Titanium allergy is barely recognized in mainstream medicine – yet laboratories using the MELISA technology have reported that about 4% of all patients tested to titanium will be allergic to it (Valentine-Thon E., et al. “LTT-MELISA is clinically relevant for detecting and monitoring metal sensitivity“. Neuro Endocrinol Lett 2006; 27(Suppl 1):17–24). For those affected by titanium allergy, the symptoms can be multiple and bewildering. These can range from simple skin rashes to muscle pain and fatigue.
From foodstuff to medicine, titanium is now an everyday metal. Several brands of candy, such as Skittles and M&M, have titanium dioxide in the coating – often described by its E-number: E171. Some brands of toothpaste contain titanium particles. Hospitals use titanium implants to rebuild bones after accidents.
More than just a rash: the effects of titanium allergy
Like all metals, titanium releases particles through corrosion. These metals become ions in the body and bind to body proteins. For those who react, the body’s immune system will attack this structure. This starts a chain reaction which can lead to many symptoms including chronic fatigue syndrome. The MELISA test is the only scientifically-proven test which can objectively diagnose titanium allergy and measure its severity.
Those who test positive are advised to avoid exposure if possible. This may include switching to titanium-free creams and cosmetics or, in some cases, considering the removal of a titanium implant.
Titanium: where to find it
Titanium dioxide (TiO2) is widely used in consumer products, as it is non-toxic – even though it triggers allergies in certain people. It is known as a “pearling agent” as it makes paper and paint glossy and white. Always check the content of food stuff, pills and cosmetics for titanium dioxide. It is found in the following:
- Orthopedic and surgical implants.
- Dentistry: in dental implants and as a colour pigment in composites.
- Sunscreen agents: finely ground titanium dioxide blocks the harmful ultraviolet rays from the sun.
- Confectionery: makes candy look brighter and adds a crunchy coat to, for example, chewing gum.
- Cosmetics: used to brighten and intensify the colour of make-up. It is regularly found in eyeshadow, blusher, nail polish, lotions, lipstick and powder.
- Toothpaste: used as a pigment agent to make the toothpaste whiter.
- Paint: TiO2 improves the durability of coatings and gives white colour.
- Plastic carrier bags: improves durability and gives white colour.
- Medical pills and vitamin supplements may also get their white coating from titanium dioxide.
- Piercing & Jewellery: for example watches and all types of body piercing. Fewer people are allergic to titanium than, for instance, to nickel.
Titanium polluted with nickel
Several studies show that titanium alloys contain traces of nickel as a result of the production process. This can pose trigger health problems in patients with nickel allergy, and also mean that a reaction may be falsely attributed to titanium itself.
Do you suspect you have titanium allergy?
If a health problem starts after you have received a titanium implant it is possible that you are allergic to titanium. You can take a MELISA test for titanium allergy through one of the clinics we cooperate with or send a sample to a laboratory. If you are planning to have a test before receiving a titanium implant it is advised to find out the exact composition of the implant. Vanadium, aluminium and other metals are sometimes added to improve the properties of titanium implants, and allergy to these metals can also be tested.
How about clinical studies?
The articles Hypersensitivity to titanium: Clinical and laboratory evidence and LTT-MELISA is clinically relevant for detecting and monitoring metal sensitivity published in 2006 can be downloaded from our Article page.
In the former article fifty-six (56) patients who had developed clinical symptoms after receiving titanium-based implants were tested in MELISA against 10 metals including titanium. Out of 56 patients, 54 were patch-tested with titanium as well as with other metals. The implants were removed in 54 patients (2 declined explantation), and 15 patients were retested in MELISA.
Of the 56 patients, 21 (37.5%) were positive, 16 (28.6%) ambiguous, and 19 (33.9%) negative to titanium. In the latter group, 11 (57.9%) showed lymphocyte reactivity to other metals, including nickel. All 54 patch-tested patients were negative to titanium. Following removal of the implants, all 54 patients showed remarkable clinical improvement. In the 15 retested patients, this clinical improvement correlated with normalization in MELISA reactivity.
The conclusion of the article is that these data clearly demonstrate that titanium can induce clinically relevant hypersensitivity in a subgroup of patients chronically exposed via dental or endoprosthetic implants. Below, you will also find several articles which discuss the issue of corrosion of titanium implants and possible reactions due to hypersensitivity.
How about patients’ stories?
On our Patient testimonials page, you can read about two young people who recovered from their serious health problems after being diagnosed with titanium allergy and having their titanium implants removed.
Medical abstracts relating to titanium:-
Further articles can be found at Articles dealing with titanium allergy
- Metal Allergens of Growing Significance: Epidemiology, Immunotoxicology, Strategies for Testing and Prevention. Forte G. et al. Inflamm Allergy Drug Targets. 2008 Sep;7(3):145-62.
- Full-mouth oral rehabilitation in a titanium allergy patient using zirconium oxide dental implants and zirconium oxide restorations. A case report from an ongoing clinical study.
Oliva X. et al. Eur J Esthet Dent. 2010 Summer;5(2):190-203.
- Study on patch test reagent for titanium. Nakajima K. Kokubyo Gakkai Zasshi. 2007 Jun;74(2):92-8.
- Allergies to dental metals. Titanium: a new allergen. Evrard L, Waroquier D, Parent D. Rev Med Brux. 2010 Jan-Feb;31(1):44-9.
- Implant failure due to Titanium hypersensitivity/allergy? – Report of a case SADJ February 2007
- Ultrafine titanium dioxide particles in the absence of photoactivation can induce oxidative damage to human bronchial epithelial cells Toxicology 2005
- Titanium particles stimulate bone resorption by inducing differentiation of murine osteoclast J Bone Joint Surg Am. 2001
- Immunohistochemical study of the soft tissue around long-term skin-penetrating titanium implants Biomaterials 1995
- Titanium dermatitis after failure of metal-backed patellas, Am J Knee Surg 1993
- In vitro corrosion of titanium Biomaterials. 1998
- Sensitivity to titanium. A cause of implant failure? Bone Joint Surg Br. 1991
- A case of allergic reaction to surgical metal clips inserted for postoperative boost irradiation in a patient undergoing breast-conserving therapy Breast Cancer. 2001
- Biocompatibility of dental casting alloys Crit Rev Oral Biol Med. 2002
- Validity of MELISA® for metal sensitivity testing Neuro Endocrinol Lett. 2003
- Das Allergiepotenzial von Implantatwerkstoffen auf Titanbasis A. Schuh, et al. Der Orthopäde
Volume 34, Number 4, 327-33
- Tissue reaction to bone plates made of pure titanium: a prospective, quantitative clinical study.
A. Ungersboeck, et al. Journal of Materials Science: Materials in Medicine
Volume 6, Number 4, 223-229
- Maternal exposure to nanoparticulate titanium dioxide during the prenatal period alters gene expression related to brain development in the mouse.
M Shimizu et al.Particle and Fibre Toxicology 2009, 6:20