Salicylate Intolerance

Margaret Moss asks who has problem – and why

AspirinProblems connected with salicylates

Decades ago, Feingold realised that hyperactive children didn’t only have a problem with the additives in processed food, but some of them also had problems with natural fruits and vegetables. In particular, he blamed salicylates in them. Some people found this hard to take. Didn’t we evolve in the Stone Age, eating fruits and vegetables? Aren’t they full of nutrients? Why should they have become a problem?

However, other problems have been reported
with salicylates, including asthma, urticaria (hives), rashes, swelling, sore eyes, nasal polyps, diarrhoea, nausea, poor memory and concentration, headaches, bed wetting, coughs, fatigue, tinnitus, and depression.

How the body deals with salicylates

Since the Second Word War we have seen an exponential growth in chemical production. Many disinfectants, detergents and drugs are phenols, as are salicylates. The capacity we have for detoxifying these phenols is still only what we had in the Stone Age.

The human body is well designed. We have two eyes and two ears, in case one is damaged. If our hearing of consonants is impaired, we can pick up hints in how the vowels are pronounced, that tell us what consonant comes before and after them. The immune system has innate immunity, to deal with new threats, as well as antibody immunity, to deal with what we have encountered in the past. When it comes to dealing with phenols, we have two systems, in case one is overwhelmed.

The first line of defence is to add sulphate to the phenol. When this is done, we can swill it out of the body in urine. This system works very well at dealing with a small quantity of phenols, but it has limited capacity. If we are short of sulphate, or if we have poorly active enzymes that transport sulphate, our capacity is particularly poor. Also, this system doesn’t only have to deal with phenols. It has to deal with amines as well, like histamine. If the total load of phenols and amines is too much, it hands over to the back-up process.

This second line of defence is less effective, but it usually has good capacity. This involves the addition of glucuronide to toxins. Glucuronide comes from carbohydrate. A small proportion of the population has poor ability to attach glucuronide. This is easily detected by a standard liver function test. If there is a problem, the level of bilirubin will be high. This is called Gilbert’s Syndrome. People with this syndrome are usually told that it is not a problem. However, if the ability to add sulphate and glucuronide are both impaired, the combination is a problem.

Salicylate sensitive people often complain that they are sensitive to a lot of things, not all of which are salicylates. If your ability to add sulphate to phenols and amines is impaired, then all sorts of foods and other chemicals will be a problem. There are phenols in olive oil, French, broad and runner beans, onions, kale,  green and black tea, tomato, apple, red wine, broccoli, lemon, grapefruit, apricot, orange, cherries, black and white grapes, chocolate, lettuce, redcurrant, plum, strawberry, turnip tops, pear, red cabbage, endive, leek, Brussels sprouts, radish, celery and red peppers. So much for the five a day message! 

Amines are an issue too

What about amines? They are in banana, plantain, papaya, passion fruit, pineapple, cheese, alcoholic drinks, raspberries, red plums, tomatoes, vinegar, sauerkraut, smoked fish, dry fermented sausage, yeast and meat extracts, leftover meat and fish, broad beans, overripe fruit and vegetables, avocado, chicken liver, aubergine, chocolate, lemon, fish, fermented soya products, vinegar, and  alcoholic drinks. Well, you do have to eat something.

Rather than eliminating all these foods, we can reduce the amines and phenols, for example by having mild rather than mature cheese, leek rather than onion, cabbage rather than kale, white rather than black grape, white rather than red wine, black rather than green tea, strawberry rather than cherry, bananas that are just ripe rather than very ripe ones, and fresh cabbage rather than sauerkraut. With food allergy, you have to eliminate tiny amounts of foods, but with food sensitivity, you just have to reduce the load to what you can tolerate.

Leaky gut

Another reason people with poor ability to add sulphate have a problem is that sulphate is needed for the gut, to stop it being too leaky. A gut that is too leaky allows food to pass into the bloodstream before it is adequately broken down, and this can cause problems in various parts of the body. A leaky gut can be addressed by bathing in Epsom salts, which is magnesium sulphate. This passes through the skin into the bloodstream. Other useful measures are to eat mushrooms, butter and coconut oil. Some people suggest having L-glutamine supplements, but glutamine readily turns to glutamic acid, which can over-excite the brain. Not a good idea. Anyway, it isn’t necessary.

Helpful nutrients for sensitive people

Nutrients involved in making enough sulphate are vitamins B1, B2, B5 and B6, the omega three fats in fish and flax, and molybdenum, zinc and magnesium. Supplementing these is a good idea. Sensitive people would do well to go out in the sun frequently in summer, without sun blocking cream, but of course avoiding being sunburnt. Sun is the best source of vitamin D, but vitamin D capsules are very useful in winter, when we cannot make the vitamin from the sun.

Foods that slow detoxification

Another thing to bear in mind is that some foods slow down the process of adding sulphate to chemicals. In particular, orange, radish and spinach slow this process, and are worth avoiding.

How salicylates cause problems

What is specific about salicylates, compared with other phenols? Omega six fats are in nuts, seeds and oils made from them. The problem is that aspirin, other non-steroidal anti-inflammatory drugs (NSAIDS) like Ibuprofen and Nurofen, and salicylates in foods block one of the ways that omega six fats convert to inflammatory chemicals. It sounds a good idea, doesn’t it, to stop making these inflammatory chemicals? Well no, because the omega six fats then convert to other chemicals instead, and these can cause asthma attacks, increase inflammation, make the nose run, and even cause anaphylactic shock. Vitamin E and omega three fats in fish both reduce the production of these chemicals. Using lots of runny vegetable oil is harmful, as it contains so much omega six fat. Oil of wintergreen in rubbing ointment is methyl salicylate, and has the same problems as oral NSAIDS.

Salicylates in foods

Work was done on analysing salicylates in foods in Australia. Unfortunately, simplified tables of this information have been circulated, that contain errors. Also the information can be misleading. For example, 100g of ginger root has 4.5mg of salicylate. 100g of apricot has 2.58. Does that make ginger nearly twice as bad as apricot? No, because you could eat more than 100g of apricots, but you aren’t going to eat 100g of ginger root, are you? Honey can have over 11mg of salicylate in 100g, but who but eats 100g of honey? Maybe Pooh? Another problem is that salicylates depend on the variety of the food, as well as the soil in which it is grown. So different researchers come up with different figures. Dried fruit and tomato paste are of course higher in salicylate than fresh fruit, as the water that diluted the salicylate has been removed.

Given that we can’t eliminate all salicylates, if we are sensitive, which are the key foods to eliminate? High salicylate fruits include apricots, blackberries, blueberries, cantaloupe melon, cherries, cranberries, black currants, red currants, dates, grapes, oranges, pineapple, raspberries, red plums and strawberries. Most of these are also high in fructose, and it may be hard to know whether to blame salicylates or fructose for their effects.

Other foods and drinks with a high level of salicylates are chicory, gherkins, green olives, sweet peppers, radishes, green and black tea, honey, almonds, Benedictine, port, and champagne. If you use spices and herbs, use them sparingly.

Avoidance is not enough

If you are sensitive to foods or components of foods, it is not enough to eliminate them, or reduce your intake of them. If this is all you do, you are likely to have to avoid more and more items as time goes on. It is important to reduce your sensitivity. There are medical ways of desensitising, but these are not available to everyone. So do simple things to help yourself, like avoiding spinach, orange and radish, taking baths with a cupful of Epsom salts in them, eating mushrooms, coconut, butter and fish, or coconut and fish oil, and taking good quality supplements. Most multivitamins and multiminerals have too little vitamin D, molybdenum or magnesium, and these may need to be taken separately. If you are sensitive to salicylates, make sure you minimise your intake of other phenols and amines, and do not just concentrate on salicylate avoidance.

For further reading please see this research from 2009 by Margaret Moss and Rosemary Waring.

You will find Margaret at www.nutritionandallergyclinic.co.uk

January 2015

For an in depth investigation into salicylate intolerance see Dr Joneja's article here and for a wide selection of other articles on salicylate intolerance, including some personal experiences see here. For articles on other uncommon allergies and intolerances see here.

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