Titanium Allergy

In the last couple of year, the question if titanium allergy really exists has been raised in scientific literature. Many requests coming through to us deal with a possible titanium allergy.  

From a clinical point of view, the frequency of titanium allergy seems to be very rare. However, many patients report worsening of health after placement of titanium implants. The reactions are not necessarily local, but appear in other parts of the body. One of the reasons why the existence of titanium allergy has been debated might be the that the golden standard for metal allergy testing, patch testing, has not been properly developed for titanium. The patch test is a skin test, where salts of the metals tested are placed on the skin of the back under occlusion. 24-72 hours later a dermatologist evaluates the reaction and the presence of a rash is taken as evidence of a positive reaction. Unfortunately, titanium dioxide, a salt of titanium used for patch testing, does not penetrate the skin under the conditions of patch test. This is one of the reasons why patch test in its current form often gives false negative results in patients with titanium-induced inflammation in the body.
The latest available research from Europe and Japan shows that between 2-4% of all patients with titanium implants develop an allergic reaction to either titanium or to one or more of the metals used in the titanium alloy.  

The symptoms most often observed after implantation with titanium-containing implants are varied, so they will be different in different patients. In addition to symptoms shown adjacent to implants on the mucosa in the mouth, or on the skin on the body, there may be other systemic symptoms. These symptoms are akin as those described after the exposure to other allergens, like nickel or mercury, in sensitised individuals. Symptoms arise because stimulated lymphocytes produce cytokines, which in turn affect the HPA-axis. The result is multiple non-specific symptoms such as profound fatigue, pain, cognitive dysfunction, headache, sleep problems etc.