Low Nickel Diet

> Research summary — not medical advice. This page synthesizes published research on a mechanism-level intervention. It is not a clinical recommendation. Consult a qualified healthcare provider before making any changes to diet, supplementation, or treatment.

Overview

A low-nickel diet (LNiD) restricts dietary nickel intake to approximately 100-150 ug/day (vs the 200-600 ug typical in Western diets) by eliminating or limiting high-nickel foods such as legumes, whole grains, nuts, chocolate, and canned goods. It is the primary intervention for Systemic Nickel Allergy Syndrome (SNAS) and Nickel Allergic Contact Mucositis (Ni ACM), and has demonstrated clinical efficacy across at least 11 distinct conditions.

Who it is for. Nickel sensitivity affects an estimated 8-19% of adults (14-20% of women, 2-4% of men) by epicutaneous patch test [1]. Ni ACM — the gastrointestinal manifestation — may exceed 30% prevalence in the general population [2]. SNAS affects approximately 20% of nickel ACD patients [3]. The strong female predominance reflects both greater sensitization exposure (jewelry, ear piercing) and hormonal modulation — nickel sensitivity fluctuates with the menstrual cycle, with reactions more severe during the progestinic phase [4].

Historical context. The first clinical trial of dietary nickel restriction was published by Kaaber, Veien, and Tjell in 1978 [5], demonstrating that oral nickel provoked hand eczema in 17/28 patients and that a 6-week LNiD improved 9/17 of those who reacted. Nearly five decades of evidence have since accumulated across dermatology, gastroenterology, gynecology, and metabolic medicine.

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Mechanism of Action -- The Metallomics Framework

The low-nickel diet operates through two distinct but complementary mechanisms: an immunological pathway (reducing the antigenic trigger in sensitized individuals) and an antimicrobial pathway (starving nickel-dependent virulence enzymes in pathogens). Both pathways converge on clinical benefit.

1. Antimicrobial Mechanism: Dietary Nutritional Immunity

Restricting dietary nickel is a clinical application of nutritional immunity — the principle that withholding essential metals from pathogens is an antimicrobial strategy. Mammals do not synthesize known nickel-requiring proteins, making nickel restriction a uniquely low-cost intervention: it imposes no metabolic penalty on the host while disabling critical pathogen enzymes [6].

Key nickel-dependent virulence enzymes disabled by dietary restriction:

EnzymeFunctionPathogens AffectedClinical Impact
ureaseHydrolyzes urea to ammonia + CO2; buffers acid environments; disrupts tight junctions; activates plateletsH. pylori, S. aureus, P. mirabilis, Ureaplasma, C. neoformansAcid survival destroyed; biofilm formation impaired; pH regulation restored
nife hydrogenaseOxidizes H2 for energy; powers CagA translocation in H. pyloriH. pylori, H. hepaticus, Salmonella, Campylobacter, ShigellaEnergy metabolism impaired; virulence factor translocation blocked
nickel glyoxalase (GloI)Detoxifies methylglyoxal; enables immune evasionP. aeruginosa, N. meningitidis, Y. pestis, Clostridia, L. donovaniPathogens become susceptible to neutrophil killing
Acireductone dioxygenase (ARD)Methionine salvage pathwayAll pathogenic gamma-proteobacteriaceaeMethionine metabolism disrupted
Ni-SODSuperoxide detoxificationStreptomyces spp.Oxidative stress defense impaired

This affects 40+ prokaryotic and 9+ eukaryotic pathogen species that depend on nickel for virulence [6]. The paradigmatic example is helicobacter pylori, where urease comprises up to 10% of the total proteome and is essential for gastric colonization.

2. Immunological Mechanism: Antigen Withdrawal

In nickel-sensitized individuals, dietary nickel triggers a Type IV (delayed) hypersensitivity reaction mediated through TLR-4 activation [1]:

  • Nickel directly activates TLR-4 on dendritic cells and keratinocytes (unique to humans — mice lack the relevant histidine residues)
  • Both Th1 (IFN-gamma, IL-2, TNF-alpha) and Th2 (IL-5, IL-13) cytokines are produced
  • IL-5 shows a statistically significant rise within 24 hours of oral nickel challenge [7]
  • IL-17/Th17 pathway activated in nickel-specific T cells, driving chronic low-grade inflammation [8]
  • Intestinal mucosa shows CD4+CD45RO+ cell infiltration with decreased CD8+ cells after nickel challenge [9]

Removing dietary nickel withdraws the antigenic stimulus, allowing the immune cascade to subside.

3. Metalloestrogen Removal

nickel acts as a metalloestrogen — it binds estrogen receptors and can induce proliferation of ERa+ cells [10]. In estrogen-dependent conditions (endometriosis, PCOS), dietary nickel restriction removes this estrogenic stimulus in addition to the immunological and antimicrobial benefits.

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Clinical Evidence by Condition

SNAS -- Systemic Nickel Allergy Syndrome

The core indication. SNAS affects ~20% of nickel ACD patients and is characterized by both cutaneous (90%) and gastrointestinal (88%) symptoms after ingestion of nickel-rich foods [3].

StudyDesignNKey Result
[3]Multicenter diet trial14541.4% complete remission; 18.6% 70%+ improvement; BraMa-Ni diet 94.4% sensitivity, 93.3% specificity
[9]Phase III NiOHT trial141GI symptoms more responsive than cutaneous; 1.5 ug Ni/week optimal dose
[11]Diet +/- probiotics51LNiD alone: 41.4% eubiosis; LNiD + probiotics: 72.7% eubiosis (p=0.026)

SNAS symptoms confirmed by oral nickel challenge [3]: Cutaneous (ACD flare-up, widespread eczema, urticaria, angioedema); Gastrointestinal (meteorism, gastric acidity, abdominal colic, diarrhea, vomiting, throat acidity). Headache, chronic fatigue, and dyspnea were NEVER induced by oral challenge and should not be considered diagnostic of SNAS.

Associated finding: Lactose intolerance occurs in 63-74% of SNAS patients, possibly from nickel-induced brush border enzymatic impairment [9].

H. pylori Infection

StudyDesignNKey Result
[12]Randomized pilot5284% eradication (NFD + triple therapy) vs 46% (triple therapy alone), p<0.01

Protocol: 30 days nickel-free diet with standard triple therapy (lansoprazole, clarithromycin, amoxicillin) starting at day 15. The 30-day pre-antibiotic nickel restriction period allows time for nickel depletion of urease and hydrogenase before antibiotic administration. This is the first study demonstrating that a dietary intervention can nearly double H. pylori eradication rates [12].

GERD (Refractory)

StudyDesignNKey Result
[13]Prospective pilot2095% improvement (19/20); GERD-HRQL decreased 27.05 points (p<0.001)

All 20 patients had refractory GERD despite 3+ months of PPI therapy. Both nickel patch-test positive and negative patients responded equivalently, challenging the assumption that patch test positivity predicts diet responsiveness. Mean BMI was 35.24; patients lost ~3 kg on average [13].

IBS (Nickel-Sensitive)

StudyDesignNKey Result
[14]Prospective pilot20All GI symptoms improved (p<0.001 to p<0.0001) except vomiting; VAS efficacy 3.9 to 7.3

Critical finding: All IBS patients with nickel allergy had altered intestinal permeability at baseline (51Cr-EDTA 5.91% vs 2.20% controls, p<0.0001). IP change after diet correlated with nickel reactivity severity. IBS-M and IBS-U subtypes were more responsive. Lactose malabsorption present in 75% [14].

Celiac Disease (Refractory Symptoms on GFD)

StudyDesignNKey Result
[2]Prospective pilot20100% Ni ACM positivity in symptomatic celiac; LNiD improved 83.4% of tracked symptoms

The gluten-free / nickel paradox: Patients on GFD experienced paradoxical symptom worsening (83.4% of symptoms WORSENED on prolonged GFD) because gluten-free substitutes (corn, buckwheat, chickpeas, lentils) are systematically high in nickel. Adding LNiD to GFD reversed this with the same magnitude of improvement. Both GI (abdominal pain, bloating, nausea, loose stools) and extraintestinal (dermatitis, headache, chronic fatigue, muscle/joint pain) symptoms responded [2]. See dietary metal paradoxes Paradox 2.

Endometriosis

StudyDesignNKey Result
[10]Open-label pilot3190.3% Ni ACM positive; all 15 GI, 7 extraintestinal, and 3 gynecological symptoms improved (p<0.005 for gyn)

The 90.3% Ni ACM prevalence in endometriosis patients with GI symptoms is the highest reported for any condition. Improvement extended beyond GI symptoms to the cardinal gynecological triad: dysmenorrhea, dyspareunia, and pelvic pain. The framework explains this through dual mechanisms: (1) nickel-dependent pathogen enzymes drive the endometriosis microenvironment (glyoxalase enables immune evasion, urease disrupts pH, hydrogenase creates hypoxia); (2) nickel as metalloestrogen stimulates estrogen-dependent lesion growth [10], [15].

Hand Eczema / Chronic Nickel Dermatitis

StudyDesignNKey Result
[5]Challenge + diet trial2817/28 reacted to oral Ni; 9/17 improved on 6-week LNiD; 7/9 relapsed on normal diet
[16]Open prospective9064% short-term benefit; 73% long-term improvement (mean follow-up 1.8 years)
[17]Open + DBPC11239% improved on LNiD; DBPC confirmed in 43/44 responders
[18]Comparative single-blind2190.9% clearance with LNiD + disulfiram vs 10% placebo (p<0.001)
[19]Case report1Complete clearance of dyshidrosiform pemphigoid in 15 days; failed dapsone and prednisolone

Long-term outcomes: specific foods, menstrual period, psychological stress, and sweating identified as aggravating factors [16]. Dermatitis types responding: vesicular hand eczema (67.7%), anogenital dermatitis (100%), vasculitis-like (66.7%) [16].

Obesity (Nickel-Sensitive Women)

StudyDesignNKey Result
[8]Pilot cross-sectional + diet87 screened; 24 dietNickel allergy 59.7% in overweight women (p<0.001 vs general); normocaloric LNiD: BMI -4.2, body fat -5.1%, waist -11.7 cm (all p<0.001)

The weight loss was achieved on a normocaloric diet — the nickel restriction itself, not caloric deficit, drove the metabolic improvement. Proposed mechanisms: IL-17/Th17 inflammatory pathway, metalloestrogen-driven adipogenesis, gut microbiota disruption, and nickel's insulin-like metabolic effects [8].

CFS / Fibromyalgia

StudyDesignNKey Result
[20]Treatment response analysis20452% of CFS women have nickel allergy; MELISA: 81% of non-responders Ni-reactive; allergic smokers: only 6% treatment response

Case reports document dramatic improvement with LNiD and smoking cessation (cigarette smoke contains trace nickel). Dietary nickel and cigarette smoke nickel appear to synergistically maintain the chronic immune activation underlying fatigue and pain [20].

Recurrent Aphthous Stomatitis

StudyDesignNKey Result
[21]DBPC oral challenge70 Ni-sensitive RAS patients45.7% DBPC-confirmed dietary nickel trigger; 21/32 improved on LNiD; reactive dose: 2.5 mg

This study demonstrated that dietary nickel can perpetuate oral mucosal ulcers even after removal of orthodontic nickel sources. In 42/70 patients, symptoms persisted after appliance removal, confirming dietary nickel as the ongoing trigger [21].

Atopic Dermatitis

StudyDesignNKey Result
[22]Open clinical2767% improvement (26% marked, 41% moderate); patients with metal contact history: 78% response

This study used a broader low-metal diet (Ni, Cr, Co) plus dental metal elimination. Eosinophils and LDH decreased significantly in responders (p<0.05), providing objective immune modulation evidence [22].

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Practical Diet Guide

Target Intake

Sensitized individuals: 100-150 ug/day nickel [23]; the BraMa-Ni diet targets <50 ug/day for diagnostic use [3]. Normal Western diets deliver 200-600 ug/day; some plant-forward diets can exceed 900 ug/day [20].

The Point-Based Scoring System

The Mislankar-Zirwas scoring system assigns points based on nickel content per standard serving (10 ug = 1 point) [23]:

  • Adults: No more than 15 points/day
  • Children under 12: No more than 10 points/day
  • Very sensitive individuals: Stay under 5 points/day
  • Diet may take up to 2 months for full clinical benefit

High-Nickel Foods (AVOID -- >100 ug/serving)

FoodNickel (ug/serving)Points
Lima beans, pinto beans, refried beans>100Avoid
Sunflower seeds>100Avoid
Chili with beans (canned)>100Avoid
Chocolate cake with icing>100Avoid
Oat ring cereal>100Avoid
Mussels~154Avoid
Spirulina~151Avoid
Soy products0.1-5.1 mg/kgAvoid
Cocoa/chocolate3.0-12 ug/gAvoid

[24], [7]

Full high-nickel food categories [3], [10]:

  • Legumes: All beans, lentils, chickpeas, peas, peanuts, soy
  • Whole grains: Oats, buckwheat, millet, whole wheat, rye, maize, corn
  • Nuts and seeds: All types (almonds, walnuts, hazelnuts, cashews, sunflower seeds)
  • Chocolate and cocoa: All forms
  • Canned foods: Nickel leaches from metal cans
  • Specific vegetables: Spinach, tomatoes, asparagus, cauliflower, onions, raw carrots
  • Specific seafood: Mussels, oysters, shellfish, lobster, herring, mackerel
  • Beverages: Black tea, coffee, red wine, beer (variable)
  • Other: Baking powder, margarine

Low-Nickel Foods (SAFE -- 0 points)

FoodNickel (ug/serving)
Apple<1
Butter<1
Cheddar cheese<1
Chicken breast (skin removed)<1
Cottage cheese<1
Eggs<1
Eggplant<1
Honey<1
Ice cream<1
Milk<1
Olive oil<1
Steak / red meat<1
Sugar<1
Tuna (canned)<1

[23]

BraMa-Ni permitted foods [3]: Semi-skimmed milk, white yogurt, rice, zucchini, chicken/lean meat, lettuce, bread (00 refined flour), apple, pasta/rice in vegetable broth, peppers, eggplant, fruit.

Strategies to Reduce Nickel Absorption

Vitamin C with meals. Ascorbic acid acts as a competitive inhibitor of nickel absorption in the GI tract. Take 500-1000 mg chewable vitamin C with every meal [23], [25].

Iron-rich foods. Iron competes with nickel for absorption via shared divalent metal transporters (DMT1). Maintaining adequate iron intake reduces nickel absorption [25].

Avoid stainless steel cookware for acidic foods. Nickel leaches from stainless steel during cooking, especially with tomato sauce, citrus, or vinegar. First use of new stainless steel releases the most nickel [25].

Flush first quart of tap water. Nickel-plated faucets release nickel into standing water. Run the faucet briefly before using water for drinking or cooking. Use bottled or distilled water for maximum restriction [23].

Avoid nonstick, aluminum, copper, and cast iron cookware during strict LNiD phases [23].

No vitamins/supplements except vitamin C during the restriction phase (many contain trace nickel) [23].

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Adjunctive Therapies

Disulfiram (Nickel Chelator)

Disulfiram (tetraethyl thiuram disulphide) chelates nickel in the body; its metabolite diethyldithiocarbamate causes nickel excretion through urine, bile, and sweat. Combined LNiD + disulfiram achieved 90.9% complete clearance in vesicular hand eczema (vs 10% placebo, p<0.001) [18].

Protocol: 125 mg/day for 2 weeks, then 250 mg/day for 2 weeks, alongside LNiD.

Risks: Metallic taste (27%), mild drowsiness (18%), anorexia, and mild liver enzyme elevation in 27.3% of patients. Hepatotoxicity requires monitoring. Absolute contraindication with alcohol (disulfiram-ethanol reaction). Use should be reserved for severe or refractory cases [18], [25].

Oral Nickel Hyposensitization (NiOH / NiOHT)

Graduated oral administration of nickel sulphate to induce immune tolerance in SNAS patients.

StudyNProtocolResult
[26]136 treated + 95 controls0.1 ng to 0.1 mg over ~6 months69.1% complete remission (vs 17.9% controls); ARR 51.2%; NNT = 1.95
[27]24 treated + 12 controls0.3 ng to 1.5 ug/week for 10 weeks87% remained symptom-free after reintroducing all Ni-rich foods; IFN-gamma -55.3%, IL-13 -58.6%, IL-5 -31.2%

The NiOH protocol induces true oral tolerance — not just symptom suppression. Cytokine analysis confirms immune modulation: significant reduction in both Th1 (IFN-gamma) and Th2 (IL-5, IL-13) responses, mediated by IL-10 increase and regulatory T cell induction [27]. The extremely low starting dose (0.1 ng) is critical — earlier studies using 3.5-5 mg caused relapse in 60% [26].

Probiotics + LNiD

LNiD alone restores gut eubiosis in only 41.4% of SNAS patients; adding targeted probiotics raises this to 72.7% (p=0.026) [11].

Strain selection by dysbiosis type:

  • Fermentative dysbiosis (64.7% of SNAS patients): Lactobacilli-containing formulations
  • Putrefactive dysbiosis (3.9%): Bifidobacteria-containing formulations
  • Mixed dysbiosis (31.4%): Broad-spectrum multi-strain formulations

Limitation: Benefits maintained only 4-6 weeks after stopping combined therapy, suggesting ongoing microbiome dependency. This temporal pattern is consistent with the nickel restriction paradox: LNiD improves symptoms by reducing nickel-mediated inflammation but may simultaneously impair commensal bacteria that depend on nickel (see dietary metal paradoxes Paradox 9) [11], [6].

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The Dietary Paradox

A low-nickel diet creates a structural conflict with several widely recommended dietary patterns, because many of the foods highest in nickel are the same foods promoted as "healthy" by conventional nutrition guidance.

Paradox 1: Plant-Based Diets

Anti-inflammatory and plant-forward diets prescribed for endometriosis, PCOS, IBD, and rheumatoid arthritis emphasize legumes, whole grains, nuts, seeds, and cruciferous vegetables — precisely the highest-nickel foods. For the 15-20% of the population with nickel sensitivity, these diets may trigger SNAS and Ni ACM, actively worsening the conditions they are prescribed to treat dietary metal paradoxes.

Harris et al. (2018) found that in 70,835 women, citrus fruits (low nickel) reduced endometriosis risk by 22%, while cruciferous vegetables, corn, and peas/lima beans (high nickel) increased risk by 13-30% — a pattern invisible without the nickel lens.

Paradox 2: Gluten-Free Diet / Nickel Load Switch

Celiac patients replacing wheat with corn, rice, buckwheat, and legume-based products substitute one dietary trigger (gluten) for another (nickel). The GFD works immunologically (antibodies normalize) but can fail clinically due to Ni ACM from high-nickel GF staples [2].

Paradox 3: The Commensal Casualty

Nickel is not only used by pathogens. Commensal gut bacteria (Bifidobacterium, Lactobacillus) also use Ni-urease for acid tolerance and nitrogen metabolism. Restricting nickel may create collateral damage to beneficial microbiota, explaining why probiotics provide additional benefit when combined with LNiD [6], [11].

Full analysis: dietary metal paradoxes

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Diagnosis -- When to Recommend a Low-Nickel Diet

Diagnostic Methods

Epicutaneous patch test (gold standard for sensitization): 5% nickel sulfate hexahydrate in petrolatum, applied under occlusion for 48 hours, read at 48 and 72-96 hours [1]. Note: timing matters in fertile women — testing during the progestinic phase is recommended, as ovulatory-phase testing may produce false negatives [4].

Nickel oral mucosa patch test (Ni omPT): 5-mm filter paper disk with 5% Ni-sulfate in Vaseline applied to upper lip mucosa for 2 hours. Detects Ni ACM — the gastrointestinal/mucosal manifestation that epicutaneous patch testing may miss [10].

Oral nickel challenge (DBPC): Gold standard for SNAS diagnosis. Challenge with nickel sulphate at increasing doses (1.25, 2.5, 3.5, 5.0 mg elemental nickel) after improvement on LNiD [3]. Dose-response: 0.3 mg provokes reactions in 40% of sensitized individuals; 4 mg in 70% [25].

BraMa-Ni scoring system: Nutritionally balanced diagnostic diet (~50 ug Ni/day; 1932 kcal men, 1733 kcal women) with 94.4% sensitivity and 93.3% specificity for detecting SNAS. Patient adherence nearly 100% (vs 26.8% for simple forbidden food lists, p=0.001) [3].

MELISA (lymphocyte proliferation test): Found 81% (13/16) of CFS vaccine non-responders reacted to nickel. May detect nickel sensitivity missed by patch testing [20].

When to Screen

Screen for nickel sensitivity BEFORE prescribing plant-forward diets in:

  • Endometriosis with GI symptoms — 90.3% Ni ACM prevalence warrants routine testing [10]
  • Celiac with persistent symptoms on GFD — 100% Ni ACM prevalence in symptomatic subgroup [2]
  • IBS or IBS-like symptoms in women — given 14-20% nickel allergy prevalence in women
  • Refractory GERD despite PPI therapy — 95% responded to LNiD [13]
  • Chronic hand eczema / vesicular dermatitis with positive nickel patch test and incomplete response to topical therapy
  • Recurrent aphthous stomatitis persisting after orthodontic appliance removal [21]
  • Overweight women with nickel allergy — 59.7% prevalence in overweight females [8]
  • CFS/fibromyalgia in women — 52% nickel allergy prevalence [20]
  • Any condition where a plant-forward diet produces paradoxical symptom worsening — consider nickel sensitivity before attributing the response to FODMAPs or generic food intolerances

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Summary Evidence Table

ConditionNKey OutcomeSource
SNAS (diagnosis + treatment)14594.4% sensitivity / 93.3% specificity (BraMa-Ni); 41.4% complete remission[3]
H. pylori eradication5284% vs 46% (p<0.01)[12]
Refractory GERD2095% improved; GERD-HRQL -27.05 (p<0.001)[13]
IBS (nickel-sensitive)20All symptoms improved (p<0.001); VAS 3.9 to 7.3[14]
Celiac (refractory on GFD)2083.4% of symptoms improved; 100% Ni ACM positive[2]
Endometriosis3190.3% Ni ACM; all GI + gyn symptoms improved (p<0.005)[10]
Hand eczema + disulfiram2190.9% clearance (p<0.001)[18]
Hand eczema (long-term)9064% short-term; 73% long-term improvement[16]
Chronic dermatopathies11239% improved; DBPC confirmed 43/44[17]
Obesity (Ni-allergic women)24BMI -4.2; body fat -5.1%; waist -11.7 cm (normocaloric)[8]
CFS/fibromyalgia20452% nickel allergy; 81% MELISA-positive non-responders[20]
Aphthous stomatitis7045.7% DBPC-confirmed; 21/32 improved on LNiD[21]
Atopic dermatitis2767% improvement with low-metal diet[22]
NiOH hyposensitization136 + 9569.1% complete remission; NNT=1.95[26]
NiOH + cytokines3687% symptom-free on full diet; IFN-gamma -55.3%[27]
SNAS + probiotics5172.7% eubiosis (diet + probiotics) vs 41.4% (diet alone)[11]
Dyshidrosiform pemphigoid1Complete clearance in 15 days (failed steroids)[19]
Pioneering 1978 study2817/28 reacted to oral Ni; 9/17 improved on LNiD[5]

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Connections

Entities: nickel, helicobacter pylori, staphylococcus aureus, candida albicans, proteus mirabilis

Enzymes: urease, hydrogenase, nickel glyoxalase

Concepts: nutritional immunity, dietary nickel exposure, nickel allergy, metalloestrogens, inflammation

Analyses: dietary metal paradoxes

Key source reviews: [6] (40+ pathogen species), [9] (SNAS comprehensive review), [7] (patient-centered review), [1] (clinical review)

Diet references: [24] (foundational food nickel data), [23] (point system), [3] (BraMa-Ni diet), [25] (practical guide)

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> Educational content, not medical advice. This page describes mechanisms by which the intervention interacts with the microbiome and metal ecology. It is not a treatment recommendation. Clinical decisions about any intervention should be made with a qualified healthcare practitioner who knows your individual history.

References (29)

  1. . ahlstrom 2019 nickel allergy review
  2. . borghini 2020 low nickel diet celiac
  3. . braga 2013 snas nosologic framework
  4. . bonamonte 2005 nickel allergy menstrual cycle
  5. . kaaber 1978 low nickel diet chronic dermatitis
  6. . maier 2019 nickel microbial pathogenesis
  7. . bergman 2016 low nickel diet review
  8. . lusi 2015 nickel allergy overweight
  9. . di gioacchino 2018 snas chapter
  10. . borghini 2020 endometriosis nickel ibs
  11. . lombardi 2020 snas probiotics dysbiosis
  12. . campanale 2014 nickel free diet h pylori
  13. . yousaf 2021 low nickel diet gerd
  14. . rizzi 2017 ibs nickel diet
  15. . pendergrass 2026 endometriosis conference
  16. . veien 1993 low nickel diet trial
  17. . antico 1999 chronic dermatopathies nickel
  18. . sharma 2006 disulfiram low nickel diet hand eczema
  19. . atakan 1993 dyshidrosiform pemphigoid nickel
  20. . regland 2001 nickel allergy cfs
  21. . pacor 2003 nickel recurrent aphthous stomatitis
  22. . adachi 1997 low metal diet atopic dermatitis
  23. . mislankar 2013 low nickel diet scoring
  24. . flyvholm 1984 nickel food content
  25. . zirwas 2009 dietary nickel dermatitis
  26. . schiavino 2006 oral hyposensitization nickel
  27. . minelli 2010 nioh cytokines snas
  28. . denkhaus 2002 nickel essentiality toxicity
  29. . genchi 2020 nickel human health environmental toxicology