Mannitol, also known as manna sugar, is a colorless, sweet sugar alcohol. A sweetener produced by plants, its name is derived from the word manna, which was the bread from heaven that God provided for the Israelites. Mannitol is made from fructose and hydrogen and can also be produced artificially. It is a high-intensity sweetener commonly used as a sugar substitute. If you put it on your finger it tastes like sugar.1,2
The Food and Drug Administration (FDA) has approved mannitol as a diuretic, a sweetener for diabetics and others with sugar intolerance. It is also used as a surgical rinsing agent. It has nearly no calories when added to foods and does not promote tooth decay or cause a spike in blood glucose.
According to the Journal of Biological Chemistry, mannitol is used to sweeten candy, jams and jellies, pudding and powdered drink mixes, and is used as the dusting powder you can find on a piece of chewing gum and in chewable pharmaceutical tablets.3
The science behind mannitol
Injected mannitol and mannitol-laced foods were evaluated for their effect on symptoms of Parkinson’s disease (PD) in the lab. It is thought that combining mannitol with other PD medications may facilitate the ability of treatments to get more easily to the targeted sites by crossing the blood/brain barrier.1,2
Scientists tested different concentrations of mannitol in a solution of alpha-synuclein. They then evaluated the levels of clumping. They found that low levels of mannitol had the strongest effect in inhibiting the formation of clusters.
Why is it of interest to those with PD?
Mannitol appears to prevent or reduce the clumping of proteins in the brain, including alpha-synuclein. It has the ability to cross the blood-brain barrier. Clumped proteins are a hallmark characteristic of Parkinson’s disease. Clinical research performed at Tel Aviv University on fruit flies and mice showed promise in destabilizing clumping proteins. By inhibiting the formation of clusters, mannitol destabilizes the proteins.4
Is mannitol safe for me?
Mannitol has approved uses. It is generally recognized as safe (GRAS) used as a food additive, and is incorporated into numerous categories of food products and medications. It increases blood glucose to a lesser extent than sucrose, so it’s most commonly used as a sweetener.
It also has medical uses. Mannitol is an approved osmotic diuretic used to treat increased pressure within the skull. There are side effects and risks. It can have the effect of drawing water from the intestinal wall. Taking in too much water, it can cause diarrhea, abdominal pain, and gas. It has also been associated with heart failure, electrolyte abnormalities, and low blood volume.
Does mannitol hold promise as a treatment?
There is no strong evidence to support that mannitol improves Parkinson’s symptoms, but many swear by it. Mannitol can be bought online as a food supplement, called a nutriment. It is widely available and already being individually tested by many with PD. People with Parkinson’s can sign up for registries to get mannitol products and have the opportunity to report their findings in various forums supported by manufacturers and suppliers. The self-reports are that people feel better, clearer and improve motor symptoms.
Human clinical studies on the efficacy of mannitiol in PD could take many more years to get approved. At this point, there isn’t enough interaction research to anticipate the effect mannitol may have on the absorption of L-dopa and other Parkinson’s disease medications. As always, remember to talk to your doctor before making any changes to your medications or taking any kind of supplement.
Manna from Heaven? Manna and Parkinson's disease. The Science of Parkinson's disease website. Published May 10, 2016. https://scienceofparkinsons.com/2016/05/10/manna-from-heaven-mannitol-and-parkinsons-disease/. Accessed online February 17, 2018.
Ferro, S. Common Sweetener Could Help Treat Parkinson's Disease. Published June 18, 2013. https://www.popsci.com/science/article/2013-06/artificial-sweetener-could-help-treat-parkinsons-disease. Accessed online February 17, 2018.
Mannitol - A natural food supplement shown to arrest Parkinson's progression and reverse symptoms. Published May 2016. https://www.fight-parkinsons.org/wp-content/uploads/2016/05/Mannitol.pdf. Accessed online February 16, 2018.
High Intensity sweeteners. Published May 19, 2014. U.S. Food and Drug Administration. https://www.fda.gov/food/ingredientspackaginglabeling/foodadditivesingredients/ucm397716.htm