How is manganese eliminated normally?

• A. Manganese is almost exclusively excreted via the hepatobiliary system
• B. Manganese is excreted by the kidneys
• C. Manganese is excreted via the lungs
• D. Manganese is excreted via the skin

Answer: (A)

Manganese is eliminated mainly through the liver via the hepatobiliary system, meaning it is excreted into bile and then eliminated in feces. A smaller amount is cleared by the kidneys, but this is not the primary route. The lungs and skin are not major elimination pathways under normal conditions. In liver disease, reduced biliary excretion can lead to manganese accumulation, illustrating why the hepatobiliary route is the key pathway for normal elimination.