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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Sulfite Intolerance)

Definition

Sulfite sensitivity is an abnormal reaction to sulfites. These are compounds that are used to make foods and beverages last longer.

Foods that may contain sulfites are:

  • Beer, wine, and soft drinks
  • Cookies, crackers, pie crust, and pizza crust
  • Dried fruit
  • Shrimp, lobster, and scallops
  • French fries and other food made with peeled potatoes, such as instant mashed potatoes
  • Fruit or vegetable juice
  • Canned fruits or vegetables
  • Syrup and fruit toppings
  • Pickles, relish, olives, and salad dressing
  • Noodle or rice mixes
  • Dried soup mixes
  • Deli meats, mincemeat, sausages

Many prescription and over the counter medicines also contain sulfites. Sulfites are also contained in products applied to the skin, such as cosmetics.

Causes

The cause of this problem is not known. Genetics and the environment may play a role.

Risk Factors

The risk factors for this health problem are not known. However, most people with sulfite sensitivity have asthma.

Symptoms

Most symptoms are mild and vary from person to person. Problems may be:

  • Wheezing
  • Shortness of breath
  • Coughing
  • Belly pain
  • Diarrhea
  • Nausea
  • Skin rash
  • Skin inflammation

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. You may need to see a doctor who treats allergies.

Blood tests will be done to look for antibodies to sulfites. An allergy skin test may also be done to look for a cause.

You may be asked to avoid certain foods or beverages for a short period of time to see if symptoms go away. This is called an elimination diet. It can help find out what is causing your symptoms.

Treatment

There is no cure. The goal of treatment is to manage symptoms. This can only be done by avoiding foods and drinks that contain sulfites. A dietitian can help. This will mean reading food and drug labels carefully. Special care will also need to be taken when eating out.

Medicines may be advised to ease symptoms. Choices are:

  • Antihistamines
  • Corticosteroids
  • An inhaler that contains medicine to open the airways

Some people may need to carry an epinephrine pen. It can be used to inject medicine to treat a severe reaction.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES

American Academy of Allergy, Asthma & Immunology  http://www.aaaai.org 

FARE—Food Allergy Research & Education  https://www.foodallergy.org 

CANADIAN RESOURCES

Allergy Asthma Information Association  http://aaia.ca 

Health Canada  https://www.canada.ca 

References

Allergic and asthmatic reactions to food additives. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/allergic-and-asthmatic-reactions-to-food-additives. Accessed March 25, 2021.

Allergy testing. American College of Allergy, Asthma & Immunology website. Available at: http://acaai.org/allergies/treatment/allergy-testing. Accessed March 25, 2021.

Bahna SL, Burkhardt JG. The dilemma of allergy to food additives. Allergy Asthma Proc. 2018 Jan 1;39(1):3-8.

Food allergy. National Institute of Allergy and Infectious Diseases website. Available at: https://www.niaid.nih.gov/diseases-conditions/food-allergy. Accessed March 25, 2021.

Sulfite sensitivity. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/11323-sulfite-sensitivity. Accessed March 25, 2021.

Sulfites: FDA guide to foods and drugs with sulfites. The Extension Toxicology Network website. Available at: http://extoxnet.orst.edu/faqs/additive/sulf%5Ftbl.htm. Accessed March 25, 2021.

Sulfites: separating fact from fiction. University of Florida website. Available at: http://edis.ifas.ufl.edu/fy731. Accessed March 25, 2021.

Revision Information