

I wrote more above, but I cannot find anything to support this claim about PAS being used because it reduces manganese either.

The mechanism of action of PAS against TB is in the Dihydrofolate Reductase pathway: https://pmc.ncbi.nlm.nih.gov/articles/PMC5395024/

I can only guess that this commenter saw that PAS can also be used for manganese chelation and jumped to conclusions?