Nickel Sensitivity and Symptom Management in Endometriosis: The Role of a Low-Nickel Diet Original paper
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Karen Pendergrass
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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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Karen Pendergrass
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Karen Pendergrass
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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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Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
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Endometriosis
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
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Low‑Nickel Diet (LNiD)
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.
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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
Fact-checked by:
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Karen Pendergrass
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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 pilot study investigated the prevalence of nickel (Ni) allergic contact mucositis (ACM) in women with endometriosis who experience gastrointestinal symptoms and evaluated the effects of a low-nickel diet on these symptoms. The study focused on assessing the gastrointestinal, extra-intestinal, and gynecological symptom reductions associated with Ni ACM and dietary interventions.
Who Was Studied?
The study enrolled 84 women of reproductive age diagnosed with endometriosis who reported significant gastrointestinal symptoms. Thirty-one participants completed the study, undergoing a diagnostic nickel oral mucosa patch test (omPT) and a subsequent three-month low-nickel diet intervention. Participants were evaluated using symptom questionnaires both at baseline and after dietary changes.
What Were the Most Important Findings?
The study found that 90.3% of participants tested positive for Ni ACM, suggesting a high prevalence of nickel sensitivity among women with endometriosis.Following three months of adhering to a low-nickel diet, significant reductions in all evaluated symptoms were reported. Gastrointestinal symptoms such as abdominal pain, bloating, and diarrhea showed marked improvement. Extra-intestinal symptoms, including fatigue and headaches, and gynecological symptoms such as pelvic pain and dysmenorrhea, also exhibited statistically significant decreases. These findings indicate that nickel sensitivity may contribute to the symptomatic burden of endometriosis, and dietary interventions targeting nickel can alleviate these issues.
The study suggests a potential mechanistic link between nickel exposure, immune responses, and the exacerbation of endometriosis symptoms. Major microbial associations (MMAs) relevant to this context include those influenced by dietary changes, although specific microbiome alterations were not detailed.
What Are the Greatest Implications of This Study?
This research highlights nickel sensitivity as a significant yet previously under-recognized contributor to gastrointestinal and systemic symptoms in endometriosis patients. The findings suggest that incorporating nickel sensitivity screening and low-nickel dietary recommendations could represent a transformative approach to symptom management in endometriosis. Although the sample size was small, the results offer strong preliminary evidence for revising dietary protocols in clinical practice to include low-nickel guidelines, potentially improving the quality of life for patients.
Nickel
Bacteria regulate transition metal levels through complex mechanisms to ensure survival and adaptability, influencing both their physiology and the development of antimicrobial strategies.
Endometriosis
Endometriosis involves ectopic endometrial tissue causing pain and infertility. Validated and Promising Interventions include Hyperbaric Oxygen Therapy (HBOT), Low Nickel Diet, and Metronidazole therapy.
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.