Medications and supplements all contain nickel in varying amounts. In the majority of cases nickel is not included intentionally, but is a contaminant that is picked up during the manufacturing process. The international agreement that sets the upper limit for nickel in pharmaceuticals, ICH Q3D, doesn't account for nickel allergy; it is concerned with nickel toxicity and limits oral nickel to 220 μg per daily dose, which is absurdly high for systemic nickel allergy sufferers. Very few supplement manufacturers test their products for nickel content at all, so it's generally recommended to stop all unnecessary supplements. However, there are times when a supplement may be of interest or prescribed by a health practitioner. Without adequate testing, a lack of confidence in the safety of a product may prevent a patient from pursuing treatment, and even strain the relationship between patient and health care provider. We have therefore invested in the private testing of a handful of products, and share here the results for those products that tested well enough to be used daily by a systemic nickel allergy patient, or well enough to be used for a short time, barring other allergies and sensitivities.
We generally selected products that have fewer ingredients to increase the likelihood of success, since every additional ingredient has its own risk of nickel contamination. This may also be helpful for reducing the risk of a sensitivity to a filler ingredient, unrelated to nickel. We also factored in Canadian availability and cost where possible. A few initial tests were performed on Nootropics Depot products by Omnient Labs in Arizona, USA, but most samples were purchased in Ontario, Canada, between 2022 and 2024 and sent to Labstat International in Alberta, who provided an improved limit of detection. Be aware that each test is a snapshot in time and will not be exactly the same across batches (much like nickel in foods). Manufacturers may also change the formula or their suppliers without notice. As such, we've opted to present the results in terms of four "levels" as opposed to strict numerical values, hoping that any variation is small:
Of the 40 products that we had tested, 10% contained over 1 μg nickel per minimum recommended daily dose, but none exceeded 2.5 μg. This suggests that the strategy of selecting products with minimal unnecessary ingredients was moderately successful in locating lower nickel options. However, without proper testing and regulation of nickel in supplements to the levels required for the health and safety of the allergic patient, it is hard to have confidence.
We have only tested one iron supplement to date. This is because we limited our testing to supplements having a higher likelihood of success. Iron deficiency or an iron-deficient diet may result in increased uptake of nickel, and supplementing with iron has been found to be helpful. However, iron excipients and supplements have been shown to be highly contaminated with nickel. More testing is needed for this important element, but the cost of undertaking the search is prohibitive due to the possibly large number of tests required to achieve success.
Please note that while we may add to this list over time, requests for product testing will not be accepted. Please contact Labstat or another lab near you to have your products tested.