Low Nickel Diet for Nickel Allergy

Published:  09/21/2017

Nickel allergy is a common cause of contact dermatitis, diagnosed through skin examination and patch testing.  Nickel exposure, both from contact and diet, can trigger reactions.  Managing a nickel allergy involves minimizing contact with nickel-containing items like jewelry, clothing fasteners, everyday objects (coins, keys, electronics), and many kitchen items (especially stainless steel cookware, utensils, appliances, sinks, and faucets).  If symptoms persist, dietary changes to reduce nickel intake may be helpful.

Careful selection of food with relatively low nickel concentration can bring a reduction in the total dietary intake of nickel per day.  This can lead to fewer and shorter flares but may not completely eliminate all your symptoms.

To see if this will work, it is important that you follow this strictly for 1 to 3 months. If you do not see improvement after following this diet for 1 to 3 months, contact your dietitian and/or doctor. If you do not have a registered dietitian, I provide remote, phone or teleconferencing consultations.

As with all food sensitivities and allergies, it is recommended that you keep a food diary in order to track what works for you and what doesn't work for you. To do this write down all foods.amounts and also make note of time and type of symptoms you get. Also make note of no reaction.

Things to keep in mind:

• The amount of nickel in the soil and water used to grow the food can affect nickel content of foods.
• Avoid or moderate canned foods. Processed and canned foods can add nickel via equipment used in manufacturing and leaching from the metallic can.
• Run the water in your sink for a five minutes before using it to ingest. Tap water may contain nickel. Hot water can leach nickel from faucets into the water sitting overnight in the fixtures. 
• Consider vitamin C and/or iron supplementation with meals. Eating foods high in vitamin C and iron can reduce the absorption of ingested nickel.  Avoid or moderate vitamin supplements/drinks containing nickel. For dose, consult your Doctor or Dietitian. 
• Avoid stainless steel cookware and nickel plated utensils when cooking with acidic foods. Stainless steel cookware such as stainless steel can leach nickel into the food if cooking with acidic foods such as tomato, rhubarb, vinegar or lemon. Alternatives are ceramic, cast iron, glass or nickel free stainless steel options.

Cookware and Kitchen Equipment for a Nickle Allergy

When choosing cookware for a nickel allergy, you can consider options like:  

Nickel-free stainless steel: This type of cookware is a good option for people with allergies or skin sensitivities. However, nickel is sometimes added to stainless steel to increase its durability and corrosion resistance. The best cookware to buy is Homichef which is Nickle Free Stainless Steel. 

Ceramic-coated cookware: This type of cookware is made from minerals and clay, and doesn't react with food or release harmful substances when heated. 

Enameled cookware: This type of cookware is another good option for people with allergies. They are usually made of sheet metal coated with enamel, which is powdered glass with a special pigment

Cutlery (silverware) composition is defined by a system of two numbers: the first is the percent chrome and the second is the percent nickel: 18/0, 18/8, and 18/10. The 18/0 stainless steel contains no nickel. So, look for 18/0 stainless steel, or switch to plastic cutlery.

Non-metal chopsticks are also a good option.

Kitchen knives are made of a wider variety of alloys than cutlery. Contact the manufacturers to find out what they use. Ceramic kitchen knives, peelers and other tools are available. 

Glass bakeware is a safe option. Parchment paper and silicone liners are a way to reuse your existing metal bakeware. 

Silicone bakeware can be used. 

Testing Metals for Nickel

You can use a (DMG) dimethylglyoxime test to test the exposed metals that are routinely in contact with your skin. When this liquid is rubbed on a surface that releases more than 10 ppm nickel, it turns pink. The test isn't perfect, though. If the test is positive, you can be 98% sure that it is releasing more than 10 ppm nickel. But if the test is negative it's not very reliable; there's a 40% chance that the test was wrong.  Thyssen, J.P. et al., 2010. Sensitivity and specificity of the nickel spot (dimethylglyoxime) test. Contact Dermatitis, 62(5), pp.279-288. Abstract

 

General Recommendations for What Food to Eat and Avoid For a Nickel Allergy

The foods with the most nickel are botanically classified as seeds: nuts, seeds, beans, whole grains, and the foods made from them, such as chocolate and tofu. There are exceptions to this rule. The amount of nickel in a food is always variable, regardless of whether it is high or low on average. This has created a great deal of confusion, and led to conflicting advice and information in the various "low nickel diet" lists. 

For Nickel Content by Food Sources in foods go here. Amounts of dietary nickel were gathered from literature review [1,4,6]. 

The overall goal of a low-nickel diet is to not exceed 150 μg of nickel per day. [5]

Following a point based diet 10 μg= 1 point. Daily goal is less than 15 points [4]. Low-nickle diet scoring system found here. 

FRUIT Peaches, pears, bananas, blueberries, strawberries, blackberries are all considered to be low-nickel fruits. Any of these can be eaten fresh or cooked, but not canned. Raspberries, pineapple, figs, dates, and prunes should be avoided. Apples, tomatoes, oranges, grapefruit, and other citrus fruits are low in nickel content but can exacerbate allergy symptoms if someone is very sensitive.

VEGETABLE Recommended vegetables include: bell peppers, cucumbers, eggplant, and cruciferous greens (cabbage, cauliflower, bok choy). Avoid green leafy vegetables (spinach, kale, lettuce), bean sprouts and legumes, especially dried beans and lentils,peas, spinach,  soy anything.

DAIRY All plain dairy products--milk, cream, cheese, butter, yogurt--are allowed. Avoid chocolate milk and raspberry or citrus yogurt.

GRAINS Refined wheat and most corn products are permitted on this diet. Pasta, white rice, cornflakes, cornmeal, and white breads are all low-nickel foods. Whole wheat and multigrain flours, however, are high in nickel content. Avoid wheat and oat bran, oatmeal, brown rice, and flower seeds (such as sunflower and sesame), whole wheat pasta, buckwheat, millet, muesli, multi grain breads, brown rice, wheat germ, oatmeal.

NUTS SEEDS SOY Avoid nuts, seeds, and soy (soybeans, soy sauce, tofu, tempeh, Tofutti ice cream, Boca Burgers and other soy based burgers, soy milks).

ANIMAL PROTEIN Most kinds of animal protein are low in nickel content. Chicken, turkey, beef, and eggs are recommended. Shellfish, such as clams, shrimp and oysters, salmon are higher in nickel. Do not eat canned meats and fish, such as tuna. 

BEVERAGES Alcoholic beverages, coffee, and tea (though not from urns or machines) are allowed, as are sodas, and juices from low-nickel fruits. Avoid apple and citrus juices and chocolate drinks.

AGGRAVATING FOODS Various food items and drinks can aggravate nickel dermatitis even though the nickel content of these foods may be low. These include beer, wine (in particular, red wine), herring, mackerel, tuna, tomato, onion, carrot, and certain fruits, in particular, apples and citrus fruits (juice). These vegetables can usually be tolerated when cooked.

Sources of Dietary Nickel To AVOID

All canned items

All nuts (walnuts, cashews, peanuts, almonds, hazelnuts, soy nuts)

All seeds (sunflower seeds, linseed)

Almonds

Baking powder, large amounts,

Beans

Bran, wheat, bran biscuits, some fiber tablets

Buckwheat

Cashews

Chocolate and cocoa drinks, especially dark chocolate, chocolate milk and raspberry or citrus yogurt

Chocolate, cocoa and beverages containing them

Cocoa

Commercial salad dressings

Dates

Dried Fruits

Fiber Tablets Containing Wheat Bran

Figs Fresh and Dried

Gelatin

Hazelnuts

Kale

Leeks

Legumes: Peas, Lentils, Peanut, Soy Beans and Chickpeas

Lentils

Lettuce

Licorice

Linseed

Margarine

Marzipan

Millet

Millet

Muesli

Multi grain breads

Multigrain Breads

Oat and oatbran

Oatmeal

Peanuts

Peas (Including Green and Split Peas)

Pineapple

Prunes

Raspberries

Red Kidney Beans

Rye

Rye bran

Salmon

Sesame seeds

Shellfish (Shrimp, Oysters, Mussels, Clams, Crawfish)

Soy ProteinProducts

Spinach

Sprouts, Beans and Alfalfa

Sesame seeds

Sunflower Seeds

Sweets Containing Chocolate

Tea from drink dispensers (the nickel leaches into the tea)

Vitamin/Mineral Supplements Containing Nickel

Vitamins containing nickel

Wheat Bran Products (Whole Wheat Breads And Cereals)

Whole Grain

Whole Wheat and multigrain 

Foods LOW In Nickel Content

(GF= gluten free) 

Some foods low in nickel may aggravate symptoms even though they are low in nickel: red wine, beer, herring, mackerel, tuna, onion, tomato, carrot, onion, apple and citrus. Some tolerated when cooked.

1/2 & 1/2

Apple Pie (GF crust)

Apples and citrus fruits and their juices

Applesauce

Asparagus

Banana

Beef

Beer can aggravate symptoms

Beets

Blackberries 

Blueberries

Broccoli

Brussel Sprouts

Butter

Cabbage, white

Cakes and biscuits not containing Buckwheat almonds or other nuts, cocoa,

Cantaloupe

Cauliflower

Celery

Cheese

Chicken 

Chinese Cabbage

Corn

Cornflakes

Cornmeal

Cornstarch

Cottage cheese

Cranberry juice

Cucumber

Dill

Dill pickles

Eggplant

Eggs

Fish such as herring, mackerel and tuna can aggravate symptoms

Flour, white wheat

Garlic in moderation

GF Mac n Cheese

GF ramen noodles

Grape Juice

Grapefruit

Grapes

Honey

Hot dog

Lamb

Liver

Macaroni

Maple Syrup

Mayonnaise

Meatloaf with GF binder

Milk (no chocolate)

Millet or chocolate Muesli and other similar breakfast cereals

Mushrooms

Okra

Onion, small amount

Oranges can aggravate symptoms

Parsley

Peach

Pear

Peppers, Green and Red

Popcorn

Potato

Poultry, eggs and fish (except salmon)

Raw tomatoes, onions and carrots

Rhubarb

Rice or corn cereals

Rice, white

Sherbet

Spaghetti

Spinach small amount

Squash

Strawberry

Tomato small amount

Tuna in water (but NOT a can) can aggravate symptoms

Turkey

Turnip

Vanilla ice cream

Watermelon

White rice

Whole grain rye and wheat in moderation

Wine (especially red wine) can aggravate symptoms

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3667300/

Penn State Nickel Diet https://goo.gl/kwD33P

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Silverberg NB, Pelletier JL, Jacob SE, Schneider LC; SECTION ON DERMATOLOGY, SECTION ON ALLERGY AND IMMUNOLOGY. Nickel Allergic Contact Dermatitis: Identification, Treatment, and Prevention. Pediatrics. 2020 May;145(5):e20200628. doi: 10.1542/peds.2020-0628. PMID: 32341178.

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