Learn from my mistakes: 5 things I wish I knew at the start of my eczema journey
Updated: Aug 11, 2020
Like most people, I found the low nickel diet on my own. Even though my doctors suspected I had a contact allergy to metal, none of them knew that I could be reacting to nickel or cobalt in my diet. Some say hindsight is 20/20 and I have to agree. Now that I have been living a low nickel/cobalt lifestyle for a few years, there are things that I wish I knew at the start of my journey. Here are the top 5 things I wish I knew when I first developed a systemic metal allergy.
1. Patch Testing
It took 3 years, 2 dermatologists, and 1 persistent patient (me!) to finally get patch tested. In order to heal eczema caused by contact dermatitis, you need to know what you are allergic to so you can avoid it. Avoidance strategies are the only way to heal contact dermatitis naturally and patch testing is the necessary first step to properly diagnose allergic contact dermatitis.
People with rashes are more prone to developing multiple contact allergies. This is because rashes damage our skin barrier. When our skin barrier is compromised, substances can seep into our general circulation. Then, our immune system can develop an immune response to certain substances it deems as an invader. This process is called sensitization. Once our bodies are sensitized to a substance, any time we come into contact with that substance our bodies will react. This is how we develop contact allergies.
Allergic contact dermatitis is a type IV hypersensitivity. It can take up to 2-4 days to react after being exposed to an allergen. This also applies to people with systemic contact dermatitis who are sensitive to dietary forms of nickel or cobalt.
2. Avoid heavy metal detox diets/supplements
After figuring out I was reacting to high nickel/cobalt foods in my diet my first thought was that I must have an excessive amount of nickel or cobalt in my system. I saw an Ayurvedic practitioner who recommended I start a heavy metal detox protocol. He had me on a whole slew of supplements that only made my rashes worse. And because I’m extra special, a year or two later I tried Medical Medium Protocols to ‘heal my liver’. Spoiler alert: it didn’t work.
Although there are a few exceptions, the majority of people with systemic metal allergies do not have excessive amounts of nickel or cobalt in our bodies. We are sensitive to small amounts of these metals. 'Detoxing the liver' or heavy metals from your body does not cure this allergy. Some doctors offer oral hyposensitization treatments that research has shown can be effective, but this treatment isn’t widely available, yet. For most of us, learning how to manage this allergy is the best treatment option, with strict avoidance strategies being the most effective thing we can do to relieve our symptoms.
3. Avoid contact
Since the beginning of my journey with systemic contact dermatitis, I was very focused on dietary sources of nickel/cobalt. I didn’t take into consideration what I was touching since I had already removed jewelry and any prolonged contact with metal. After I learned more about allergic contact dermatitis and systemic contact dermatitis, I realized that every form of exposure matters. This allergy is an ‘allergy of accumulation’ and we need to be careful to avoid our allergens from all sources - contact, products, cookware, food - it all counts!
It is important to take inventory of everything in your environment when you are trying to figure out what is causing a flare. Most of the time it is really hard to pinpoint a reaction. Be careful with assigning blame to one particular thing. It is hard to know for sure when nickel and cobalt are so widespread in our food and environment.
4. Histamine intolerance
Some people with a systemic nickel or cobalt allergy can be sensitive to foods high in histamine. I am one of those people. My histamine intolerance waxes and wanes. I’ve noticed I seem to be more sensitive to histamine when I am in an active flare or when my seasonal allergies are acting up. Histamine is a chemical found in our body that is produced during an allergic reaction. Some foods also contain histamine. Adding more histamine into our bodies from food sources can cause symptoms of excess histamine, especially for those who have a chronic allergy.
Flushing, headaches, palpitations, itching, insomnia, and hives are some symptoms I’ve experienced after eating foods high in histamine. Foods high in histamine include citrus fruits, strawberries, tomatoes, avocados, spinach, eggplant, aged food like yogurt, olives, fish, aged meat and cheese. For more information on histamine intolerance check out my histamine intolerance page.
5. Go slow with reintroductions
Before learning about this allergy, many of us were eating a lot of high nickel foods unknowingly. (Mmmm almond butter, kale smoothies, and lentil soup topped with avocado were my jam!) It takes time and patience to calm down our immune system and slowly recover from accumulated nickel and cobalt in our system. It took me around 4 months to clear my rashes on a low nickel/cobalt diet.
A few months after you recover and give your immune system a much-needed break, some doctors recommend reintroducing higher nickel foods back into your diet in rotation. A low nickel/cobalt diet can be restrictive and unfortunately, we have to avoid many nutrient-rich foods. The goal is to expand our diet and find our personal threshold. Everyone is different. Most people need to stay around 150 mcg/day, but you may be able to tolerate more.
Don’t make the same mistake I made. I jumped into reintroductions too fast. I tried too many new foods at one time. By new foods I mean moderately high nickel foods I was avoiding when I started a low nickel diet such as potatoes, broccoli, blueberries, arugula, baby lettuce, romaine and wild fish. A general rule of thumb: try one new food and wait 4 days to monitor for any reactions. It can take 3 - 4 days to develop a reaction to moderate/high nickel food.