Nickel

Related Terms

Atomic number 28, Ni, nickel chloride, nickel sulfate, nickelous sulfate, n?quel (Spanish), nitinol, trace element.

Background

Nickel is trace element that is necessary for the survival of bacteria, plants, and mammals. It is a hard, bright, silver-white metal that is present in soil, water, cocoa and chocolate, nuts, dried beans, peas, soya beans, spinach, lettuce, oatmeal, grains, fruits (including canned fruits), other vegetables (including canned vegetables) and leguminous seeds, as well as shellfish, salmon, hydrogenated shortenings, eggs, and milk. Drinking water and food are the main sources of nickel. The average American diet contains about 300 micrograms of nickel daily.
Nickel alloys are metals created by combining nickel with another metal, such as titanium, and are used in many medical and dental applications, including dentures, dental crowns, stents, hip replacements, and screws used during bone reconstruction surgery. Nickel is also used to manufacture stainless steel. It is a common component of silver coins, belt buckles, and inexpensive jewelry. It is used in the automobile industry, electronics, chemical processes, nickel-cadmium batteries, and many household products.
Nickel is the most common cause of metal allergy, which affects females more often than males. It may develop at any age and tends to last throughout an individual's lifetime. Symptoms of nickel allergy include an itchy rash at the site where nickel contacted the skin. This reaction may occur after chronic exposure to nickel-containing products, such as eyeglass frames, dental materials, and inexpensive jewelry. Human exposure to highly nickel-polluted environments, such as those associated with nickel refining, electroplating, and welding, may cause skin allergies and cancer of the nose and lung.
The European Union Nickel Directive limits the amount of nickel allowed in consumer products that come into direct and prolonged contact with the skin (e.g., earrings, watchbands, and zippers). There are some indications that this regulation has reduced the amount of nickel allergy in Europe. In North America, where no regulations are in place, the incidence of nickel-induced skin allergy is increasing. Some experts believe that regulations should be in place in the United States and other countries to prevent unnecessary nickel allergies.
Although nickel deficiency may theoretically exist, scientific evidence of any benefit from nickel supplementation in humans is lacking in the available literature.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
There is no established recommended daily allowance (RDA) for nickel. Common amounts included in supplements range from 35 to 100 micrograms daily.
Dietary nickel intake is variable, averaging about 150-300 micrograms daily. Dietary nickel comes predominantly from roots and vegetables, grain, and bread. Certain food items, such as cocoa and chocolate, nuts, dried beans, peas, soya beans, spinach, lettuce, oatmeal, grains, fruits (including canned fruits), other vegetables (including canned vegetables) and leguminous seeds, as well as shellfish, salmon, hydrogenated shortenings, eggs, and milk, may have very high nickel contents.
Baking powder and cocoa powder may contain excessive amounts of nickel, due to nickel leaching during the manufacturing process. Consumption of these items in large amounts may increase the nickel intake to 900 micrograms daily or more. Soft drinking water (containing fewer dissolved minerals than hard water) and acid beverages may dissolve nickel from pipes and containers. Leaching or corrosion processes may contribute significantly to oral nickel intake, occasionally up to 1,000 micrograms daily, which is equivalent to the tolerable upper intake level for nickel in adults.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Nickel may interfere with cytochrome P450-dependent microsomal drug-metabolizing enzymes; this effect may be additive with other metals. As a result, the levels of these drugs may be increased or decreased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Nickel may alter the insulin response. Caution is advised when using medications that may affect insulin levels or blood sugar levels. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Nickel exposure may enhance the toxic effects of ultraviolet radiation and X-rays, as well as cis-platinum, trans-platinum, and mitomycin C.
Nickel should be used cautiously in combination with disulfiram therapy in patients with nickel dermatitis, due to the risk of liver toxicity.
Patients using immunosuppressive drugs who have autoimmune diseases (i.e., multiple sclerosis, psoriasis, systemic lupus erythematosus, or atopic eczema) may be more hypersensitive to nickel than healthy individuals.
Cigarettes and cigarette smoke may contain nickel and thus may increase nickel exposure.
Nickel may also interact with agents that are toxic to the kidney, agents that are toxic to the liver, anticancer agents, blood vessel-widening or -constricting agents, gastrointestinal agents, heart rate-regulating agents, hormonal agents, and neurologic agents.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Beyersmann D, Hartwig A. Carcinogenic metal compounds: recent insight into molecular and cellular mechanisms. Arch Toxicol. 2008 Aug;82(8):493-512.
Das KK, Das SN, Dhundasi SA. Nickel, its adverse health effects & oxidative stress. Indian J Med Res. 2008 Oct;128(4):412-25.
Falagiani P. Nickel hyposensitization: a literature review. Int J Immunopathol Pharmacol. 2005 Oct-Dec;18(4 Suppl):3-5.
Goodman JE, Prueitt RL, Dodge DG, et al. Carcinogenicity assessment of water-soluble nickel compounds. Crit Rev Toxicol. 2009;39(5):365-417.
Goodman JE, Prueitt RL, Thakali S, et al. The nickel ion bioavailability model of the carcinogenic potential of nickel-containing substances in the lung. Crit Rev Toxicol. 2011 Feb;41(2):142-74.
Li Q, Zeng Y, Tang X. The applications and research progresses of nickel-titanium shape memory alloy in reconstructive surgery. Australas Phys Eng Sci Med. 2010 Jun;33(2):129-36.
Lu LK, Warshaw EM, Dunnick CA. Prevention of nickel allergy: the case for regulation? Dermatol Clin. 2009 Apr;27(2):155-61, vi-vii.
Navarro Silvera SA, Rohan TE. Trace elements and cancer risk: a review of the epidemiologic evidence. Cancer Causes Control. 2007 Feb;18(1):7-27.
Pazzini CA, Pereira LJ, Marques LS, et al. Allergy to nickel in orthodontic patients: clinical and histopathologic evaluation. Gen Dent. 2010 Jan-Feb;58(1):58-61.
Pizzutelli S. Systemic nickel hypersensitivity and diet: myth or reality? Eur Ann Allergy Clin Immunol. 2011 Feb;43(1):5-18.
Plotino G, Grande NM, Cordaro M, et al. A review of cyclic fatigue testing of nickel-titanium rotary instruments. J Endod. 2009 Nov;35(11):1469-76.
Schram SE, Warshaw EM, Laumann A. Nickel hypersensitivity: a clinical review and call to action. Int J Dermatol. 2010 Feb;49(2):115-25.
Thyssen JP, Uter W, McFadden J, et al. The EU Nickel Directive revisited--future steps towards better protection against nickel allergy. Contact Dermatitis. 2011 Mar;64(3):121-5.
Thyssen JP, Carlsen BC, Menn? T. Nickel sensitization, hand eczema, and loss-of-function mutations in the filaggrin gene. Dermatitis. 2008 Nov-Dec;19(6):303-7.
Wild P, Bourgkard E, Paris C. Lung cancer and exposure to metals: the epidemiological evidence. Methods Mol Biol. 2009;472:139-67.