This article has been medically reviewed by Dr. Charles Penick, MD
Low Nickel Diet for IBS: New research highlights the potential benefits of dietary changes in the management of Irritable Bowel Syndrome symptoms. Today we explore IBS and the link between nickel and the symptoms.
IBS and Functional Medicine
Irritable Bowel Syndrome (IBS) is an illness that affects approximately twenty percent (60 million) Americans and yet is hardly recognized by mainstream medicine. With symptoms including bloating, diarrhea, cramps, gas, nausea, constipation, and pain, IBS can seriously impact the quality of life and work productivity. 
IBS is categorized as a psychosomatic by allopathic doctors, who tackle symptom management with prescriptions that generally involve fiber supplements, sedatives, pain drugs, and even anti-depressants. 
This illness is addressed much differently in the functional medicine community, where the goal is to identify and address the root cause of an illness. With a functional medicine approach, IBS is often rooted in a few major ‘problems,’ including gut imbalances and food allergies.
The gut lining and proper functioning of your GI tract matter greatly when it comes to whole-body health. As the gate-keeper of your body, your gut decides what gets let into the bloodstream and what does not. It also comprises approximately 60% of your immune system and is also the production center for various hormones, including serotonin. [3,4]
Stress (be it chemical, emotional, or physical) breaks down the gut lining, triggering an immune response in the brain and a host of unfavorable side effects. An imbalance of bacteria in the gut (an overgrowth of the ‘bad’ kind) known as SIBO has been linked to IBS. 
Food sensitivities are very common with IBS patients, with up to 65% of them considered to be ‘hypersensitive.’  Food hypersensitivity can be caused by pharmacologically active constituents (like caffeine found in coffee) and common enzyme deficiencies (like lactose and fructose intolerances). In the general population, only about 5% report true food hypersensitivities, compared to the 20-65% of those with IBS.
Milk, wheat, and eggs, as well as salicylate or amine content, are most frequently identified to cause symptom exacerbation when it comes to IBS and food sensitivities.  One of the more recent and lesser-known connections between food sensitivities and IBS is the prevalence of nickel as a potential allergy.
Nickel Allergy and IBS
Nickel is a silvery-white metal, the chemical element of atomic number 28. Normally associated with money or jewelry, nickel is also present in many foods. This metal is often recognized to cause skin reactions like irritation, redness, and swelling– and similarly, it can have this impact inside the body. [7, 8]
The throat and gut lining is made of epithelial tissues that are highly sensitive and reactive to what they come in contact with. Someone who is allergic to nickel could have an internal allergic reaction to nickel-rich foods, causing an inflammatory response and IBS flare-up. 
Unlike jewelry that sits in one spot for extended periods, food passes through relatively quickly, meaning that not everyone who experiences nickel skin allergies will necessarily experience an internal reaction too.
High Nickel Foods to Avoid
A study that linked high-nickel foods and IBS found significant success by restricting dietary nickel. The metric was avoiding all foods considered ‘high nickel’, with a content of over 100 μg/kg. These high-nickel foods include:
- Chocolate (cacao)
- Black tea
- Nuts (peanuts, walnuts, almonds)
- Soybeans and other legumes (chickpeas, lentils)
- Canned food in general
The study followed participants for three months, monitoring the effects of a low nickel diet on gastrointestinal symptoms control, intestinal barrier function, quality of life, and psychological status. Results highlight that a low nickel diet improves all four of the metrics, in patients with IBS. 
If dealing with IBS, an elimination-diet for high nickel foods should be non-negotiable. Unfortunately, there is no proper testing other than skin patch tests for topical nickel allergies, which are not adequate for diagnosing dietary-nickel allergies. 
Removing high nickel foods from your diet for three months and then reintroducing them can give you clear insight into the relationship between nickel and your body. With studies suggesting a strong link, anyone experiencing IBS should consider this relationship as a part of their functional medicine, a whole-body approach to healing.
Pots and Pans: A Hidden Culprit
Do you use stainless steel pots and pans? Stainless steel is often used in pots and pans as it helps with thermal conductivity and resistance to corrosion. According to research, some stainless steel cookware contains approximately 8–12% nickel, and some industrial cookware can contain from 10–14% nickel. Stainless steels often maintain direct and prolonged contact with food during cooking and manufacturing processes, and nickel can leach into food. The longer a tomato sauce cooked, correlated with higher levels of nickel detected in the sauce.
These researchers concluded:
All tomato sauce samples that were cooked in the presence of stainless steel using typical cooking procedures showed significantly elevated Ni and Cr concentrations. In addition to other natural dietary sources, stainless steel cookware is an under-recognized source that can potentially contribute to overall nickel and chromium consumption.
Nickel affects stainless steel’s corrosion resistance and level of shine. The types of stainless steel pots are 18/10, 18/8, and 18/0. Each of these types is classified by the percent of chrome and nickel found in the steel. 18/10 stainless steel has 18% chrome and 10% nickel, hence the 18/10 classification. Likewise, 18/8 stainless steel has 18% chrome and 8% nickel. While 18/0 stainless steel has 18% chrome and 0% nickel. So although it might not be the shiniest and most expensive, from a health perspective you would want to stick with 18/0.
What About Flatware?
In the world of stainless steel flatware, there are several different types as well, with similar classifications of pots and pans. But the most desirable types of flatware are actually highest in nickel! Higher levels of nickel in flatware make them sturdier and shinier, less likely to dull and corrode. But, like with pots and pans, you want to stick with 18/0 flatware, with a less appealing appearance but best from a health perspective.
Irritable Bowel Syndrome (IBS) affects about 20% of Americans and has a profoundly negative impact on the quality of life and work productivity. Misunderstood by mainstream medicine, a functional medicine approach to healing can help address the root causes of this illness. Two main factors include gut disorders and food sensitivities. The latest science suggests a strong connection between nickel allergy and IBS, which can be explored via a nickel elimination diet of foods with a nickel content of over 100 μg/kg.
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- Klein, Kenneth B. “Controlled Treatment Trials in the Irritable Bowel Syndrome: A Critique.” Gastroenterology, vol. 95, no. 1, 1988, pp. 232–241., doi:10.1016/0016-5085(88)90319-8.
- Kau, Andrew L., et al. “Human Nutrition, the Gut Microbiome, and the Immune System.” Nature, vol. 474, no. 7351, 2011, pp. 327–336., doi:10.1038/nature10213.
- Kim, Doe-Young, and Michael Camilleri. “Serotonin: a Mediator of the Brain-Gut Connection.” The American Journal of Gastroenterology, vol. 95, no. 10, 2000, pp. 2698–2709., doi:10.1111/j.1572-0241.2000.03177.x.
- Sachdeva, Sanjeev, et al. “Small Intestinal Bacterial Overgrowth (SIBO) in Irritable Bowel Syndrome: Frequency and Predictors.” Journal of Gastroenterology and Hepatology, vol. 26, 2011, pp. 135–138., doi:10.1111/j.1440-1746.2011.06654.x.
- Choung, Rok Son, and Nicholas J Talley. “Food Allergy and Intolerance in IBS.” Gastroenterology & Hepatology vol. 2,10 (2006): 756-760.
- Sharma, Ashimavdeb. “Relationship between Nickel Allergy and Diet.” Indian Journal of Dermatology, Venereology and Leprology, vol. 73, no. 5, 2007, p. 307., doi:10.4103/0378-6323.35733.
- Rizzi, Angela et al. “Irritable Bowel Syndrome and Nickel Allergy: What Is the Role of the Low Nickel Diet?.” Journal of neurogastroenterology and motility vol. 23,1 (2017): 101-108. doi:10.5056/jnm16027
- Borghini R, Donato G, Alvaro D, Picarelli A. New insights in IBS-like disorders: Pandora’s box has been opened; a review. Gastroenterology and Hepatology From bed to Bench. 2017 ;10(2):79-89.
- Picarrelli, A, et. Al., Oral Mucosa Patch Test: A New Tool to Recognize and Study the Adverse Effects of Dietary Nickel Exposure. Biol Trace Elem Res. 2010 Mar 5.
- Kamerud, Kristin L et al. “Stainless steel leaches nickel and chromium into foods during cooking.” Journal of agricultural and food chemistry vol. 61,39 (2013): 9495-501. doi:10.1021/jf402400v
Medical Disclaimer: This article is based upon the opinions of Dr. Daniel Pompa. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Pompa and his associates. This article has been medically reviewed by Dr. Charles Penick, MD for accuracy of the information provided, but Dr. Pompa encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.