[12] It was originally made from the flowering ash and called manna due to its supposed resemblance to the Biblical food.

[13][14] Mannitol is on the World Anti-Doping Agency's banned substances list due to concerns that it may mask prohibited drugs.

[3] In the European Union, mannitol is indicated for the treatment of cystic fibrosis (CF) in adults aged 18 years and above as an add-on therapy to best standard of care.

[4] Mannitol is used intravenously to reduce acutely raised intracranial pressure until more definitive treatment can be applied,[16] e.g., after head trauma.

While mannitol injection is the mainstay for treating high pressure in the skull after a bad brain injury, it is no better than hypertonic saline as a first-line treatment.

[18][19] It may also be used for certain cases of kidney failure with low urine output, decreasing pressure in the eye, to increase the elimination of certain toxins, and to treat fluid build up.

[citation needed] The use of mannitol, when inhaled, as a bronchial irritant as an alternative method of diagnosis of exercise-induced asthma has been proposed.

The presence of mannitol preserves renal function during the times of low blood flow and pressure, while the patient is on bypass.

Mannitol can also be used to temporarily encapsulate a sharp object (such as a helix on a lead for an artificial pacemaker) while it passes through the venous system.

[23] Mannitol increases blood glucose to a lesser extent than sucrose (thus having a relatively low glycemic index[24]) so is used as a sweetener for people with diabetes, and in chewing gums.

Although mannitol has a higher heat of solution than most sugar alcohols, its comparatively low solubility reduces the cooling effect usually found in mint candies and gums.

[11] Mannitol is an isomer of sorbitol, another sugar alcohol; the two differ only in the orientation of the hydroxyl group on carbon 2.

[25] Mannitol is one of the most abundant energy and carbon storage molecules in nature, produced by a plethora of organisms, including bacteria, yeasts, fungi, algae, lichens, and many plants.

Heated, pressurized, subcritical water is even cheaper, and is shown to have dramatically greater results than traditional extraction.

[33] In the early 1880s, Julije Domac elucidated the structure of hexene and mannitol obtained from Caspian manna.

[35][36][37][38] The three studies[39][40][41] that originally found high-dose mannitol effective in treating severe head injury were the subject of an investigation.

Published in 2007 after the lead author Dr Julio Cruz's death, the investigation questioned whether the studies had actually taken place.

[42] The co-authors of the paper were not able to confirm the existence of the study patients, and the Federal University of São Paulo, which Cruz gave as his affiliation, had never employed him.