FAQs About Nickel Allergies

FAQs about nickel allergies
Photo by Vlad Bagacian on unsplash.

Maybe you recently returned from your doctor’s office, after a skin patch test, or perhaps you’re searching for answers about living with systemic nickel allergy. Many times the actual diagnosis can be confusing and overwhelming. There’s no magic bullet or fast acting solution for treating your nickel allergy. 

Moving forward when you’re first diagnosed can feel like hiking up a mountain without a map. You will figure out what’s best for you, even if the process takes time and I am referring to months or even years. Don’t be discouraged by this fact. Instead find hope that you’re finally here and now actually have that map to chart your own trajectory and heal, if you stay on course. Changing your diet, cookware and many other little things can be time consuming and costly. All of these changes also can be gradual and will make a positive difference.

First and foremost, the best thing you can do is to follow all of the advice from your doctor. If you have questions after the initial appointment or when you were diagnosed, follow-up with him/her and ask your questions. Only you and your doctor truly know and understand your personal circumstance. Many physicians now use electronic health record applications to communicate with their patients, such as mychart. Take advantage of these services to get all your questions answered. 

If you don’t have a doctor who diagnosed your nickel allergy, it could be beneficial to get a primary care doctor or a dermatologist. Others have told me their horror stories about being denied medical care. I’ve also heard from folks who inform me their doctor questioned them about trying the low nickel diet, when the individual attests that it works for him/her. Typically it costs the same amount of money to see a good doctor as it does to see a bad doctor. Yet the emotional toll of seeing a terrible doctor isn’t worth the energy. You will have to become your own self-advocate, as there are providers who don’t know about allergic contact dermatitis, or systemic nickel allergy syndrome. There are also plenty of doctors that don’t listen or take their patients seriously.

More and more research is being published about allergic contact dermatitis, atopic dermatitis, and systemic nickel allergy syndrome. More still needs to be learned, researched and known. Trust yourself and your own experience.

My skin patch story or this page discussing my nickel food allergy story with links to other helpful posts is a great place to start when you’re first diagnosed. I share so much information throughout my website about various things that work for me.

In this post, I’ve answered various frequently asked questions individuals ask me. Some of the questions are from folks are newly diagnosed with a contact nickel allergy or a systemic nickel allergy. Other questions are more specific about the “nickel allergy detox” or how to read processed food labels. So let’s begin!

Question: How should I proceed when first diagnosed with a nickel allergy?

Answer: The first recommendation my dermatologist told me prior to undergoing my skin patch test was to eliminate any and all fragrances from all of my cosmetics and laundry detergents. Within two weeks of eliminating fragrances, my eczema had improved by about 50%. Since nickel is all around us, it’s very difficult to eliminate all of your exposure. However there are many ways you can consciously work to reduce your exposure, by avoiding food higher in nickel, avoiding canned goods and stainless steel products which contain nickel.

Question: What’s the most effective way to get diagnosed or accurately tested?

Answer: Skin patch testing is the most accurate type of test for diagnosing a nickel allergy. Since my nickel allergy is systemic, I also eat an elimination diet called the low nickel diet. After my skin patch test results I was told to try eating a strict low nickel diet for 4-6 weeks. If you try the low nickel diet and do not experience improvement in your symptoms after 4-6 weeks, it’s best to consult a medical professional to identify what else could be the culprit. You could have a histamine intolerance or allergic contact dermatitis and not a systemic nickel allergy. Eating an elimination diet is not fun or wise without consulting medical professionals.

Question: Why are there so many different lists identifying which foods are higher or lower in nickel?

Answer: Nickel is a natural heavy metal found in our air, soil and water. Some foods absorb and retain more or less nickel predominately from these sources. Meat and dairy products tend to contain the lowest amounts of nickel. Whereas foods primarily cultivated in soil contain higher concentrations of nickel. Generally, the more volcanic the soil the higher the concentration of nickel, which is tricky as volcanic soils tend to be very fertile and retain water. 

Different lists that identify the nickel quantities can be more or less specific to food grown in a specific area or include a high level overview of what to eat or avoid. That’s why regardless of the “list” there are several foods such as soy, oats, nuts, whole grains, seeds, beans, leafy greens, pineapple, raspberries that are consistently identified as containing higher concentrations of nickel on nearly every list. 

The benefit of globalization is that we can taste foods from all over the world, often year round. Since the majority of our food is not sourced locally, sometimes it can be beneficial for you to shop locally if where you live has less nickel than in other parts of your country, as the soil of different parts of the world can contain lower or higher amounts of nickel. 

In 2009 when I was diagnosed, my dermatologist provided me with a list of foods with nickel that I’ve shared on my website. The Rebelytics low nickel diet scoring sheet and companion mobile application has data and research from various countries throughout the world. Some use the Rebelytics scoring sheet to introduce or reintroduce foods with higher amounts of nickel in their diet after eating a strict low nickel diet for months. 

Question: What about foods not high in nickel that can trigger similar eczema symptoms?

Answer: Some with allergic contact dermatitis or systemic nickel allergies are also sensitive to foods that release more histamines or have a histamine intolerance. Certain foods, frozen foods or leftovers can cause the body to release more histamines when ingested.

Sometimes the longer you’re on the low nickel diet, the better you can tolerate moderate to higher nickel foods from time to time. Some can tolerate iceberg lettuce or lettuce grown hydroponically. The longer a food ripens or even storing cooked food in the frig can cause histamine reactions, which can mimic eczema symptoms. For instance, tomatoes are higher in histamines, despite their lower nickel content, some react more to them than others. Using a food journal is a great tool to identify what you can or cannot tolerate.

Question: What about a “nickel allergy detox”?

Answer: Again, there is no magic bullet, cleanse, detox, or cure for systemic nickel allergies. Unfortunately there are non-medical professionals who do not know or understand systemic nickel allergies, but are quick to offer bad solutions they promote as a “detox.” Do not unintentionally harm yourself by seeking these remedies, as they can backfire and cause severe long term health issues. I don’t believe in intermittent fasting or “diet” plans. The low nickel diet is not a weight loss plan, but an elimination diet where foods higher in nickel are avoided.

There are some well known physicians who understand systemic nickel allergies and treat their patients using chelation therapy. I have never sought this therapy. There may be naturopaths that promote herbs, but I avoid supplements so I have not tried this remedy. I also don’t know about whether cosmetic CBD products work or contain nickel. There have been some successful clinical trials using oral hyposensitization. These are under the care of trained medical providers and not considered a “cleanse” or “detox” remedy.

The best known and well researched “treatment” for systemic nickel allergies is to strive to live low nickel, using these 3 strategies. First stay hydrated and eat a strict low nickel diet avoiding foods higher in nickel, second, cook using low nickel cookware like glass, cast iron or ceramic, and third work to avoid touching anything containing nickel, like stainless steel.

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Question: What are the most common nickel allergy or systemic nickel allergy symptoms?

Answer: Many people with a nickel allergy or systemic nickel allergy don’t experience immediate, but delayed symptoms. Allergic contact dermatitis is more common than systemic nickel allergy, as both can involve a delayed immune system reaction to an allergen or in my case nickel. Even if you don’t experience an obvious contact allergy when you touch nickel it’s recommended to limit all physical contact with nickel as your body can still be reacting internally. That’s also why changing your cookware and what you eat can also be so impactful to your symptoms.

My severe eczema symptoms appear on my face around my mouth or eyelids, on my neck or inner elbow don’t usually appear until 12-24 hours after I’ve eaten something higher in nickel. Other common symptoms can include brain fog, inflammation, muscle weakness, joint issues and gastrointestinal issues. If you need a medical explanation or diagnosis for a particular symptom you may be experiencing, seek medical care from a provider. 

Question: What’s a low nickel gluten free flour alternative?

Answer: Prior to their nickel allergy diagnosis, some individuals are told to avoid gluten. However, eating gluten free foods can aggravate systemic nickel allergies as they usually contain copious amounts of nickel, or oats, nuts, seeds and soy. Many individuals with systemic nickel allergies can tolerate white flour, just not whole wheat flour. If you still want to avoid gluten, alternative flours can include white rice flour, arrowroot flour, quinoa flour, or banana flour. You can also use sweet potato or regular potato flours.

Question: What about supplements?

Answer: I choose to avoid supplements as there can be undisclosed ingredients in some of them that could include heavy metals. Many supplements can contain heavy metals and in the U.S., companies aren’t required to disclose their ingredients. 

Question: When will I know whether or not the low nickel diet is working for me?

Answer: If you do decide to try a low nickel diet it can take 4-6 weeks to experience results. My eyelids, lips, neck and elbows always experience eczema first when I eat foods higher in nickel. There’s lots of great information on my website. This page discussing my nickel food allergy story and linking to other helpful posts is a great place to start. Often the low nickel diet is a diet of trial and error, so using a food journal can help make the process more like a personal investigation than a hardship.

Question: How do I interpret food labels to know what I can eat or should avoid?

Answer: Unfortunately I’ve never seen a food labeling identifying “nickel” in the ingredients list. If you choose to eat processed food you have to take the time to learn how to interpret food labels. Many preservatives or additives in processed foods can contain nickel or aggravate nickel allergies. I find it is easier to avoid eating any and all processed foods. Eating homemade food from scratch where you control the ingredients and how your food is cooked will always be a better option than anything processed.

Question: What about low nickel cooking oils?

Answer: Olive oil or butter are great options for low nickel cooking oils. There are some cooking oils or sprays that have seed based ingredients, like sunflower oil or safflower oil. I primarily use olive oil but will occasionally use spray oils with sunflower oil as they don’t cause me to react. Since I cannot tolerate coconut, I do avoid coconut oil.

Question: What cosmetic products should I use or avoid?

Answer: I don’t have an answer for what cosmetic products, especially makeup, you should or should not use. I choose to not wear any makeup. Finding nickel free products can be very challenging. The best recommendation is to call the manufacturer, instead of trusting product labels, as often they’re not accurate. In addition, just like always checking food labels, I recommend you also always verify the ingredients in cosmetics even if you’ve used them previously as often the ingredients in cosmetic products can be changed without any notice to consumers. 

Lastly, if you’re trying out different products to see if they will or won’t work for you, you could always participate in a “do-it-yourself” skin patch test. This is where you place a small amount of the new product on your inner arm, maybe near your wrist or elbow and cover it with a Band-Aid. Since the majority of our bodies have a delayed reaction, it’s best to not wash the area for 3-5 days. If your skin didn’t react, then most likely your body can tolerate the product. Sometimes however we can become oversensitized when various products are used for an extended period of time and/or again the manufacturer can add new ingredients that can cause us issues later without us necessarily knowing.

Question: What about vaccines?

Answer: Even with my severe nickel allergy and thimerosal allergy, I regularly receive vaccines. Personally, I do not want to get COVID-19, the flu, measles, meningitis, polio, tetanus, etc. When I receive a vaccine, usually I’ll experience minor side effects at the injection site and a sore arm for a couple days. The CDC and FDA say all of the COVID-19 vaccines are safe. After both doses of my COVID-19 vaccine, I experienced a sore arm and redness at the injection site, and after the second dose I experienced minor body aches, tiredness and chills. I took it easy for a couple days and was fine. If you have concerns about any vaccine or the COVID-19 vaccine, please consult your primary care physician or allergist.

Do you have a question I didn’t include in this post? Or maybe a tip you’d like to share? Feel free to ask via in the comment section below.

  1. Thank you for this FAQs list of questions and answers. As I read it, I sat here nodding in agreement the whole way through.

    My nickel allergy was diagnosed three years ago, and your help has been invaluable. It took me a couple of months to determine my primary irritants, which were stainless steel (especially utensils) and a few high-nickel foods that I ate frequently, and after making a few changes, I have not had a rash for over a year. Yea!

    1. Hi Kathy,
      Thanks for your comment and appreciation for my website and this post. That’s wonderful it resonated with you. I am also very happy to hear that making those changes in your life have made such a big difference in your eczema symptoms for over a year! That is a major success.
      Warm regards,

  2. Hi Christy,
    Thank you for your website. this is an amazing resource as I navigate a newly diagnosed nickel allergy and a terrible and long-lasting AD flare. I have been living on oats and nut butters and leafy green and pineapple smoothies thinking they would heal me and now I realize is making my skin worse. What about seeds – like chia, hemp, flax seeds? Are these also a no-go on a nickel-free/low nickel allergy?
    Thank you so much for all you do on this subject.

    1. Hi Hilleary,
      Thanks for your comment and appreciation for my website.  Many of us relate to your story, as we also ate a lot of “healthy foods” that aren’t necessarily healthy for use with systemic nickel allergies and can cause us issues. Yes, seeds are well known for being higher in nickel and should be avoided or eaten sparingly, when eating a low nickel diet.
      Warm regards,

  3. Thank you for all the information on your site. Do you have a recommendation for a type of flatware to use? I was patch tested for nickel, and the information my doctor provided said to avoid chromium too. I’m not sure if that’s just because many people are allergic to both – I don’t think they specifically patch tested me for chromium. I’m not sure if titanium plated over 18/0 flatware will be sufficient, or if there’s a better option to look for? Thank you!

    1. Hi Miriam,
      Thanks for your comment and appreciation for my website. Stainless steel flatware that’s 18/0 works well for many with systemic nickel allergies. I’ve not used titanium plated flatware, but it also could be 18/0 titanium/nickel ratio. I wouldn’t know if that flatware doesn’t contain chromium, so I’d suggest reaching out to the product manufacturer. There are bamboo or reusable plastic flatware alternatives you could research. Many people with severe nickel allergies can be allergic to other heavy metals, but typically those are gold, stainless steel or cobalt.
      Warm regards,

  4. I just found out about my nickel allergy and you are a huge help in navigating the way forward. I was especially happy to have the ways to safely continue to drink tea.
    I wanted to share/ask about another resource I found that may be helpful for some : skinsafeproducts.com and SkinSAFE mobile app. Its a resource for those with skin sensitivities and allergies that allows you to find products (beauty, baby, health care, household, personal care, pet care) without specific allergens and irritants including nickel. It appears to have been developed quiet recently with the help of the Mayo Clinic. I’m in the process of exploring it and how it works and wondered if you had come across it or if it would be something you might find to be a helpful resource?
    Thank you again!

    1. Hi Pamela,
      Thanks for your comment and appreciation for my website. Though the SkinSafe app can be a useful website, it’s not entirely accurate, as the website does not test products for their nickel content. It appears to use the product’s ingredients list to identify what is or isn’t “safe” and nickel typically isn’t listed on cosmetic labels as an ingredient. Many people with nickel allergies can’t use cosmetics that contain foods higher in nickel, such as soy, oats, shea butter, etc, or other ingredients bad for eczema like additives or fragrance. Learning to interpret labels takes time, but is worth it.
      Warm regards,

  5. Hi Christy,
    Thankyou for your website.
    I’ve been struggling with my nickel allergy for years. And I wonder if you experience problems with your water works ? That seems to be my main reaction if I’ve eaten something with nickel it irritates my bladder and feels like a water infection and soreness down below. I end up taking antihistamine and ibuprofen to calm it down. Does this happen to other people with this allergy? Or am I an unusual case? The other reaction I get is swollen eyelids and eczema around my eyes .
    Sometimes swollen lips and little bumps in my mouth . And sometimes like prickly heat in my bowel . I’ve cut out so much from my diet . My worst foods are oats brown bread dark chocolate coffee nuts seeds tomatoes bean sprouts apricot green beans wine beer onions the list goes on !
    From Laura.

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