Cobalt Toxicity
Cobalt is part of vitamin B12, so you need a tiny amount. Too much, usually from a worn metal-on-metal hip replacement, can damage tissue around the joint and, rarely, the heart, nerves, thyroid, eyes and ears.
Sources
- Metal-on-metal hip replacements and resurfacings, mostly put in between the late 1990s and around 2010
- Worn or failed implants of other types, especially after a ceramic part breaks
- High-dose cobalt supplements, including some sold for “energy” or sports
- Hard-metal and some mining or manufacturing jobs
Symptoms
- Hip pain, swelling or a clunking hip; a lump of inflamed tissue (pseudotumour) near the joint
- Rarely, whole-body effects: heart muscle weakness, hearing or vision loss, nerve damage, an underactive thyroid, fatigue, low mood or poor memory
Have a metal-on-metal hip? You should have regular review with your surgeon, including blood cobalt and chromium levels and sometimes imaging. If you’re not sure what type of hip you have, ask the hospital or check with your GP.
Testing and treatment
- Whole-blood cobalt and chromium levels, repeated over time
- Ultrasound or MRI to look for tissue damage around the hip
- Revision surgery (replacing the implant) when levels are rising, symptoms appear or tissue is damaged
- Levels usually fall after revision
Hip replacements are usually brilliant. A clunky one with rising cobalt is not a “wait and see” hip.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Cobalt supplementsNo proven benefit, and serious heart and thyroid harm has been reported.
- Chelation “detox” for mildly raised levelsNot routine; the fix is removing the source.
Weird history
- In the 1960s, breweries in Quebec, Minneapolis and Belgium added cobalt to beer to stabilise the foam. Heavy drinkers developed a deadly heart condition, “beer drinkers’ cardiomyopathy”
- Cobalt was named after the kobold, a mischievous German goblin blamed by miners for troublesome ores
Common questions
Can a hip replacement cause cobalt poisoning?
Rarely. Worn metal-on-metal hips can release cobalt and chromium, damaging tissue around the joint and, uncommonly, the heart, nerves, thyroid, eyes and ears.
What are the symptoms of cobalt toxicity?
Hip pain or swelling, and rarely heart weakness, hearing or vision loss, nerve damage, thyroid problems and fatigue.
How is it treated?
Monitoring blood cobalt and chromium, imaging, and revision surgery when needed. Levels usually fall afterwards.
Helpful resources
- Australian Orthopaedic Association National Joint Replacement RegistryImplant outcomes data. Free.
Evidence and more information
maladywise.com/cobalt/