What works to get rid of dietary nickel from my body?

This post is a gentle reminder to all who might be reading, that ACD (allergic contact dermatitis) and SCD (systemic contact dermatitis) are type 4 allergies, with delayed response.

For now, I won't be posting any popular "detox methods" but will focus on steering us back to what the emerging science is telling us about how to safely reduce our symptoms with dietary nickel in mind.  But first ...

There is no known "cure" for ACD or SNAS (systemic nickel allergy), so avoidance of our contact allergens is so far, the most successful method of reducing symptoms. Of course, avoidance should be combined with "healthy living" and good overall self-care strategies. This is especially important in the managing of skin, and (with SNAS) GI symptoms.

With SCD, like systemic nickel allergy, which is the focus of the Facebook group, EATING WILL WITH SYSTEMIC NICKEL ALLERGY (SNAS),  it is crucial to remember that SYSTEMIC NICKEL ALLERGY is an allergy of EXPOSURE and ACCUMULATION.  Think of your body as a bucket, and every time we eat nickel loaded foods, the bucket gets fuller, until we excrete the nickel that we have ingested. So any time we who have systemic responses to the nickel in our foods, exceeding a certain threshold of consumption, we have allergic reactions that can manifest in a variety of different ways, as we have discussed many times in this, and other groups.

Whatever method of self-care we choose, whether proven or not, if it does no harm and only good, of course, we should not discourage each other from at least trying. However, I want to be very clear about one very important point with SNAS - however we choose to "draw out" nickel from the body, the moment we introduce higher nickel foods and reach that threshold of accumulation that provokes reactions - somewhere between 100 ug and 250 ug ++, we will once again experience reactions. This is the nature of the allergy itself.

I am sure most of us have all tried various "detox" methods, but so far the best and most "gentle" one, proven by science (and even so, it gets a lot of resistance in the western medical communities) is the 8 week low nickel "detox" phase of the INDD.  This is because it is designed to keep our daily consumption of dietary nickel to levels below 100 ug per day. Any other self care strategy should be implemented only after addressing the diet, adding vitamin C to every meal, and taking the right probiotic (and if you can tolerate it, some high quality dairy). Then, if you find that there are a number of external methods of "detox" ... baths, soaks, foot baths, etc. that might do your body good, I think they can only enhance your already focussed approach to keeping Ni out of your life (and your body).  That said, be every mindful of all your contact allergens and other allergens, or you may provoke additional skin reactions.

I have allergies to formaldehyde releasers, so when considering any bath or soak, I will read labels and ingredients carefully.  Watching out for all our triggers should be a way of life for us.  With some carefully implemented strategies and consistency with the INDD, I think we can all achieve a decent state of well-being, with enough flexibility to follow our own unique paths to healing.   

FREQUENTLY ASKED QUESTION, 2 -How to determine if you have SNAS, or "just" ACD to nickel?

Q:  HOW DO I TELL IF I HAVE A SYSTEMIC NICKEL ALLERGY OR "JUST" ACD (allergic contact dermatitis) TO NICKEL?  
A:  I don't know the science behind this, but it seems that this approach has been mentioned by several doctors in the studies, as a possible approach: 

If you have contact allergic dermatitis (ACD) to nickel, you don't automatically have the systemic version - allergy to the dietary nickel in foods you eat. To determine if your nickel allergy is "systemic" two steps are involved:

1. Do a strict low nickel diet for 8 weeks (keeping below 100 ug of dietary nickel daily, if possible, and not exceeding 150 ug per day). 
 2. "Oral provocation test" ... after the 8 weeks, you will notice that your symptoms have improved. However this doesn't mean you have SNAS. The provocation challenge will tell you this -- It involves introducing high nickel foods again. After a period of 4 days to several weeks, if your symptoms return, this means that you are reacting to dietary nickel, or that in fact, you have SNAS.

Discuss with your doctor ... especially important here in North America, as most doctors aren't really clear on SNAS or whether it is a "real" condition. The oral provocation challenge is the proof.

If you aren't reactive later on with the reintroduction of higher nickel foods - Yay you!

FREQUENTLY ASKED QUESTIONS, 1 - a quick "draft" about the diet

QUESTION OF THE DAY -  WHY ARE YOU INTRODUCING US TO YET ANOTHER DIET?  

ANSWER(s): 

• I'M NOT!
• But, I have received a number of questions about "this Italian diet" and some people have raised concerns that the foods on this list that I have dubbed the INDD (Italian Nickel Detox Diet), don't jive with what they knew from other lists ... well ...   

• Yes, they actually do!

• As you may have noticed - none of the lists out there that cover dietary nickel content have ever matched.  
• This is merely a template for how to manage the diet, but doesn't solve the issue of variance in the data on nickel content collected from region to region. Ni content varies from growing region to growing region, from farm to farm, and from day to day.  This is how nature works. 

• This template provides you with a STRUCTURE, but it isn't designed to replace any list your doctor has given you ... 
• But hopefully it will complement what you have been provided till now.  Hopefully, it can work in tandem with most information sheets handed out by North American health providers, since their info is generally based on the research coming out of Europe on the subject of SNAS. 

• To find the links to the databases and the Ni App to count Nickel in your food, please go right => and click on the links I provided.  

• The INDD has merely counted the nickel ugs for you, and created a list you can use to stay well below 150 ug (or parts per million) per day.  This is the daily threshold of dietary nickel content that the studies say we need to stay below in order to reverse symptoms and remain non-reactive.  When we are better, we can slowly increase up to 250 ug in many cases. 

• The second column includes the mid-range nickel foods, and the third column, if you are lucky enough to achieve enough healing, are the "avoid foods" that you might be able to add back to your diet, with extreme, caution, in rotation - one day!

• But, it could reduce your frustration about how to go about finding and eating nutrient-dense foods, especially during the early days of the diet, or in the "detox" phase, while you allow your body to adjust to avoiding dietary nickel.
• SO, to help us all out, I took the diet, created a draft and added some average Nickel values beside most of the foods for the LOW/YES (or "detox") column, and a few in the MODERATE (use with caution/sparingly) column.  The nickel values/ug are in the colour pink.  
• I have also included an [H] where appropriate to indicate high histamine foods which can provoke reactions along with our Ni allergic reactions.  Please proceed with caution if you are HIT intolerant, or be aware that if a low Ni food is causing you issues, it may not be because the "nickel charts" are wrong, or because you are "super sensitive" to minuscule amounts of Ni, but because you may be highly histamine reactive - or histamine intolerant (HIT).  Your body may be producing too much histamine along the H2 pathway.  
• This is just a DRAFT document - a working document, if you will ... so I will eventually take it down and replace it as time goes on.

• I recommend you get into the habit of looking up Ni values yourself on the App or the online documents I already introduced you to here in the blog [go right, see the list of links, it is all there].  It gets easier if you do this, as you will eventually have it all committed to memory.  

• It is based on 100 gram units of measure 

• Just for fun, you can create a one-day menu plan (or a few) from column 1, and add up the ugs per serving, and total everything up for the day.  
• My guess is that you will end up ALWAYS well under 150 ug.  

• That was the point of this structure - the LOW list is meant to be strictly adhered to for "detox' weeks, and used as a baseline when you are feeling better and can add some foods back that are a little higher.  
• The MODERATE list is to be used to enhance your diet after "detox phase" ... and so on ... 
  HAPPY COUNTING and HAPPY MEAL PLANNING!!
• 

FAQ - Ways to think about this "allergy of accumulation"

From my Facebook post of May 24th, 2017
Why we have to keep total exposure in mind beyond Ni accumulation in our foods. An example from my own life - recently, I had some exposure to my other big allergy - formaldehyde releasers. So, my hand was acting up. A bit of DE, some cracking and peeling. Then a chest rash, then a rash all over my shoulder blade. I haven't changed my laundry products, so I doubted that the chest rash was a formaldehyde reaction. I had worn a bra with underwire a couple of weeks ago, with a mild reaction, but it had cleared up, and bang suddenly it was back 5-fold. Plus the back rash. My flirtation with chocolate was behind me, and that reaction had subsided. But I had some bread that turned out to have soy in it (I am slightly IgE allergic to soy, plus the nickel allergy), so another reaction. By last night, the itching was sooooo bad, after a low nickel meal. WTF, I asked myself.

Then I took a good look in the mirror. No eye swelling, hmmm ... but in my ears - a pair of gold hoop earrings! I have always been able to wear 18k gold and above, and these are the earrings I default to when I do try to wear jewellery these days. I took them off, had a shower, and didn't even bother with taking any of my rescue meds or extra vitamin C. I simply went to bed, and meditated my way through itching so intense it felt like nerve pain. Woke up this morning much improved. A food reaction doesn't reverse this quickly with me. My body is hopefully letting go of the last of the soy. But I took a good look at the earings, with a magnifying glass, and yep ... I had assumed they were 18k, but nope, they are 10k! Probably up to 8% nickel. Had them on for about 4 days, and with each day the tiny rashes were growing.
Today, no itching. Coincidence, or total accumulation and exposure?

That's today's aha moment!

Getting Started, Part 3 - Rationale for My Approach

The dietary approach that I am following personally, is informally dubbed by a few of us SNASies, as the INDD (Italian Nickel Detox Diet).  It is loosely based on the Mediterranean diet, and more specifically on the  Italian Low Nickel Detox Diet, adapted from Italian FB group - Allergia al Nichel - Il gruppo originale! -  ... with permission of the group's administrator, Mavie Aliena.  Versions of this diet are utilized and recommended by the medical community, and backed by extensive research, in Italy and Denmark.

A similar approach also seems to be getting more and more recognition  by researchers and medical professionals in the US and Canada, but I believe the lists that patients get here, often do not go into enough detail, or provide enough education to help us manage the fact that SNAS is allergy to accumulation (of nickel) while at the same time, it can provoke or exacerbate additional symptoms of excess histamine production in our bodies.  The INDD does take into account that to achieve symptom relief, it's important to give ourselves at least an eight (8) week period on both - a very low nickel diet combined with ideally, a low histamine diet as well.  This approach assumese that certain high histamine foods can keep us in cycles of reactions that may not be directly related to the accumulation of nickel in our bodies. This is what happened to me!  My body was very reactive even to low nickel foods, initially, but when I addressed the need to stay away from histamine-loaded foods, as well as nickel-loaded foods, my symptoms began to slow down and resolve.  Unfortunately, I hadn't realized that there was a whole diet in Italy that addressed this 2-prong approach, and I thought that this was a situation unique to my body.  So, I would constantly have to consult several different lists as well as the nickel "counting" lists and the Ni App.   When I discovered the Italian groups I was thrilled!

Their philosophy is that during the "detox" period, this combined approach allows the body time to naturally "detox", or naturally eliminate the nickel in our digestive tract from our former nickel-loaded diet, while helping reduce symptoms more quickly than the low nickel diet alone. 

The Mediterranean Diet Pyramid
Modifications for the INDD (or  a Modified Mediterranean Diet for SNAS):
While we must exclude most whole grains, nuts and legumes, and a number of dark green vegetables during the detox phase of the INDD,  this pyramid depicts the Mediterranean approach - We must also, ideally include perhaps more meet, fish and eggs initially, during the nickel detox period, the focus is on whole foods, variety in choices, drinking water always, and daily physical activity.   

In other words, or to reiterate - the INDD goes a step further in the early stages of the low nickel diet that is normally recommended here in North America, because it  embeds in its philosophy the role of histamine production in our GI systems, and the role that histamine reduction n symptom plays with allergies that manifest through the same or parallel pathways in our bodies.  So, it is intentionally designed to also reduce our consumption of high histamine, and histamine liberating foods.  The good news is that many high nickel foods are already, coincidentally high in histamine, so it only takes a few tweaks to customize the "dual" approach! The basic theory is that Healing takes longer if we consume too many histamine foods during the detox period of the low nickel diet, because they provoke similar symptoms in a vast majority of people with SNAS.

I think it is really important to learn about the nickel content of your food, and not just follow lists that have been provided to us, which can be either outdated or not relevant to our geographic area, or to the area where our foods are grown.  I know, this just sounds like too much! But it becomes important in the context of this allergy being one of "accumulation" - Researchers have suggested that to be free of symptoms, you must eat below the threshold of 150 ug total dietary nickel per day. Other researches peg it as high as 250 ug per day. Many of our peers say they actually need to be as low as 100 or fewer ug per day ... Children under 12 also must consume below 100 ug of nickel per day. 

All this takes time, and it isn't always completely necessary to change your life overnight, unless you are very ill.  Start with the basics - Part 1, and move toward starting the full INDD (Italian nickel detox diet), in Part 2, after a week or 10 days.  

The "Getting Started, Part 1" document is something I created myself, distilled from and supported by research, and accepted practices by health providers who deal with the allergy around the world. I believe it is quite comprehensive enough to get new SNASies started.

"Getting Started, Part 2", is the INDD in detail, translated from the Italian, and adjusted to reflect foods available in North America.  It may continue to be adjusted over time, as we learn more.  Both these posts will be edited and revised soon, to reflect my own learnings as I move through the diet and the research.  And of course, we should maintain a practice of checking the Ni content in foods lists (the Ni App and/or the other lists I have included in the side-bar of this blog.

Getting Started on the Low Nickel Diet, Part 2 - The INDD (Italian Nickel Detox Diet)

*Revised April 20, 2017*
Listed here is an updated version of the Italian Nickel Detox Diet. Adapted from the Italian online community "ALLERGIA AL NICHEL: il gruppo originale!" (on Facebook) 

The "Key to the Diet" page provides a more or less direct translation of the Italian original text, and hopefully it clarifies some questions, and key concerns that Canadians and Americans have around how to manage the diet.

The KEY is still too lengthy and disjointed, but that is how the Italian version reads.  In time I will continue to edit and re-organize it and the diet itself to meet our needs.  A work in progress ...

The food charts themselves have been partially adjusted to include some common food names and examples that weren't included in the Italian version.  These are highlighted in red.

Day to Day Strategies - #3 Coping Tips for Menu Planning

COPING TIPS - menu planning, recipes and food:
I mentioned in the Facebook Group, what I think is an important reminder for day to day coping with the challenge of meal preparation and planning, but I want to make sure people see it, so am giving it a blog post space ... feel free to add your comments - either here or in the group

One important piece of advice - Never be afraid to search the internet for recipes, and see how you can adapt them to a low Ni version! That's what I have been doing. Arm yourself with the INDD list and don't just dismiss recipes that might have questionable ingredients. I have always eliminated various ingredients and made substitutions based on what I thought might have been a reactive ingredient for me. Eg - substitute shallots for onions, reduce garlic, if you think it gives you issues. Substitute fresh herbs for dried ones, and so on.

Of course, don't go searching for recipes that have legumes, soy, whole grains, or chocolate as your base, or main ingredients! Be bold and adventurous - try "new" vegetables. Make soups and stews with our Ni safe foods! Embrace it. Really, what choice do we have? There are tons and tons of adaptable recipes out there!

Nickel levels in fats and oils ... a very incomplete working document

Day to Day Strategies for Coping with the SNAS Diet

These steps form an important part of our daily dietary and lifestyle routines:

First and foremost, the low-nickel diet doesn't replace the need to avoid or reduce your exposure to nickel in your environment.

• Avoid stainless steel cookware, use parchment paper in your bakeware.  Ideally, cook with glass, ceramic, cast iron, carbon steel, and ceramic lined metal pots and pans. 
• Be aware of nickel content in your stainless steel cutlery.  If you are highly reactive, use plastic cutlery and and ceramic knives. 
• Get your tap water tested - to be safe we need to stay at < 2 parts per million.  For the general population, it is pegged at 5 ppm. 
• Avoid contact with laptops and cell phones.  Use silicone covers, otter boxes, wear cotton gloves or vinyl gloves. 
• Become familiar with nickel content in your cosmetics, hair products and lotions and potions.
• Use simple laundry products
• Be aware of door knobs, hand rails, appliances. Think about how much nickel is in those nice stoves, fridges, microwaves, kettles, toasters that are made of stainless steel. 

Besides avoiding the highest nickel foods from the various lists,or going on a full nickel-poor diet, a couple of things should be considered "mandatory" as they might help you manage: 

These supplements should be taken every day:

1.  Vitamin C (at mealtime)

2.  Probiotic - preferably Lactobacillus Reuteri strain, or Lactobacillus Rhamnosus

3.  An iron supplement, or preferably eat animal protein and other high iron foods

4.  Vitamin D

How to approach the use of these supplements and incorporate in you diet:

1. make sure you take vitamin C with every meal.   Capsule, tablet powder or liquid
• powder and liquid form are easiest to absorb.
• The studies recommend 500 mg per meal, but it can vary from individual to individual.  It binds with the nickel in food, so we can excrete it instead of digest it and ultimately ending up in our blood stream.
• I now take 1000 per meal most of the time. But I have severe reactions that the C has really helped to keep at bay, and it helps me keep increasing my healthy food intake.     
• If you "slip up" take a little extra vitamin C after your meal.  
• Some folks have sensitive stomaches, so look for a brand that is buffered.  
• Vitamin C is also a natural antihistamine.
2. take a good quality probiotic - 
• L. Reuteri and L. Rhamnosus strains have been studied and considered most effective for SNAS.  
• This is proven to help via several studies to help increase the resilience of the gut micro biome, and in turn offer protection against dietary nickel.  It helps reduce the likelihood of skin symptoms, and helps with GI symptoms.
3. Take an iron supplement and B12 if needed, every day.  
• If your iron stores are good, you should still consider eating good quality, high iron animal protein, for iron as well as other micronutrients.  
• Iron is a nickel chelator as well. 
4. Take a Vitamin D3 supplement every day.  
• Studies have shown that most North Americans and northern Europeans are low in vitamin D levels from lack of sunshine in winter and use of sunscreens in summer (vitamin D is metabolized through exposure to sunlight.  
• Further studies are showing that those of us with low vitamin D are also gut compromised and immune compromised, so we seem to need it for efficient digestive processes, and as a boost to our immune systems.  

Also important:

A. Drink lots of water - at least 2 litres a day.  Or more. 

B. Include some dairy, especially plain, natural Greek yogurt, plain kefir, or ricotta cheese - dairy is a nickel chelator.  If you cannot tolerate dairy, omit this step, but consider increasing your probiotic. 

C.  Whenever possible, try to get as many of your nutrients from food - eat daily those foods that are high in vitamin C, iron, B12 and vitamin D.

revised 08-04-2017

nichelina & co

coachgilda@gmail.com

Strategies for Eating Out with Systemic Nickel Food Allergy

First and foremost - whenever possible avoid fast food places and franchise chains. Focus on small, independently owned restaurants. Ask to speak to owner or chef, state your allergies and ask lots of questions. 

And do all of these if necessary ...

1)   take an antihistamine combo (H1 & H2 - like Zantac + Zyrtec) before and after the meal. Check with your GP or allergist re: what is advisable for you and your particular basket of health issues.

2)   with the meal, take at least 500 to 1000 mg of vit C if you can tolerate it – it will help with chelation of Nickel.  Some folks tolerate only smaller doses.  Start at 250 mg, and see how you fare.  

3)    take your vit C with meals every single day ... not just when you go out.

4)    take a good probiotic with L reuteri strain every day

5)    take an extra dose of the probiotic when you eat out

6)    drink lots of water, even more than usual when you go out

7)    on the day you eat out, take an antihistamine like benadryl or atarax at bedtime.

8)    take an extra dose of vitamin C at bedtime

9)    have a dairy-based dessert or bedtime snack for extra chelation

I did all of this on vacation last year x 2 weeks ... this was before I knew that SNAS was at the root of my massive flare-ups. I was fine the whole time for the first time ever when travelling ...

NOTE:  

• Not everyone needs to do step #1.  Some folks report that antihistamines don't help their symptoms much.  
• What is important to keep in mind is a healthy gut micro biome.  Digestive enzymes may be needed and there is research showing that DAO supplements or Quercetin can be helpful.  Talk to your health practitioner to see what might be helpful.  You may find that you need to take these in step #1, to be able to eat out.  

January, 2017

Getting Started on the Low Nickel Diet, Part 1 - The Basics

The "Italian Nickel Detox" Diet 

(revised 20-03-2017)

CLICK HERE FOR THE DIET

If you have been diagnosed with or suspect you have Systemic NickelAllergy Syndrome (SNAS), it is important to understand that it is connected with, or is a consequence of Allergic Contact Dermatitis - and one of the most effective treatments is to implement a low-nickel diet.  Systemic reactions to nickel can be closely connected with the naturally occurring presence of the element - nickel in our foods, or to the presence of added nickel through preparation, manufacturing, packaging and cooking methods. 

The low nickel diet can significantly reduce the following symptoms of nickel allergy or intolerance - dermatitis, hives, eczema, rashes and i(often extreme) itching.  Other symptoms include headaches, migraines, asthma, IBS, colitis, joint swelling and pain, tinnitus and more.  These symptoms often occur with a number of other conditions, so SNAS is often difficult to diagnose as a result.

In order to achieve symptom reduction, it is important to avoid certain foods.  The low-nikel diet recommendations fall under 3 general categories:

·                Foods that naturally contain Nickel : beans, peas, nuts seeds chocolate, and more;

·                Foods that do not contain nickel, but that come into contact with certain processing and baking procedures : flour milling, acids (tomato products, lemon, citrus) cooked in stainless steel cookware, canned food;

·                Foods that absorb the Nickel from soil in which they are grown (dark leafy greens, root vegetables),or the waters in which they are caught or bred: the tap water that comes in contact with nickel in the plumbing pathways and pipes.

FOODS TO AVOID

It's easier to start with the top nickel-loaded foods - and to eliminate them right away.  And consider that most other foods will be relatively safe in a balanced diet.
Many foods (including many that are normally considered very healthy otherwise) contain traces of nickel,that contribute to, or trigger reactions for those of us who are allergic or highly intolerant, while causing no such reactions to otherwise healthy individuals.  The top nickel-loaded foods include:

1.            Chocolate and cocoa powder: these are the foods with the highest concentration of absolute Nickel, caused by the long refining processes and constant contact with steel machinery. Cocoa powder has a nickel concentration of 9.8 ug per gram!

2.            Cashews : despite their purported health benefits in the prevention of cardiovascular disease, these nuts are among the highest in Nickel and therefore must be eliminated

3.            Beans and legumes , especially lentils

4.            Green leafy vegetables :  such as spinach, lettuce, kale and certain cabbages should be avoided.

5.            Whole wheat flour and whole grains have a high concentration of Nickel

6.            Peanuts, almonds and walnuts and seeds : flax seeds, sunflower seeds

7.            Soy : including tofu, soy sauce and soy beans

8.            Shellfish : shrimp, oysters, clams

9.            Meat and canned fish , like “tinned beef or pork” or canned tuna, salmon, herrings etc.

10.        All canned products : green peas, chickpeas, legumes in general, fruit, peeled

Other foods to avoid or reduce with a lower concentration of nickel:
Raw tomatoes, onions, carrots, beer, red wine, eggs, asparagus, parsley, peppers, potatoes, yeast.
These foods can be eaten sparingly, but it is suggested to avoid in the early stages of the low nickel diet.

In addition to the foods to avoid, some important suggestions:

DAILY HABITS - What to include:

·                Eat foods rich in Iron -  to counteract the absorption of nickel;

·                Take Vitamin C  - also counteracts nickel absorption

·                Use cookware suitable for those suffering from allergies to heavy metals:  ceramic, glass, carbon steel, cast iron.  For stainless steel,  the 18/10 acronyms, 18/8 and 18/0  on the pans reflect the ratio of nickel alloy in the material.  Stainless steel it is an alloy composed of iron, chromium, nickel and other metals. The first number indicates the percentage of chromium present in the alloy, the second shows the percentage of nickel. If you are allergic to the latter material, it is therefore necessary to choose pots and pans in stainless steel 18/0, ie totally free of nickel.

·                do not use aluminum foil in the kitchen

·                drink a lot of water

This should all help get you started on the low-nickel way of life, and you are encouraged to keep exploring and learning more.



WANT TO GO STRAIGHT TO THE DIET?   CLICK HERE!