Heavy metals blood test results for Metal on Metal hip joint

@tim11 - Welcome to Mayo Connect. There are a few of us out here who have been through the heavy metal issue with our hips.
Typical guidelines are less than 7ng/ml for Chromium and less than 5ng/ml for Cobalt. Sensitive individuals can experience issues at even lower levels.

However, it is not the amount of heavy metal, it is how it is affecting/can affect your body & your health. Heavy metals can cause bone, muscle, tendon, organ and nervous system damage. I had pain, weakness in the legs, a host of nervous system & thyroid issues 5 years post-implant. My leg muscles & tissue we damaged to the point the surgeon described it a "gray, lumpy oatmeal." 11 years later I have indentations along the sides of my thighs that never really filled back in.

If someone suggests "chelation therapy" to remove the metal from your blood, please don't believe it - the implant will continue to shed more metal as long as you have it.

So, the question is, what led you to be tested? If you have any symptoms, you need further evaluation, and probably replacement of the implants. My surgeons were able to replace the ball, acetabular cup & liner, but leave the titanium shaft in the femur.

What have the doctors advised so far?
Sue

Sue,

Thank you for your reply.

Original (and only) surgery was a full hip replacement using DuPuy (J&J) Pinnacle and S-ROM metal on metal device. It was a cement-less installation. That was in 2005. No problems till last year (2021) when several symptoms appeared including:

Pain in that hip joint
Burning feeling in hip
Clicking sounds from hip
Squeaking sounds from hip
Movement of hip in joint
Spasms in that leg at night
Trouble swallowing (suspected thyroid problem)
"Foggy" brain
Vision difficulties
Itching and rashes in various locations
Depression
Anxiety

After repeated X-rays showing that all looked normal and then a month of physical therapy with strong results we introduced our local rural western US doctor to information about heavy metal poisoning that we learned of on the web...including from this excellent group. The Dr. had not heard of MoM joints with the impact of their wear releasing ions into the body...but went ahead and ordered the tests at our prompting.

The actual analysis of the blood was not done here; it was shipped across country to a renowned laboratory...you guessed it, Mayo Lab in Rochester. Results arrived yesterday providing us the feeling that at least now we know what the problem is.

I have an appointment with a local orthopedic Dr. in three days and a thyroid biopsy in five.

Our objective is to get the MoM parts removed first then move forward on removing the remaining heavy metals (if that is even possible) and manage health issues onward from there.chelation

I agree with your comment about chelation therapy. There seems to be no currently acceptable combination of chemicals to remove cobalt or cadmium (if it were lead than that would be different. Saving children from lead poisoning using chelation therapy has been very effective. If only I had gotten a pewter prosthesis. 🙂

Thank you.

Good morning Tim - Wow, that was the same hip I got, only I was the lucky recipient of two - and mine failed after only 5 years.

There is good news here in your post - now you know the issue! And -
You don't need to worry about chelation after surgery - over a few months, you liver will process the remaining metal and it will go away as your blood cells are naturally replaced. Mine metal levels were normal 6-7 months after surgery.
If your thyroid is giving you problems, again metal removal and patience are the keys. We were just about to schedule removal of mine after my hips healed, and blood tests showed the levels of thyroid hormones normalizing. We decided to watch & wait and everything calmed down after one year - no surgery required. I still (11 years later) have normal blood tests and just a few nodules that are monitored by ultrasound each year and have not changed.
I also had brain fog, fatigue, headaches, itches & rashes, hair loss and depression - all were resolved within a year after surgery.

Next - I see you are in a rural area, so this may be difficult - you NEED to find a orthopedic surgeon experienced in hip revision, and if possible MoM revision. They are going to find damage that needs repair. And ugly tissue that needs to be excised. I suggest you find a local ortho and ask where they send their "tough" cases. If you are in/near Washington, Seattle has some excellent surgeons who do this work, not sure about other areas. Mayo is possibly an option, if your insurance covers it.

Good luck - will you let me know what you learn from the ortho next week? Finding this issue and dealing with it will put on the road back to good health!
Sue

I had a total hip replacement using the DuPuy. I got a call from the surgeon 3 or 4 years later telling me the hip was recalled due to heavy metals getting into the blood. For three years blood was monitored and the cobalt and chromium levels kept increasing. Then in the 6th year post op they doubled.
I consulted with three surgeons. Two said they would do revisions when they thought necessary and that they would have to go in through the long scar on the side of my hip.
The original surgeon, who is in our small rural town but was trained at the Mayo Clinic in Rochester, said he could do it right away and he could do it from the front with minimal incision.
All went great, and 6 weeks after surgery my cobalt and chromium levels were back to almost zero. The numbers were never very high but my concern was that they were going up quickly.
I hope you are able to get a revision soon and get it out of your body. It was worth it for the peace of mind.

My Cobalt is in the 5-6 range and I’m being scheduled for anterior revision soon. The original THR was posterior. The Zimmer implant was placed in 2009. It is not a MoM ball/cup causing the problem, it is the Cobalt/Chromium ball rubbing on the Titanium stem that is releasing Cobalt. I am happy to see the post on this thread that issues resolve so quickly after revision.

Sue,

Thank you! Just what we needed to hear. I was getting a bit tense with all the issues hitting at once.

Your right. Knowing the problem is a relief. Now to deal with it!

I was hoping to hear that a recovery from the heavy metals would happen after the MoM device removal. Thanks for the hope!

We will be talking with the surgeon on Monday. I doubt that he will be "the one" and the original surgeon is on the east coast so he is out of the picture. Travel to Seattle is possible as well as to Mayo in Rochester. A few months ago I tried to get an appointment at Mayo in Arizona (drive-able from home in Western Colorado) but was turned away at that time because I have Medicare insurance as primary.

It worries me about recovery from the surgery away from my home...the first time was not all that pleasant and took a while. Perhaps the procedure has been improved in the last 17 years resulting in a quicker and easier recovery?

Do you know if Mayo has a register of MoM revision trained surgeons that I can peruse? Maybe there is one closer to my home.

Thank you!

JPRust,

Thank you for sharing.

It has taken me a year pushing and prodding my local rural medical provider as I tried to find out what was happening.

Only because we did the research and found out about the failures and toxicity of the prosthesis are we getting somewhere. (My Dr. would probably have ordered another course of physical therapy!) They had not heard of MoM problems and did not know what blood tests to order! We researched the issue and told them what tests to order. As soon as I get this issue resolved I will be finding a new provider. (end Rant)

I am looking forward to getting rid of this thing! I'll be seeing the first Orthopedic surgeon on Monday and expect that to lead to us seeking others. But it is a step in the right direction!

Chadessa,

Good luck with your procedure.

I agree, having others report the decrease of heavy metals after surgery is reassuring.

I envy your low numbers.

I don't know if anyone has a list, but knowing you are in Colorado, there are some well-respected ortho facilities in the big cities. (Thank you skiiers!) So I would think you can find someone fairly easily.
Perhaps you will have an answer as soon as tomorrow.
Sue

Sue,

Your crystal ball was spot on! After a year of bumbling about with the GP and Physical Therapy things have shifted into high gear.

The meeting with the orthopedic surgeon two days ago was excellent. He immediately told us that a revision was required and that he was going to be referring me to a speciality organization that only does hips and knees. The organization is in Denver, about a five hour drive east from our location (like you said, Colorado, a Mecca for joint repair!)

But before going to Denver he ordered two STAT tests in this area: an aspiration of the hip and a MRI with metal suppression. The aspiration occurred the next day with results twelve hours later. The MRI is scheduled for Saturday (three days from today) at the only hospital in the area with this capability which is an hour drive away.

In addition, a biopsy of my thyroid is scheduled for tomorrow. My earlier complaints of swallowing difficulty (possibly one of my metallosis related complaints) revealed issues on an ultra sound prompting the biopsy. I have asked them to include my metal levels in their considerations for the biopsy and resulting lab analysis...will see.

We are getting comfortable with this first part of the process...removing the MoM implant to eliminate the source of the metals. But the affect of metals on my mind and body are causing increased difficulty. I wonder how one can accelerate the purging of Chromium and Cobalt from the body...

Thank you for your support and guidance.