Sulfite Allergy

What you need to know

Complied by M. McKee

Note: Much of the information that follows has been gleaned from
various sources; including Medical Journals, Sulfite Allergy web-
sites and personal experience.

If you are the victim of an allergy, you know that life can be difficult
and sometimes downright miserable. Allergic reactions can range from
mild – virtually unnoticeable – to fatal, and everything in between.
There are several approaches to dealing with allergic reactions: Take
something like an antihistamine to counteract the allergy, or remove
the source of the allergen.

In my case, the Benadryl or Claritin, which had been working fairly well
for about a year, were no longer able to control my symptoms and so I
had no choice but to remove the source of my allergic reactions. But
first, I had to figure-out the cause.

Diagnosis

Initially, I had gone to my regular doctor who did not know what the
problem was, other than to say it was likely some kind of dermatitis.
He sent me to a doctor specializing in these sorts of things, who
subsequently prescribed a steroid cream for me. While I can’t
necessarily say that this made my symptoms worse, it certainly did
not do anything to help the situation – and so I decided that I needed
to diagnose myself.

While there have been some case reports of people being diagnosed
with sulfite allergy using skin testing, there is no reliable, commercially
available skin test for sulfite allergy. Typically, the diagnosis is
suggested by a history of adverse reactions after consuming sulfite-
containing foods or medications.
However, in order for the diagnosis to be confirmed, an allergist may
perform an oral metabisulfite challenge for a patient suspected of
having sulfite allergy. This procedure involves giving a person
increasing amounts of sulfites to swallow, with close monitoring of lung
function and vital signs. A significant drop in lung function confirms
sensitivity to sulfites. This test should only be performed under direct
supervision of a physician who has been trained and is experienced
with such a procedure. In my case, it was fairly easy to diagnose –
after just 1 glass of wine I would see welts appearing on my neck
within a few minutes. This coupled with my significant loss of strength
and asthma were all good indicators of the source of my allergic
reactions.

As in my case, specific reactions to a Sulfite allergy might be more

apparent after ingestion of a moderate to high-sulfite food and may
include; fatigue, flushing, itching, asthma, strength loss and rashes.
For myself, my allergy had, over the course of about a year, developed
into asthma, a significant loss of strength, and a severe case of hives.
This would be most noticeable just minutes after I had ingested
something with even a moderate level of sulfites, such as Wine, Beer
or French Fries.

Sulfa, Sulfite, Sulfate and Sulfur

There is much confusion regarding allergy to sulfa-containing drugs,

sulfites as a preservative agent in foods and medications, sulfate salts
of medications and the chemical element sulfur. Many people assume
that if they are allergic to one of these agents, then they are allergic to
all of them. This is not necessarily true.
Sulfa
Sulfa-containing medications are a common cause of drug allergy,
and perhaps the reason for most of the confusion. The majority of
the time, a person with a sulfa allergy has experienced an allergic
reaction to a sulfa-containing antibiotic. The antibiotic sulfonamides
are different structurally from the non-antibiotic sulfonamides, and
appear to be much more likely to result in allergic reactions. Many
of the sulfa non-antibiotics, therefore, do not cause problems in
people with sulfa antibiotic allergy.
Sulfite
Sulfites (in the forms of sodium sulfite, sodium bisulfite, sodium
metabisulfite, potassium bisulfite and potassium metabisulfite) are
common preservatives used in various foods and medications.
Sulfites have been used for centuries, mainly as food additives, but
can also occur naturally in foods such as fermented beverages and
wines. Sulfites are best known to cause worsening breathing
problems in certain people when foods or beverages containing
sulfites are eaten. Other people have experienced severe allergic
reactions after eating foods or taking medications that contain
sulfites.
Sulfate
Sulfates are salts of sulfuric acid, and are commonly used in the
making of various drugs, such as albuterol sulfate, iron sulfate,
chondroitin sulfate and codeine sulfate. Sulfates can also be used in
Dry Cleaning solvents and other industrial applications. While
allergic reactions to these medications are possible, it’s not likely
that it’s because of the sulfate group. There does not appear to be
any specific reason for people with sulfa or sulfite allergies to avoid
medications that contain a sulfate salt (though this may not
necessarily be the case for severe allergic reactions – as in my
case).
Sulfur
Sulfur is a chemical element that is used in the production of
countless pharmaceutical and commercial chemicals, and is present
in (and responsible for the names of) sulfa drugs, sulfite
preservatives, and sulfates. The current belief is that the element
Sulfur is too small to cause allergic reactions by itself; therefore,
there does not appear to be a reason for people with sulfa and/or
sulfite allergy to specifically avoid sulfur-containing compounds –
which is fortunate since many foods contain sulfur compounds.
What is a Sulfite Allergy?

Sulfites usually cause little to no problems in most people without

allergies and asthma, even when large amounts are consumed.
Sulfites are known to increase asthma symptoms in approximately 5%
of asthmatics, particularly in adults with severe disease. Numerous
well-controlled studies show that some asthmatics can have severe
asthma symptoms with eating sulfite-containing foods/beverages or
inhaling sulfite fumes or vapors.

Less is known about hives and anaphylaxis as a result of sulfites,

although various cases have been described in which the consumption
of sulfite-containing foods/beverages leads to severe allergic reactions.
This was particularly true in my case as the consumption of wine, beer
or potatoes resulted in severe reactions.

Some very sensitive people even had positive skin tests to sulfites
(myself included), suggesting the presence of allergic antibodies to the
preservative. Other people have experienced severe reactions from
sulfite-containing medications, including intravenous drugs and inhaled
medications. These reactions included flushing, hives and a drop in
lung function as a result of the medications being given.

It’s not completely known how sulfites cause reactions in certain

people. Some people clearly make allergic antibodies against sulfites,
while others do not. The gases generated from sulfites might cause
muscle spasms in the lungs of some asthmatics, or could be related to
the inability in some people to metabolize the sulfites appropriately.

Why are Sulfites Added to Medications?

Sulfites are added to some medications for their antioxidant properties

as well as the prevention of browning of medications. Sulfites are
added to injectable epinephrine to prevent browning, which decreases
the effectiveness of the drug. However, epinephrine has not been
reported to cause adverse reactions in people with sulfite allergy, and
should not be withheld in an allergic emergency. Injectable
epinephrine may prove life saving in people with sulfite allergy
experiencing anaphylaxis. Some inhaler solutions used to treat asthma
contain sulfites, although many asthma drugs have had sulfites
removed due to safety concerns.

Why are Sulfites Added to Foods?

Sulfites are added to foods for various reasons. These include:

• Reduction of spoilage by bacteria
• Slows the browning of fruit, vegetables and seafood
• Inhibits of growth of bacteria during fermentation of wines
• Conditioning of dough in frozen pie and pizza crust
• Bleaching effect for maraschino cherries and hominy

In the past, sulfites were added to fresh foods in restaurants and

grocery stores to prevent browning. An increase in reactions led the
Food and Drug Administration (FDA) to ban the use of sulfites in fresh
foods in 1986, particularly on fresh lettuce in salad bars. The FDA now
requires that any food containing more than 10 parts per million (ppm)
concentration of sulfites to be declared on the label. Except in rare
cases (myself included) foods that contain less than 10 ppm of sulfites
have not been shown to cause symptoms, even in people allergic to
sulfites.

Which Foods Contain Sulfites?

Greater than 100 ppm of sulfites

Very high levels, strict avoidance advised in people with sulfite
allergy

• dried fruits
• bottled lemon juice (non-frozen)
• bottled lime juice (non-frozen)
• wine
• molasses
• sauerkraut (and its juice)
• grape juices (red, white and sparkling, juices)
• pickled cocktail onions
Between 50 and 99.9 ppm of sulfites
Moderate to high levels of sulfite, avoidance advised in people with
sulfite allergy.

• dried potatoes
• wine vinegar
• gravies/sauces
• fruit toppings
• Maraschino cherries

Between 10 and 49.9 ppm of sulfites

Low to moderate levels of sulfite, may cause symptoms in people
with severe sulfite allergy.

• pectin
• fresh shrimp
• corn syrup
• pickled peppers
• pickles/relish
• corn starch
• hominy
• frozen potatoes
• maple syrup
• imported jams and jellies
• fresh mushrooms
• imported sausages and meats
• cordials (alcoholic)
• dehydrated vegetables
• various cheeses
• corn bread/muffin mix
• canned/jarred clams
• clam chowder
• avocado dip/guacamole
• imported fruit juices and soft drinks
• ciders and cider vinegars
• Breads
Less than 10 ppm of sulfites
Very low sulfite levels, generally do not pose a risk, even for people
with sulfite allergy.

• malt vinegar
• canned potatoes
• beers
• dry soup mix
• soft drinks
• frozen pizza and pie dough
• beet sugar
• gelatin
• coconut
• fresh fruit salad
• domestic jams and jellies
• all crackers
• all cookies
• fresh grapes
• high fructose corn syrup

Varying amounts of sulfites (and/or sulfates)

May have medium to low sulfite levels, may pose a risk for people
with sulfite allergy.
• sunflower seeds
• garlic
• lentils
• soybeans
• yogurt
• turnips
• canned tuna
• eggs
• dry cereals
• vegetable juices, canned vegetables, frozen vegetables
• pickled vegetables (cauliflower, peppers and sauerkraut)
• hot sauces
• baked goods
• potato chips
• trail mix and trail mix bars
 • apple ciders
• teas
• most bottled condiments
• grain products: cornstarch, modified food starch, spinach
pasta, gravies, hominy, breading, batters, noodle and rice
mixes
• breads containing dough conditioners, cookies, crackers,
pie and pizza crusts, tortillas, waffles
• beverages containing sugar or corn syrup, dried citrus fruit
beverages
• processed cheese foods
• scallops frozen, canned or dried clams, shrimp, lobster,
crab, scallops, dried cod
• fresh grapes, dried fruits (including raisins and prunes and
especially pale fruits that have not discolored)
• frostings: fruit fillings, flavored and unflavored gelatin,
pectin, jelling agents, canned frostings and frosting mixes
• hard candies
• soy protein products including tofu, textured vegetable
protein, infant formula
• filled crackers
• flour tortillas, corn tortillas, tortilla chips
• white and wheat breads
• sugars: brown, white, powdered and raw sugars
• vegetarian (and other) refried beans
• virtually all alcohols and alcoholic drinks except sake (if
made in the traditional fashion) and most vodkas
• bottled waters (such as Dansani, etc.)
• well water (at my house: 12 ppm)

Examples of non-food items that may contain sulfites

(and/or sulfates) include:
• Avon products (some, not all)
• Avon Skin-So-Soft
• Bag Balm
• Burt’s Bee’s products (some, not all)
• hand lotions
 • toothpastes
• deodorants
• eye drops (some, not all)
• most hand soaps
• most laundry detergents
• dry cleaning solvents
• vitamins (many, not all)

What to look for…

As can be seen above, sulfites may hide in various food (and non-
food) ingredients, without being obvious. However, some sulfite-
containing ingredients are listed on food labels. This will include (but
not necessarily be limited to):

• Sulfur dioxide
• Potassium bisulfite
• Potassium metabisulfite
• Sodium bisulfite
• Sodium metabisulfite
• Sodium sulfite

Now what do I do?

Now that you’ve been diagnosed as having at least some sensitivity to
sulfites (and/or sulfates), the question is what to do about it – or, in
other words, how screwed are you? Well, the answer depends on how
much you like to cook. Essentially, you will not be able (at least until
your sensitivity decreases over time) to buy much of anything at your
local Supermarket that you can open and eat directly. Virtually
everything falling into this category will contain some amount of a
sulfite preservative.

For some period of time, it may be necessary to adhere to a sulfite

(and perhaps even sulfate) free lifestyle. The more severe your
reaction, the longer you may to detoxify your body of sulfites. Note
that diets such as Vegan (www.ExploreVeg.org) and the popular Paleo-
diets (www.paleodiet.com) are not sufficient in removing sulfites from
your intake. Your needs here will be much more restrictive – almost as
bad as a prisoner on bread and water; except you can’t have bread.

You may, for the most part, need to cook your own food for all meals.
Most fish (except Salmon) and raw meats should be sulfite-free as will
most raw vegetables. Fresh fruit can be safely eaten as long as it’s
peeled, as sulfites may be present on the skins. While most breads will
contain some amount of sulfites, natural substitutes like Lavash (whole
grain wrap) and Pita are less likely to contain these chemicals.

Misinformation
It is VERY important to note that virtually all wait-staff in restaurants
as well as staff at food markets DO NOT KNOW whether the food they
serve [or sell] contains sulfites. Many people have ended-up in the ER
as a result of taking the advice of these folks. The staff [for the most
part] has no knowledge of sulfite allergies in general, or your particular
sensitivities in particular. Also, be aware that various markets (such
as; Whole Foods, Holistic Foods, etc) will say that almost none of their
foods contain sulfites, which is NOT TRUE. Although a small
percentage of the foods sold in these places will be sulfite-free, most
will contain ingredients containing sulfites. It will be up to you to
protect yourself against the wealth of misinformation concerning this
[potentially fatal] allergy.

And, while on the subject of misinformation, I have read several

articles stating that if sulfites do not appear on the ingredients labels
of a given food – and, if that food has not been processed using the
same equipment as foods containing sulfites – then the food in
question will be safe to eat. This is NOT TRUE. Sulfites will most
certainly be lurking in a variety of ingredients that are not obviously
labeled so. Also, sulfites may exist in food at less than 10 ppm, and
not need to be present on the ingredients list.

One additional thing to note: As you’ll be on a very restrictive diet, you

will likely lose some amount of weight. It is important to know that
sulfites – much like other toxins – can be stored in your fat cells. As
your body processes these fat cells, the sulfites contained therein will
be released into your blood stream. You may experience a sulfite
reaction during this phase of your diet for some period of time.

Restaurants
If you choose to eat in a restaurant, once you’ve been diagnosed as
having sulfite sensitivity, you will be taking a very big risk. Although
most restaurants have some sort of allergen information sheet, only
one I’ve found (Denny’s) includes sulfites on their spreadsheet. The
bottom line is, unless you’ve prepared the meal yourself, you may
be taking a risk in consuming that food.
Vitamin B-complex
There is a growing body of evidence to suggest that vitamin B-
complex may help in the alleviation of the symptoms resulting from
a sulfite allergy [sulfites are known to destroy vitamin B1
(thiamin)]. See the following reference for an excellent discussion
of vitamin B and its relation to sulfite sensitivity:
http://www.housemouse.com/sulfites.htm

Molybdenum
There is some evidence to suggest that sulfite sensitivities are not
necessarily an allergic reaction, but the result of a metabolic
imbalance resulting from the lack of molybdenum. Sulfite sensitivity
may be caused by a relative deficiency of the enzyme sulfite
oxidase which breaks down sulfites and requires molybdenum as a
cofactor. If this is true, this is a metabolic problem and not an
allergic one and, perhaps, curable. Additional studies concerning
this issue are currently in progress.

Molybdenum is a trace mineral found in most plant and animal

tissues. Molybdenum is an essential cofactor for many of the
enzymes involved in protein synthesis and the mobilization or iron
use in the body. Most people are not deficient in this mineral if the
food they eat comes from nutrient-rich soil. Molybdenum also helps
with metabolism of fats and carbohydrates.

Usage Guidelines: The RDA for molybdenum is 75 mcg, and

recommended use varies from 75-500 mcg. Toxicity is rare, but
symptoms produced may include stiffness and swelling of the joints,
stunted bone growth, diarrhea and anemia.

Some Natural Sources: Meats, whole grains, buckwheat, barley,

wheat germ, legumes, lima beans, canned beans, and dark green
leafy vegetables

Black Beans: Black beans are an excellent source of molybdenum,

an integral component of the enzyme sulfite oxidase, which is
responsible for detoxifying sulfites. If you have ever reacted to
sulfites, it may be because your molybdenum stores are insufficient
to detoxify them. A cup of black beans will give you 172.0% of the
daily value for this helpful trace mineral.
References and Links

Find out more about sulfite allergy and the treatment for sulfite
allergy, at these sites.

Find out more about sulfa allergy, and what medications should be
avoided in someone with a sulfa allergy.

Additional references:
http://foodallergies.about.com/od/foodallergybasics/f/intolerances.
htm
www.moondragon.org/health/disorders/allergiessulfite.html
http://allergies.about.com/od/foodallergies/a/sulfites.htm
http://allergies.about.com/od/foodallergies/a/sulfites_2.htm
http://archive.longhaircommunity.com/showthread.php?t=34009
www.orthomolecular.org/nutrients/micronutrients.shtml
www.drugs.com/sfx/ferrous-sulfate-side-effects.html
www.scribd.com/search?cat=solr&q=sulfates
http://www.cancure.org/cancer_fighting_foods.htm
http://www.diagnose-me.com/cond/C488839.html

Sulfite Free/Low Sulfites Products

Sulfite-Free Dried Fruit:

Newman’s Own Organics - www.newmansownorganics.com
Made in Nature - www.madeinnature.com

Wines with Low Sulfites:

Frey Vineyards www.freywine.com
Vida Orgánica Wine - www.vidaorganica.com

Sulfite-free shampoos:
killerstrands.blogspot.com/2008/01/sulfate-free-shampoo-list.html

Soaps & Detergents:

Sulfite-free detergent (such as ECOver 2.0 and All Free and Clear)
as well as sulfite-free hand soaps can be found at a variety of
locations.