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Essential to man, and gives hydroxocobalamin that lovely placebo colour. Cobalt toxicity, caused for example by breakdown of metal to metal hip implants has been associated with dilative cardiomyopathy.
PMID link to reference awaited


This is presently poorly understood and is likely a function of the free ion Co2+, rather than that bound to other substances such as albumin. A review suggests cardiomyopathy and vision or hearing impairment, are reported at peak blood Co concentrations over 700 µg/L (8-40 weeks). Hypothyroidism and polycythaemia occur with briefer exposures with serum levels above 300 µg/L. The MHRA recommend yearly monitoring of blood levels in those with certain metal to metal implants. Perhaps one should not get too concerned with levels less than 300 µg/L but we do not know and will await the long term results of the monitoring exercise on approximately 1 million patients world wide who started their potential exposure between 2001 and 2010 by receiving metal on metal implants[2][3].