Sulfite Allergies & Sensitivities
Evidence-based information about symptoms, diagnosis, and management of sulfite allergies and sensitivities
What are Sulfite Allergies?
Sulfites are preservatives widely used in food and beverages to extend shelf life and prevent discoloration. While many people can consume sulfites without issues, some individuals experience adverse reactions that range from mild sensitivities to severe allergic responses.
It's important to note that true sulfite allergies (involving the immune system) are rare. Most reactions to sulfites are actually intolerances or sensitivities. However, for people with asthma, sulfite sensitivity can be particularly problematic and potentially dangerous.
Important Note
If you suspect you have a sulfite allergy or sensitivity, consult with an allergist for proper diagnosis before making dietary changes.
Common Sources of Sulfites
Sulfites are found in many foods and beverages. Understanding where they appear can help you avoid them if you have a sensitivity or allergy.
Foods
- Dried fruits (especially light-colored ones like apricots)
- Processed potatoes (french fries, potato chips)
- Packaged soups and sauces
- Condiments (vinegar, pickles, relishes)
- Canned vegetables and fruits
- Shrimp (preserved)
- Maraschino cherries
Beverages
- Wine and beer
- Hard cider
- Fruit juices (especially grape)
- Soft drinks
- Tea (some instant varieties)
- Cocktail mixes
Sulfites are also found in some medications and cosmetics. Common sulfite additives to look for on labels include:
- Sodium sulfite
- Sodium bisulfite
- Sodium metabisulfite
- Potassium bisulfite
- Potassium metabisulfite
- Sulfur dioxide
In the United States, the FDA requires that the presence of sulfites be declared on food labels when they're present at levels of 10 parts per million (ppm) or higher.
Symptoms of Sulfite Sensitivity
Reactions to sulfites can vary widely in severity and may affect different body systems. Symptoms typically appear within 15-30 minutes of consuming sulfite-containing foods or beverages.
Common Symptoms
- Respiratory Symptoms
- Wheezing, coughing, difficulty breathing, chest tightness, asthma attacks (in people with asthma)
- Skin Reactions
- Hives, itching, redness, flushing, eczema flare-ups
- Digestive Issues
- Stomach pain, nausea, vomiting, diarrhea
- Severe Reactions
- Anaphylaxis-like symptoms: drop in blood pressure, rapid heartbeat, loss of consciousness (rare, but more common in people with asthma)
Warning for Asthmatics
People with asthma are at higher risk for severe reactions to sulfites. If you have asthma and suspect a sulfite sensitivity, it's especially important to consult with a healthcare provider for proper management.
Diagnosis and Testing
Diagnosing sulfite sensitivity can be challenging. There are no standardized skin or blood tests for sulfite reactions as there are for true allergies. Diagnosis typically involves a combination of approaches.
Diagnostic Methods
Medical History
Your doctor will ask detailed questions about your symptoms, when they occur, and your dietary habits to identify patterns related to sulfite consumption.
Food Diary
Keeping a detailed record of what you eat and any symptoms that follow can help identify potential triggers.
Elimination Diet
Removing all sulfite-containing foods from your diet for a period, then gradually reintroducing them while monitoring for reactions.
Oral Challenge Test
Under medical supervision, you may be given increasing amounts of sulfites to see if they trigger symptoms. This should ONLY be done in a medical setting due to the risk of severe reactions.
Your healthcare provider will interpret the results of these approaches in the context of your medical history to make an accurate diagnosis.
Managing Sulfite Sensitivity
Currently, there is no cure for sulfite sensitivity. Management involves avoiding sulfites and being prepared for accidental exposure.
Avoidance Strategies
- Read food labels carefully. Look for sulfite-containing additives.
- Be cautious when dining out. Ask about ingredients and food preparation methods.
- Choose fresh foods over processed ones when possible.
- Be particularly careful with wine, dried fruits, and preserved foods.
- Consider using a sulfite-removing product for wine if you occasionally want to drink it.
- Prepare more meals at home where you can control the ingredients.
Emergency Preparedness
- If you have asthma and sulfite sensitivity, always carry your rescue inhaler.
- For those with severe reactions, carry an epinephrine auto-injector if prescribed.
- Wear a medical alert bracelet or necklace indicating your sensitivity.
- Create an emergency action plan with your healthcare provider.
- Educate family members, friends, and colleagues about your sensitivity and how to help in an emergency.
Nutritional Considerations
When avoiding sulfites, it's important to ensure you're still getting a balanced diet. Consider these tips:
- Work with a registered dietitian who specializes in food allergies and sensitivities.
- Focus on fresh fruits and vegetables, which generally don't contain added sulfites.
- Consider vitamin C supplements, as some research suggests vitamin C may help neutralize sulfites in the body (consult with your doctor first).
- Explore organic and specialty food stores, which often carry sulfite-free alternatives to common products.
Always consult with your healthcare provider before making significant changes to your diet or starting any supplements.