Allergic to nickel? Patients about to undergo joint replacement surgery can now get a simple blood test that will reveal whether or nor they are allergic to metals. A team has devised a blood test to determine allergies to nickel and is working on developing blood tests for other allergens such as cobalt and the bone cement that is used in most implants.
The researchers forecast that by 2030, more than 11, 000 people a day will have implant surgeries in the U.S. alone. That is an increase of 174% for hip replacements and nearly 700% for knees.
Karin Pacheco, an allergist at National Jewish Health in Denver said that joint replacement patients with “serious allergies due to implants are a problem that is sure to get worse in the coming years. We are an aging society, and the number of people who need new joints is going to increase and, for some of these people, they won’t know that they’re allergic until after the implant is put in.” She added, “Nine out of 10 people who get implants do great. But 10% don’t, and they’re miserable.”
Pacheco and her team at National Jewish Health came up with the first blood test that can detect allergies to nickel. Nickel is not only one of the most common metals used in joint implants, but it’s also the most common contact allergen. Pacheco says there are many advantages to the concept of using a blood test to check for allergies before surgery.
This article has misrepresented several facts and borders on libelous and wrong.
1. Nickel comprises < 1% of most implant metals (e.g. Co-alloy).
2. Allergy to nickel does not mean allergy to cobalt, titanium, aluminum (and vice versa).
3. This exact test has been used for over 40 years and Pacheco did not even come close to developing it.
4. Many others have used this LTT testing with other metals that are more relevant..the group at NJH has no expertise in this specific field and no publications.
There are several labs around the US conducting this testing with more appropriate challenge agents (e.g. Orthopedic Analysis LLC),
Getting this right is important given the increasing demographics and increasing potential for mis-diagnosis.
Would you please be able to give me a reference for a reputable place to get tested for allergic reactions to titanium alloys in the Los Angeles area? I have lost 4 dental implants, and the fusion surgery I had 2 years ago is failing. I need to get to the bottom of these rejections before going further. Thank you, Kathryn J.
I have been having itching burning tingling all over my body after disk fusion. Came to realize I am allergic to nickel alloy used in my neck. Please check before surgery. I used a company called MELISSA TESTING
Doctors Data a private lab tests for Implants, Implant Profile; whole blood, and a separate test for Titanium; whole blood. My mom had the Watchmen Device placed and her health has declined. The doctors did not do any testing for allergies prior to placement. There are also Reactivity Tests prior to dental or orthopedic. Here are two links.
Dental Panel
Orthopedic Panel
https://www.ccrlab.com/
https://www.elisaact.com/clifford-materials-reactivity-testing/
https://www.doctorsdata.com/
I am considering a Watchman but am concerned about nickel allergy. Patch test was negative but I am not convinced. Looking for a more definitive answer. Local primary care and cardiologists are of no help.
A blood test for metal allergy sure seems to be the right thing to do before an implant (specially if you have a history of contact allergy to metal).
It is unfortunate however that the folks at National Jewish are claiming to be the first ones to come up with this test. Nickel allergy testing in blood started all the way back in the 70s and has been widely published ever since. There are also well established labs and universities with many publications on the topic that have been doing this test for years now.
Also Nickel is not the most common used metal in implants. It constitutes 1% of one of the most common used alloys.
Thank you, this is great information.
What labs do the testing?
I would also like to know which labs do this test. I have a spinal fusion resulting in a lot of pain. I would like to be tested. Thank you for this information.
Please share labs which offer metal hypersensitivity testing (LTT, LPT).
Thank you.
Dr, Nadim Hallab (Orthopedics Analysis-Chicago) and Dr. Joshua Jacobs (Rush Univ Med Center-Chicago; also Pres. of Amer Acad of Ortho Surgeons), are both recognized as “experts” by their peers in metal sensitivity, LTT testing, and have published over 100 articles in “peer reviewed” medical journals, since 1998. Prior to my recent revision surgery due to complications from a metal-on-metal hip implant, Orthopedics Analysis confirmed my being metal sensitive to one of the alloys used in my initial THA. My previous surgeon was intending to reuse metal components for the revision. The results of the “Metal-LTT” spared me from additional revisions, as I was revised to non-metal components. The symptoms/disorders resulting from my initial m-o-m components are improving, and I’m only 2 months out from my revision. This test is a MUST for those who have concerns they may be “allergic” to various metals!
I was wanting to conect to Shari number 6. Seems like this person has a lot of answers.
I understand from the scientific studies on hyper-sensitivity type IV allergic reactions to metals that metal allergies are present in about 10% of the population.
But this percentage increases dramatically in people with failed metal implants where hyper-sensitivity reactions (new allergic reactions to metals) are found in a average
of 60% of failed metal implant patients.
Also, I understand that if a person has develops a local or systemic hypersensitivity reaction to the metals from the first failed prosthetic implant, a high percentage of patients with no initial allergy to metals develops an allergy to the metals used in the prosthetic implant revision.
Hence, if a person had an initial allergy to cobalt or developed on during the time period in which their
metal-on-metal hip was failing, if they then have a revision to an implant with titanium parts (which usually includes trace amounts of nickel used in the manufacturing process), it has been determined in the scientific studies that these patients have at least a 60% likelihood of developing a hyper-sensitivity reaction to the titanium implant.
It has been known for over 30 years that all of these metals breakdown in the human body fluids, even without metal on metal contact. It is also known that metal ions from substances like cobalt become biologically active in the human body and complete with other necessary metals like iron, but also calcium and iodine, for getting inside the cells of the body.
Even though this is well-known in the scientific community, patients with anemia of chronic disease or
post-surgery anemia often go without treatment of their anemia allowing more cobalt to be absorbed into their cells and tissues disrupting delivery of oxygen into the cells as cobalt replaces the essential oxygen-carrying iron. The cobalt also disrupts the function of enzymes.
The scientific and medical community seem to be hyper-focused on serum levels of cobalt which are only indicators of on-going exposure of a continuous source of cobalt debris from an implant. Serum levels do NOT
reflect how much cobalt has been absorbed into the tissues and organs of the body over the lifetime of the implant. There are no currently available tests to check the cobalt accumulation in the liver, kidney, heart, etc. of metal-on-metal patients. The tests that
have been done on humans are done at the time in
which an autopsy has been done. At time of autopsy, a very substantial accumulation of cobalt has been found in these organs of deceased metal-on-metal
patients.
Orthopedic Analysis in Chicago, IL does the LTT for Metal Allergies. LTT proved I was allergic to all the metals I was tested for. I had systemic pain and fatigue shortly after double knee replacement. With a few months after surgery I needed help dressing, turning over in bed and could not lift a half gallon of milk. After many hurdles, I had left knee revision in January, 2014 and right knee revision in May, 2014 both at The Hospital for Special Surgery in New York City. If you cannot wear costume jewelry tell your surgeon before any metal is placed in your body. Take the LTT Blood Test. Insist that no nickel or cobalt be placed in your body. 10% of the population getting joint replacements are allergic to metal. Relatively low % but not when over a million people a year get joint replacements. Too many people are suffering and the FDA needs to approve metal allergy testing or hold the Surgeons responsible to discuss metal allergies with patients before surgery.
Are there any labs that do metal testing in northern California?
I am having a knee replacement in January and need a nickel sensitive blood test before as my sister has a replacement done and her body rejected it due to the allergy, they want to be sure I am ok.
I am having a hard time in getting the blood test ordered.
My orthopedic says go to my primary, my primary says go to my orthopedic.
‘help….
I live in Arizona and would like to know we’re I can go to get a blood test for a nickel allergy
Did you find out where to get LLT test?
I also live in az a d am planning on zepher valves
Is there any labs in TN that do the Metal-LTT Blood Test?
Is the LTT test similar to the Melisa test. I need to have blood testing done to determine any sensitivity or allergy to titanium plates and screws implanted in forearm for ulna and radius break. Please let me know who and where these tests are done and are they conclusive. I live in New York State. thank you Mary D.
Going for thr and would like to know where I can be tested for allergy to nickel I live in Las Vegas and would rather be tested before I go for surgery to avoid a revision surgery
what tests should be done to determine if you are sensitive to an implant for a broken arm
I had knee replacement surgery 4 years ago and suffered unexplained weight and hair loss. 2 years ago I did acupuncture and after a few sessions, I started showing little red dots where the needles were placed and they itched. I had hip replacement surgery a month and a half ago on the same side as the knee and I started losing hair again. I am still experiencing pain in the hip area and now also the knee. Where can I get titanium testing in Des Moines, Iowa or the general midwest area?
Thank You For Providing information. You efforts are admirable and helps me a lot. Which labs do the test?
I am in need of a TMJ total mandibular replacement and have been struggling here in Boston to find a lab that performs this test. My primary care physician says to have my surgeon ordered a test the surgeon says have your primary care physician order the test I’ve tried calling different labs all while dealing with excruciating/debilitating pain, inability to sleep and on a liquid diet.
One of the dentist’s I went to for an implant is the only one of the many I have consulted for my treatment that will require 5 implants that mentioned a nickel allergy for implants. He said 90% of the implants that fail do so because of metal allergies and also levels of Vitamin D being too low or insufficient. Since most of the time the teeth implants are titanium I want to be tested for all metals. Luckily I am here in Chicago so at least I have a starting point for finding a place. Thank you for having this website and comments-
I have been struggling with nickel poisoning in my blood for 25 years. Please if you have any information I would greatly appreciate it.I finally found a Doctor who has listened to my problem and is trying to find a Doctor who is maybe a researcher.So far the Mayo Clinic has turned me down.The clinics in Arizona and Minnesota do contact dermatitis but so far nothing I can find on nickel in the blood. This is a death sentence for me. PLEASE HELP. Thank you….
What options do you have if you have a nickel and cobalt allergy in thr? All the stems and cups are pretty much made of titanium alloys which may contain trace amounts of nickel, are these trace amounts a concern, and does any manufacture have such a nickel free version of the hip implant parts?