# Systemic Nickel Allergy Systemic nickel allergy is on the differential diagnosis as a mimic of ME/CFS and fibromyalgia. Those with a vegetarian or vegan diet tend to have higher nickel content in their diet and so may be at higher risk. Cigarettes also contain nickel and can flare symptoms. Unfortunately, there is no way to test for systemic nickel allergy and the treatment is difficult to adhere to, especially for vegans and vegetarians, since nuts and legumes tend to be high in nickel. Treatment involves avoiding skin contact with nickel, avoiding external sources of nickel (such as cigarettes) and maintaining a low nickel diet. Foods highest in nickel include whole grains, legumes, seafood, tea, baking powder, and certain nuts/seeds. There are a couple of cookbooks on the market for low nickel diet recipes. 1. Bjorn Regland, Olof Zachrisson, Vera Stejskal, Carl-Gerhard Gottfries. Nickel Allergy is Found in a Majority of Women with Chronic Fatigue Syndrome and Muscle Pain—and may be Triggered by Cigarette Smoke and Dietary Nickel Intake. *Journal of Chronic Fatigue Syndrome*. 2011;VOL(ISSUE);57–65.10.1300/J092v08n01_04 2. Jan A. Marcusson, Gudrun Lindh, Birgitta Evengard. Chronic fatigue syndrome and nickel allergy. *Contact Dermatitis*. 1999;VOL(ISSUE);269–272.10.1111/j.1600-0536.1999.tb06061.x