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Why Do Some People Develop Salicylate Sensitivity? | Foods To Avoid in Salicylate Sensitivity? | Diagnosis and Treatment of Salicylate Sensitivity

Food intolerances and sensitivities have become quite common these days, and these can sometimes be challenging to diagnose, causing the person to suffer until the proper treatment can be started. While some food sensitivities such as gluten or lactose intolerance are common and well known, there are certain conditions like salicylate sensitivity that are not only less common but also lesser known, often leading to a misdiagnosis of the condition. Salicylates are a type of compound that is commonly found in medications, foods, and some other products as well. For those individuals who cannot tolerate salicylates, the compound can cause many types of adverse reactions. Read on to discover the various causes, symptoms, diagnosis, treatment, and what to avoid if you have salicylate sensitivity.

What are Salicylates?

Salicylates are a type of compound or group of chemicals that are derived from salicylic acid. Salicylates can be found in plants, and they are also a naturally occurring ingredient in many vegetables, fruits, coffee, tea, honey, and spices. In fact, plants manufacture certain types of natural salicylates as a defense mechanism to protect against many harmful elements like fungus, insects, and diseases. They are also manufactured for use in a variety of products, including toothpaste, aspirin, other pain-relieving medications, and even food preservatives. Both natural and artificial salicylates are also found in many commonly used beauty and health products. When compared to foods, medications like aspirin that contain salicylates usually have larger amounts of the compound, which is why salicylate sensitivity is usually associated with certain medications.(12345)

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However, natural and artificial forms of salicylates can cause adverse reactions in some people who are unable to tolerate these compounds. The dietary intake of salicylates typically ranges from 10 to 200 milligrams per day. When you compare this to one dose of aspirin, you will be consuming roughly 325 to 650 mg of salicylates, depending on the type of aspirin you take. This is much higher than the dietary intake, which may lead to salicylate intolerance in some people.(6)

Why Do Some People Develop Salicylate Sensitivity?

When you have a very high intake of salicylates, it can cause an adverse reaction in anyone. However, most people go on to safely consume foods that have an excessive amount of salicylates on a daily basis without experiencing any negative effects, or they can easily take a few aspirin occasionally for a headache or body pain and not experience any side effects.

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People who are sensitive to salicylates, though, are likely to experience adverse effects when they eat a food or have a medicine or any other product that contains even trace amounts of salicylates. Such people have a reduced ability to metabolize and excrete salicylates from their body correctly. But why is it that only certain people have these side effects and not everyone?

Well, sensitivity to salicylate is believed to be caused by an overproduction of leukotrienes, which are inflammatory mediators that have been associated with a lot of conditions, such as asthma, rheumatoid arthritis, anaphylaxis, allergic rhinitis, and even interstitial lung diseases.(7)

This overproduction of leukotrienes happens because of the inhibition of cyclooxygenase, which is an enzyme that controls the production of leukotrienes in the body. This accumulation of leukotrienes in the body causes the various symptoms that are associated with salicylate sensitivity.(8)

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Even though the percentage of people who have an intolerance to salicylate remains unknown, it is believed to be more commonly observed in adults who have asthma.(9) It is estimated that nearly 2 to 22 percent of adults who have asthma are particularly sensitive to salicylates.(10) Studies have also shown that people who have inflammatory bowel disease and other types of food allergies are more susceptible to being intolerant of salicylate. And such people cannot have even a tiny bit of salicylates without experiencing adverse effects.(11)

What are the Symptoms of Salicylate Sensitivity?

Intolerance to salicylate causes different types of symptoms. Many of these symptoms mimic those of other diseases and allergies, which is why it makes it challenging to diagnose salicylate sensitivity. Furthermore, some people with this condition even experience specific symptoms that only appear when there are other, unrelated allergies present. This makes salicylate intolerance a very challenging condition to diagnose.

The most common symptoms of salicylate sensitivity involve the respiratory tract, though the intestinal tract and skin may also get affected. Here are the symptoms of salicylate sensitivity:(12)

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The symptoms of salicylate sensitivity vary from person to person, therefore, it is not necessary that everyone having this type of intolerance experiences the same signs and symptoms. At the same time, the amount of salicylates that has been consumed and triggers the reaction also differs depending on the body’s ability to break the chemical down. This is why some people tend to experience the symptoms after getting exposed to just a small amount of salicylates, while others are able to tolerate larger amounts of these chemicals before they have an adverse reaction.

Which Foods Should You Avoid If You Have Salicylate Sensitivity?

If you have salicylate sensitivity, there are several foods that you should avoid since they contain salicylates. Vegetables, fruits, and certain spices are known to have the largest amounts of salicylates, though these compounds can be found in some other foods as well. The exact level of salicylate in a food item differs depending on a number of factors, such as preparation, level of ripeness, and even the growing conditions. For example, dried fruits have a higher level of salicylates than raw, fresh fruits because the water gets removed during processing.

Some of the foods that you should avoid since they contain the highest amounts of salicylates include:(13)

  • Vegetables: Alfalfa sprouts, artichokes, broad beans, broccoli, chicory, cucumbers, endive, watercress, eggplant, squash, spinach, okra, radishes, zucchini, sweet potato, and spinach.
  • Fruits: Prunes, raisins, apricots, strawberries, guava, cherries, grapes, cranberries, blackberries, blueberries, plums, pineapples, oranges, and tangerines.
  • Spices: Aniseed, cayenne, cinnamon, cumin, curry, dill, allspice, ginger, clove, mustard, pimiento, oregano, turmeric, tarragon, thyme, rosemary, and paprika.
  • Other foods: Coffee, tea, wine, cordials, rum, vinegar, almonds, mints, gravies, water chestnuts, jam, chewing gum, licorice, honey, food colorings, fruit flavorings, savory-flavored crackers, and chips, aloe vera, pickles, and olives.

While this is not a complete list, and there are still many other foods that contain salicylates, but these are some of the most common ones that are used in the everyday lives of people.

Salicylates can also be found in a variety of non-food products, such as:

  • Perfumes
  • Toothpaste, especially mint-flavored
  • Mouthwash
  • Shampoos
  • Conditioners
  • Medications
  • Lotions

It is essential to know that salicylates can also get absorbed through the skin. This is why people who have salicylate sensitivity must check the ingredient list on cleansers, perfumes, and lotions.(14)

The most potent sources of salicylates are aspirin and some other nonsteroidal anti-inflammatory drugs, such as ibuprofen.(15)

Diagnosis and Treatment of Salicylate Sensitivity

Salicylate sensitivity to medications such as aspirin or ibuprofen is well documented. However, there are few studies that show the salicylate intolerance to foods. Presently, there are no laboratory tests that can diagnose salicylate sensitivity, though there are several tests that are used to rule out other allergies.

The standard diagnostic test used to establish salicylate intolerance to medications is provocation or exposure, which is done by introducing a small amount of salicylic acid into the body and waiting to see any symptoms. However, it is important to note that this test should only be done by doctors as severe reactions can occur from administering salicylic acid.

Individuals who already know that they are sensitive to aspirin and other such medications that contain salicylates should avoid taking these medications. At the same time, being diagnosed with salicylate sensitivity to aspirin and other salicylate-containing medications does not mean that you have to avoid consuming any salicylate-containing foods.(16)

This is because medications like aspirin contain high amounts of salicylates as compared to what food items have. And most intolerance is dependent on the dosage you take. Nevertheless, those people who are extremely sensitive to salicylates can benefit by avoiding or at least limiting their intake of foods that contain salicylates.

Your doctor will take your detailed medical history and ask you to maintain a symptom diary following the consumption of certain foods. Maintaining this type of food diary can be of immense help to your doctor to reach a diagnosis of salicylate sensitivity.

If your doctor suspects that you have salicylate intolerance, the preferred treatment for salicylate sensitivity is to follow an elimination diet that excludes foods that contain high levels of salicylates.(17)

Do You Need To Avoid Salicylate-Containing Products and Foods Completely?

Most people do not need to avoid any salicylate-containing foods or other products. However, if you suspect that you have a salicylate sensitivity, then it is better to consult a doctor and avoid salicylates if your doctor recommends you to do so.

Following a low salicylate diet can be restrictive and difficult to follow. It can also mean that you are unnecessarily cutting out many foods that contain salicylates can be harmful to your health because salicylates are known to be anti-inflammatory foods. This means that foods high in these chemicals are known to reduce the risk of developing inflammatory diseases, including colorectal cancer.(18)

Also, vegetables, fruits, and spices that are rich in this chemical are beneficial for your overall health. They contain essential vitamins, minerals, and other potent plant compounds that keep you healthy.(1920)

People who should avoid having salicylate-rich foods are those who experience symptoms of salicylate sensitivity after having them. Since salicylate intolerance is typically dose-dependent, and there are so many foods that contain these chemicals, that limiting consumption of only the foods that contain the highest amounts of salicylates is the best option to follow.

There is very limited research available on the effects of following a salicylate-restricted diet, so the long-term effects of this remain unknown. However, in one study, 74 children who followed a salicylate-restricted diet were found to develop many nutritional deficiencies as well as aversions to some foods after being on this type of diet.(21)

Due to this, you should only avoid salicylate-containing foods or a salicylate-restricted elimination diet when it is recommended by your doctor or monitored closely by a doctor. But overall, only people who are highly sensitive to salicylates should avoid having salicylate-containing foods.

Conclusion

Salicylates are naturally occurring and synthetic compounds found in many foods, medications, and other products like toothpaste, perfumes, etc. Most people are able to tolerate salicylates without any reaction, but some individuals are highly sensitive to these compounds.

People with salicylate sensitivity may need to avoid taking foods that contain very high levels of salicylates, medications, and other products that are high in salicylates. More research is still required on salicylate sensitivity as the long-term effects of following a salicylate-restricted diet remain unknown. Of course, complete avoidance of salicylates is problematic since these compounds are present in so many foods and products.

Owing to the wide variety of symptoms this type of sensitivity causes, it is pretty challenging for doctors to diagnose salicylate intolerance, and the treatment options are also limited as of today. If you feel you might be having salicylate sensitivity, it is essential to consult a doctor and not resort to cutting out salicylates altogether from your diet. Your doctor will help diagnose the right condition and also recommend the best possible treatment if you have salicylate sensitivity.

References:

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