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All About Salicylate Sensitivity + How To Know If You Have It

salicylate-sensitivity

You’ve probably heard of salicylic acid, a major ingredient in many topical anti-acne products, including cleansers, lotions, and spot treatments. But did you know that salicylates are a much larger group of ingredients that can help some, and irritate others? As you will soon learn, salicylates are also found in many “healthy” foods, and people with a salicylate sensitivity or intolerance may be eating foods thinking they are having something healthy but unintentionally causing reactions and inflammation in their body. 

Keep reading to have all your salicylate questions answered. 

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Healing Salicylate Intolerance

What are salicylates? 

Salicylates are a type of chemical. And while the word “chemical” often gets a bad rap in the health and wellness world, salicylates are found naturally in plants, including many popular fruits and vegetables. In the natural world, salicylates protect the plant (1) against threats like insects, diseases, and fungi. In the world of human health, salicylates are the major ingredient in aspirin, muscle relaxants, cough medicines, antacids, and acne lotions. Salicylates are naturally occurring and can be extremely beneficial to human health; that is, unless you have a sensitivity to them, which brings us to…

What is a salicylate sensitivity? 

A salicylate sensitivity is exactly as the name suggests: a sensitivity to salicylate chemicals. A sensitivity is different from an allergy because with an allergy, you typically have to avoid the substance completely (or risk dangerous and acute side effects). But with a sensitivity, you just can’t handle more than a certain amount of salicylates in a certain amount of time.

In other words, you may be able to handle a few salicylates in fruits but not in topical medications; or, you may be able to handle antacids but not combined with aspirin. The root cause of a sensitivity is an inability to metabolize these chemicals and properly remove them from the body. This causes a production of inflammatory mediators (2) that cause the symptoms associated with sensitivities. 

What are the symptoms of a salicylate sensitivity? 

A sensitivity to salicylates presents in the body like most other food sensitivities. If I see a patient with any of the following, I would consider a salicylate sensitivity or another food or ingredient sensitivity: 

  1. Chronic swelling and/or hives 
  2. Eczema 
  3. Rashes
  4. Anxiety/Depression
  5. Brain fog/Memory loss
  6. Fatigue
  7. Nasal polyps
  8. Asthma 
  9. Post-nasal drop, nasal congestion, running nose 
  10. Digestive problems
  11. Ringing in the ears

If you’re experiencing any of the symptoms above, you can’t assume it’s a salicylate sensitivity. The truth is, many different underlying health imbalances can cause these symptoms, which is why my job as a functional medicine expert is to narrow it down and perform necessary testing to figure out the root cause of your symptoms. 

How do you diagnose a salicylate sensitivity? 

Diagnosing a salicylate sensitivity can be an obvious call or a little more complicated, depending on the individual and their lifestyle. For many people, cutting out medications containing salicylates will reveal the sensitivity right away. That’s because compared to foods, medications contain a much higher concentration. For example, a typical person eats about 10 to 200 mg of salicylates per day but one dose of aspirin contains 325 to 650 mg of salicylates. (3)

In a medical setting, a salicylate sensitivity is diagnosed by observing someone immediately after they’ve ingested high-salicylate substances and blood tests can confirm the sensitivity. 

What foods are high in salicylates? 

Pinpointing a salicylate sensitivity from food is a little trickier. Typically, I recommend keeping a food journal and noting how you feel after eating different foods. Then, you can see if they are high in salicylates and make the connection. The Auckland Asthma & Allergy Clinic (4) has a great list of high salicylate foods, which include: 

Fruits:

  • Apricot
  • Blackberry
  • Blackcurrant
  • Blueberry
  • Boysenberry
  • Cherry
  • Cranberry
  • Currants
  • Dates
  • Grapes
  • Guava
  • Loganberry
  • Oranges
  • Pineapple
  • Plum
  • Prunes
  • Raisins
  • Raspberry
  • Redcurrant
  • Rockmelon
  • Strawberry
  • Tangelo
  • Tangerines
  • Youngberry

Vegetables:

  • Champignon
  • Chicory
  • Courgette
  • Endive
  • Gherkins
  • Hot Peppers
  • Olives
  • Radish
  • Tomato
  • Tomato based foods

Nuts, sweets, and snacks: 

  • All jams, except pear
  • All jellies
  • All marmalade
  • Almond
  • Chewing gum
  • Fruit flavors
  • Honey and honey flavors
  • Licorice
  • Mint flavored sweets
  • Muesli bars
  • Peppermints
  • Savory flavored items
  • Water chestnuts

Herbs, spices, and condiments:

  • Aniseed
  • Cayenne
  • Commercial gravies
  • Commercial sauces
  • Curry
  • Dill
  • Thyme
  • Fish paste
  • Meat paste
  • Tomato paste
  • White vinegar
  • Worcester sauce

Reading this list, you may be having an “aha!” moment, realizing that salicylates are what the foods you don’t feel great after eating actually have in common. At the end of the day, the best way to be sure you have a salicylate sensitivity is to eat as little as possible of the foods on this list for a month or two, and then add them back in slowly and methodically to pinpoint which ones are causing you issues. 

What should you do if you have a salicylate sensitivity? 

If you have a salicylate sensitivity, focus on eating meat, fish, and fruits and vegetables that aren’t high in salicylates. You can also focus on decreasing chronic inflammation, which can exacerbate the inflammatory response and symptoms caused by salicylate sensitivities. If you’re not sure where to start, check out my functional medicine guide to calming inflammation

At the end of the day, you can’t avoid every single ingredient on that list all the time. And the good news is that you don’t have to! Once you get your salicylate levels low enough to prevent the inflammatory response, you’ll get back to feeling like yourself and you can still enjoy most of the foods on the list above — just in moderation.

If you want to learn more about your own health case please check out our free health evaluation. We offer in person as well as phone and webcam consultations for people across the country and around the world.

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References:

  1. Baenkler HW. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. Dtsch Arztebl Int. 2008;105(8):137-142. doi:10.3238/arztebl.2008.0137 
  2. Sharma JN, Mohammed LA. The role of leukotrienes in the pathophysiology of inflammatory disorders: is there a case for revisiting leukotrienes as therapeutic targets?. Inflammopharmacology. 2006;14(1-2):10-16. doi:10.1007/s10787-006-1496-6 
  3. Baenkler HW. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. Dtsch Arztebl Int. 2008;105(8):137-142. doi:10.3238/arztebl.2008.0137 
  4. Auckland Allergy & Eczema Clinic. Auckland Allergy & Eczema Clinic. Accessed September 14, 2020. http://www.allergyclinic.co.nz/salicylate-sensitivity

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BY DR. WILL COLE

Evidence-based reviewed article

Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.

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