FOOD INTOLERANCE NETWORK FACTSHEET

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Nickel allergy and other heavy metals
- from dermatitis to neurological symptoms

Introduction
Symptoms of nickel allergy – not just skin
Photos
From the medical journals – 4 cases
The science
What you can do
Reader reports
Scientific references
More information

Keywords: nickel, multiple sclerosis, MS, allergy, contact dermatitis.

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Introduction

Nickel is the most common cause of contact allergy dermatitis.  It is used in a wide range of consumer items including mobile phones, jewellery, coins, watch bands and stainless steel cookware.  Women with pierced ears are the most likely to suffer from nickel allergy though others can be affected too.  The problem is so widespread that in the EU, the amount of nickel released by certain consumer items is restricted by the 1994 Nickel Directive but nickel allergy continues to increase.  Dental and medical implants are not covered by the Nickel Directive.  

I am particularly alarmed by three reports we have received concerning the effects of nickel-containing dental bridges or braces linked to neurological symptoms: seizures in a teenager, multiple sclerosis, and possible motor neurone disease. In the first two cases, the symptoms disappeared when the implant was removed. See Reader reports below.

Symptoms of nickel allergy – not just skin

Nickel allergy can be difficult to diagnose. It seems that nickel allergy can cause inflammation in any part of the body – inside or out - including gastrointestinal, respiratory and neurological symptoms.

As reported by the Implant Allergy Register, the following adverse reactions have been noted:
  • skin reactions
– pain, itching, rash, swelling
  • non-skin reactions
- persistent inflammatory response
-  disappearance of complaints when the implant is removed

Photos

Nickel01

Photo: nickel contact allergy

MSscans

Photo: Danelle’s MRI scans showing  reversal of MS lesions [1236] Danelle’s story: MS reversed (October 2013)

From the medical journals: 4 cases

1. A 5 year old girl suffered from persistently dry, itchy, tender skin around the mouth and ear lobes for two and a half years due to nickel-containing metal caps on her front teeth and nickel-containing earrings. Unsuccessful treatment during that time included antibiotics, cortisone creams and lip balms. See photos http://archpedi.jamanetwork.com/article.aspx?articleid=1695351

2. A 46 year old woman who developed gum lesions adjacent to dental bridge work also suffered from stomach pain and was diagnosed with eosinophilic gastritis. Patch testing showed positive reactions to a number of metals, and all her gastrointestinal symptoms improved spontaneously shortly after the dental work was replaced. http://www.ncbi.nlm.nih.gov/pubmed/23192576

3. In a Dutch case, oral exposure to nickel in an orthodontic appliance resulted in eczema on the hand. The patient was exposed to nickel by fixed dental prostheses, a removable dental prosthesis, and food. When removal of the orthodontic appliances did not result in complete healing, the fixed dental prostheses also had to be removed and food had to be prepared in nickel free pans. http://www.ncbi.nlm.nih.gov/pubmed/23858637

4. An 18 year old male suffered from widespread dermatitis on his abdomen, face, arms and legs due to nickel in his belt buckle and cell phone. With photo http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151128/

The science
 
Heavy metals are known for their neurotoxicity. The oral ingestion of soluble nickel compounds leads to neurological symptoms in humans and nickel-induced neurological effects have been demonstrated in mice (He et al, 2013).

Some researchers consider that patients suffering from non-skin reactions including gastrointestinal, respiratory, neurological, and others to be part of a controversial syndrome called systemic nickel allergy syndrome (SNAS). An Italian study of 178 SNAS subjects with irritable bowel symptoms and 60 healthy controls found that 74% of the SNAS patients with tested positive for lactose intolerance compared to 6% of the controls, suggesting that either people with food intolerance are more likely to be sensitive to nickel or that nickel allergy can cause food intolerance, or both.  (Cazzato et al, 2011)

 
What you can do

  • Testing. A patch test is medically recommended, for example:  “After excluding causes such as infection or mechanical failure, allergy diagnosis using a patch test with implant metals and bone cement components is recommended in cases of suspected implant allergy.” (Eben et al, 2009)

  • Removal or avoidance. See this extract from Dr Robert Gammal’s article:

    Why would I, a dentist, be writing about MS?  Multiple Sclerosis, we are told, is a disease which has ‘no known cause’ and ‘no known treatment’ and is in the medical rather than dental domain. The answer is that I have been fortunate enough to see a number of spontaneous remissions of this disease following dental intervention . (Note - I am not offering a magic bullet. I have also seen many MS cases that did not resolve)….” (from Gammal, 2012)http://betterdentistry.net/wp-content/uploads/2014/08/MultipleSclerosis2012.pdf

Reader reports

[1238] Scary neurological problems caused by nickel in dental braces (October 2013)

My salicylate-sensitive teenage daughter started having scary episodes at school where she seemed to zone out for 15 minutes or more, staring at the ground, not responding, as well as other longer lasting episodes, where she was confused and shaky, with red cheeks, and described afterwards that she was aware of some things while it was happening, but it was like she was hallucinating. We think of these as hypo-episodes and have tightened up on her diet. They've been diagnosed as absence seizures but a brain scans recommended by a neurologist didn't show any abnormalities.

The most recent presentation is for things to happen that she cannot remember doing. e.g. one day I found her in the bathroom scrubbing at her arms, trying to remove intricate patterns of drawing from her left arm. She was upset, and said she could not remember drawing it, she first noticed it at lunchtime. The patterns look like those I've seen her draw quite often. She has previously shown me writing in notebooks that she can't remember writing, some of it not in English! This type of episode had been happening along with "absence seizures" and also full-on "hypo-episodes".  We  have not had reports of absence seizures or the hypo episodes for some time, but how can you be sure that the absence seizures are NOT happening; they are so subtle.  Over the time that these episodes have been happening, her maths performance and attitude has dropped off dramatically, to the point that she now refuses to even try.

Update one year later: When her dental braces were removed, we finally discovered  that our daughter's "unexplainable" neurological issues over 3.5 years had been due to a reaction to the nickel in the stainless steel.  Many things have settled down now, but it's been quite a journey. - by email

[1239] Did nickel allergy trigger my mother’s motor neurone disease? (October 2013)

After reading your website, I am wondering whether my mother’s final illness may have been due to nickel allergy. She started having problems with slurred speech soon after going to the dentist, and we all thought it must have been due to something not right in her mouth. She actually went back to the dentist to check. From then on it was downhill all the way. Over 2 nightmarish years she lost her ability to speak, to swallow food or drink including water, and was losing her ability to walk. She was diagnosed with motor neurone disease and chose to end her life by refusing a peg feeding tube rather than to end up completely helpless. – by email.

[1236] Danelle’s story: MS reversed (October 2013)

Scientific references

The Nickel Directive - Thyssen JP et al  The EU Nickel Directive revisited--future steps towards better protection against nickel allergy. Contact Dermatitis. 2011 Mar;64(3):121-5. http://www.radoslawspiewak.net/2011-3.pdf

Nickel allergy and implant surgery - Giménez-Arnau A et al. Metal-induced generalized pruriginous dermatitis and endovascular surgery. Contact Dermatitis. 2000 Jul;43(1):35-40. http://www.ncbi.nlm.nih.gov/pubmed/10902587

Non-skin symptoms - Rosato E and others, Recurrent infections in children with nickel allergic contact dermatitis. J Biol Regul Homeost Agents. 2011 Oct-Dec;25(4):661-5. http://www.ncbi.nlm.nih.gov/pubmed/19828094

Schnabel E et al, Sensitization to contact allergens and bronchial hyper-responsiveness. Contact Dermatitis. 2010 Sep;63(3):157-63. http://www.ncbi.nlm.nih.gov/pubmed/20690939

From the medical journals: 4 cases
Johnson EF et al, Picture of the month. Allergic contact dermatitis to nickel-containing dental work. JAMA Pediatr. 2013 Jun;167(6):581-2. http://archpedi.jamanetwork.com/article.aspx?articleid=1695351

Pföhler C et al Contact allergic gastritis: an underdiagnosed entity? BMJ Case Rep. 2012;2012.
http://www.ncbi.nlm.nih.gov/pubmed/23192576

Feilzer AJ and others.  [Systemic reactions to orally applied metal alloys]. [Article in Dutch] Ned Tijdschr Tandheelkd. 2013 Jun;120(6):335-41.
http://www.ncbi.nlm.nih.gov/pubmed/23858637

Lionel Bercovitch, Cellphone contact dermatitis with nickel allergy CMAJ. 2008 January 1; 178(1): 23–24. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151128/

The science
He MD and others, Disturbance of aerobic metabolism accompanies neurobehavioral changes induced by nickel in mice. Neurotoxicology. 2013 Sep;38:9-16. http://www.ncbi.nlm.nih.gov/pubmed/23727075

Cazzato IA and others, Lactose intolerance in systemic nickel allergy syndrome. Int J Immunopathol Pharmacol. 2011 Apr-Jun;24(2):535-7.
http://www.ncbi.nlm.nih.gov/pubmed/21658331

Eben R and others  [Implant allergy register--a first report]. [Article in German] Orthopade. 2009 Jun;38(6):557-62. http://www.ncbi.nlm.nih.gov/pubmed/19468709

Gammal R, Multiple sclerosis and other brain diseases, November 2012 http://betterdentistry.net/wp-content/uploads/2014/08/MultipleSclerosis2012.pdf

More information

Introduction to food intolerance
 
www.fedup.com.au

The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. You can see our list of experienced and supportive dietitians http://fedup.com.au/information/support/dietitians 

© Sue Dengate October 2013

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