Laura Duzett stumbled upon something quite surprising when a small patch of eczema on her hand rapidly escalated into a painful, itchy, debilitating systemic rash.
Faced with a three-month wait to see a dermatologist, she sought answers on her own. An online support group suggested two possible solutions: eliminating all chemical detergents and soaps or eating a low-nickel diet.
Duzett tried the former—it seemed easier to her—but without success.
“I tried to be patient, but it was getting worse and worse,” she told The Epoch Times. “It was absolutely horrendous because it was all over my body and I was in so much pain.”
Skeptically, she began a low-nickel diet. Within a few days, Duzett’s entire body began to cool. The resolution, it seemed, was through her gut.
Research is increasingly showing nickel allergy, which may affect as much as 20 percent of the American population, is linked to irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).
The inner lining of the digestive tract is an epithelial tissue, much like the skin, protecting the rest of the body from invaders. Nickel—found in plant foods, water, jewelry, cookware, and medical devices—seems to be responsible for reactions inside and outside of the body.
Duzett’s reaction was eventually confirmed with a nickel patch test—small amounts of allergen placed on the skin and covered with a patch for 48 hours.
Influencing Factors
Duzett was recovering from a traumatic brain injury after being hit by a car on her bicycle not long before her eczema appeared. Combined with Duzett’s lifelong sensitivity to nickel on her skin and a history of IBS since her teens, these factors may have created the perfect conditions for an immune reaction.
“The more your body reacts to nickel, the more it creates T cells that are made to look for nickel,” Duzett, a certified nutritional therapy practitioner and an osteopathic medical student, told The Epoch Times. “The body says, ‘There’s this new thing we need to kill that’s in the body.’ It’s going to make all these guys run around and fight it because they want to protect your body.”
T cells are part of the immune system that fight off infection and disease-causing pathogens. They multiply to form an “army” when they detect an invasion.
The severity of reactions can depend on a complex interplay of many factors, including the amount of nickel in the exposure, the duration of contact, and absorption, according to the Academy of Nutrition and Dietetics.
Another possible factor is iron deficiency. Iron and nickel share the same transport mechanism across the intestinal mucosa, the innermost layer of the intestine. “So, when iron is transported, nickel is not,” the organization wrote online. “Only a small amount of the nickel in food is absorbed, but individuals who are deficient in iron may be at risk of absorbing increased amounts.”
Another factor could be dysbiosis—an imbalance in gut microbiota. This condition can cause intestinal permeability that allows nickel to cross the gut barrier and cause a systemic reaction. Stress, a known cause of dysbiosis, played a role in Duzett’s case.
The Gut-Nickel Connection
Patch testing in various studies has shown that nickel allergies occur alongside a significant percentage of gastrointestinal issues and are more prevalent in patients with gastrointestinal (GI) problems than in the general population.
A 2024 review in Nutrients highlights studies involving Crohn’s disease and ulcerative colitis—the two forms of IBD—showing higher rates of nickel hypersensitivity in IBD patients compared to healthy controls. Nickel particles have been observed in the submucosa of Crohn’s-affected tissues and have induced colitis in mice susceptible to IBD.
Such findings suggest that nickel could exacerbate IBD—at least for a subset of people suffering from the disease, according to the authors.
A 2023 study in ProQuest found nickel sensitivity in 40 percent of 50 IBS patients versus 17.5 percent of 40 healthy controls. The authors concluded that they believe nickel sensitivity is “important in the pathogenesis of IBS disease.”
They noted that several other studies have shown an association between nickel and GI diseases, with one reporting symptomatic improvement in patients following a low-nickel diet.
A Red Flag
Nickel allergies, particularly for patients with persistent eczema that doesn’t respond to standard functional medicine treatments, should be considered, according to Dr. Kara Fitzgerald, a naturopathic doctor and faculty member at the Institute for Functional Medicine.
She told The Epoch Times that she doesn’t see systemic reactions often, but the fact that such a large percentage of the population gets contact dermatitis from wearing nickel jewelry ought to be a red flag for patients with chronic gut or systemic issues.
“It’s pretty ubiquitous. A lot of us can’t handle it,” Fitzgerald said of nickel. “Jewelry, if you react, that’s going to bump nickel up in my list of concerns.”
There may be nickel reactions isolated to the GI tract that go unnoticed, she added. An example would be eating a chocolate bar that’s high in nickel and then experiencing GI pain afterward.
Low-Nickel Eating
For some people with GI diseases, eating less nickel-containing food could be a beneficial strategy to consider. However, the Academy of Nutrition and Dietetics issues a bit of caution: The diet isn’t appropriate for children, and studies on adults are minimal.
Duzett recommends keeping total consumption below 150 milligrams per day. Two approaches to achieving that are using a calculator app called Nickel Navigator or following an elimination diet that excludes all nickel-containing foods.
Safe foods include meat and animal-based products such as cheese. However, many vegetables, fruits, grains, drinks, herbs, and spices are also low in nickel. A strict elimination diet is not necessary to sufficiently lower nickel exposure to determine if it’s the culprit.
Water can contain nickel as well. If you don’t use a water filter, you can reduce nickel accumulation by running the tap for 30 seconds before use, especially after water has been sitting in pipes overnight.
“If you know you’re eating very low to zero amounts of nickel foods for at least the first couple of weeks, you don’t have to worry about the stress of counting,” Duzett said. “I think that’s really important in the beginning because people are already overburdened by their symptoms. Try to keep it simple.”
Challenges With Nickel Content in Food
Determining nickel content in food can be difficult.
Packaged food is problematic because nickel content is not listed on labels. One reason for this is the difficult task of determining how much nickel is present in plants. For instance, potatoes grown in volcanic soil can have high nickel, but potatoes grown in other soil might have a moderate amount.
“Several studies referenced grains, nuts, legumes and chocolate to be among the highest sources,” according to the Academy of Nutrition and Dietetics. “However, the level of nickel in foods varies depending on the soil used to grow the plant and the source of water in the case of seafood.”
Additional Considerations
Stainless steel, which accounts for two-thirds of global nickel production, can be a source of nickel exposure.
That means that flour, for example, can have higher levels of nickel depending on the type of metal grinders used in grain mills. Cooking with stainless steel and using stainless steel utensils can also increase nickel exposure, according to the Academy of Nutrition and Dietetics.
Nickel is also found in dental and medical implants, as well as tattoo inks.
Another thing to keep in mind is that patch tests sometimes produce a false negative result, Fitzgerald said.
She cautions that while nickel sensitivity could be a factor for some people, it’s a “really small player” in the broader context of GI issues, warning that drastic dietary changes can lead to potential nutrient deficiencies, disordered eating, and food avoidance anxiety.
Raising awareness, however, can help those affected connect the dots. Duzett, who wrote a book called “The Low Nickel Diet Cookbook and Guide,” hosts a YouTube channel to educate others about nickel allergies.
“IBS is a huge issue in this country, and to think that 40 percent of those people could potentially reduce or completely get rid of these symptoms with a low-nickel diet is pretty incredible,” she said. “I really want to get this information out. It’s so important.”
