Cobalt toxcity

Posted by sallysher @sallysher, 1 day ago

My husband was diagnosed with Parkinsonism over 5 years ago but I have long been convinced that he was suffering from cobalt toxicity from a Metal on Metal hip replacement from 2009. He has had cobalt levels from 10-16 for over 10 years and because he had no local pain or deterioration, the 3 orthopedic surgeons we consulted (including the original Dr) advised that if there was no pain, no deterioration and his levels not that high, to not do a revision surgery. Fast forward he is manifesting neurologic and cognitive decline, and aft3er much research and consultations, are directly tied to cobalt in the blood. Due to his age, 84, and physical decline, we have decided not to do revision surgery, which is the only real solution. We are trying a course of supplements including NAC (N-Acetyl-L-Cysteine), Alpha Lipoic Acid, and Glutathione to see if that will bind some of the cobalt of his system and the symptoms can at least be stable. From what I understand, the physiological symptoms cannot be reversed but the cognitive can a bit. Attached are studies I have found helpful

Shared files

PLOS 1 cobalturia and CSS (PLOS-1-cobalturia-and-CSS.Tower2023.pdf)

EJNMMI published 20 Dec 19 F-18 FDG PET brain imaging in symptomatic arthroprosthetic (EJNMMI-published-20-Dec-19-F-18-FDG-PET-brain-imaging-in-symptomatic-arthroprosthetic.pdf)

JAMA (JAMA.pdf)

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steveinarizona | @steveinarizona | 15 hours ago

Wow. That is a horrible story. Is the implant still leading cobalt into his body? I don't think age by itself should be an issue ... I am almost 81 and six months ago I had a very successful right total knee replacement.

There are implants that are allegedly biocompatible. My surgeon uses the Smith & Nephew Journey II series and they are made of oxidized zirconium and are allegedly biocompatible.

If the cobalt is still affecting his cognition, I would question whether a revision would be a good idea after all. But that also might depend upon how bad his cognition is these days. Despite my memory defects, my neurologist keeps insisting to me that I do not have Alzheimer's. Would he be able to do the physical therapy exercises that are an essential part of a TKR recovery?

areichel | @areichel | 12 hours ago

I have a documented nickel allergy with some nickel in my chromium/cobalt knee replacement. I have often wondered about this very same issue. I have since been dx with fibromyalgia, now considered a neurologic condition.

You bring up an interesting, but very sad, dilemma. It sounds as if you are on top of it. I wish I had something to add.

chadessa | @chadessa | 8 hours ago

I'm so sorry for your husband's situation. After discovering cobalt in my blood 14 years after THR, I had hip revision at 73. My numbers were similar to your husband's. The surgeon who put it in me, the hospital and the manufacturer all knew cobalt was in me and none of them notified me.

When I discovered it and contacted the original surgeon his response was that it is "an allergy to Cobalt that only 2 percent of patients have." None of this is true, of course. I have found that orthopedic surgeons, after consulting many with my issues, can be deceptive on this issue.

I was followed by a toxicologist after my revision who said the effects of exposure depend on three things: the level of it in your blood, the length of time your body is exposed and your own body's sensitivity to the metal. He said the effects can manifest anywhere touched by cobalt, that cobalt goes everywhere your blood goes ... and that is everywhere in your body.

I would suggest a second opinion about a revision. Try to find a sports medicine or revision specialist orthopedist or a toxicologist for a referral. I have found these to be more transparent on this issue.

In my case the cobalt was confined to the ball so that was a simpler surgery not involving bone. Revisions can cause new issues of their own but they are not life threatening like cobalt can be. After revision symptoms can lessen or disappear.

If revision is not possible I hope you find ways to filter out the cobalt. A toxicologist (they are also called occupational and environmental doctors because that is where most exposures happen) would be a good resource.

Thank you for sharing the studies. They are telling. It is unfortunate that the medical community leaves us in the dark and/or misleads us. I wish you and your husband all the best.