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 are intolerant.
A sensitivity to these compounds is associated with a wide variety of symptoms, making it hard to identify.
This article explains the causes and symptoms of salicylate sensitivity, including which foods to avoid.
Salicylates are a group of chemicals derived from salicylic acid.
They are found naturally in certain foods and also synthetically produced for use in products like aspirin, toothpaste and food preservatives.
Both natural and synthetic forms can cause adverse reactions in some people.
In their natural form, plants produce salicylates to defend against harmful elements like insects, fungus and disease (1).
This form is 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 like aspirin contain high 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, depending on the type (2).
Summary Salicylates are chemicals found naturally in certain foods and also synthetically produced 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 them from their bodies.
Salicylate sensitivity is thought to be caused by an overproduction of leukotrienes, which are inflammatory mediators that have been linked to a variety of conditions, including asthma, rheumatoid arthritis and inflammatory bowel disease (3).
This overproduction is caused by the inhibition of cyclooxygenase, an enzyme that regulates the production of leukotrienes (4).
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 suffer from asthma (5).
In fact, it’s estimated that 2–22% of adults with asthma are sensitive to these compounds (6).
Those with food allergies and inflammatory bowel disease have also been shown to be more likely to have this intolerance (7).
Summary People with salicylate intolerance are unable to consume even small amounts of these chemicals without experiencing negative side effects.
Salicylate sensitivity can cause varied symptoms that mimic allergies and illness.
What’s more, some people only experience its symptoms in the presence of unrelated allergies, making it 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 (2):
- Stuffy nose
- Sinus infection and inflammation
- Nasal and sinus polyps
- Abdominal pain
- Gut inflammation (colitis)
- Tissue swelling
However, keep in mind that symptoms can vary from person to person.
The amount of salicylates that trigger 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 a reaction is triggered.
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 highest amounts, though they 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 higher amounts than raw fruits due to 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, radish, 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.
Aside from foods, they can be found in a number of non-food products including:
- Mint-flavored toothpaste
- Shampoos and conditioners
Furthermore, salicylates can be absorbed through the skin, so those with an intolerance should also be aware of the ingredients in lotions, cleansers and perfumes (9).
The most potent source is aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (10).
Summary Salicylates can be found in a number of foods and are also found in non-food products like toothpaste and medications.
Though salicylate intolerance to medications like aspirin has been established, there is a lack of research exploring salicylate intolerance to foods (10).
Currently, there are no laboratory tests to diagnose it. However, certain tests may be given 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.
This test is only administered by medical professionals, as there can be serious reactions.
In those with a known intolerance to aspirin and other medications that contain salicylates, avoidance of these medications is necessary.
However, a diagnosed sensitivity to aspirin and other medications high in salicylates doesn't necessarily mean that avoidance of salicylate-rich foods is necessary.
This is because medications like aspirin contain much higher amounts of them than foods, and an intolerance is usually dose-dependent.
However, people who are extremely sensitive to salicylates may benefit from restricting their intake of foods that contain them.
In order to diagnose a salicylate intolerance to foods, a detailed medical history, including a food and symptom diary, are the best indicators.
If an intolerance is suspected, an elimination diet that excludes foods rich in salicylates is usually the treatment option of choice.
Summary Diagnosis of a dietary intolerance to salicylates usually involves a detailed history of diet and related symptoms conducted by a medical professional. For those who are very sensitive to dietary salicylates, a salicylate-restricted diet may be necessary.
There is no reason to avoid salicylates unless you suspect that you have an intolerance to them, or your doctor recommends doing 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 like colorectal cancer (11).
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 (12, 13).
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 highest amounts is your best bet.
It should be noted that 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 (14).
For this reason, a salicylate-restricted elimination diet should be monitored by a medical 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 only be cut out of your diet if an intolerance is suspected.
Salicylates are a natural component of many foods and found in many medications and other non-food items.
While most people can tolerate these compounds, some are extremely sensitive to them.
Those with salicylate sensitivity may need to avoid foods, medications and products highest in salicylates.
There is much to be discovered about salicylate intolerance, 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.
Due to its 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 your doctor to ensure proper diagnosis and treatment options.