Germanium is a semiconductor element that is present in trace amounts in the human body (with an estimated total body germanium content of approximately 50mg), and it is found primarily in the blood, the liver, and the kidneys, where it is thought to function as an oxygen radical scavenger and as an immunomodulatory compound. The biological functions of germanium are not well characterised by modern nutrition science — the element was popularised as a therapeutic compound in the 1980s and 1990s by the Japanese researcher Kazuhiko Asai, who claimed that germanium (particularly the organic germanium compound Ge-132, the bis-carboxyethyl germanium sesquioxide) had remarkable health benefits, including the immune enhancement, the oxygen radical scavenging, the antiviral effects, and the anti-tumour activity. While the extraordinary claims made by Asai and by the proponents of the germanium therapy have not been substantiated by rigorous clinical trials, the evidence from in vitro studies and from animal models suggests that germanium does have oxygen radical scavenging activity and immunomodulatory effects — and that its deficiency may contribute to the oxidative stress, the immune dysfunction, and the chronic fatigue that are the hallmarks of the germanium deficiency syndrome.
Germanium and the Oxygen Radical Scavenging
Germanium is thought to function as an oxygen radical scavenger by virtue of its semiconductor properties — the germanium atom can donate electrons to the reactive oxygen species (ROS) and neutralise them before they can damage the cells and the tissues. This electron-donating capacity of germanium is analogous to the electron-donating capacity of the other antioxidants (including vitamin C, vitamin E, and the polyphenols), and it suggests that germanium may act as a supplementary antioxidant in the body — protecting the cells from the oxidative damage that is caused by the ROS that are generated by normal cellular metabolism, by the environmental toxins, and by the inflammatory response. However, the evidence for the in vivo oxygen radical scavenging activity of germanium is limited — most of the studies have been conducted in cell culture or in animal models, and the relevance of these findings to human health is uncertain. The germanium supplementation in humans has not been shown to have consistent antioxidant effects in the clinical trials that have been conducted to date.
The clinical importance of the germanium for the immune function is underscored by the observation that the germanium deficiency is associated with the immune dysfunction, the chronic fatigue, and the chronic pain — symptoms that are also associated with the oxidative stress and with the mitochondrial dysfunction. However, the germanium deficiency has not been well characterised in humans — there are no established diagnostic criteria, no known health consequences of a low germanium intake, and no known dietary requirement for germanium. The germanium is present in trace amounts in a wide variety of foods (including the whole grains, the vegetables, the fruits, the legumes, the nuts, and the fish), and the dietary germanium intake is generally adequate for the maintenance of the normal germanium status. The supplementation of germanium is therefore not recommended for the general population — the claims of the immune enhancement and the anti-tumour activity have not been substantiated by rigorous clinical evidence, and the high-dose germanium supplementation (particularly with the inorganic germanium compounds) has been associated with the kidney toxicity and the neurological damage.
Germanium and the Anti-Inflammatory Effects
The organic germanium compound Ge-132 has been studied in cell culture and in animal models for its anti-inflammatory effects — it has been shown to inhibit the COX-2 expression and to reduce the production of the prostaglandin E2 (PGE2) in the activated macrophages, and to inhibit the NF-kappaB activation and the inflammatory cytokine production in the other cell types. These anti-inflammatory effects are thought to be mediated by the modulation of the oxygen radical-dependent signalling pathways (particularly the ROS-dependent activation of the NF-kappaB and the AP-1 transcription factors), and they are consistent with the hypothesis that germanium acts as an oxygen radical scavenger in the cells. However, the anti-inflammatory effects of the Ge-132 have not been demonstrated in rigorous clinical trials in humans, and the relevance of these findings to the management of the inflammatory conditions is uncertain.
Practical Application
For general germanium supplementation, the evidence-based approach is to obtain the germanium from the dietary sources (whole grains, vegetables, fruits, legumes, nuts, fish) rather than from the supplements, because the dietary germanium intake is generally adequate for the maintenance of the normal germanium status and because the safety of the long-term germanium supplementation has not been established. The organic germanium compound Ge-132 is available as a supplement, but it is not recommended for the general use because the claims of the immune enhancement and the anti-tumour activity have not been substantiated by rigorous clinical evidence and because the high-dose germanium supplementation has been associated with the kidney toxicity and the neurological damage. For comprehensive immune and antioxidant support, germanium pairs well with the other antioxidants (vitamin C, vitamin E, the polyphenols) that work synergistically to neutralise the ROS and to protect the cells from the oxidative damage, with the selenium (which is required for the glutathione peroxidase enzyme and which works synergistically with the antioxidant network), and with the zinc (which is required for the normal development and the function of the immune cells).
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