Home Ingredients Germanium (Organic Germanium, Ge-132)

Germanium (Organic Germanium, Ge-132)

Evidence Level
Preliminary
6 Clinical Trials
5 Documented Benefits
1/5 Evidence Score

Germanium is a trace element found in small amounts in soil and food, but it is not an essential nutrient: no human requirement or deficiency has been shown. Supplements have been sold as germanium sesquioxide (Ge-132), germanium-enriched yeast and, in the past, inorganic germanium dioxide. Safety is the main issue. Published case series link long-term use of germanium products to kidney failure and deaths, many of them involving germanium dioxide or products contaminated with it, and kidney function often did not fully recover. The FDA calls germanium a nonessential element that has caused kidney injury and death and may detain imported germanium supplements at the border. Human studies of organic germanium are few and short and measure immune lab markers rather than health outcomes. Propagermanium, a related compound, is a prescription drug in Japan and not a supplement.

Studied Dose No established dose or requirement. Studies used Ge-132 at 1000 mg/day for 10 days, single doses of 1 to 4 g/m2 in volunteers, and a germanium yeast product at 1200 mg/day for 8 weeks. The Japanese drug propagermanium was tested at 30 to 90 mg/day.
Active Compound Germanium, a nonessential trace element. Supplement forms include germanium sesquioxide (Ge-132, also called carboxyethylgermanium sesquioxide), germanium-enriched yeast, and inorganic germanium dioxide; propagermanium is a related Japanese prescription drug.

Benefits

Natural killer cell activity in an 8-week trial of germanium-enriched yeast

In 130 Korean adults, 1200 mg a day of a germanium-enriched yeast product for 8 weeks raised natural killer cell activity in a lab assay while it fell on placebo. Activity started lower in the germanium group, IgG1 only fell less than on placebo, and no infection or health outcomes were measured. The maker funded the trial.

Supported by Trial 1

Natural killer cell activity during short courses of Ge-132

In 18 people with cancer in Japan, Ge-132 at 1000 mg a day raised natural killer cell activity by day 3, but with daily dosing it had dropped in all of them by day 10. There was no control group and no clinical outcome, so this is a lab marker finding only.

Supported by Trial 2, Trial 1

How the body absorbs and clears Ge-132

In 24 healthy volunteers given one oral dose of Ge-132, blood germanium peaked within 2 hours and fell with a half-life of about 5 to 6 hours, and only 6 to 11% of the dose appeared in urine over 24 hours. These were single doses, so the study says nothing about long-term safety or benefit.

Supported by Trial 3

Organic and inorganic germanium in animal kidney studies

In rats, 24 weeks of germanium dioxide caused kidney tubule damage that kept progressing after it was stopped, while Ge-132 caused no kidney changes. A 90-day rat study of purified germanium sesquioxide found no adverse effects. An earlier 6-month rat study of Ge-132 of unstated purity reported some kidney effects, and FDA reviewers found lower toxicity of organic forms in people not conclusive.

Supported by Trial 4, Trial 1

Propagermanium as a prescription drug in Japan

Propagermanium is a germanium compound used in Japan as a prescription drug for chronic hepatitis B. Small trials have tested it in other conditions, such as a 12-month pilot in people with diabetes and kidney disease that found no drop in urine albumin. These are drug studies in patients, not evidence for germanium supplements.

Supported by Trial 5

Mechanism of action

1

Organic and inorganic forms differ chemically

In Ge-132 the germanium atom is bonded to carbon in a propanoic acid chain, and in water the polymer dissolves to a small organic acid called THGP. Germanium dioxide has no such bond. In rats the two behaved differently in the kidney, but organic products can be contaminated with germanium dioxide.

2

Germanium can build up in kidney tissue

In people who took germanium preparations for months, germanium accumulated in the kidney and other organs, and biopsies showed damage to the kidney tubules, with dense deposits inside the cells' mitochondria in patient biopsies and in rats. The damage often appeared without protein or blood in the urine.

3

Propagermanium blocks a chemokine receptor

Propagermanium is described as blocking the CCR2 receptor for the chemokine CCL2, a signal that draws immune cells into tissue. This is the basis for its testing as a drug and does not apply to Ge-132 supplements.

Clinical trials

1
Germanium-Enriched Yeast and Immune Markers: 8-Week RCT (maker-funded)
PubMed

Randomized, double-blind, placebo-controlled single-center trial of Bio-Germanium, a germanium-enriched yeast product, 1200 mg a day for 8 weeks, funded by the maker Geranti Pharmaceutical. (Cho et al. 2020, PLoS One)

130 Korean adults (about 90% women) with white blood cell counts of 4,000 to 8,000 per microliter. 128 were analyzed (66 germanium, 62 placebo).

Natural killer cell activity rose in the germanium group and fell on placebo at all four test ratios (between-group P of 0.007 or lower), but baseline activity was significantly lower in the germanium group at three of the four ratios. IgG1 fell less than on placebo (P = 0.044) rather than rising, and IgG2 and IgM did not differ. No adverse events over 8 weeks, and kidney and liver blood tests did not change differently between groups. Lab markers only; no infection outcomes.

2
Ge-132 and Natural Killer Cell Activity in Cancer Patients (uncontrolled)
PubMed

Uncontrolled study comparing daily and intermittent oral Ge-132 dosing, published in Japanese with an English abstract. (Tanaka et al. 1984, Gan To Kagaku Ryoho)

18 cancer patients in Japan taking Ge-132 1000 mg a day.

Natural killer cell activity was higher at day 3, but with daily dosing for 10 days it was depressed in all cases by day 10. With intermittent dosing, more than half of those who responded at day 3 kept higher activity at day 10. No control group, no clinical outcomes.

3
Ge-132 Pharmacokinetics: Single Oral Doses in 24 Volunteers
PubMed

Single-dose pharmacokinetic study of oral Ge-132 at three dose levels, measuring germanium in plasma and urine. (Long et al. 1996, Zhongguo Yao Li Xue Bao)

24 healthy Chinese volunteers, 8 at each dose of 1, 2.5 or 4 g per square meter of body surface.

Peak plasma germanium came at 0.75 to 2 hours and the elimination half-life was about 5 to 6 hours at every dose. Peak levels rose with dose, while the share of germanium recovered in urine within 24 hours fell from 11% to 6%. No safety or benefit outcomes were reported.

4
Germanium Dioxide Products and Kidney Failure: 5-Patient Case Series (plus rat study)
PubMed

Case series of patients who took germanium dioxide-containing compounds, with a comparison study in rats of germanium dioxide and Ge-132. (Sanai et al. 1990, Nephron)

5 patients in Japan with chronic kidney failure after taking germanium dioxide products; rats given germanium dioxide or Ge-132 orally for 10 weeks.

Kidney function declined slowly and 2 patients needed temporary dialysis. After stopping, function improved but stayed abnormal over 10 to 40 months, and there was no protein or blood in the urine. Rats on germanium dioxide developed the same tubular damage, while rats on Ge-132 did not.

5
Propagermanium Added to Usual Care: 12-Month Open-Label Pilot RCT (null)
PubMed

Randomized, open-label, two-arm pilot trial at nine Japanese centers of the prescription drug propagermanium 30 mg a day versus usual care alone. Primary outcome: change in urine albumin-to-creatinine ratio. (Hara et al. 2020, Endocrinol Diabetes Metab)

29 adults aged 30 to 75 with type 2 diabetes and kidney disease (19 propagermanium, 10 usual care).

Propagermanium did not reduce urine albumin (change 25.0%, 95% CI -20.4% to 96.5%, P = .33). No severe adverse events or kidney events occurred. This tested a Japanese prescription drug, not a germanium supplement.

6
Propagermanium Phase I Dose-Escalation Trial (drug safety study)
PubMed

Phase I dose-escalation trial of oral propagermanium given around breast cancer surgery; primary end point was the rate of dose-limiting toxicity. (Masuda et al. 2020, Cancer Sci)

12 women with primary breast cancer in Japan.

No dose-limiting toxicity was seen and the maximum dose was set at 90 mg a day. Blood IL-6 fell with higher doses, a lab marker. A drug safety study with no control group; one author is an employee of Sanwa Kagaku Kenkyusho, which makes the drug.

Side effects and drug interactions

Common Potential side effects

Kidney failure and death: at least 31 published human cases linked months of germanium intake to kidney failure, and some patients died. Total intake ranged from 15 to over 300 g over 2 to 36 months, and kidney function recovered slowly and incompletely after stopping.
Many cases involved germanium dioxide or products contaminated with it, but cases also involved Ge-132 and germanium lactate citrate, a compound sold as organic germanium. An organic label does not guarantee a product is free of inorganic germanium.
Other reported effects of long-term germanium intake include anemia, muscle weakness, peripheral nerve damage and, in one case, a fatty, enlarged liver.
Kidney damage from germanium often developed without protein or blood in the urine, so it can go unnoticed until kidney function is already reduced.
Propagermanium, the Japanese prescription drug, was followed by moderate to severe liver damage in about 4% of hepatitis B patients in a postmarketing survey.
Safety in pregnancy, breastfeeding and children has not been studied; do not use germanium supplements in these groups.

Important Drug interactions

No specific drug interactions have been established for germanium supplements in human studies.
Kidney function: because the main documented harm is kidney damage, people with reduced kidney function, or who take medicines that can strain the kidneys, should not take germanium without a doctor's advice.
Propagermanium is a prescription drug in Japan; anyone prescribed it should not add germanium supplements and should follow the prescriber's liver monitoring.

Frequently asked questions about Germanium (Organic Germanium, Ge-132)

Is germanium an essential nutrient?

No. There is no known biological requirement for germanium, and no deficiency has been shown in people or animals. Food supplies small amounts, estimated at about 1.5 mg a day, and supplements have provided far more than that.

Is organic germanium (Ge-132) safer than germanium dioxide?

In rats, Ge-132 did not cause the kidney damage seen with germanium dioxide, and the Ge-132 maker reports no problems in its own studies. But FDA reviewers found the evidence for lower toxicity in people not conclusive, some kidney failure cases involved products sold as organic germanium, and products can be contaminated with germanium dioxide.

Can germanium supplements be sold in the US?

The FDA has an import alert (54-07) that lets border staff detain germanium products for human consumption without examination, naming products such as GE-132 and Vitamin "O". One firm's germanium yeast products are on the alert's Green List, which exempts them from automatic detention; that is not an approval of any health benefit.

Is propagermanium the same as Ge-132?

No. Propagermanium is a different germanium compound used in Japan as a prescription drug for chronic hepatitis B, and it has been linked to liver damage in some patients. Research on it does not show that germanium supplements work or are safe.

Would I notice if a germanium product were harming me?

Not necessarily. In published cases, kidney function declined slowly over months, often with no protein or blood in the urine. If you have taken germanium, stop and ask your doctor about a blood test of kidney function.

What is Germanium?

Germanium is a trace element found in small amounts in soil and food, but it is not an essential nutrient: no human requirement or deficiency has been shown. Supplements have been sold as germanium sesquioxide (Ge-132), germanium-enriched yeast and, in the past, inorganic germanium dioxide. Safety is the main issue.

What is Germanium used for?

Germanium has several researched uses. In 130 Korean adults, 1200 mg a day of a germanium-enriched yeast product for 8 weeks raised natural killer cell activity in a lab assay while it fell on placebo.

What doses of Germanium have been studied?

Germanium is a drug or research chemical, not a dietary supplement: it is a prescription medicine in some countries, is not approved for sale as a supplement in the US, or has a regulatory warning against it. Doses used in studies: No established dose or requirement. Studies used Ge-132 at 1000 mg/day for 10 days, single doses of 1 to 4 g/m2 in volunteers, and a germanium yeast product at 1200 mg/day for 8 weeks. This is not dosing advice; use it only under the care of a licensed prescriber.

Is Germanium safe, and does it have side effects?

Germanium is a drug or research chemical, not a dietary supplement: it is a prescription medicine in some countries, is not approved for sale as a supplement in the US, or has a regulatory warning against it. Side effects and cautions reported for Germanium include: Kidney failure and death: at least 31 published human cases linked months of germanium intake to kidney failure, and some patients died. Total intake ranged from 15 to over 300 g over 2 to 36 months, and kidney function recovered slowly and incompletely after stopping. It may also interact with some medications. Germanium is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Germanium interact with any medications?

Possible interactions include: No specific drug interactions have been established for germanium supplements in human studies. Kidney function: because the main documented harm is kidney damage, people with reduced kidney function, or who take medicines that can strain the kidneys, should not take germanium wi… If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Germanium?

NutraSmarts rates the evidence for Germanium as Preliminary (1 out of 5). It is backed by 6 clinical trials and 16 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies. For a drug or research chemical, this rating does not mean it is suitable for self-use.

References(16 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Tao SH, Bolger PM. Hazard assessment of germanium supplements. Regul Toxicol Pharmacol. 1997;25(3):211-9. doi: 10.1006/rtph.1997.1098.PubMedUsed to support: Hazard review by scientists at the FDA Center for Food Safety and Applied Nutrition. Germanium is not an essential element. At least 31 reported human cases linked prolonged intake of germanium products to kidney failure and even death, with anemia, muscle weakness and peripheral neuropathy also reported. Total germanium ingested ranged from 15 to over 300 g over 2 to 36 months, as germanium dioxide, carboxyethyl germanium sesquioxide, germanium lactate citrate or unspecified forms. Kidney recovery was slow and incomplete. Because organic products were not shown conclusively to be less toxic to the kidney and could be contaminated with inorganic germanium, the authors concluded germanium products present a potential human health hazard.
  2. Schauss AG. Nephrotoxicity and neurotoxicity in humans from organogermanium compounds and germanium dioxide. Biol Trace Elem Res. 1991;29(3):267-80. doi: 10.1007/BF03032683.PubMedUsed to support: Review: there is no known biological requirement for germanium and no germanium deficiency has been shown in any animal; average dietary intake is estimated at 1.5 mg a day. Since 1982, 18 cases of kidney dysfunction or failure, including two deaths, were linked to germanium elixirs containing germanium dioxide or Ge-132, with cumulative intakes of 16 to 328 g over 4 to 36 months in 17 of the 18 cases. Kidney function improved after stopping but never fully recovered. The author recommends medical monitoring for anyone taking germanium well above dietary levels for more than 3 months.
  3. Sanai T, Okuda S, Onoyama K, Oochi N, Oh Y, Kobayashi K, Shimamatsu K, Fujimi S, Fujishima M. Germanium dioxide-induced nephropathy: a new type of renal disease. Nephron. 1990;54(1):53-60. doi: 10.1159/000185810.PubMedUsed to support: Case series of 5 patients who developed chronic kidney failure while taking products containing germanium dioxide; 2 temporarily needed dialysis. Kidney function improved after stopping but stayed abnormal over 10 to 40 months of follow-up, and there was no protein or blood in the urine to signal the damage. In a parallel rat study, germanium dioxide reproduced the tubular damage, while carboxyethylgermanium sesquioxide (Ge-132) did not and left less germanium in the kidney.
  4. Okada K, Okagawa K, Kawakami K, Kuroda Y, Morizumi K, Sato H, Morita H, Shimomura S, Saito S. Renal failure caused by long-term use of a germanium preparation as an elixir. Clin Nephrol. 1989;31(4):219-24..PubMedUsed to support: Case report of 3 Japanese adults who took the same germanium preparation, mainly inorganic germanium, at about 90 mg of germanium a day for 6 to 20 months as a health elixir and developed chronic kidney failure. A kidney biopsy showed tubular degeneration, and high germanium levels were found in hair and nails.
  5. Nagata N, Yoneyama T, Yanagida K, Ushio K, Yanagihara S, Matsubara O, Eishi Y. Accumulation of germanium in the tissues of a long-term user of germanium preparation died of acute renal failure. J Toxicol Sci. 1985;10(4):333-41. doi: 10.2131/jts.10.333.PubMedUsed to support: Fatal case: a middle-aged woman who took 600 mg a day of a germanium preparation for 18 months as an elixir developed acute kidney failure with muscle disease and skin rash and died. The preparation was mainly germanium dioxide with some organic compound. At autopsy, germanium levels were many times higher than in a comparison case, including 69 times higher in the kidney cortex. The authors said the role of this accumulation in her kidney failure remained to be clarified.
  6. Raisin J, Hess B, Blatter M, Zimmermann A, Descoeudres C, Horber FF, Jaeger P. [Toxicity of an organic Germanium compound: deleterious consequences of a "natural remedy"]. Schweiz Med Wochenschr. 1992;122(1-2):11-3..PubMedUsed to support: Swiss case report (article in German, English abstract): a 25-year-old woman with HIV infection took a total of 47 g of germanium as germanium lactate citrate, a product sold as organic germanium. She developed severe kidney insufficiency and an enlarged, fatty liver, with germanium levels in kidney and liver tissue raised 68 and 140 fold. Kidney function was still severely reduced 9 months later.
  7. Sanai T, Okuda S, Onoyama K, Oochi N, Takaichi S, Mizuhira V, Fujishima M. Chronic tubulointerstitial changes induced by germanium dioxide in comparison with carboxyethylgermanium sesquioxide. Kidney Int. 1991;40(5):882-90. doi: 10.1038/ki.1991.289.PubMedUsed to support: Rat study, not human: 24 weeks of oral germanium dioxide caused kidney tubule degeneration (score 95%), weight loss, anemia and liver dysfunction, and kidney scarring progressed even 16 weeks after it was stopped. Rats given Ge-132 showed no toxic effects or kidney abnormalities (tubular score 3% versus 1% in controls).
  8. Reddeman RA, Glávits R, Endres JR, Murbach TS, Hirka G, Vértesi A, Béres E, Szakonyiné IP. A Toxicological Evaluation of Germanium Sesquioxide (Organic Germanium). J Toxicol. 2020;2020:6275625. doi: 10.1155/2020/6275625.PubMedUsed to support: Laboratory and animal studies, not human, sponsored by Designed Nutritional Products, which supplied the test material: a highly purified germanium sesquioxide (at least 99.6% pure, under 50 ppm germanium dioxide) showed no mutagenicity in bacterial or cell tests, no genotoxicity in a mouse micronucleus test up to 2000 mg/kg a day, and no adverse effects in a 90-day rat study dosed by gavage up to 2000 mg/kg a day. The authors note that earlier germanium sesquioxide studies often did not state the purity of the test material, and that an earlier 6-month rat study of Ge-132 reported some adverse kidney effects.
  9. Doiyama S, Nakamura T. Summary of the Safety Assessment Data of the Most Common Organogermanium Food Ingredient, Asaigermanium (Poly-trans-[(2-carboxyethyl)germasesquioxane]). J Food Sci. 2026;91(6):e71204. doi: 10.1111/1750-3841.71204.PubMedUsed to support: Review written and funded by the Ge-132 maker (Asai Germanium Research Institute). It describes Ge-132 as first developed as a pharmaceutical and now sold as a food supplement ingredient, summarizes animal toxicity studies, and states that in water the polymer dissolves to the small organic acid THGP. It reports that a Japanese 1987 kidney failure cluster was later attributed to a product contaminated with germanium dioxide, and cites two small human studies with no abnormalities found (23 healthy adults at 25 to 75 mg/kg a day in an early phase I study, and 12 adults at 1000 mg a day in 2025). Most of its animal toxicity data are the maker's unpublished studies.
  10. Cho JM, Chae J, Jeong SR, Moon MJ, Shin DY, Lee JH. Immune activation of Bio-Germanium in a randomized, double-blind, placebo-controlled clinical trial with 130 human subjects: Therapeutic opportunities from new insights. PLoS One. 2020;15(10):e0240358. doi: 10.1371/journal.pone.0240358.PubMedUsed to support: Randomized, double-blind, placebo-controlled 8-week trial in 130 Korean adults with normal white cell counts, funded by the maker (Geranti Pharmaceutical): 1200 mg a day of Bio-Germanium, a germanium-enriched yeast product, raised natural killer cell activity in a lab assay while it fell on placebo (between-group P of 0.007 or lower), but baseline activity was lower in the germanium group. IgG1 fell less than on placebo (P = 0.044) rather than rising, and IgG2 and IgM did not differ. No adverse events were seen over 8 weeks, and kidney and liver blood tests did not change differently between groups. Lab markers only; no infection outcomes were measured.
  11. Tanaka N, Ohida J, Ono M, Yoshiwara H, Beika T, Terasawa A, Yamada J, Morioka S, Mannami T, Orita K. [Augmentation of NK activity in peripheral blood lymphocytes of cancer patients by intermittent GE-132 administration]. Gan To Kagaku Ryoho. 1984;11(6):1303-6..PubMedUsed to support: Uncontrolled Japanese study (article in Japanese, English abstract) in 18 cancer patients: oral Ge-132 at 1000 mg a day raised natural killer cell activity at day 3, but with daily dosing for 10 days activity was depressed in all cases by day 10; with intermittent dosing more than half of the responders kept higher activity at day 10. No control group and no clinical outcomes.
  12. 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):415-8..PubMedUsed to support: Pharmacokinetic study in 24 healthy Chinese volunteers given a single oral dose of Ge-132 at 1, 2.5 or 4 g per square meter of body surface (8 per dose). Peak blood germanium came at 0.75 to 2 hours, the elimination half-life was about 5 to 6 hours, and only 6 to 11% of the dose appeared in urine within 24 hours. Single doses only; no safety or benefit outcomes.
  13. Masuda T, Noda M, Kogawa T, Kitagawa D, Hayashi N, Jomori T, Nakanishi Y, Nakayama KI, Ohno S, Mimori K. Phase I dose-escalation trial to repurpose propagermanium, an oral CCL2 inhibitor, in patients with breast cancer. Cancer Sci. 2020;111(3):924-931. doi: 10.1111/cas.14306.PubMedUsed to support: Phase I dose-escalation trial in 12 women having surgery for breast cancer in Japan. It describes propagermanium as a CCL2 inhibitor used in Japan as a drug for chronic hepatitis B. No dose-limiting toxicity was seen and the maximum dose was set at 90 mg a day. A drug safety study, not evidence for germanium supplements; one author is an employee of Sanwa Kagaku Kenkyusho, which makes the drug.
  14. Hara A, Shimizu M, Hamaguchi E, Kakuda H, Ikeda K, Okumura T, Kitagawa K, Koshino Y, Kobayashi M, Takasawa K, Hisada Y, Toyama T, Iwata Y, Sakai N, Wada T. Propagermanium administration for patients with type 2 diabetes and nephropathy: A randomized pilot trial. Endocrinol Diabetes Metab. 2020;3(3):e00159. doi: 10.1002/edm2.159.PubMedUsed to support: Randomized, open-label pilot trial in 29 Japanese adults with type 2 diabetes and kidney disease: adding propagermanium 30 mg a day for 12 months to usual care did not reduce urine albumin (change 25.0%, 95% CI -20.4% to 96.5%, P = .33). No severe adverse events or kidney events occurred. Propagermanium is described as an organic compound that blocks the chemokine receptor CCR2.
  15. Hirayama C, Suzuki H, Ito M, Okumura M, Oda T. Propagermanium: a nonspecific immune modulator for chronic hepatitis B. J Gastroenterol. 2003;38(6):525-32. doi: 10.1007/s00535-003-1098-7.PubMedUsed to support: Review of propagermanium as a prescription treatment for chronic hepatitis B in Japan, including a controlled pilot study and an open study. A postmarketing survey found moderate to severe liver damage after treatment in about 4% of patients, and the authors advise monitoring liver function during treatment. Evidence about a prescription drug in patients, not about supplements.
  16. US Food and Drug Administration. Import Alert 54-07: Detention Without Physical Examination of Germanium Supplements for Human Consumption. FDA Import Alerts. 2026;Published 03/05/2026 (revision of the 11/8/2023 version); accessed 2026..SourceUsed to support: Official FDA source, not PubMed-indexed. The alert states that germanium is a nonessential trace element that has caused kidney injury and death when used chronically by humans, even at recommended levels of use. FDA may detain without examination all germanium products offered for import for human consumption, including those named GE-132, GE-OXY-132, Vitamin "O", Pro-Oxygen, Nutrigel 132, Immune Multiple and Germax, as possibly containing a poisonous or deleterious substance. One firm is on the alert's Green List (Geranti Pharmaceutical, for Geranti Bio-Germanium and Bio-Ge Yeast, added 05/22/2024).