The 3 Tenets of a Successful Low Nickel Diet

REDUCE NICKEL INTAKE: <150 mg/day (1-5)  

  • WATER: Drink filtered water with electrolytes added back in.

  • Tap water and unfiltered water is the #1 source of ingested nickel by a large amount. If you can eliminate this source alone, you will make a big difference. (6) If you let the water run from your faucet for a few minutes before using it in the morning, you can flush out a lot of the nickel that may have settled in the pipes overnight. See tools & resources page for details.

  • FOOD: Make animal-based foods the foundation of your meals. Add the low-nickel plants that you tolerate. (Check out the food guides for details) 

  • Animal products are not only the lowest-nickel foods available, but they also carry the benefit of being the most nutrient-dense and bioavailable sources of nutrition on the planet; Rich in the vitamins, proteins, and fats required for health, but also for effective healing and immune function like arginine, glutamine, omega-3 fatty acids, zinc, and Vitamin D. (7,8)

  • Avoid canned food, canned beverages, & food that has been cooked in stainless steel, as it all releases nickel. (9) Replace your cookware and utensils to be nickel-free when and if you can. See tools & resources page for details.

  • ENVIRONMENT:

  • Reduce your exposure to nickel in cigarette smoke, pollution, jewelry, cooking utensils, personal care products, & cleaning products. See tools & resources page for details.

 

INCREASE NICKEL RELEASE

  • SWEAT, THEN RINSE: Releases nickel and histamine through the skin (10)

  • HEAT THERAPY: Enjoy the Sauna, steam room, or hot baths when you aren’t in an active flare, because heat can exacerbate a flare. Make sure to rinse off regularly or shortly afterwards to minimize re-absorption or reaction.

  • EXERCISE: Low to Moderate Intensity Exercise 3-5 days/week encourages release. 

  • VITAMIN C WITH EVERY MEAL:

  • It binds and removes nickel before it can be absorbed (called “chelation”). (6,11)

  • It is also a major cofactor (a requirement) for collagen synthesis, immune function, and tissue health. (12)

  • 1000 mg a meal is commonly recommended. Go to the tools & resources page to see where to buy.

  • PARSLEY & CILANTRO

  • These are natural chelators of metals and can provide an extra boost to nickel removal when added to your meals.

 

BE KIND TO YOUR IMMUNE SYSTEM

  • SLEEP: 7+ hours a night

  • There is a well demonstrated causal link between the health of your immune system and the quality of your sleep. (13,14) In fact, your skin’s immune health is enhanced when adequate sleep is achieved and decreased even after one night of sleep deprivation. (15,16)

  • FAST: 16+ hours a day, several days a week.

  • Intermittent fasting or “time restricted feeding” is simply making sure that you are eating or drinking anything with calories (and nickel) in a window of 8 hours or less every day. This has been demonstrated to improve immune function, reduce infections and cancer risk, and reduce systemic inflammation. (17-19)

  • DESTRESS & SIMPLIFY: Stress disrupts your skin’s barrier immune system and healing ability. (16)  

  • Relaxing habits and rituals “tell” your body to prioritize healing. They promote parasympathetic dominance (a state of the autonomic nervous system that will put more energy into healing activities).

  • Remove all unnecessary obligations & stressors in your life that you can think of. Making change takes a lot of brain power because it requires sustained focus, discipline, & consistency. These few months are your time to focus on putting yourself and your health first so you can get your health back. The world can wait!

  • DIGEST: Support excellent digestion: Chew thoroughly (at least 20 times per bite!) in a calm, relaxed state (not while driving or working at your desk!).

  • MINIMIZE “LEAKY GUT”:

  • “Leaky Gut” is a layman’s term for “intestinal permeability”: A state in which your intestinal lining is not as selective as it should be about what makes it into your body. This can allow more things through to encounter your immune system and over-activate it, which is something you want to avoid, particularly when you are not only trying to calm down your immune system, but also limit the amount of nickel crossing this barrier! In fact, research has shown that for moderate and severe nickel allergy, an increase in intestinal permeability increases symptoms, showing a meaningful link. (20) 

  • In order to limit intestinal permeability, it is wise to limit or avoid gluten (which causes intestinal permeability in all people, not just those with Celiac disease or gluten sensitivity (21)), most other grains, alcohol, sugar, processed foods, unnecessary drugs, stress, and high intensity exercise. (22-26)

  • PROBIOTICS: L. reuteri and L. rhamnosus

  • Supplementing with probiotic strains L. reuteri and L. rhamnosus has been shown to reduce symptoms. (27,28) L. reuteri has also been demonstrated to increase GLP-1, a satiety/appetite-suppression hormone that also reduces inflammation. (29) Go to the tools & resources page to see where to buy.

For more tips on how to approach the low nickel diet, check out the cookbook, The recommended approaches graphic, and the Low Nickel Food Lists

References

1.         Antico A, Soana R. Nickel sensitization and dietary nickel are a substantial cause of symptoms provocation in patients with chronic allergic-like dermatitis syndromes. Allergy & Rhinology. 2015;6(1):ar. 2015.6. 0109.

2.         Bergman D, Goldenberg A, Rundle C, Jacob S. Low nickel diet: a patient-centered review. J Clin Exp Dermatol Res. 2016;7(355):2.

3.         Kaaber K, Veien N, Tjell JC. Low nickel diet in the treatment of patients with chronic nickel dermatitis. British Journal of Dermatology. 1978;98(2):197-201.

4.         Mislankar M, Zirwas MJ. Low-nickel diet scoring system for systemic nickel allergy. Dermatitis®. 2013;24(4):190-195.

5.         Da Mata Perez L FA, Zimmerman JR. Systemic nickel allergy syndrome. The World Allergy Organization Journal. 2015;8(Suppl 1)doi:10.1186/1939-4551-8-S1-A89

6.         Solomons NW, Viteri F, Shuler TR, Nielsen FH. Bioavailability of nickel in man: effects of foods and chemically-defined dietary constituents on the absorption of inorganic nickel. The Journal of Nutrition. 1982;112(1):39-50.

7.         R. G. Vitamin B 12 deficiency from the prespective of a practicing hematologist. Blood. 2017;129(19)

8.         Martindale RG MS, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition: Executive Summary. Critical care medicine. 2009;2009:1757-1761.

9.         Sunderman F. Chelation therapy in nickel poisoning. Annals of Clinical & Laboratory Science. 1981;11(1):1-8.

10.       Hohnadel DC, Sunderman Jr FW, Nechay MW, McNeely MD. Atomic absorption spectrometry of nickel, copper, zinc, and lead in sweat collected from healthy subjects during sauna bathing. Clinical chemistry. 1973;19(11):1288-1292.

11.       Sharma AD. Iron therapy in hand eczema: A new approach for management. Indian Journal of Dermatology. 2011;56(3):295.

12.       JK S. Understanding the Role of Nutrition and Wound Healing. Nutrition in clinical practice. 2010;25:61-68.

13.       MR I. Why Sleep Is Important for Health: A Psychoneuroimmunology Perspective. Annual review of psychology. 2015;66:143-172.

14.       Cohen S DW, Alper CM, Janicki-Deverts D, Turner RB. Sleep Habits and Susceptibility to the Common Cold. Archives of internal medicine. 2009;169:62-67.

15.       Smith TJ WM, Karl JP, et al. Impact of sleep restriction on local immune response and skin barrier restoration with and without "multinutrient" nutrition intervention. Journal of applied physiology. 2018;124:jap005472017 - 200.

16.       Altemus M RB, Dhabhar FS, Ding W, Granstein RD. Stress-Induced Changes in Skin Barrier Function in Healthy Women. Journal of investigative dermatology. 2001;117:309-317.

17.       Cissé YM BJ, Lemanski E, Walker 2, William H, Nelson RJ. Time-Restricted Feeding Alters the Innate Immune Response to Bacterial Endotoxin. The Journal of immunology. 2018;2018:681-687.

18.       Marinac CR NL, Sears DD, et al. Prolonged Nightly Fasting and Breast Cancer Risk: Findings from NHANES (2009-2010). Cancer epidemiology, biomarkers & prevention. 2015;24:783-789.

19.       Gasmi M SM, Denham J, et al. Time-restricted feeding influences immune responses without compromising muscle performance in older men. Nutrition. 2018;51-52:29-37.

20.       Rizzi A, Nucera E, Laterza L, et al. Irritable bowel syndrome and nickel allergy: what is the role of the low nickel diet? Journal of Neurogastroenterology and Motility. 2017;23(1):101.

21.       Hollon J PE, Greenwald B, Goldberg E, Guerrerio A, Fasano A. Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients. 2015;7:1565-1576.

22.       Edwards KH AK, Watson G, et al. The influence of exercise intensity and exercise mode on gastrointestinal damage. Applied physiology, nutrition, and metabolism. 2021;46:1105-1110.

23.       WANG Y TJ, CHANG B, WANG B, ZHANG D, WANG B. Effects of alcohol on intestinal epithelial barrier permeability and expression of tight junction-associated proteins. Molecular medicine reports. 2014;9:2352-2356.

24.       L. C. The role of stress on physiologic responses and clinical symptoms in irritable bowel syndrome. Gastroenterology. 2011;140:761-765.

25.       Kelly JR KP, Cryan JF, et al. Breaking down the barriers: the gut microbiome, intestinal permeability and stress‐related psychiatric disorders. Front Cell Neurosci. 2015;9:392.

26.       Kau AL AP, Griffin NW, Goodman AL, Gordon JI. Human nutrition, the gut microbiome and the immune system. Nature. 2011;474:327-336.

27.       Randazzo C, Pino A, Ricciardi L, et al. Probiotic supplementation in systemic nickel allergy syndrome patients: study of its effects on lactic acid bacteria population and on clinical symptoms. Journal of applied microbiology. 2015;118(1):202-211.

28.       Rosenfeldt V, Benfeldt E, Nielsen SD, et al. Effect of probiotic Lactobacillus strains in children with atopic dermatitis. Journal of Allergy and Clinical Immunology. 2003;111(2):389-395.

29.       Simon M SK, Nowotny B, et al. Intake of Lactobacillus reuteri improves incretin and insulin secretion in glucose-tolerant humans: a proof of concept. Diabetes. 2015;38:1827-1834.

 

Laura Duzett1 Comment