What Are Abnormal Cobalt Levels?
More and more hip replacement patients are finding that they have “elevated” cobalt levels. But what does this mean?
Metal-on-metal hip replacements created a new predicament within the medical community. There is a growing amount of research indicating what blood cobalt levels are considered “normal”. This may lead us to understand the potential health consequences from elevated blood cobalt levels.
Dr. Brian Klatt, an orthopedic surgeon from the University of Pittsburgh Medical Center, states that anything over 0.3 micrograms of cobalt per liter of blood should be considered abnormal, while levels over 5 micrograms of cobalt per liter of blood are considered toxic. Rather than opt for revision surgery, many surgeons chose to only monitor patients more closely if their cobalt levels were over 5 micrograms per liter. Other surgeons state that patients with cobalt levels over 7 micrograms per liter should have their hip replaced with an implant that does not contain cobalt.
Metal toxicity expert, Dr. Michael McCabe, states that “normal” cobalt levels (without added exposure) should be below 1.0 microgram per liter of blood. He recalls that the general regulatory standard for blood levels over 5 micrograms of cobalt should be considered abnormal. This figure is based on previous occupational studies on cobalt exposure in which the means of exposure were inhalation, ingestion, or skin contact. Metal wear debris, from metal-on-metal hip implants, is regarded as a more dangerous source of exposure since cobalt is released directly into the tissue and bloodstream.
Common questions regarding cobalt blood levels:
Are there long term consequences associated with having elevated cobalt levels?
According to the Agency for Toxic Substances & Disease Registry, cancer occurred in animals when cobalt was placed subcutaneously or intramuscularly. Based on this research, the World Health Organization’s International Agency for Research on Cancer includes cobalt as a potential carcinogen for humans.
Numerous reliable studies demonstrate that cobalt exposure may initiate an inflammatory process that infiltrates the T-lymphocytes (immune mediated cells) and increase the body’s hypersensitivity response. According to a 2009 study “Cellular and molecular pathways linking inflammation and cancer,” evidence indicates that cellular inflammation is a key contributor to cellular malignancy, tumor formation, and potentially the onset of cancer.
Historical evidence, and the occupational studies noted above, have also shown that other methods of exposure to cobalt can lead to cardiomyopathy (weakening of the heart), hypothyroidism, dermatitis, visual changes, peripheral neuropathy, and other health problems.
If I have my metal hip prosthesis removed, will my cobalt levels go down?
Cobalt is not an accumulating metal, meaning it is not stored in the bones, but rather it is stored in the liver and can be processed out of the body through the urine. The red blood cells that carry the cobalt have a typical lifespan of 3 months. Theoretically, once the cobalt source has been eliminated, the blood’s cobalt levels should return to normal.
However, if the body’s inflammatory process begun, it is still possible that a more serious ailment was initiated. Therefore, it is important to continue monitoring long term health after exposure to cobalt has ceased and blood levels have returned to normal.
Video Part 12: Potential Long Term Effects of Cobalt & Chromium
In the above video, toxicology expert Dr. Michael McCabe discusses how the body’s immune response to cobalt and chromium metal debris wear may adversely affect the patient with long term health problems.
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