Patient: Is it possible for an allergy to nickel (braces for teeth) to cause an allergic reaction other than contact dermatitis? (chronic fatigue syndrome, hypothyroidism)
Symptoms: Since having braces put on my daughter has been having fatigue, thyroid problems. She is on thyroid medication now and her thyroid levels are ok but fatigue continues. This has been going on for a couple of years. She is 17
Doctor: Hello,Thank you for your medical query at AskTheDoctor.comI understand your concern.In recent times, nickel has em erged out to be a frequently used component in orthodontics treatment procedures, and they are used in some braces. The only manifestation that humans show to nickel is the contact dermatitis. In oral cavity, a burning sensation, gingival hyperplasia,24 labial desquamation, angular cheilitis, erythema multiforme, periodontitis, stomatitis with mild to severe erythema, papular perioral rash, loss of taste or metallic taste, numbness, soreness at side of the tongue are the secondary manifestations of nickel wire based braces.But, the other possibilities that you mentioned seem unrelated to nickel braces, and it is possible that uncorrected hypothyroidism is leading to a chronic fatigue. You need to check her thyroid profile and correct the thyroid deficiency by an external supply through Levothyroxine or Thyronorm tablets, based on your endocrinologist’s choice. This is definitely not related to nickel. In her age ( pubertal ), it is common to develop thyroid deficiencies, due to increased demand.Particularly for the nickel dermatitis, if she is showing the oral manifestations as mentioned above, please consult her dentist, and see if the nickel-based wire can be replaced with a stainless steel wire or Titanium Molybdenum wire, which does not contain nickel and is well-tolerated. The symptoms can be managed by local corticosteroid ointments and antihistaminics if required.Hope this was helpful,Regards.