Your Good Health: High cobalt levels a sign hip replacement is failing

Dear Dr. Roach: I am having significant issues with my hip replacement that was performed 10 years ago. It can get quite painful after kneeling, lifting heavy objects or sitting in some chairs for extended periods. My MRIs show no issues. C-reactive protein tests and sedimentation rates are within the normal range, so my doctors are not sure what is causing the pain.

Is there anything I can do to reduce these levels and prevent damaging my cardiovascular and nervous systems?Cobalt toxicity is not common. By far, the most common time I see elevated levels of cobalt is in people who have a hip replacement that is wearing out and failing. Very occasionally, the cobalt is high enough to cause symptoms of toxicity, such as heart or nerve symptoms; thyroid issues; smell, hearing and taste loss; rashes; muscle weakness; and fatigue.

Exactly what cobalt levels should bring concern is a topic that there seems to be uncertainty about. Some sources say that systemic symptoms are unlikely at a level below 100 mcg/L, but several well-respected authors have suggested that a level above 20 mcg/L might be enough to cause local symptoms, such as the pain you are experiencing around your hip. Your levels are unlikely to cause symptoms.

Dear Dr. Roach: Do people with dementia who are starting to lose touch with things realize it? Are they in denial, or do they not even know that there is a problem?Every person is different and the different types of dementia behave very differently. In people with Alzheimer’s dementia, the most common type, memory loss is among the earliest symptom, but different types of memory are affected distinctly.

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