Nickel allergy: symptoms, diagnosis, and foods to exclude

Nickel allergy is an immune reaction of the body in response to contact with this common metal found in many everyday objects such as jewelry, zippers, kitchen utensils, and even food. It is a widespread condition in Italy, with estimates varying depending on detection methods and reference sources: it ranges between 10-15% and 30% of the population. What is confirmed from all fronts, however, is that females are more affected, possibly due to greater exposure to this metal through the use of jewelry, cosmetics, and detergents. This situation is less common in children but still present: it is estimated that about 1 in 10 in our country suffers from it.

Symptoms and diagnosis

The allergy can manifest with skin symptoms and, in more severe cases, with systemic symptoms. The skin symptoms of Allergic Contact Dermatitis (ACD) are:

• Redness and itching
• Rashes or eczema, often on hands, wrists, neck, ears, and navel (areas more exposed to the metal)
• Dryness and peeling of the skin
• Blisters and lesions similar to atopic dermatitis

The symptoms of Systemic Nickel Allergy Syndrome (SNAS) can cause more extensive reactions when ingested with food:

• Gastrointestinal problems: abdominal bloating, nausea, diarrhea, or constipation
• Respiratory symptoms: rhinitis, asthma, or breathing difficulties
• Chronic fatigue and headache
• Joint and muscle pain

The diagnosis is made by a dermatologist or allergist through:

• Patch test (epicutaneous test): patches containing nickel are applied to the skin for 48 hours, and if a reaction (redness, itching) appears, the test is positive.
• Oral provocation test: in case of suspected SNAS, the doctor may have the patient consume foods containing this metal under supervision to observe any reactions.
• Blood tests (not always conclusive): some tests measure the immune response (IgE or T lymphocytes), but they are not always reliable for this allergy.

Remedies and precautions

There is no definitive cure for nickel allergy or sensitivity, but strategies can be adopted to reduce symptoms, such as avoiding contact with the metal by choosing clothes and jewelry that are free of it (surgical steel, titanium, nickel-free silver 925, plastic, or ceramic) and wearing protective gloves if handling it. The same goes for choosing cosmetics and, of course, foods. In the latter case, the level of restriction and caution varies based on the severity of the personal situation. As always, it is advisable to rely on relevant specialists in the field to find the most suitable balance for one's needs.

Foods to avoid or moderate

Some foods are particularly rich in this metal and should be avoided by those allergic to it. For other foods, it depends on the level of personal sensitivity and other factors, as the concentration varies depending on the soil, processing methods, and environmental conditions. Cooking also makes a difference: cooking in stainless steel pots can increase contamination (as with canned food). It is better to prefer glass, ceramic, or non-stick without heavy metals.

In general, nickel-rich foods, to be excluded in case of severe allergy, are:

• Legumes: soy, lentils, beans, peas, chickpeas
• Nuts and seeds: walnuts, hazelnuts, almonds, cashews, peanuts, sunflower seeds, flax seeds
• Whole grains and derivatives: whole wheat flour, bran, oats, barley, rye, corn, buckwheat, quinoa
• Chocolate and cocoa
• Coffee and tea (especially black and green)
• Some vegetables: spinach, cabbage, asparagus, onions, mushrooms, tomatoes, carrots, lettuce
• Some fruits: pears, plums, figs, raspberries
• Fish and seafood: herring, oysters, mussels, shrimp, canned tuna
• Some industrial products: margarine, baking powder, preserves, and canned foods (due to nickel leaching from the container)

Low-nickel foods, which offer more tolerance, are:

• Fresh meats: chicken, turkey, beef, pork
• Fresh fish: cod, sea bream, trout
• Milk and derivatives: milk, yogurt, butter, fresh cheeses
• Eggs
• White rice and refined pasta
• Low-nickel fruits: apples, bananas, citrus fruits, grapes, peaches, melons
• Some vegetables: potatoes, zucchini, peppers, fennel

Safe recipes

No worries: there are still many and varied safe recipes for those with an allergy or sensitivity to this metal. For example, soups made with fresh vegetables, risottos prepared with white rice, or lean meat dishes cooked in the oven are excellent choices. Need some advice on how to creatively and deliciously combine these ingredients? On Tuduu, you will find many ideas and dishes designed for you by our expert food creators 😉