Steven Lippmann, M.D.

Aluminum and psychiatry? Aluminum is the third most common element in the earth. Dementia specialists and others have debated whether aluminum ingestion through the gastrointestinal track or skin is bad for brain health. Does it cause or facilitate cognitive decline or development of other neurologic disorders?

The research is not conclusive. Some studies suggest that aluminum is a potential inducer of Alzheimer’s disease-like presentations. It may also contribute to a variety of brain disorders like Parkinson’s disease or autism, or even other conditions.  However, further investigations do not evidence a causal relationship. There is too little reliable research published on this topic. No proofs. The more you know about it, the more you know how little you know. Being so unclear, everyone can make up their own decisions. Despite lack of certainty, lots of people no longer use aluminum cookware.

Aluminum is widely used in certain food preparations, like in pickling processes, baking products like baking powder, pared packaged foods, even water purification, and in beverage container cans. Aluminum-free versions of baking powder also are fortunately very commonly available; many varieties contain only sodium bicarbonate, that is safe for food consumption.

Low levels of aluminum are also present in very many fruits, vegetables, meats, fish, and cheese; yet, it is widely thought that aluminum presence in these edibles is safe. But then, why is there concern … who knows? Fortunately, millions of people seem unaffected in any recognized negative way. Nevertheless, questions continue to be asked and with few clear answers; aluminum-containing food selection remains a question for some people.

There are industrial uses for aluminum. Their compounds can have acidity. In healthcare medicine, aluminum hydroxide is used as a vaccine adjuvant, to enhance the potency and/or efficacy of those reparations. Pertinent now, during COVID-19 vaccination efforts in 2021, is that reportedly neither Pfizer, Moderna, Johnson and Johnson, nor Astra-Zeneca vaccines contain aluminum. Many antacids prominently contain aluminum salts. There are other applications for aluminum as well.

Aluminum has astringent, antibacterial, hemostasis, and odor protection properties. For these reasons, aluminum is utilized in under-arm anti-perspirants. Note that anti-perspirants diminish sweating, while deodorants just mask or cover odors. Actually, numerous cosmetics and skin care products also contain this metallic agent. A less common application is in styptic pencils or powders that decrease bleeding and infections, as in shaving cuts. There are some who still wonder whether any of these are dangerous to health.

The safety of aluminum under-arm odor mitigation products is a concern. At least some of them state in clear, up-front, proper labeling that they do not contain aluminum chlorohydrate. But that opens a question: Why do they so clearly document, in big letters, absence only of that specific aluminum salt? While on the back label there, in some cases, is smaller, much less obvious print documenting that this product contains potassium alum.

What is alum?  Sounds like aluminum, so is it?

Alum is an inorganic chemical compound commonly in a sulfated or potassium aluminum salt. There are also other aluminum salts, like of sodium or ammonium, etc. Potassium alum is called potash alum and is a common aluminum-containing compound. They reportedly are said to be safe for humans.

Potash alum is frequently the active ingredient in so-called natural anti-perspirants, utilized in place of aluminum chloride or aluminum chlorohyrate. Note that aluminum can be absorbed into the skin, and it is known that aluminum has toxicity to humans and animals. Some literature indicates that aluminum chlorohydrate is a small, thus dangerous molecule, easily absorbed through the skin, but that alum, as a larger molecule, is claimed to be stable and with less skin penetration. This may be true; however, the way it is sometimes commercially presented is deceptive, appearing to try to hide that it is an aluminum containing product. On the front label stating that it contains no aluminum chlorohydrate, but on the back recording that it does contain potassium alum, which is an aluminum-potassium salt. This seems to be advertising tricky in that the manufacturer appears to hope that customers only read the front label and/or do not understand the meaning of the wording of “alum”. And, who knows, maybe alum is truly safe for humans, too.

The full story is yet to be established. Additionally, it is possible that overt, clinical aluminum toxicity is primarily associated to people with genetic predispositions to retain and/or deposit aluminum in the brain.  For such vulnerable persons, amounts innocuous to other people could be damaging to those with predisposition; that might explain why there is true confusion about risks by the general population. On that basis, restricting aluminum exposure to individuals with a family history of early-onset dementias is recommended, even if no signs of concern are evident.

A myriad of unanswered questions exist, and the pathophysiology of some neurodegenerative disorders remains unclear. A dearth of reports about proven toxicity links might even be some comfort. For the moment, there are some easy steps to follow to diminish aluminum exposure. These include avoiding aluminum-containing anti-perspirants, not cooking in aluminum ware – even aluminum foil, minimizing consumption of prepared foods, and not using aluminum containing baking powders, antacids, and/or vaccinations (current COVID-19 vaccines reportedly contain no aluminum).

The bottom line: be aware of the concerns, proceed with reasonable precautions, and  avoid known high aluminum exposure sources. Good luck to us all.