The body needs molybdenum (moh-LIB-den-um) for normal growth and health. For patients who are unable to get enough molybdenum in their regular diet or who have a need for more molybdenum, molybdenum supplements may be necessary. They are generally taken by mouth in multivitamin/mineral products but some patients may have to receive them by injection. Molybdenum is part of certain enzymes that are important for several body functions. A deficiency of molybdenum is rare. However, if the body does not get enough molybdenum, certain enzymes needed by the body are affected. This may lead to a build up of unwanted substances in some people.

Molybdenum is an essential trace mineral in animal and human nutrition. It is found in several tissues of the human body and is required for the activity of some enzymes that are involved in catabolism, including the catabolism of purines and the sulfur amino acids. Molybdenum is a transition metal with atomic number 42 and an atomic weight of 95.94 daltons. Its symbol is Mo. Compounds of molybdenum are among the scarcer constituents of the earth's crust. In fact, molybdenum is only about three times more abundant than gold. The principal ore of molybdenum is molybdenite (molybdenum disulfide). Organic forms of molybdenum are found in living matter, from bacteria to animals, including humans.

Importance of Diet

For good health, it is important that you eat a balanced and varied diet. Follow carefully any diet program your health care professional may recommend. For your specific dietary vitamin and/or mineral needs, ask your health care professional for a list of appropriate foods. If you think that you are not getting enough vitamins and/or minerals in your diet, you may choose to take a dietary supplement. The amount of molybdenum in foods depends on the soil in which the food is grown. Some soils have more molybdenum than others. Peas, beans, cereal products, leafy vegetables, and low- fat milk are good sources of molybdenum.

Uses for Molybdenum

Preliminary evidence indicates that molybdenum, through its involvement in detoxifying sulfites, might reduce the risk of sulfite-reactive asthma attacks. However, a physician should be involved in the evaluation and use with sulfite sensitivity. Molybdenum is indicated in cases of molybdenum deficiency due to prolonged use of total parenteral nutrition. Despite some epidemiological evidence showing a higher incidence of esophageal carcinoma in those who live in areas where the soil is low in molybdenum, there is as not currently any indication for the use of supplemental molybdenum in the prevention of cancer. Claims that molybdenum may help prevent anemia, dental cavities, and help in cases of sexual impotence have no credible support.

Dosage and Administration

Molybdenum supplements are usually available in the form of sodium molybdate and sometimes in the form of ammonium molybdate. Molybdenum is found in combination products, including multivitamin/multimineral formulas. A typical supplementary dose is 75-250 micrograms daily. The amounts of molybdenum on nutritional supplement labels are expressed as elemental molybdenum.

Other Studies

1. Barceloux, DG. Molybdenum. J Toxicol Clin Toxicol. 1999;37(2):231-7.

Molybdenum does not exist naturally in the pure metallic form and of the 5 oxidation states (2-6) the predominant species are Mo(IV) and Mo(VI). Molybdenum rapidly polymerizes to a wide variety of complex polymolybdate compounds in solution. The vast majority of molybdenum is used in metallurgical applications (stainless steel, cast-iron alloys). Ammonium tetrathiomolybdate is an experimental chelating agent for Wilson's disease. For the general population, the diet is the most important source of molybdenum and concentrations in water and air usually are negligible. The average daily dietary intake is about 0.1-0.5 mg m.o. Molybdenum is an essential element with relatively low toxicity. Enzymes containing molybdenum catalyze basic metabolic reactions in the carbon, sulfur, and nitrogen cycles. Elimination of molybdenum occurs via the kidney and usually is complete within several weeks. Molybdenosis (teart) is a form of molybdenum toxicity that produces a disease in ruminants similar to copper-deficiency. Little data are available on the human toxicity of molybdenum. A gout-like syndrome and pneumoconiosis have been associated with excessive concentrations of molybdenum, but the inadequate design of the studies prevents an adequate determination of the etiology of these effects.

2. Arslanoglu S, Yalaz M, Goksen D, Coker M, Tutuncuoglu S, Akisu M, Darcan S, Kultursay N, Ciris M, Demirtas E. Molybdenum cofactor deficiency associated with Dandy-Walker complex. Brain Dev. 2001 Dec;23(8):815-8.

Molybdenum cofactor deficiency is a rare and devastating disease leading to intractable seizures in the neonatal period. Severe loss of neocortical neurons, gliosis, and cystic necrosis of cerebral white matter resulting in significant cerebral volume loss are the neuropathological findings. The mechanism of cerebral injury is unknown, but sulphite excess, and sulphate or uric acid deficiencies are possible factors. We present here a new case of Molybdenum cofactor deficiency associated with Dandy-Walker complex with a history of three dead siblings, the latter also having Dandy-Walker malformation. We speculate that severe cerebral volume loss due to the above mentioned mechanisms may lead to an appearance resembling Dandy- Walker malformation.

3. Chan S, Gerson B, Subramaniam S. The Role of Copper, Molybdenum, Selenium, and Zinc in Nutrition and Health. Clin Lab Med. 1998 Dec;18(4):673-85.

Copper, zinc, selenium, and molybdenum are involved in many biochemical processes supporting life. The most important of these processes are cellular respiration, cellular utilization of oxygen, DNA and RNA reproduction, maintenance of cell membrane integrity, and sequestration of free radicals. Copper, zinc, and selenium are involved in destruction of free radicals through cascading enzyme systems. Superoxide radicals are reduced to hydrogen peroxide by superoxide dismutases in the presence of copper and zinc cofactors. Hydrogen peroxide is then reduced to water by the selenium- glutathione peroxidase couple. Efficient removal of these superoxide free radicals maintains the integrity of membranes, reduces the risk of cancer, and slows the aging process. On the other hand, excess intake of these trace elements leads to disease and toxicity; therefore, a fine balance is essential for health.

Trace element--deficient patients usually present with common symptoms such as malaise, loss of appetite, anemia, infection, skin lesions, and low-grade neuropathy, thus complicating the diagnosis. Symptoms for intoxication by trace elements are general, for example, flu-like and CNS symptoms, fever, coughing, nausea, vomiting, diarrhea, anemia, and neuropathy. A combination of observation, medical and dietary history, and analyses for multiple trace elements is needed to pinpoint the trace element(s) involved. Serum, plasma, and erythrocytes may be used for the evaluation of copper and zinc status, whereas only serum or plasma is recommended for selenium. Whole blood is preferred for molybdenum. When trace element levels are inconsistent with medical evaluations, a test for activity of the suspected enzyme(s) would support the differential diagnosis. Furthermore, it is important to differentiate whether trace element deficiency or toxicity is the primary cause of the disorder, or is secondary to other underlying diseases. Only successful treatment of the primary disorder will lead to complete recovery. In the event of sample contamination during collection or analysis, the physician may be misled by falsely elevated results. Royal blue top evacuated tubes containing negligibly low concentrations of the trace element or acid-washed plastic sterilized syringes should be used for blood, serum, or plasma collection. Powdered gloves must be avoided. When possible, mineral supplements are not to be administered to the patient for a minimum of 3 days prior to sample collection. Serum and plasma specimens are to be transported in acid-washed polypropylene and polyethylene tubes.

Analysis is performed in a controlled environment to minimize or eliminate contamination. During analysis, all laboratory wares should be acid-washed for decontamination. A detailed description of these precautions may be found in reviews by Aitio and Jarvisalo and by Chan and Gerson. Copper and zinc analysis on serum and plasma are commonly performed by flame atomic absorption spectrometry, inductively coupled plasma-atomic emission spectrometry, and inductively coupled plasma-mass spectrometry. Serum and plasma selenium levels are determined by graphite furnace atomic absorption with Zeeman background correction and neutron activation analysis. Molybdenum levels are best determined by neutron activation and highly sensitive inductively coupled plasma-mass spectrometry. The reader is referred to reviews by Tsalev and Jarvis.

4. Welman A Shrader, Jr. Short and Long Term Treatment of Asthma with Intravenous Nutrients. Nutr J. 2004; 3: 6.

Asthma is an increasing problem in this country and others. Although medications for the treatment of asthma abound and are improving, there are inherent risks and side effects with all of them. Intravenous magnesium has been employed in the treatment of acute asthma, but its use has not become universal, nor has it been studied for the treatment of chronic asthma. It is known to be a safe drug with minimal side effects. In this study, the author investigates the use of magnesium and other nutrients in the treatment of both acute and chronic asthma.

In this non-blinded outcome study, following informed consent, forty-three randomly selected volunteer patients with both acute and chronic asthma were treated with IV infusions described herein. All patients were observed with spirometry 10 minutes post-infusion; two sub-groups of patients were also observed after multiple infusions over a short period of time (less than one month) and a longer period of time (average 5.8 months). Pulmonary function was analyzed by spirometric testing with pre- and post-infusion spirometric measurements with the pre/post group. For longer term (Trend) patients, baseline spirometry measurements were compared to spirometry measurements after patients had received multiple infusions over a period of time. Eight patients were measured for both pre/post and Trend data.

The 38 pre-infusion/post-infusion patients with acute and chronic asthma demonstrated an overall average improvement (percentage improvement in percent predicted) of 45%. The 13 patients measured for improvement over time (Trend data, average duration 5.82 months), demonstrated an overall average improvement (percentage improvement in percent predicted) of 57%. Of the 13 patients in the multiple infusion group, 9 patients who received longer-term therapy (average duration of 12.58 months) for chronic asthma demonstrated an overall average improvement of 95% (percentage improvement in percent predicted).

The use of intravenous treatment with multiple nutrients, including magnesium, for acute and chronic asthma may be of considerable benefit. Pulmonary function improved progressively the longer patients received treatment.

Asthma has become increasingly more difficult to treat. Several studies indicate the mortality of asthma is higher and that the incidence of status asthmaticus patients seen in emergency rooms has increased. Despite many newer drugs for asthma, people are dying more frequently from this illness. In view of these rather grim realizations and statistics, the author has undertaken research of a modality in an attempt to mitigate the effects of asthma. A most promising treatment appears to be intravenous therapy with magnesium and other nutrients, both for the acute and chronic illness.

The use of IV parenteral nutrient therapy for asthma was begun in the author's office in the late 1980's, soon after the first papers appeared in the literature involving the use of IV magnesium for the treatment of acute asthma. Many papers have followed since then, but they have concentrated primarily on intravenous magnesium, usually in the sulfated form. Most of these authors have found that magnesium sulfate, via IV infusion, is beneficial for the treatment of asthma, and often extremely so. However, not all study results have been positive. This may have been due to the way the infusions were administered, the dose employed, or other factors such as severity of disease.

This study began with a total of 49 patients who came to the author's clinic for treatment from 1989 through 1998. These patients all had moderate to severe (steroid- dependent) asthma, and all required one or more medications for asthma. Patients were asked to volunteer for the study, and all signed appropriate informed consent documents. Not all patients treated in the clinic volunteered for the study, and no patient who volunteered was excluded unless therapy appeared to fail.

During the study, 6 patients showed no initial response to the first treatment. These 6 patients were considered non-responders and were not included in the data pool in this study, since there was no measurable improvement with a trial infusion. Forty -three (43) patients of mixed Caucasian descent were eventually enrolled, consisting of 16 males and 27 females, with a combined average age of 53 years.Patients evaluated for pre- and post infusion results were given the IV "Push" protocol indicated in Table 1. These patients were evaluated at random times at the clinic; some were in mild to moderate distress. This IV was administered by a nurse with a 35 cc BD syringe and a 23-25 gauge butterfly needle attached, with the amount of sterile water indicated. The IV Push infusions were administered over 10-15 minutes, rapidly enough to cause the patient to experience some sensation of warmth and flushing, but not rapidly enough to cause significant hypotension. Patients in the longer-term group ("Trend") were given one Push protocol initially. Subsequent to this, the "Infusion" protocol was given as an IV infusion in 250 cc of Sterile Water, generally over 45-60 minutes. Sterile Water was used to keep osmolarity in tolerable ranges. Of the thirteen patients in trend group, eight were also evaluated in the pre/post group, while five were evaluated only for Trend data. In the Trend group, the pre/post data was taken from the initial IV session.

Although there were no age-matched control patients in this outcome study, and certainly uncontrolled variables, considerable improvement was observed after parenteral infusion therapy with multiple nutrients, both for pre/post treatment and treatment over time. There was more pronounced improvement after longer-term treatment. Patients who received treatment for longer than a month fared considerably better than those who stopped therapy within a month or less.

Patients experienced rapid clinical relief during or at some time after most infusions, depending on their degree of distress, and as the data demonstrates, pulmonary function improved overall during the sequential infusion study. It would also appear that the effectiveness of this type of therapy might be cumulative, as patients appeared to require treatment less often as time passed. Drug usage was decreased in all patients, and discontinued or reduced to intermittent use in over half of the patients studied.

The primary reason mixed nutrients were employed in this study is that prior to this study the author had observed that the effect of a combination of nutrients was consistently more beneficial than the infusion of IV magnesium sulfate alone. Patients given magnesium (sulfate) alone also seemed to develop a more rapidly increasing tolerance for (or resistance to) magnesium, and pulmonary function did not improve nearly as significantly as were those of patients who were given the complete protocols. Therefore, infusions of magnesium sulfate alone, without other nutrients added, was not employed in this study.

It has been demonstrated previously that intravenous infusions with magnesium sulfate appear to be more effective that nebulized albuterol alone, and it has also been demonstrated that intravenous magnesium may be successful when all other more "traditional" interventions, including corticosteroids, have failed. Considering this, the results of this study came as no surprise to the author.

There are numerous metabolic and biochemical explanations as to why each of the specific nutrients added might indeed provide more benefit for asthmatics than magnesium sulfate alone. For example, Vitamin C is known to have a general antihistaminic effect, it decreases bronchial responsiveness overall and bronchial responsiveness to histamine in patients with allergic rhinitis. Vitamin C is also a potent free radical scavenger, and free radicals are known to play a role in the cause of airway obstruction attendant with asthma.

Trace minerals also mitigate the inflammatory response, perhaps because they play a major role in the anti-oxidation of free radicals. Further, manganese has been found deficient in bronchial biopsies of asthmatic patients, indication manganese replenishment could aid in the treatment of asthma.Lastly, zinc is an essential trace mineral for most immune mechanisms in the body to function, including lymphocyte (T- cell) function.

This reasoning could partly explain why the patients in this study who received longer-term therapy with infusions fared best. Molybdenum, as Wright's study demonstrated, may be a significant part of the long-term benefit. Indeed, those patients who received an average of less than one infusion monthly for over a year fared almost three times as well as those who received infusions for a month or less.

Over the period of this study, the author observed that 6 of 44 asthmatic patients appeared to fail with this particular type of infusion therapy. These 6 patients, however, were judged as failures prior to any patient having received three IV treatments. Since this study was undertaken, the author has found that it sometimes takes 3 to 5 infusions for patients to observe a substantial clinical benefit. Therefore, actual failure may be in question.

Shortly after this study was first begun, it became clear that patients who received weekly or more frequent therapy with these parenteral nutrients for a period of 1 1/2 to 3 months improved more rapidly and distinctly than patients who received only occasional infusions. It also became evident that this group of patients was able to extend the interval between treatments to 8-14 days and then longer. Several patients were able to extend their intervals out as far as 4-6 months with little apparent loss of efficacy.

It was also often observed that patients with acute asthma sometimes did not improve immediately, or even appeared to worsen immediately after an infusion. This is very likely secondary to the acute bronchodilitation resulting from this treatment, with resultant mucous production (release) and coughing. Studies have shown that optimal pulmonary function is likely to occur considerably later than 10 minutes after an infusion of magnesium, even out to perhaps 80-110 minutes [10]. The author's experience supports this observation and it is likely that the post-infusion measurements in this study were usually taken before the maximum benefit occurred.

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