History & Overview Annual Report President's Pages Center News Community Affairs
Make a Gift Cycle for Survival Fred's Team Rock & Run on the River Yankees Universe Fund Thomas Blake Sr. Memorial Research Fund Donating Blood & Platelets Volunteering Thrift Shop Park Avenue Potluck CELEBRATIONS
Press Releases In the News Information for Journalists News@MSKCC
Manhattan New Jersey Long Island Westchester
Working at Memorial Sloan-Kettering Work Sites College Recruitment About Nursing Job Fairs & Career Days IS Careers Job Search & Apply Online
Making an Appointment
Search About Herbs:

Germanium

How It Works

Bottom Line: Germanium (also called spirogermanium) is NOT an effective treatment for cancer, HIV, or any other medical condition. It has caused severe side effects and death.

Germanium is a naturally occurring element that can be found in foods such as shittake mushrooms, garlic, tuna, and tomato juice. It is not classified as an essential nutrient for human health, but it is actually not known whether the body's physiological processes require germanium. No humans have ever suffered from germanium deficiency, indicating that it may not be essential. Germanium may be an antioxidant, neutralizing free radicals that can damage DNA and cells. In laboratory experiments, a derivative of germanium called spirogermanium has been shown to inhibit replication in certain cancer cells, but this anti-cancer activity has not been shown in human studies.

Purported Uses

  • To treat arthritis
    No scientific evidence supports this use.
  • To treat cancer
    Clinical trials do not support this use.
  • To maintain general health
    No scientific evidence supports this use.
  • To treat HIV and AIDS
    No scientific evidence supports this use.

  • Research Evidence

    Cancer treatment:
    In the early 1980s, several clinical trials tested germanium against various cancers. A large number of patients in these trials developed serious toxic side effects such as kidney, liver, and nerve damage. At the present time, nine people have died from the toxic effects of germanium supplements.

    In 1984, a phase I trial was conducted to find the highest dose of intravenous germanium that could be given to cancer patients without toxic side effects. Fifteen patients with various cancers (leukemia, lymphoma, Hodgkin's disease, ovarian, colon, lung, and head/neck) enrolled in the study. All of the doses, even the lowest, caused toxic side effects, including phlebitis (vein inflammation) and neurologic effects (stuttering, confusion, tremors, and hallucinations). None of the patients experienced improvement of their condition while taking germanium, indicating that treatment with this supplement may not be worth its toxic effects.

    The Eastern Cooperative Oncology Group (ECOG) conducted a clinical trial of germanium in the treatment of lymphoma or Hodgkin's disease in 1986. Twenty-five patients enrolled; all had undergone at least one prior course of chemotherapy. The patients received 80 mg/m2 of spirogermanium intravenously three times a week for two weeks. Cancer progressed in most patients within a few weeks. Toxic side effects were common, which prompted the ECOG to recommend that no future studies be conducted with germanium.

    Warnings

  • Because of the frequency of toxic side effects such as kidney, liver, and nerve damage, germanium supplements should not be used, even at low doses.
  • This supplement may cause the following changes to lab tests: elevated liver enzymes, increased serum creatinine, decreased blood counts, and elevated creatinine phospho kinase (CPK).
  • This product is regulated by the FDA as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. The product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.

  • Side Effects

  • Weight loss
  • Fatigue
  • Nausea and vomiting
  • Loss of appetite
  • Anemia
  • Muscle weakness
  • Abnormal sensations such as numbness, burning, tingling, or prickling
  • Sensory ataxia (failure of muscle coordination)
  • Less frequent side effects of germanium include chronic kidney failure, elevated liver enzymes, fatty degeneration of the liver, peripheral nerve problems, cerebellar ataxia, and slowed growth of the bone marrow.

  • Common Name

    Inorganic germanium, germanium dioxide (GeO2), spirogermanium, carboxyethylgermanium sesquioxide (Ge-132), germanium sesquioxide, germanium-lactate-citrate (Ge-lac-cit), organogermanium, germanium elixir

    Clinical Summary

    Germanium is a naturally occurring element. It is promoted for treating cancer, HIV, and AIDS. Supplementation with germanium has resulted in renal, hepatic, myelogenous, and neurologic toxicities. To date, 9 deaths have been reported in the literature from as little as 15 grams cumulative dose (2) (3) (6) (7). Limited clinical research has been conducted in humans. The toxicity risk from germanium supplements outweighs any benefit.

    Food Sources

    Shittake mushrooms, garlic, tuna, pan fish, tomato juice
    (2)

    Purported uses

  • Arthritis
  • Cancer treatment
  • Health maintenance
  • HIV and AIDS

  • Mechanism of Action

    Germanium has chemical properties similar to tin, silicon, and arsenic. It is unknown whether germanium is an essential ultra-trace element for humans; no cases of germanium deficiency are known to have occurred. The atomic structure of germanium allows it to act as a free-radical scavenger (1). Neuronal activity may be due to suppression of catecholamines and stimulation of serotonin. Spirogermanium has been shown to inhibit DNA and RNA synthesis in HeLa cells (2).

    Pharmacokinetics

    Absorption:
    Oral administration of germanium dioxide (GeO2) to rats demonstrates approximately 95% bioavailability. Organic radiolabeled germanium (Ge-132) has repeatedly been shown to have 30% bioavailability in humans and animal models.
    Distribution:
    Extensive throughout body, but detectable levels in tissue vary based on dose and frequency of administration. Can be detected in blood, lung, and spleen with preferential accumulation in liver and kidneys.
    Elimination:
    Excreted primarily by the kidneys.
    (3)

    Warnings

    Germanium supplements should not be consumed due to concerns of renal, hepatic, and neurotoxicity. Although acute toxicity studies in animals reveal low potential for toxicity, low-dose chronic toxicity has been demonstrated repeatedly. Renal toxicity is characterized by vacuolar degeneration in renal tubular epithelial cells, without proteinuria or hematuria, in the absence of glomerular changes (2) (7).

    Contraindications

    Patients with a history of seizures should not take germanium.

    Adverse Reactions

    Common: Weight loss, fatigue, nausea, vomiting, anorexia, anemia, muscle weakness, paresthesias, and sensory ataxia (1).
    Rare: Chronic renal failure, elevated liver enzymes, hepatic steatosis, peripheral neuropathies, cerebellar ataxia, and bone marrow hypoplasia (4) (5) (6).

    Herb-Drug Interactions

    Theoretically, may have additive toxicity with other drugs known to cause renal (e.g. aminoglycosides), hepatic, or neurotoxicity (e.g. taxanes), or myelosuppression.

    Lab Interactions

    Elevated liver enzymes, increased serum creatinine, decreased blood counts, and elevated creatinine phospho kinase (CPK).

    Literature Summary and Critique

    Many clinical trials evaluating spirogermanium for various cancers were conducted in the early 1980s. A significant incidence of renal, hepatic, and neurological toxicity was documented. To date, 31 case reports of toxicity, including 9 deaths, have been published.

    References

    1. Goodman S. Therapeutic effects of organic germanium. Med Hypotheses 1988;26:207-15.
    2. Schauss AG. Nephrotoxicity and neurotoxicity in humans from organogermanium compounds and germanium dioxide. Biol Trace Elem Res 1991;29:267-79.
    3. Tao SH, Bolger PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol 1997;25:211-9.
    4. Asaka T, et al. Germanium intoxication with sensory ataxia. J Neurol Sci 1995;130:220-3.
    5. van der Spoel JI. Dangers of dietary germanium supplements. Lancet 1990;336:117.
    6. Krapf R, Schaffner T, Iten PX. Abuse of germanium associated with fatal lactic acidosis. Nephron 1992;62:351-6.
    7. Boros L, et al. Phase II Eastern Cooperative Oncology Group study of spirogermanium in previously treated lymphoma. Cancer Treat Rep 1986;70:917-8.
    8. Woolley PV, et al. A phase I trial of spirogermanium administered on a continuous infusion schedule. Invest New Drugs 1984;2:305-9.

    Last Updated: Mar. 18, 2009
    E-mail your questions and comments to aboutherbs@mskcc.org.
    Bookmark and SharePrintEmail This Page