When you buy a dietary supplement like a vitamin, you’re doing so because you want to ingest something that’s beneficial for you.

The same is said about medications. Those little white pills are intended to be beneficial.

But what if you’re actually consuming a harmful compound, at the same time as the helpful ingredient?

This pigment, along with compounds like aluminum silicate, are currently classified as being perfectly safe for consumption. But recent research suggests that may not be the case and even if you don’t take vitamins or wear makeup, you still may be exposed to a “staggering” number of these nanoparticles per day just from what you eat (1).

titanium dioxide safety warning

That’s trillions of particles! That’s how much you might be ingesting on a daily basis, if you eat the typical American diet.

Research suggests consumption might be linked to oxidative stress, mitochondria damage, neurodegenerative diseases, GI diseases like Crohn’s, and possibly pose risks for pregnant women.

If you have kids or know someone who does, you will want to pay special attention since research estimates their consumption is far higher than that of adults.

And if you think this is all scaremongering and conspiracy theories, at least pay attention to the fact that it is banned in Germany and the EU just announced a few months ago they would be re-evaluating its use as a food additive due to questions as to whether it’s as safe as previously thought.

Here in America, you will find high amounts added to all sorts of things you eat and drink daily, including those which are thought of as being healthy and good for you. It’s also found in many brands of toothpaste, soaps, sunscreens, and cosmetics like foundation, nail polish, and lip balm.

What is titanium dioxide used for?

By the year 2022, it has been estimated the global consumption of titanium dioxide will be a 7.8 million metric tons (2).

When it comes to the mineral titanium (the origin this dioxide is made from) the United States does not even rank in the top 5 countries for production. Those are China, Russia, Japan, Kazakhstan, and Ukraine (in the order). China is the largest, responsible for around 40% of the supply (3).

titanium dioxide powderWhen it comes to the coloring agent, which is titanium dioxide in a powdered form, only around $3 billion worth is made in the US annually (4). Given the global market value, that equates to only around 17% being made domestically.

The vast majority of this pigment is used for industrial purposes, such as paint. It’s what gives your Valspar or Behr eggshell that ultra-white color. This shouldn’t concern you though, because titanium dioxide is non-toxic on its own.

The concerns which have been raised are not related to the paint on your wall, but rather the things you eat which contain it.

The titanium dioxide color is used in a plethora of different foods to make them brighter and whiter.

In addition, you may be absorbing these micro and nanoparticles via transdermal means, from the stuff you slather on your face and body.

makeup artists applying eye shadowYour cosmetics ranging from BB cream to lip balm may be making use of it. Likewise for sunscreen. Even something like a Neutrogena acne product (i.e. Skin Clearing Liquid Makeup) lists it in the ingredients label.

Yet at least you could make the argument those products are offering aesthetic benefits. For the titanium dioxide in toothpaste, what’s the point of that?

For some bizarre reason, Crest, Colgate and the other guys are stuck in your parents and grandparents generation. They must think millennials care more about how white and bright the paste is, rather than what’s inside of it.

The good news is that the pigment used in those brands and most other toothpastes are not nanoparticle size (they’re bigger). However, they are still microparticle-sized.

Even if they are microparticles being used, is it possible to ensure all of them are larger?

As published in Environmental Science & Technology, researchers at Arizona State University did a thorough analysis of the precise diameter of nanoparticles in food (5). In the white coloring they tested, here is a graph of what they found for the distribution of the primary particle size.

size distribution of nanoparticles“Electron microscopy and stability testing of food-grade TiO(2) (E171) suggests that approximately 36% of the particles are less than 100 nm….”

E171 is the official code for this titanium dioxide food coloring.

100 nanometers is considered to be the cutoff point for nanoparticle vs. microparticle.

But that was just a single source of E171, maybe it was just a fluke?

To find out if this problem is widespread, let’s turn to a more recent 2014 study out of the Netherlands (6). They tested 24 different food products and 3 personal care items. Do any of those have detectable amounts of nanoparticles under 100 nm?

Yes, and the number was shocking.

“In 24 of the 27 foods and personal care products detectable amounts of titanium were found ranging from 0.02 to 9.0 mg TiO2/g product.”

That’s 89% of the foods and products! In other words, across all of the things tested, only 11% seem to be doing a good job at using above 100 nm particle sizes.

Plus that was over in Europe, where they scrutinize nanoparticles even more so than the United States.

In fact, there’s so much scrutiny over there, that at the end of 2016, they announced they’re doing a “re-evaluation” in the European Union as to whether titanium dioxide is safe to eat (7). It sounds like their concerns center not around it being genotoxic or carcinogenic, but rather reproductive health:

“The Panel noted that possible adverse effects in the reproductive system were identified in some studies conducted with material which was either non-food-grade or inadequately characterized nanomaterial…”

Regardless of whether they’re super tiny or not, it begs the question as to why they are even bothering to put this unnecessary chemical in these things to begin with.

Aquafresh toothpasteThere doesn’t seem to be health benefits of titanium and it’s certainly not an essential mineral for humans (or animals for that matter). So there’s no point of these cosmetic uses, which serve no purpose other than making their products prettier.

Inevitably, you do ingest some paste in the process of brushing, which is concerning because that earlier ASU report claims that for the toothpastes, sunscreens, and other personal care products which contain the pigment, they are a whopping 1% to 10% titanium by weight!

That’s a lot of unneeded color being added. We wish they made them dull and ugly instead.

While you may be spitting out 99% of your toothpaste, the same cannot be said about the foods you eat. Instead, your goal is swallow them!

That’s what makes edible items containing titanium dioxide so much more concerning. At least with a deodorant or topical acne product for your skin, not all of it is entering into your body. Not the case with something you eat.

20 highest foods with titanium dioxide

So which types of things in your diet might this color be used for? In that ASU study, they tested a total of 89 items and these were the 20 which they reported as having the most. Beginning with the highest first:

  1. Dickinson’s coconut curd
  2. Mentos Freshmint gum
  3. Hostess Powdered Donette
  4. Good and Plenty candy
  5. Kool Aid Blue Raspberry
  6. Eclipse spearmint gum
  7. M&M’s Chocolate candy
  8. Albertson’s vanilla pudding
  9. Betty Crocker whipped cream frosting
  10. M&M’s Chocolate with peanuts

  1. Trident White peppermint gum
  2. Jello Banana Cream pudding
  3. Dentyne Ice peppermint gum
  4. Kool Aid Lemonade
  5. Mother’s oatmeal iced cookies
  6. Albertson’s mini marshmallows
  7. Dentyne Fire Spicy Cinnamon
  8. Pop Tarts Vanilla Milkshake flavor
  9. Mentos mints
  10. Nestle Original coffee creamer

Now you may see those items and think “those are all junk food, nothing relevant to my diet.”

Well, if you keep going down the list of foods you will find that many healthier things also make use of this additive.

milk glassWhile their concentrations were much lower, dairy products tested positive including milk, cheese, and yogurts.

For example, low fat milk was 0.26 µg Ti/mL. Even before testing, they mentioned how they suspected the low fat dairy products may have the TiO2 added to boost color and texture. The worst dairy product for it was a cheese (Albertson’s American single slices).

Now if you’re vegan, you may think you’re off scot-free, but don’t count your blessings just yet. When compared to the low fat cow milk, the amount in plant-based milks:

“…was comparable with nondairy substitutes including soy- and rice-based drinks.”

Mayonnaise, whipped cream, and yogurts were also offenders in the dairy category. Whether it’s coming from those, candies, or something else, the amount of titanium dioxide in food might impact children the most, if it is found to have side effects.

Why? Because that same ASU research team put together an estimation of total dietary intake by age and here is a graph of the data.

how much titanium dioxide is consumed by age graph

Their estimates make complete sense, because we do tend to feed our kids high amounts of processed junk, especially candies and sweet baked goods which may have white frosting.

Avoiding white foods isn’t a reliable way of avoiding titanium dioxide.

This is because it’s used as a brightener too, where it may be mixed with other colors. For example, the blue raspberry Kool Aid highlighted above is definitely not white, yet it does have vivid colors.

Whether you buy your snacks from Chevron or Starbucks, you might be ingesting this controversial chemical.

Starbucks coffee cupsIt is found in a number of desserts for sale at Starbucks; iced lemon pound cake, doughnuts (various flavors), cake pops (various flavors), chocolate crème whoopie pies, and their Frappuccino cookie. Although they previously announced they would be removing these things in 2017, we still see it listed in the ingredients for these items.

Though at least Starbucks has enough decency to disclose its use in those.

According to CFR Title 21, Sec. 73.575, the FDA allows up to 1% food-grade concentrations to be used without any disclosure on the ingredients label (8). It could be in something without any way for you to know it.

Is titanium dioxide safe?

Currently, it is considered to be a benign and inert compound which poses no health risks. As a food additive, it is Generally Recognized as Safe (GRAS) by the U.S. Food and Drug Administration. Even though it is not believed to have toxicity, an increasing number of studies have suggested there may be safety concerns which warrant further research.

Elsewhere in the world, we already mentioned how E171 is undergoing a “re-evaluation” for human consumption in the European Union. It is banned in Germany (9).

Whether it be nano, micro, or another particle size, or perhaps even the more recent invention of nanotubes, this oxide of titanium may be bad for you in other ways.

Under the Workplace Hazardous Materials Information System (WHMIS) in Canada, they give it a D2A “very toxic material” designation (10). Though to be clear, that’s referencing occupational exposure, not when it’s contained in food. OSHA also gives strict guidance on its use.

IARC cancer ratingsThe International Agency for Research on Cancer, which is part of the World Health Organization, has a total of 292 agents listed in their Group 2B. They consider those agents “possibly carcinogenic to humans” and titanium dioxide has recently been added to this category, for when it is inhaled as dust.

France’s ANSES submitted a proposal to the European Chemicals Agency for it to be escalated to a Group 1b carcinogen for inhalation (11). They cite research of rats inhaling it, which reportedly led to an increase in malignant tumors. France put forth this proposal in 2016 (12).

If the French are proposing it should rank as a Group 1B carcinogen for inhalation, then why should eating it still be okay?!

Dunkin’ Donuts is phasing out its use, but what about “inhaling” a bag of Hostess powdered mini donuts? Even if you were to eat those slowly, the dusts still goes airborne.

While not intending to defend the food industry, it should be pointed out that occupational exposure seems to be the focus for France. Still though, why intentionally consume something if there are dangers suspected? Why not forgo the use of titanium dioxide for dietary purposes altogether, just to be extra safe?

As long as question marks linger, why are we giving so much of it to our babies and kids?

baby brushing his teeth

Whether it’s for use in snacks, dairy, or toothpaste, there are substitutes for E171 including calcium phosphate and silica dioxide which can be used as brightening agents, if people really insist on having a pretty color.

Other titanium dioxide dangers?

While there are grave concerns about possible health risks from inhaling it, when it comes to eating it, officially there are no recognized side effects.

allergic skin reaction of hives and itchingSince it is an inert non-organic material, having a titanium dioxide allergy is rare. Reactions documented in medical literature to the metal in general (not necessarily the dioxide form) include the following (13):

  • Hives
  • Eczema (atopic dermatitis)
  • Edema
  • Redness and itching of the skin or mucosa (localized or distant)
  • Slow healing of fractures
  • Pain, necrosis and weakening of orthopedic implants
  • Hyperplasia

While you can be allergic to titanium, there may be much more serious things to worry about.

The following adverse reactions are unproven in humans, but they raise serious questions as to the possibility that TiO2 may not be as safe to ingest as previously thought.

Yellow nail syndrome

Not be confused with merely having discolored nails, this is a rare medical condition that’s technically known as “primary lymphedema associated with yellow nails and pleural effusion.” Chronic cough and sinusitis are side effects which often go along with the yellow and brown nails.

Researchers in Sweden published research suggesting this disease may be linked to titanium exposure (14).

“It is caused by the galvanic release of titanium ions by other metals or by the oxidative release of titanium ions by fluorides or by the uptake of titanium dioxide from the digestive tract. Presence of titanium in the nails confirms the diagnosis, even in the absence of characteristic nail changes.”

Where was the metal coming from?

“In patient 3 the titanium evidently derived from chewing gum only”

broken tib fib X ray with intermarrow nail implantedChanging your chewing gum is easy, changing your bones isn’t.

The bad news is that the vast majority of the people in the study were found to have implants made of the metal, including in the teeth or jaw (20 people), intramarrow rods or screws in bones of the leg (4 people) and in the form of staples in the abdomen (1 person).

That sounds like a whole can of worms for people with orthopedic implants, given that this 22nd element on the periodic table is the go-to choice for many, if not most, internal fixation screws, rods, and plates.

What you see here is an X-ray of one of own fib/tibs with a titanium alloy inside. Additionally, there are over a dozen similar implants throughout his body.

Blood sugar and insulin resistance

Scientists from China and Japan wanted to see if these nanoparticles were toxic to the endocrine system of mice.

The mice were split into three groups; receiving none, a low dosage, or a high dosage. This continued for a period of 14 weeks (15).

  • Higher levels were found to accumulate in vital organs; liver, kidneys, spleen, small intestine, and pancreas.
  • Blood sugar levels (plasma glucose) “significantly increased” even though there was no change in how much insulin was being secreted. They said the titanium “induced insulin resistance” in the mouse liver. In their conclusion, they said the mechanism causing this was that it activated the the inflammatory response and MAPK pathways.
  • Reactive oxygen species (ROS) levels were higher in the liver, which suggests oxidative stress was occurring.

Brain damage and oxidative stress

neurons, brain cellsAccording to researchers out of the University of Nebraska, animal studies have found that there is “significant nanoparticle accumulation in the brain.” That raises alarm bells about titanium dioxide color since it is the 2nd most common nanomaterial used in the world (16).

Astrocytes cells are the most prevalent in the brain, yet research is limited on them regarding this topic. That’s why they specifically wanted to find out what happened to them upon exposure, in their 2015 published study.

  • “Significant loss of glutamate uptake” was observed with all 3 of the titanium nanoparticles tested in rats. Why that ‘s important is because it’s believed to impair the function of the astrocyte cells.
  • Evidence of oxidative stress and mitochondrial damage was seen. The lower dose caused tubulation, while the higher caused outright fragmentation.

What they used as the “high” amount of exposure was not extreme; 100 parts per million of commercially available P25 TiO2 nanoparticles. The other two concentrations were 25 and 50 ppm. The changes in cell viability were said to be “concentration dependent” which may raise the question, what is the safe level of titanium in food when it’s in the nano form, if any?

In response to the apparent mitochondrial damage, they said:

“Therefore, we conclude that TiO2 nanoparticles could potentially contribute to subsequent adverse health effects and the development of neurodegenerative diseases.”

They did not list any specific neurodegenerative diseases, but one has to wonder if they had in mind things like Alzheimer’s, Parkinson’s, Multiple Sclerosis, ALS, and other frightening disorders of the central nervous system?

The theory of brain health risks is not new. There have been a number of disturbing studies published throughout the past several years.

For example, a year before the Nebraska study, Mexican scientists claimed that it can build up in the hippocampus region, and toxic side effects were observed in cultured human brain cells (U373 glial cell line) (17). They didn’t mince words when they said these nanoparticles:

“…can cause brain injury and be hazardous to health.”

Pregnancy dangers

pregnant woman with husbandIn the EU’s “re-evaluation” of white food coloring made from this metal, they expressed concerns over reproductive health safety.

Like the brain, research continues to come out which suggests there might be risks involved with titanium dioxide during pregnancy.

Some of the earliest research on this topic came from the Tokyo University of Science. In mice given TiO2, they reported the brains of offspring were affected during the perinatal period – that’s the time immediately before and after birth (18).

After injecting pregnant mice with nanoparticles, they found changes in gene expression in the brain. They made note of the cerebral cortex, the olfactory bulb (near the forehead, between the eyes), and areas related to dopamine production and receptors.

Critics might say that’s only seen in mice, but the catch-22 is how do you do studies like that in humans?

Regulators would not approve a human study which might intentionally harm a human baby (and for good reason, obviously).

Aside from cutting out dietary sources, women using sunscreen while pregnant should be using nanoparticle free brands as a precaution to be safe. Titanium dioxide in cosmetics is another unnecessary form of exposure.

IBD and GI symptoms

Inflammatory Bowel Diseases (IBD) include Crohn’s, ulcerative colitis, and others resulting from inflammation in some or all of the digestive tract.

A cohort of Brazilian medical professionals and researchers published research back in 2012 in which their conclusion said (19):

“Our findings indicate that TiO2 particles induce a Th1-mediated inflammatory response in the small bowel in mice.”

Much earlier, back in 2004, Italian scientists looked at colon tissue samples taken from dead humans who had cancer or Crohn’s disease (20).

18 out of the 18 were found to contain micro and nanoparticles.

Contrast that the the 3 control samples used; people who had died from catastrophic events like car accidents. Those “showed the absence of debris within the normal, healthy colon mucosa.”

That was only 21 humans, which is a small sample size.

A few years before that was a slightly larger study involving living humans; 28 who had ulcerative colitis, 21 with Crohn’s disease, and 36 healthy people to use for comparison (21).

The scientists took intestinal biopsies from them and then in the lab, they treated the tissues with the coloring to see if side effects would occur.

No inflammation was seen.

But when they added bacteria endotoxemia along with the TiO2, the inflammatory response was seen:

“A ‘Trojan horse’ mechanism may operate whereby lumen toxins (e.g. bacterial lipopolysaccharide) or antigens (e.g. bacterial and food proteins) are transported into the intestinal mucosa on the surface of dietary microparticles.”

In other words, the titanium dioxide is safe on its own, but a problem may result because bacteria latch onto the microparticles.

That is somewhat similar to the problem with stevia. When evaluated on its own, stevia appears to be safe. Yet after digestion, the human gut flora convert it to mutagenic byproducts, which means stevia’s side effects include it being a mutagen.

Shortly after that ‘Trojan horse’ suggestion, the nutrition and dietetic department out of a hospital in London published a double-blind, randomized, pilot study which looked at 20 patients with Crohn’s disease (22).

  • 10 patients were used as a control, receiving a standard diet.
  • 10 were placed on a low microparticle diet.

Their conclusion stated:

“A low microparticle diet may be effective in the management of ileal Crohn’s disease…”

But wait, those particles might not be the problem…

fast food hamburgerYou see in addition to removing those, they also avoided things like processed meats/fish, mozzarella and cottage cheese, and most of the other known foods with titanium dioxide in them like candies, coffee creamers, and so forth.

So how do we know if it was the TiO2 removal or these other dietary eliminations which led to reduced inflammation and better control of side effects like diarrhea, constipation, rectal bleeding, and abdominal pain.

That same London hospital then conducted another trial to answer that question.

What they concluded next actually overruled their earlier suggestion that titanium dioxide is dangerous for this inflammatory disease (23).

After evaluating 83 patients with active Crohn’s, they found that when both groups – those on a normal diet and those on a low TiO2 diet – had cut back on the processed meat and seafood, they both experienced similar benefits.

The improvement may not have been from eliminating microparticles, but rather the elimination of meats.

This coincides with related research, which has found that people with Crohn’s disease are not consuming above-average amounts of the microparticles in their diet (24).

If anything, it seems to validate all the other research which says that a plant-based (vegan) diet rich in whole foods is an excellent choice for those with this disease. For the Cliff Notes version of why, read this letter from the gastroenterology division at a Japanese hospital. They reported that relapse rates at 1 and 2 years were only 0% and 8%, respectively, for those on a semi-vegetarian diet. Compared to 33% and 75% for patients on an omnivorous diet.

Does that mean that the dioxide of titanium plays no part in the worsening of symptoms? Even though it’s unknown, many hold opinions such as this (25):

“…high concentrations of dietary microparticles should not be completely ruled out as a potential contributors to intestinal inflammation.”

Living titanium and nanoparticle free

This is a huge challenge, especially if you live in the US.

Thanks to a loophole in the law, up to 1% concentrations of TiO2 color may be in your food and legally, it doesn’t even have to be disclosed to you in the ingredients.

official USDA organic sealIn 2010, the National Organic Standards Board (NOSB) made a recommendation to the USDA to prohibit the use of nanoparticles for items labeled organic (26).

Even though the US National Organic Program (NOP) voted to accept the recommendation a couple months after, the outcry has been that the USDA is “looking the other way” when it comes to this issue (27).

Not much has changed in the 7 years since, when they said they “will gather information from other agencies…and report back to the NOSB.”

When are they going to “report back” so regulation for it can begin for organic foods?!

Unless a manufacturer specifically says what you’re buying is free of nanoparticles and/or titanium dioxide, don’t automatically assume it is.

Diet?

This answer may not be what you want to hear, but ultimately the best way to be sure you’re not eating it is to make your food from scratch using fresh vegetables, fruits, and other unprocessed ingredients.

Supplements?

athlete holding supplementsTrust the brand you buy.

That’s only advice there is when it comes to vitamins and minerals, since there’s no requirement for them to disclose this additive if it’s used to whiten the capsule or tablet.

The good news is that many supplements are titanium free and made white with something else. They use rice powder as a filler agent, in order to get the correct dosage of the active ingredient in the capsule. For example, if you’re taking a 10 mg dose of PQQ, it leaves a lot of empty space in the capsule which needs to be filled up with something else.

Toothpaste?

Be careful, because Tom’s of Maine still uses TiO2 in a number of their products, including several flavors of toothpaste. For example their “Botanically Bright” touts being fluoride free on the box, yet it still contains this controversial pigment.

We buy Tom’s fluoride-free antiplaque & whitening on Amazon, which lists zinc citrate in the ingredients. That’s a natural white substance which happens to contain a beneficial essential trace element (zinc). It’s sweetened with xylitol.

If you want something even better, try Redmond Earthpaste. It is fluoride and SLS free, containing only 5 ingredients.

Sunscreen and makeup?

sunscreen on knee with heartUsing zinc oxide is preferable over the synthetic and artificial sunblocks. It’s arguably the best natural compound for protection from UVA rays. EWG says zinc oxide is their “first choice for sun protection.”

For body protection, an excellent product made without titanium dioxide is ThinkSport. A couple of us here buy ThinkSport from Amazon on a recurring basis (Subscribe and Save) and have been doing so for years. Burn Out Eco-sensitive is another good choice.

For face protection, you probably want something that won’t give you a ghostly appearance. Use ThinkSport’s naturally tinted version which offsets the natural whiteness of zinc. For many, it can even serve in place of a foundation or BB cream.

For lip protection, being that we’re big users of lip balm, we continuously research the best on the market. Our favorite brand is not cheap, but we buy it regardless because it’s the only one that checks off all of our necessary boxes; All Good Lips SPF 20 coconut lip balm.