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Cobalt Chromium Toxicity

What Are Abnormal Cobalt Levels?

More and more hip replacement patients are finding that they have “elevated” cobalt levels. But what does this mean?

Unfortunately, there isn’t a great deal of information readily available on the topic of cobalt blood levels. Metal-on-metal hip replacements have introduced the medical community with a new predicament that has not been thoroughly studied, and unfortunately, the implants themselves were not thoroughly tested. However, there does exist a growing amount of research that can provide indication of what we may consider “normal” blood cobalt levels, and that may lead us to understand the potential health consequences from elevated blood cobalt levels.

One orthopedic surgeon from the University of Pittsburgh Medical Center, Dr. Brian Klatt, states that anything over 0.3 micrograms of cobalt per liter of blood should be considered abnormal, while levels over 5 are considered toxic. However, many surgeons have chosen to simply monitor their patients more closely if their cobalt levels are over 5 micrograms per liter. Some surgeons state that patients with cobalt levels over 7 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 explains that the general regulatory standard stating that blood levels over 5 micrograms of cobalt should be considered abnormal are based on previous occupational studies on cobalt exposure in which the means of exposure were inhalation, ingestion or skin contact. Because metal wear debris is generated internally from metal-on-metal hip implants directly into the tissue and bloodstream, it is potentially more dangerous than being exposed to an external source of cobalt.

Common questions regarding cobalt blood levels:

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 has been shown in animals when cobalt was placed directly into the muscle or under the skin. Based on this research, the World Health Organization’s International Agency for Research on Cancer includes cobalt found in hard metals as a potential carcinogen for humans.

Numerous reliable studies demonstrate that cobalt exposure may initiate an inflammatory process that infiltrates the T-lymphocytes (T-cells) and increase the body’s hypersensitivity response. According to a 2009 study titled “Cellular and molecular pathways linking inflammation and cancer,” evidence indicates that cellular inflammation may be a key contributor to cellular malignancy, tumor formation, and potentially the onset of cancer.

Historical evidence and the occupational studies noted above also have shown that other methods of exposure to cobalt can lead to cardiomyopathy, 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, so theoretically, once the cobalt source has been eliminated, the blood’s cobalt levels should return to normal.

However, if the body’s inflammatory process has begun, it is still possible that a more serious ailment has been initiated. So it is important to continue monitoring one’s health long after the 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.

Getting the help you deserve

Do you have an advocate looking out for your best interest?  At Kershaw-Talley we represent hundreds of hip replacement patients who, for decades, continue to rely on our knowledge and expertise in fighting and winning cases against manufacturers that put defective medical devices on the market. All it takes is 3 simple steps! Start by sharing your story with us through our free evaluation form on this page or give us a call toll free at 888-817-2527 for a no-cost, confidential case review.

At Kershaw-Talley, we look forward to serving you and your family.