March 22, 2017



Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Azaspirane compounds, carboxyethyl germanium sesquioxide, Ge-132, germanium citrate lactate, germanium dioxide (GeO2), germanium elixir, germanium lactate citrate, germanium salts, inorganic germanium, lactate-citrate-germanate, Mu-trioxo-bis [betacarboxyethyl] germanic anhydride, organogermanium compound, poly-trans-(2-carboxyethyl) germansesquioxane, propagermanium (3-oxygermylpropionic acid polymer), proxigermanium, proxygermanium, repagermanium, S 99 A, sanumgerman, Serocion, SG, Spiro 32, spirogermanio (Spanish), Spirogermanium 32, Spirogermanium dihydrochloride, spirogermanium hydrochloride, vitamin O.

  • Note: This monograph reviews the therapeutic benefit of organic germanium compounds, specifically spirogermanium and carboxyethyl germanium sesquioxide. Inorganic germanium compounds (germanium dioxide, germanium citrate lactate, and elemental germanium) are potentially toxic and should not be confused with organic germanium.


  • There are two general forms of germanium: organogermanium compounds, which are carbon-containing compounds (carboxyethyl germanium sesquioxide, spirogermanium, propogermanium, Ge-132); and inorganic (non-carbon containing) germanium compounds (Ge, germanium citrate lactate, germanium dioxide). In this monograph, elemental germanium is classified as inorganic. Inorganic germanium is present in all living plant and animal matter in micro-trace quantities.

  • In recent years, inorganic germanium salts and novel organogermanium compounds have been sold as nutritional supplements in some countries for their purported immunomodulatory effects or as health-producing elixirs. Bis (2-carboxyethyl germanium sesquioxide), simply called germanium sesquioxide, has been shown in animal studies to have anti-viral and immunological properties including the induction of gamma-interferon, macrophages, T-suppressor cells and augmentation of natural killer cell activity. Another organic germanium, spirogermanium (3-(8,8-diethyl-3-aza-8-germaspiro[4.5]dec-3-yl)-N,N-dimethyl-propan-1-amine), is a heavy metal compound in which germanium has been substituted in an azaspirane ring structure. The supposed therapeutic attributes of organogermaniums include: immunoenhancement, oxygen enrichment, free radical scavenging, analgesia and heavy metal detoxification. However, because of the possibility of contaminated organic germanium products on the market and several unclear and poor-quality scientific reviews, all types of germanium are currently thought of as unsafe.

  • The National Nutritional Foods Association continues to support a voluntary ban on the sale of germanium. Based on information accessed on February 2, 2007, the import alert against germanium products (see related terms) remains in effect. This import alert was created in 1988, and amended in 1995 to prevent the importation of germanium-containing products that are deemed as "poisonous and deleterious substances (PSNC)" or "unapproved new drugs (DRND)" by the U.S. Food and Drug Administration (FDA).

Scientific Evidence


These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.


Hepatitis B

There is early evidence for the use of propagermanium (an organogermanium) in the treatment of hepatitis B. Additional research is warranted in this area.


Multiple myeloma

There is early evidence for the use of propagermanium (an organogermanium) in the treatment of multiple myeloma. Additional research is warranted in this area.


*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).


The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Amyloidosis (disease), analgesia, angina, antioxidant, antiviral, arteriosclerosis (hardening of arteries), arthritis, asthma, Behcet's disease, breast cancer, burns, cancer, cancer (intestinal), carcinoma (renal cell), cardiac abnormalities, cataracts, cerebral sclerosis, cervical cancer, chemotherapy (adjuvant), chronic fatigue syndrome, circulatory disorders, corns, depressive symptoms, detoxification, diabetes, digestion disorders, eczema, epilepsy, Epstein-Barr virus, eye diseases, gastritis, glaucoma, heart attack (acute myocardial infarction), heart disease, herpes, HIV/AIDS, hypertension (high blood pressure), immune stimulant, inflammation (retina and optic nerves), influenza, leukemia, lung cancer, lupus erythematosus, lymphoma, malaria, mental disorders, neuropathy, non-Hodgkin's lymphoma, osteoporosis, ovarian cancer, Parkinson's disease, prostate cancer, radiation toxicity, Raynaud's disease, rheumatoid arthritis, schizophrenia, skin eruptions, stress, tumors, ulcers, warts.


The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

  • There is no proven safe or effective dose for germanium. For cancer, intermittent administration of germanium sesquioxide (trade name: Ge-132) 1,000 milligrams has been shown to augment natural killer cell activity for up to ten days. For Epstein-Barr virus syndrome, 150-500 milligrams daily of Ge-132 (germanium sesquioxide) has caused marked symptom relief. For advanced malignant neoplasms, spirogermanium, one type of organogermanium, had limited and acceptable toxicity in utilizing a dose of 120 milligrams per m2 infused over two hours, three times weekly however, the benefits of this dosing remain unclear.

Children (under 18 years old)

  • There is no proven safe or effective dose for germanium, and use in children is not recommended.


The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.


  • Avoid in individuals with a known allergy or hypersensitivity to germanium. Skin rash occurred in a patient taking a germanium preparation (main component was germanium dioxide with some organic compound present). There have been no available reports of allergy to germanium sesquioxide, spirogermanium or other pure organogermanium compounds.

Side Effects and Warnings

  • Pure organic germanium (germanium sesquioxide, Ge-132) is possibly safe when used at recommended doses and monitored by a qualified healthcare professional, including a pharmacist. However, more study is needed to make a firm recommendation. To date, there have been no clinical trials studying germanium sesquioxide but one available case report indicated no side effects.

  • Most trials have been conducted on spirogermanium and have reported neurotoxicity and neurologic adverse effects; although there is at least one trial that has reported no adverse effects at all. Lethargy, dizziness, ataxia, lightheadedness, visual blurring, partial loss of taste, extreme weakness, ataxia, paresthesia, nausea and grand mal seizure have occurred. Rash and diarrhea have also been reported in patients taking spirogermanium, although it is unclear whether spirogermanium was the cause. There are relatively few reports of hepatic (liver) or renal (kidney) adverse effects with spirogermanium. However, hematologic (blood) toxicity and pulmonary (lung) toxicity have been observed in patients taking spirogermanium and 5-fluorouracil. Spirogermanium is likely unsafe when taken long-term or at high doses.

  • Depression was observed in two patients receiving propagermanium.

  • Peripheral neuropathy, anemia, kidney dysfunction, kidney tubular degeneration, myopathy (muscle disease), and germanium accumulation have occurred in those who ingested marketed organic germanium contaminated with germanium dioxide, carboxyethyl germanium sesquioxide, germanium lactate citrate, and/or unspecified forms. Avoid inorganic germanium products because of potential toxic effects. Also avoid ingesting organic germanium from unregulated sellers as it may be contaminated with toxic inorganic germanium.

Pregnancy & Breastfeeding

  • High doses of germanium may result in an increased embryonic resorption, but possible malformations have been reported only after administration of dimethyl germanium oxide (GeO2; inorganic germanium) to pregnant animals. Inorganic germanium should be avoided during pregnancy, and organic germanium is not recommended because of insufficient scientific evidence. Not recommended during breastfeeding due to insufficient available scientific evidence.


Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Two toxic deaths, both attributable to neutropenia and sepsis, were reported in a phase II trial studying spirogermanium in combination with 5-fluorouracil. Significant toxicity has occurred and caution is advised.

  • Ge-132 (germanium sesquioxide) may enhance morphine analgesia in humans following both oral and intraperitoneal injection. Caution is advised.

Interactions with Herbs & Dietary Supplements

  • Insufficient available evidence.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).


Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Asaka T, Nitta E, Makifuchi T, et al. Germanium intoxication with sensory ataxia. J.Neurol.Sci. 1995;130(2):220-223. View Abstract

  2. Gerber GB, Leonard A. Mutagenicity, carcinogenicity and teratogenicity of germanium compounds. Mutat.Res. 1997;387(3):141-146. View Abstract

  3. Hirayama C, Suzuki H, Ito M, et al. Propagermanium: a nonspecific immune modulator for chronic hepatitis B. J Gastroenterol. 2003;38(6):525-532. View Abstract

  4. Ishiwata Y, Yokochi S, Hashimoto H, et al. Protection against concanavalin A-induced murine liver injury by the organic germanium compound, propagermanium. Scand.J Immunol. 1998;48(6):605-614. View Abstract

  5. Kaplan BJ, Andrus GM, Parish WW. Germane facts about germanium sesquioxide: II. Scientific error and misrepresentation. J.Altern.Complement Med. 2004;10(2):345-348. View Abstract

  6. Kaplan BJ, Parish WW, Andrus GM, et al. Germane facts about germanium sesquioxide: I. Chemistry and anticancer properties. J.Altern.Complement Med. 2004;10(2):337-344. View Abstract

  7. Kuwabara M, Ohba S, Yukawa M. Effect of germanium, poly-trans-[2-carboxyethyl] germasesquioxane on natural killer (NK) activity in dogs. J Vet.Med.Sci. 2002;64(8):719-721. View Abstract

  8. Long QC, Zeng GX, Zhao XL. Pharmacokinetics of germanium after po beta-carboxyethylgermanium sesquioxide in 24 Chinese volunteers. Zhongguo Yao Li Xue.Bao. 1996;17(5):415-418. View Abstract

  9. Luck BE, Mann H, Melzer H, et al. Renal and other organ failure caused by germanium intoxication. Nephrol.Dial.Transplant. 1999;14(10):2464-2468. View Abstract

  10. Mainwaring MG, Poor C, Zander DS, et al. Complete remission of pulmonary spindle cell carcinoma after treatment with oral germanium sesquioxide. Chest 2000;117(2):591-593. View Abstract

  11. Ming X, Yin H, Zhu Z. [Effect of dietary selenium and germanium on the precancerous lesion in rat glandular stomach induced by N-methyl-N'-nitro-N-nitrosoguanidine]. Zhonghua Wai Ke.Za Zhi. 1996;34(4):221-223. View Abstract

  12. Shamir M, Sprung CL. [Fatal multiple organ system dysfunction associated with germanium metal used in complementary therapy]. Harefuah 11-16-1997;133(10):446-7, 502. View Abstract

  13. Tao SH, Bolger PM. Hazard assessment of germanium supplements. Regul.Toxicol.Pharmacol. 1997;25(3):211-219. View Abstract

  14. Tsutsumi Y, Tanaka J, Kanamori H, et al. Effectiveness of propagermanium treatment in multiple myeloma patients. Eur.J Haematol. 2004;73(6):397-401. View Abstract

  15. Unakar NJ, Tsui J, Johnson M. Effect of pretreatment of germanium-132 on Na(+)-K(+)-ATPase and galactose cataracts. Curr Eye Res. 1997;16(8):832-837. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.


March 22, 2017