Salicylate Sensitivity

Have you ever heard of it? Yes, it’s a real thing. I know. I have it.

First of all, what is salicylate? It is an organic acid and the most common forms include salicylic acid and acetylsalicylic acid. Salicylic acid is often used in topical medications for acne and other skin disorders. Acetylsalicylic acid is better known as aspirin and I shouldn’t need to further explain aspirin and its many uses. Further, methyl salicylate shows up in “minty” topical drugs like mouthwashes and “Bengay” type creams.

Salicylic acid was first isolated in the bark of the willow tree. It is naturally occurring in many plants, albeit at much lower levels than you would find in an aspirin.

So what happens to those who are sensitive or allergic to salicylates? In my case, the same type of reaction I have to other offending foods – stomach and bowel upset, body aches, fatigue, overall inflammation.

I came about my personal diagnosis of salicylate sensitivity from a number of random varied exposures that all made sense in a greater context:

  1. I eat almost all types of squash on a regular basis as a dietary staple. Almost all, except one that makes me very sick. That would be zucchini. It turns out zucchini is high in salicylates.
  2. A couple of years ago I injured my hand and was using a topical pain-relieving analgesic cream on it (that stuff does help). I accidentally over-applied some of the cream and just smeared it off onto another part of my body. Well, I absorbed too much of the active ingredient and got very sick. What is the active ingredient? Methyl salicylate.
  3. I put those events behind me and planned to avoid salicylates. This plan went well until I recently had a bad, bleeding cut in my mouth (bit off more carrot than I could chew – don’t ask!) and used a dose of Listerine. The next day, I had a bad reaction and was sick again. What is one of the active ingredients in Listerine? Methyl salicylate, which made its way into my bloodstream via the open cut in my mouth. Oops!

The unique lesson I learned from exposures 2 and 3, above, is that I can still have a food allergy type reaction and get very sick with digestive symptoms even if the offending substance is not ingested. Huh, interesting.

There are extensive lists of high salicylate foods on the internet. Most of them are, for me, something I’m already allergic to or contraindicated by the Specific Carbohydrate Diet. So I’m not missing too much by avoiding high salicylate foods. The zucchini squash was the only zinger for me and quite a surprise since I can eat every other squash I’ve tried so far.

Food Challenges

In prior blogs, I’ve talked about what are called food challenges. Now I will explain what they are and how I was taught they work.

Although there are different types of blood tests that can be performed to test for food allergies, the absolute gold standard of food allergy testing is the oral food challenge.

For those people who have a fairly immediate, possibly life-threatening, reaction, food challenges are best conducted under the supervision of medical professionals. For those of us with somewhat milder, delayed reactions, food challenges performed in the comfort of your own home is a possible solution.

How does it work?

  1. Pick a food you suspect is causing you problems.
  2. Completely eliminate that food from your diet for at least two weeks (if you begin to feel better, that’s a clue, but you’re not done yet!).
  3. Eat the food prepared in a normal manner in typical serving sizes regularly, every single day, for up to five days. Keep the rest of your diet fairly routine during this period.
  4. If you get a reaction in five or fewer days, you likely have some kind of allergy or intolerance to that food. STOP eating it as soon as you’re sure of a reaction!
  5. If you have no reaction after fives days, you may begin rotating that food back into your diet.

Rest and then repeat the process as many times as needed for different suspect foods (or for the same food if you’re uncertain or think you ate something that messed up your testing).

Remember the timing. Two weeks off – five days on.

Beware, I have eaten foods that have successfully passed the challenge and they eventually began to bother me weeks or months later. So, this method is not foolproof to the extent that it can predict if you will EVER react to a food.

Also, some foods, like herbs, spices and condiments may typically be consumed in small enough quantities that a reaction is uncertain. It’s not until you consume a larger quantity for an extended period that you trigger a reaction. This has happened to me with the mint family plants (basil, oregano, peppermint), olives, and black pepper.