When someone gets a dental implant, it is commonly made out of titanium. And titanium is also used in other procedures, as some hip replacements use titanium alloys. While many people with these implants seem to do fine, some people have asked whether titanium can be a trigger for Graves’ Disease, Hashimoto’s Thyroiditis, or another autoimmune condition.
Before I answer this, you might wonder why titanium is commonly used in the first place. One reason why it is commonly used is due to its high resistance to corrosion (1), which obviously is very important. Another reason is because most people seem to have a low sensitivity to titanium when compared to other metals. In fact, one study showed that all casting alloys seem to have a potential for eliciting adverse reactions in individual hypersensitive patients, although it listed titanium as being a possible exception (2). However, as I’m about to discuss, some people do in fact react to titanium, and of course this can be a big problem for someone who has a dental implant, or titanium as part of a hip or knee replacement.
Why Is Titanium Problematic In Some People?
Although most people don’t have a problem with titanium implants, a small percentage of people are sensitive. A clinical study involving 1,500 people who received dental implants showed that nine of these patients demonstrated a titanium allergy (3). The good news is that only 0.6% of these patients experienced problems with the dental implants. On the other hand, if titanium can lead to certain chronic health conditions, then even a small percentage o f negative reactions might be too high. Another study involved fifty-six patients who developed clinical symptoms after receiving titanium-based implants, and 21 of these tested positive for a titanium allergy, with another 16 showing ambiguous results (4). Sometimes someone will experience symptoms caused by these implants but they won’t make the connection, and many times their doctors also won’t be able to figure this out..
For example, a few years ago it was revealed that the actor Dick Van Dyke had experienced severe headaches which affected his sleep and caused chronic fatigue. Over a seven year period he saw numerous healthcare professionals, received a CAT scan, MRI, and a spinal tap, along with other tests, but everything came back negative. It wasn’t until his dental implants were removed that he finally received relief from his symptoms.
Once again, most people do fine with titanium implants. But these patient experiences I mentioned show that in some cases, titanium can lead to severe symptoms. In some cases the symptoms can be debilitating. And many times people live with these symptoms for years before it is figured out that the problem is due to titanium.
Can Titanium Trigger Autoimmunity?
There is no concrete evidence that having titanium implants can trigger an autoimmune response. However, this doesn’t mean that it’s not possible, as other metals such as mercury and nickel have been associated with thyroid autoimmunity (5) (6). As a result, if someone with Graves’ Disease or Hashimoto’s Thyroiditis was diagnosed with their condition after getting an implant which consisted of titanium, then this is a factor that should be considered. Of course it can be difficult to make such a connection, as someone can be in the “silent” autoimmune stage for years, which means they might have elevated antibodies for many years, yet no positive tests or symptoms. As a result, even if someone with an autoimmune thyroid condition began presenting with symptoms shortly after getting a titanium implant, this doesn’t necessarily mean the implant was responsible for the development of their condition. With that being said, if you have a titanium implant and then developed an autoimmune thyroid condition, then it might be worth doing some testing to see if you have a sensitivity to titanium.
What Other Options Are There?
Before someone gets a dental implant, or a hip or knee replacement which involves titanium, it probably would be a good idea to get a metal allergy assessment along with some allergy testing. Skin testing is an option, as the sensitivity of patch tests has been shown to be about 75% for a type IV metal allergy, although so far no study related to dental implant allergies has used this method (7). A lymphocyte transformation test is another option, although false-positive results are possible (7). There is also a Memory lymphocyte immuno-stimulation assay (MELISA) test (8), which can determine if someone has an allergy to a metal such as titanium. In my opinion it should be routine to get such testing before getting a metal implant.
Another option is to use something else other than titanium. Zirconia is a ceramic and is an option to consider. It has been used to replace hip joints, and can also be an option to consider with dental implants. However, even though one is less likely to be sensitive to zirconia, a sensitivity is still possible. But if I were getting a dental implant I probably would choose a zirconia implant over a titanium implant.
In summary, although many people do fine with titanium implants, there are some people who have a titanium allergy. And in some cases titanium can cause severe symptoms. Although there is no research which shows that titanium can trigger an autoimmune thyroid condition such as Graves’ Disease or Hashimoto’s Thyroiditis, if someone received a titanium implant and then developed an autoimmune thyroid condition, it might be a good idea to do some testing to see if they have a sensitivity to titanium. For those who are sensitive, zirconia can be an alternative option to consider.
Thank you for addressing this.There is more than just allergy to titanium for people with autoimmune issues. The failure rate increases because our bodies sometimes reject the implant or the bone does not osseointegrate.
I had (2) dental implants done I had to get bone grafting, because I am 53, and I have bone loss. (more on the right then the left)
People with Hashimotos have increased pain, besides the risk of allergy to titanium.
There is a specific test, that I believe costs only $56.00.
After 7 months, tooth # 5 on the upper jaw failed. (Bone loss)
I told the periodontist that I have Hashimoto’s @ the consult.
I would be skeptical IF you need bone grafting especially.
Its too expensive for a “maybe” outcome. Getting a failed implant removed, is torture.
Research and ask questions. Make sure they are aware of your whole medical history, to make sure they actually address pain issues.
I was not afforded that so my experience was horrible. I am still “not out of the water”, because #5 may need to be removed for a second time.
Hi Kristine-5 years ago I had back surgery. they put a titanium cage and 6 screws. 1 screw broke and is sheared just above the spine and the surgeon wont go in for there is not enough of the screw to grab onto, plus I had a bone graft (which did not take) but 1 and a half years ago they found out that I have hashimotos. I am in a lot of pain and about 2 years ago my body will not allow me to take pain meds anymore, I just feel really sick when I try any narcotic drug, so I know how you feel. This was a very good article, hope you do well.
This great information as I have hashimotos, I’ve been experiencing issues with a root canal. Is there a common issue with autoimmunity and root canals?
Thank you Dr. Eric for all the fantastic information you provide concerning this disease. As mentioned above, I have hashimotos and my mother suffers from Graves disease. Why won’t doctors listen to us, frustrating.
Hi Shirley,
I’m glad you enjoyed my blog post on titanium implants, thank you for reading it. I wouldn’t say that there is a “common” issue between autoimmunity and root canals, but root canals definitely can be an issue for some people. Here is a blog post I wrote on this topic:
https://www.naturalendocrinesolutions.com/archives/dental-amalgams-root-canals-thyroid-health/
Can you please address Graves disease and hair loss?
Thank you
Hi Shirley,
Unfortunately hair loss is very common with both Graves’ Disease and Hashimoto’s Thyroiditis, and is usually due to the imbalance of thyroid hormone, although there can be other factors involved. The good news is that the hair loss almost always stops and grows back. Here is an article I’ve written on this:
https://www.naturalendocrinesolutions.com/articles/3-ways-stop-thyroid-hair-loss-graves-disease-hashimotos-thyroiditis/
Hi Dr Eric,
I have had a Hashimoto’s diagnosis for three and a half years and my first symptoms certainly seemed to be a whole variety of leg pain with a subsequent diagnosis about 2 years ago of advanced arthritis in both knees. Next week I have an appointment with a surgeon to discuss knee replacements but I have concerns about my possible reaction to titanium. Over a period of several months at the beginning of this year, I had problems with a new dental implant. It was very slow to heal and when it did, there was a rounded bulge of tissue/ inflammation for many weeks. The bone actually decreased around the screw after several weeks but then, according to the dentist, increased sufficiently, though not optimally to complete the implant. There appeared to be no infection during this whole time. Is it possible I am allergic to titanium? At the time of the implant surgery I was very hypo symptomatic and subsequently had T3 meds added to my T4 meds, with optimal health yet to be achieved. Sorry this is so long but I’m trying to paint a full picture. I would appreciate your thoughts please.
Approximately 4 years ago I fractured my right shoulder and received titanium plates and pins. I have experienced chronic pain around the plates and pins since the implants, and limited mobility. I was just diagnosed with Hashimoto’s disease, and I have a history of allergic reaction in multiple layers. I’ve questioned being allergic to the titanium from the very beginning but was told that no one has a problem with the metal, that the pain is just something I would have to learn to live with, and that most of my symptoms are all in my head. Wow, does this article give light to my thoughts. Back to the doctor to discuss being tested! Thanks for the article; the information sure has helped.
In february of 2016 I had an dental implant. In July I was diagnosed with Hashimitos and 2 large nodules on my thyroid, which I hadn’t noticed until after my blood tests came back from my first visit in June with low thyroid numbers. How would I go about seeing if the implant triggered this auto immune response?
In february of 2016 I had an dental implant. In June I asked for blood work because I was absolutely exhausted, to the point I couldn’t get up to help my husband move us to our new home. I had some blood work in early June which showed bad Thyroid levels. I found myself touching my thyroid, wondering about it one day, and realized I had a very large lump on it. When I went in for more testing in July I was diagnosed with Hashimitos and nodules all over my thyroid, with 2 prominent ones around 2cm. How would I go about seeing if the implant triggered this auto immune response? If it did, would removing the implant stop the auto-immune response? The other thing that happened in January or February is I had a mild case of Serotonin Syndrome from reading a bottle incorrectly. Could this have caused it? I realize, there is the possibility this had been ‘brewing’ for quite awhile. However, I would like to eliminate any possibilities that are ‘fixable’ if I can. thanks so much!
HI Robyne, how do you feel, did you removed your implants?
I had a metal on metal hip replacement 1/5/2012. I had an MRI last month because I have had pain in my groin, hip and thigh for several years. I have a bursa sac filled with fluid. 20cm x 5cm x 10 cm. I am going to have a revision this year to replace the cup and ball. I was diagnosed with Hashimoto’s and Hypothroid a couple years ago. My energy level has plummeting in the last few years. Could the hip replacement have anything to do with the Hashimoto’s and Hyporthroid?
I don’t know about titanium causing auto-immune disease, but I can say that removing the titanium plates and screws from my ankle was a godsend. Not only did my chronic fatigue and arthritis go away, but my eczema cleared up also.
That’s great Deb! Thank you for sharing your experience with everyone!
Deb, you say that your eczema went away after the removal of your screws and plates around your ankle. Can I ask where on your body your eczema was? I’m only asking because I want to remove my screw in my ankle because I think it’s causing my eczema and thyroid issues.
Can a person develop loss of hair because of orthodontic braces? Especially if they get braces later in life. Once braces are removed should hair return to normal condition?
Michelle, I can’t say that I have noticed a correlation between orthodontic braces and hair loss. I did come across a case report in Pubmed where a 12-year old boy developed alopecia areata 4 months after the onset of orthodontic treatment, and four months later he had lost all of his hair:
https://www.ncbi.nlm.nih.gov/pubmed/19641764
That being said, this is probably rare, but I guess it’s a possibility. As for will the hair grow back if the braces were the cause, I’m honestly not sure, as I haven’t experienced this situation with any of my patients.
I developed some chronic Thyroiditis condition that 4 different endocrinologist can’t figure out almost to the year after having two dental implants. My thyroid is enlarged and can get very painful. I get very ill if I take any kind of medication, even medications I use to take before that caused me any side effects. I went to my dentist and asked about having the implants removed but she literally told me I was crazy and had no basis for what I was saying. Can you recommend a dentist that is truly holistic and open minded about these issues?
Margarita, before getting the implants removed you might want to look into getting the Clifford test, as you might not be reacting to the titanium, and it would be a bummer to get the implants removed if they weren’t responsible for your thyroiditis. Here is some information on this:
http://www.ccrlab.com/
As for finding a biological dentist, you can search the IAOMT website:
https://iaomt.org/for-patients/search/