Nickel Allergy is Found in a Majority of Women with Chronic Fatigue Syndrome and Muscle Pain—and may be Triggered by Cigarette Smoke and Dietary Nickel Intake Original paper
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease—four years before the first published case study.
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Metals
Metals
OverviewHeavy metals play a significant and multifaceted role in the pathogenicity of microbial species. Their involvement can be viewed from two primary perspectives: the toxicity of heavy metals to microbes and the exploitation of heavy metals by microbial pathogens to establish infections and evade the host immune response. Understanding these aspects is critical for both […]
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Nickel
Nickel
Bacteria regulate transition metal levels through complex mechanisms to ensure survival and adaptability, influencing both their physiology and the development of antimicrobial strategies.
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Karen Pendergrass
Researched by:
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Karen Pendergrass
ID
Karen Pendergrass
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Karen Pendergrass
What was studied?
This study investigated the relationship between nickel allergy, cigarette smoking, and dietary nickel intake in women diagnosed with chronic fatigue syndrome (CFS) and muscle pain. The primary aim was to evaluate the prevalence of nickel allergy in this population and explore how smoking and dietary nickel may trigger or exacerbate symptoms.
Who was studied?
The study involved 204 women aged 21 to 73 years with chronic fatigue and muscle pain, meeting the criteria for fibromyalgia and chronic fatigue syndrome but with no signs of autoimmune disorders. The participants underwent immune stimulation therapy using a Staphylococcus vaccine for six months, and their nickel allergy history, smoking habits, and treatment responses were analyzed.
What were the most important findings?
The study found that 52% of the women had a history suggestive of nickel allergy, and 28% were habitual smokers. Nickel allergy and smoking significantly influenced treatment outcomes, with non-allergic, non-smoking participants showing the highest treatment success rates (39%), compared to only 6% in allergic smokers. Additionally, two case reports highlighted the impact of dietary and smoking changes: one participant improved after quitting smoking and reducing dietary nickel intake, while another experienced sustained symptom relief by following a low-nickel diet. Notably, nickel hypersensitivity was associated with increased fatigue and muscle pain symptoms triggered by dietary nickel or cigarette smoke, both of which contain trace amounts of the metal. The findings indicate that systemic nickel allergy, potentially exacerbated by smoking or high dietary nickel, may contribute to chronic fatigue and muscle pain.
What are the greatest implications of this study?
This research emphasizes the importance of recognizing nickel allergy as a potential factor in chronic fatigue syndrome and muscle pain. The interplay between nickel hypersensitivity, dietary nickel intake, and smoking could have significant clinical implications. Managing nickel exposure through dietary adjustments such as a low-nickel diet and smoking cessation may serve as a non-invasive strategy to alleviate symptoms in affected patients. Furthermore, the study underscores the need for broader awareness and diagnostic consideration of systemic nickel allergy in chronic fatigue-related conditions, particularly in women.
Low‑Nickel Diet (LNiD)
A low-nickel diet (LNiD) is a therapeutic dietary intervention that eliminates high-nickel foods, primarily plant-based sources such as legumes, nuts, whole grains, and cocoa, to reduce systemic nickel exposure. It is clinically validated for managing systemic nickel allergy syndrome (SNAS) and nickel-induced eczema. Its relevance is well-established in microbiome modulation, with studies demonstrating clinical benefits in conditions such as endometriosis, fibromyalgia, irritable bowel syndrome, and GERD.