MELISA testing is best used to check if any ongoing metal exposure is causing unexplained symptoms. It can be chronic long term symptoms or new symptoms that appeared after surgery. Generally, all ongoing exposure should be considered, even if the symptoms started after, for example, placement of an implant. The reason being that galvanic effects between different metal alloys can lead to increased corrosion and release of metal ions, which can fuel symptoms. Also, removing dental fillings or crowns are usually preferable to removing implants.

MELISA can also check pre-operatively for specific metal allergy in patients presenting with a history of suspected metal allergy (e.g. dermal reactions to jewellery, contact dermatitis, etc.) to ensure the biocompatibility of the new implant. Studies have shown patients who reacted to a
single metal have an increased chance of co-sensitization to another metal, so self-reported nickel allergy may indicate hypersensitivity to other metals. However, it is crucial to understand that increased metal exposure after implant-placement may lead to a stronger immune response (metal reactivity). For more information, see Pre-testing.

You may need to check with your healthcare professional for the exact metal content of a device or implant.

To decide what to test for in MELISA consider the following:

Do you have any dental restorations; silver/amalgam fillings, crowns, bridges, implants and orthodontic braces/retainer?

Do you have any orthopaedic devices; knee, hip, shoulder replacements, pins and plates?

Do you have any cardio and vascular devices: embolization coils, stents, septal occluders, implanted defibrillators and pacemakers?

What about environmental or occupational exposure; jewellery, cell phones, coins, certain foods and medications etc.

A detailed overview of metals found in frequently used dental and orthopaedic restorations as well as an overview of metals present in our environment can be found at Metal exposure.

Please see Testing panels for more information on what metals can be tested in MELISA.