Is a low-nickel diet even a thing? Yes, yes it is! Did you know it’s estimated that 18% of people in North America are allergic to nickel?1 That’s not a small percentage and while it isn’t a life-threatening allergy, it can still cause a reduced quality of life for those who suffer from it.
Nickel is naturally found in certain foods and is completely safe to eat for those who do not have a nickel allergy but can be detrimental for those who do. Keep scrolling to learn more about this allergy, what a low-nickel diet is and what foods are safe to consume.
A low-nickel diet is recommended for some people with a nickel allergy. A nickel allergy is just like other allergies, it is caused by our body’s IgE mediated immune response to a certain substance (in this case nickel) that it deemed harmful.
Usually, this allergy presents itself as a rash, typically on the hands or abdomen, that can begin within hours after exposure and last for up to 4 weeks.
It’s important to note here, that food allergies, food intolerances, and celiac disease are all different. Food allergies are mediated by IgE antibodies misinterpreting things as dangerous, triggering an allergic reaction. Food intolerances can be mediated by a variety of things impacting the proper digestion of specific foods. Celiac disease is triggered primarily by IgA antibody overreaction. I say this because people often confuse these things for each other, and the disease process matters for treatment. (I make note of Celiac because I am a celiac dietitian).
While we do not know what causes an allergy to nickel, we do know it can show up in a few different ways. It can show up as allergic contact dermatitis, systemic contact dermatitis, and systemic nickel allergy syndrome.
Allergic contact dermatitis (ACD) develops when our skin is exposed to an allergen and causes a nasty rash that’s red and itchy. In this form of a nickel allergy, a low nickel diet likely isn’t needed. You just need to avoid skin exposure by trying to limit or replace the following items:
Unlike the allergic contact dermatitis presentation of a nickel allergy, the systemic presentations likely require a low-nickel diet. Your doctor will tell you exactly what is required.
This is because a nickel allergy can present itself through the systemic route called systemic contact dermatitis (SCD). This happens when consuming foods high in nickel trigger hand dermatitis. This dermatitis can also be localized or widespread.
Additionally, the other systemic presentation, systemic nickel allergy syndrome (SNAS), can also be caused by nickel in the diet. It is different from the last two as it can cause more wide-reaching effects on the body such as gastrointestinal and respiratory issues. It is common to feel lightheaded, have a headache, or even a fever.3
Unfortunately, people who are allergic to nickel can also develop a cobalt allergy as well. This can cause dermatitis, either acute or systemic contact and the symptoms are similar to a nickel allergy.4 The good news is that foods low in cobalt also tend to be low in nickel so you don’t need to restrict your diet further.
Before going on a low-nickel diet, it’s important to make sure you have reason to. This means if you feel you have a nickel allergy it is best to visit a doctor who can do a patch test on your skin to determine if nickel is the cause.
If you have already been diagnosed but your rash is getting painful or producing pus, it is best to see your doctor right away to make sure there is no infection. Sadly, there is no treatment that can completely rid you of your allergy. Instead, the best advice is to avoid all sources of nickel and use topical creams to relieve discomfort from rashes. Of course, always discuss your options with your provider.
Now that we’ve broken down what a nickel allergy is and how it can present, let’s talk about one of the potential treatments, a low-nickel diet. I’m sure you have noticed that nickel is not one of the nutrients you find on the nutrition label and that can make limiting nickel time-consuming and frustrating? A low-nickel diet is one that limits your exposure to nickel by consuming foods that are low in (you guessed it) nickel.
To make matters a bit more confusing, the amount of nickel in certain foods can depend on the type of soil, type and use of pesticides, and the storage and preparation methods. For example, most canned foods should not be eaten, even if the contents inside are typically low in nickel.6 A nice alternative to canned foods would be plastic cups of food. Like plastic cups of green beans and mandarin oranges.
Studies have shown that combining a low-nickel diet with increased consumption of vitamin C and iron has been shown to reduce the amount of nickel absorbed.5 However, before taking any supplements, it is very important to consult with your doctor first.
For a guide, we have created a 5-day meal plan to get you started and comfortable with eating a low-nickel diet that is also gluten-free. This plan includes simple recipes and easy-to-find foods so it is easy to replicate. However, please note this meal plan is meant for educational purposes only and is not meant to substitute a tailored diet that meets your specific needs provided by a dietitian.
Following a low-nickel diet is crucial to avoiding a severe reaction in some types of nickel allergy and can greatly increase your quality of life. However, limiting nickel in your diet might not be enough to avoid rashes, so it is best to limit external sources of nickel such as cookware and jewelry as well. Luckily, nickel allergies are not life-threatening but can cause a lot of discomforts if exposed which is why it’s important to adhere to a low-nickel diet and lifestyle.
Remember, a low-nickel diet is only necessary for people who have a nickel allergy triggered by dietary intake, so please reach out to your doctor if you suspect you are allergic and need to follow this medical diet.
Fear not, there are plenty of foods that are low in nickel and safe to eat on a nickel allergy diet! Most dairy and animal products are naturally low in nickel, as are fruits and vegetables. Coffee and tea are fine to drink but not out of urns or machines. Alcoholic beverages are also low in nickel as are sodas and juices from fruits low in nickel that are not in a can.
Fruits that generally can be enjoyed on a low-nickel diet include: peaches, pears, bananas, blueberries, strawberries, blackberries, pomegranate, apples, grapes, cherries, mango, kiwi, and watermelon.
Vegetables that can be generally enjoyed on a low-nickel diet include: bell peppers, cucumbers, eggplant, cabbage, cauliflower, bok choy, onion, carrots, potatoes, mushrooms, corn, and turnips.
Most dairy can be enjoyed on a low-nickel diet except for chocolate milk.
Gluten-free grains that can be generally enjoyed on a nickel allergy diet include white rice and corn.
Animal products allowed on a low nickel diet include chicken, turkey, beef, and eggs.
The main foods to stay away from are nuts, seeds, and soy products. While many animal products are safe to consume, stay away from shellfish and any canned products. Avoiding canned products in general, even if the food is typically low in nickel, is recommended as nickel can leach from the cans into the food.
Specific fruits to avoid on nickel allergy diet include: raspberries, pineapple, figs, dates, prunes, avocados, and coconut,
Specific vegetables to avoid include spinach, legumes (beans), bean sprouts, asparagus, peas, okra, kale and lettuce.
Be sure to avoid chocolate milk, soy milk, and almond milk.
And gluten-free grain wise, be sure to avoid oats, brown rice, quinoa, amaranth, and bean flours (like soy and chickpea flour).
Additionally, be sure to avoid shellfish, salmon, tofu, and nuts and seeds.
Of note, supplements are noted to be avoided in some resources due to the lack of regulation and ability to know nickel content, with the exception of vitamin C. Which sometimes is recommended to be taken at 500-1000mg doses with every meal to prevent nickel absorption. As always, talk to your healthcare team before making any changes to your current lifestyle.
With all of the foods to remember to avoid, it can feel overwhelming to follow a low-nickel diet on top of being gluten-free. Below is a 5-Day Gluten-Free Low-Nickel Meal-Plan to inspire you. Please note: do not follow any meal-plan or change your diet without consulting your healthcare team. This nor anything on my website should not replace individual care provided to you by your healthcare team.
Below is a 5-day guide to inspire your meals on a gluten-free and low-nickel diet. That said, when building your own skills in meal-planning with this diet, consider the following tips:
Extra fun low-nickel and gluten-free recipes for desserts and drinks:
A low nickel diet can be hard on its own and also when you’re following other medical diets like a gluten-free diet for celiac disease. It’s completely understandable if you are overwhelmed with this new information and a new set of foods to avoid.
Luckily, many foods that have gluten are also high in nickel, so the choices in foods that are safe to consume haven’t changed all that much. The differences are in some types of fruits and vegetables, especially leafy greens. You can still enjoy a good variety of produce, dairy, and protein.
Remember, before starting or stopping any medical diet, medications or supplements, contact your doctor first. It is also important to make sure you are allergic to nickel before eliminating it from your life. Once you are diagnosed, you can discuss treatment options and whether or not a nickel-allergy diet will be required and how to approach starting and following the diet specifically for your needs.