Food sensitivities and intolerances are common problems that can be difficult to diagnose.

While salicylate sensitivity, also known as salicylate intolerance, is not as common as gluten or lactose intolerance, it’s a real issue for some people.

Salicylates are compounds found in foods, medications, and other products that can cause adverse reactions in those who cannot tolerate them (1).

A sensitivity to these compounds is associated with a wide variety of symptoms and can therefore be hard to identify.

This article explains the causes and symptoms of salicylate sensitivity, including which foods to avoid.

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Salicylates are a group of chemicals derived from salicylic acid.

They are found naturally in certain foods and manufactured for use in products such as aspirin, toothpaste, and food preservatives.

Both natural and synthetic forms can cause adverse reactions in some people.

Plants produce natural salicylates to defend against harmful elements like insects, fungus, and disease (2).

Natural salicylates are found in a wide array of foods, including fruits, vegetables, coffee, teas, nuts, spices, and honey.

Meanwhile, the synthetic form is commonly used as a food preservative and found in medications like aspirin and Pepto-Bismol.

Compared to foods, medications such as aspirin contain larger amounts of salicylates, which is why salicylate intolerance is most commonly linked to medications.

For example, dietary intake of salicylates is usually 10–200 mg per day. Comparatively, a single dose of aspirin can contain 325–650 mg of salicylates, depending on the type (1).

Summary

Salicylates are chemicals found naturally in certain foods and manufactured for use in medications and other products.

While consuming excessive amounts of salicylates can result in adverse reactions in anyone, most people can safely consume foods rich in them on a daily basis or take a couple of aspirin now and then for a headache.

However, those with a sensitivity to salicylates may experience side effects when they consume a food or use a product that contains even small amounts of these chemicals.

These people have a decreased ability to properly metabolize and excrete salicylates.

Salicylate sensitivity is thought to be caused by an overproduction of leukotrienes — inflammatory mediators that have been linked to a variety of conditions, including asthma, allergic rhinitis, anaphylaxis, rheumatoid arthritis, and interstitial lung diseases (3).

This overproduction is caused by the inhibition of cyclooxygenase, an enzyme that regulates the production of leukotrienes (1).

The buildup of leukotrienes in the body leads to symptoms related to salicylate intolerance.

Although the percentage of people who have a salicylate intolerance is unknown, it is more common in adults who have asthma (4).

In fact, it’s estimated that 2–22% of adults with asthma are sensitive to these compounds (5).

Research also suggests that people with food allergies and inflammatory bowel disease are more likely to have this intolerance (6).

Summary

People with salicylate intolerance cannot consume even small amounts of these chemicals without experiencing negative side effects.

Salicylate sensitivity can cause varied symptoms that mimic those of allergies and other illnesses.

What’s more, some people experience symptoms only in the presence of unrelated allergies, making salicylate sensitivity a difficult condition to diagnose.

The most common symptoms involve the respiratory tract. However, the skin and intestinal tract may also be affected.

Symptoms include (7):

  • stuffy nose
  • sinus infection and inflammation
  • nasal and sinus polyps
  • asthma
  • diarrhea
  • gas
  • abdominal pain
  • gut inflammation (colitis)
  • hives
  • tissue swelling

However, keep in mind that symptoms can vary from person to person.

The amount of salicylates that triggers a reaction can differ depending on the individual’s ability to break them down.

Therefore, some people experience symptoms after being exposed to a small amount of these chemicals, while others can tolerate larger amounts before they have a reaction.

Summary

Salicylate sensitivity is linked to a variety of symptoms, including stuffy nose, asthma, diarrhea, and hives. It can be difficult to diagnose because its symptoms can vary from person to person.

A number of foods contain salicylates.

Fruits, vegetables, and spices tend to contain the largest amounts, though salicylates are found in other foods as well.

The salicylate level of a food can vary based on a number of factors, including growing conditions, preparation, and level of ripeness.

For example, dried fruits contain larger amounts than raw fruits as a result of the removal of water during processing.

Foods highest in salicylates include (8):

  • Fruits: raisins, prunes, apricots, blackberries, blueberries, cherries, cranberries, grapes, pineapples, plums, oranges, tangerines, strawberries, and guava
  • Vegetables: broccoli, cucumbers, okra, chicory, endive, radishes, zucchini, watercress, alfalfa sprouts, eggplant, squash, sweet potato, spinach, artichokes, and broad beans
  • Spices: curry, aniseed, cayenne, dill, ginger, allspice, cinnamon, clove, mustard, cumin, oregano, pimiento, tarragon, turmeric, paprika, thyme, and rosemary
  • Other sources: tea, rum, wine, cordials, vinegar, gravies, mints, almonds, water chestnuts, honey, licorice, jam, chewing gum, pickles, olives, food colorings, aloe vera, savory-flavored chips and crackers, and fruit flavorings

This list is not exhaustive, as there are many other food sources of these compounds.

Salicylates are also found in a number of non-food products, including:

  • mint-flavored toothpaste
  • perfumes
  • shampoos and conditioners
  • mouthwash
  • lotions
  • medications

Furthermore, salicylates can be absorbed through the skin, so those with an intolerance should be aware of the ingredients in lotions, cleansers, and perfumes (9).

The most potent sources are aspirin and other nonsteroidal anti-inflammatory drugs, including ibuprofen (9).

Summary

Salicylates are found in a number of foods, as well as in non-food products like toothpaste and medications.

While salicylate intolerance to medications like aspirin has been established, there is a lack of research exploring salicylate intolerance to foods. Currently, there are no laboratory tests to diagnose it. However, certain tests may be used to rule out an allergy.

The standard test for salicylate intolerance to medications is exposure or provocation, which involves administering a small amount of salicylic acid and monitoring for symptoms.

Only healthcare professionals should administer this test, as serious reactions can occur.

People who have a known intolerance to aspirin and other medications that contain salicylates should avoid these medications.

However, having a diagnosed sensitivity to aspirin and other medications high in salicylates doesn’t necessarily mean you need to avoid salicylate-rich foods.

This is because medications such as aspirin contain much larger amounts of salicylates than foods do, and an intolerance is usually dose-dependent.

Still, people who are extremely sensitive to salicylates may benefit from restricting their intake of foods that contain these compounds.

A detailed medical history, including a food and symptom diary, is the best indicator a healthcare professional can use to diagnose a salicylate intolerance.

If a healthcare professional suspects an intolerance, an elimination diet that excludes foods rich in salicylates is usually the treatment option of choice.

Summary

To diagnose an intolerance to salicylates, a healthcare professional will usually take a detailed history of diet and related symptoms. People who are very sensitive to dietary salicylates may require a salicylate-restricted diet under the direction of a doctor or registered dietitian.

There is no reason to avoid salicylates unless you suspect that you have an intolerance to them or a healthcare professional recommends that you do so.

A low salicylate diet can be restrictive. Moreover, unnecessarily cutting out foods that are rich in these compounds can be detrimental to your health.

In fact, salicylates are anti-inflammatory. Foods high in them have been proven to reduce the risk of inflammatory diseases such as colorectal cancer (2).

Also, the fruits, vegetables, and spices that are high in these compounds are beneficial for health and contain loads of vitamins, minerals, and potent plant compounds that help keep you healthy (10, 11, 12).

However, people who experience symptoms after consuming salicylate-rich foods should consider avoiding them.

Since an intolerance is usually dose-related and so many foods contain these compounds, restricting only the foods that contain the largest amounts is your best bet.

Research on salicylate-restricted diets is very limited, so their long-term effects are unknown.

In one study, 74 children who were put on a salicylate-restricted diet experienced nutritional deficiencies and food aversions (13).

For this reason, a salicylate-restricted elimination diet should be monitored by a healthcare professional.

Summary

Only those who are very sensitive to salicylates need to follow a salicylate-restricted diet. Foods rich in these compounds have many health benefits and should not be cut out of your diet unless a healthcare professional suspects you have an intolerance.

Salicylates are a natural component of many foods and are found in many medications and other non-food items.

While most people can tolerate these compounds, some are extremely sensitive to them.

People who have a salicylate sensitivity may need to avoid the foods, medications, and other products that are highest in salicylates.

More research on salicylate intolerance is necessary, and the long-term effects of a salicylate-restricted diet are unknown.

Salicylates are found in countless foods and products, so complete avoidance is difficult.

Because it has a wide range of symptoms, salicylate intolerance is often difficult to diagnose, and treatment options are limited at this time.

If you feel that you may be sensitive to salicylates, speak with a healthcare professional to ensure proper diagnosis and treatment.