Sulfite Allergy Overview and Foods to Avoid
Food additive that can trigger asthma symptoms
Sulfides have been used as food additives for centuries, but they also occur naturally in foods such as fermented drinks and wines.
Examples of sulfides include:
Sodium sulfate
Sodium bisulfate
Sodium metabisulphite
Potassium bisulfite
Potassium metabisulfite
Sulfur dioxide
Let us examine the basics of a sulfide allergy, including how it is diagnosed when diagnosed with this allergy and how to prevent a reaction.
overview
The good news is that sulfides do not cause a few problems in most people without allergies and asthma, even when consumed in large quantities.
However, in about 5 percent of people with asthma, sulphides are known to increase asthma symptoms, especially in adults with severe disease. Numerous well-controlled studies have shown that some asthmatics may have severe asthma symptoms after eating sulphide-containing foods / beverages or inhaling sulfite fumes or vapors.
Although various cases have been described where consumption of sulphide-containing foods / beverages leads to severe allergic reactions, less is known about hive / swelling and anaphylaxis as a result of sulfides. Some of these people have performed positive skin tests for sulfides and suggest existing allergic antibodies to the preservative.
Other people have experienced serious reactions from sulfide-containing drugs, including intravenous drugs and inhaled drugs.
These reactions included flushing, hives and a decrease in lung function as a result of the drugs administered.
Sulphides do not appear to be a criminal in people suffering from recurrent anaphylaxis attacks of unknown cause. In addition, there is no risk of anaphylaxis in people with mastocytosis and appears to be less risky for those without asthma and without atopy.
Causes
It is not known exactly how sulfides cause reactions in certain humans. Some people clearly make allergic antibodies to sulfite, while others do not. Gases from sulfides can cause muscle spasms in the lungs of some asthmatics, or in some people may be associated with inability to properly metabolize sulfides.
Diagnosis
Although there are some case reports using skin testing in some cases diagnosed with sulfite allergy, there is no reliable, commercially available skin test for sulfite allergy. Typically, the diagnosis is recommended with a history of adverse reactions consuming sulphide-containing foods or medicines.
However, in order to confirm the diagnosis, an allergy may make an oral challenge for a patient suspected of having a sulfite allergy.
This procedure involves an individual increasing the amount of sulfide to swallow while closely monitoring lung function and vital signs. A significant decrease in lung function confirms the sensitivity to sulfides.
This test should only be performed under the direct supervision of a trained and experienced physician.
Why are sulphides added to foods?
Sulphides are added to foods for various reasons.
These include:
Reduction of degradation by bacteria
Frying of fruit, vegetables and seafood
Inhibiting the growth of bacteria during fermentation of wines
Conditioning the dough in frozen pastry and pizza crust
Bleaching effect for cherry liqueur sour cherry and hominis
In the past, sulfides have been added to fresh foods in restaurants and markets to prevent browning. The increase in reactions caused the Food and Drug Administration (FDA) to ban the use of sulfide in fresh lettuce, especially in salads, and in 1986 in fresh foods.
The FDA now requires any foodstuff containing a concentration of more than 10 parts per million (ppm) sulfide on the label.
This is because foods containing less than 10 ppm of sulphide are not shown to cause symptoms, even in those who are allergic to sulfites.
Foods Containing Sulfite
There are foods containing sulphides. Here are examples of foods divided into sulfide levels in a particular substance:
More than 100 ppm sulfite (very high levels, solid avoidance is recommended for people with sulfite allergy)
Dried fruits (excluding dark raisins and prunes)
Bottled lemon juice (not frozen)
Bottled lemon juice (not frozen)
Wine
Sugar cane
Sauerkraut (and its juice)
Grape juices (white, white sparkling, pink sparkling, bright red)
Pickled cocktail onion
50 to 99.9 ppm sulfite (moderate to high sulfite levels, advice for people with sulfite allergy)
Dried potatoes
Wine vinegar
Gravies / sauces
Fruit Toppings
Maraschino cherry
10 to 49.9 ppm sulfite (low to moderate sulfide levels can cause symptoms in people with severe sulfite allergy)
Pectin
Fresh shrimp
Corn syrup
Pickled peppers
Pickles
Corn starch
corn flour
Frozen potatoes
Maple syrup
Imported jam and jam
Fresh mushrooms
Imported sausages and meat
Cordials
Vegetables, dried
Various cheeses
Corn bread / muffin mix
Canned / jarred oysters
Clam soup
Avocado sauce / guacamole
Imported fruit juices and soft drinks
Cider and apple cider vinegar
Less than 10 ppm sulfide (very low sulfide levels, usually not a risk even for people with sulfite allergy)
Malt vinegar
Canned potatoes
beer
Dry soup mix
Soft drinks
Frozen pizza and pastry dough
Beet sugar
Gelatine
coconut
Fresh fruit salad
Domestic jams and jellies
Cracker
Cookie
grape
High fructose corn syrup
Containing Drugs: Sulfides
Sulphides are added to certain drugs to prevent their reddening, as well as their antioxidant properties. The sulfides are added to the injectable epinephrine (eg EpiPen) to prevent browning, which reduces the effectiveness of the drug.
However, it has not been reported to cause adverse reactions in people with epinephrine sulfite allergy and should not be left in an allergic emergency. Injectable epinephrine can be life-saving in people with sulfide allergy experiencing anaphylaxis.
Some inhaler solutions used in the treatment of asthma contain sulfide, but many asthma medicines have released sulfides for safety concerns. People with sulfite allergy should avoid sulfide-containing drugs other than injectable epinephrine (eg EpiPen and Twinject).
Here are examples of drugs containing sulfides:
Bronchodilator solutions for asthma
Adrenaline chloride 1: 1000 concentration (epinephrine)
Bronchosol (isoetharin)
Isuprel (isuprel hydrochloride)
Topical eye drops
Bleph-10 (sulfacetamide sodium)
AK-Dex, Ocu-Dex (dexamethasone)
Pred-Forte (prednisolone acetate)
Pred-Mild (prednisolone)
Injectable drugs
Adrenaline, Ana-Kit, EpiPen (epinephrine)
A-Hydrocort, Solu-Cortef (hydrocortisone-injectable)
Amikin (amikacin)
Aramin (metharaminol)
Celestone (betamethasone phosphate)
Compazine (prochlorperazine)
Decadron (dexamethasone phosphate)
Demerol (meperidine)
dopamine
Garamycin (gentamicin)
Izetharin HCl
Isuprel (isoproterenol-injectable)
Levophed (norepinephrine)
Nebcin (tobramycin)
Novocaine (procaine)
Phenergan (promethazine)
Solutions for total parenteral nutrition and dialysis
Torazine (chlorpromazine)
Epinephrine xylokine (epinephrine lidocaine)
treatment
In general, people with known or suspected sulphite allergies should avoid sulfite-containing foods and medicines. This should be successful given the authorization granted by the FDA to label foods containing less than 10 ppm of sulphide.
Furthermore, although the FDA prohibits sulfides from fresh fruits and vegetables in restaurants (as in salad bars), the risk of accidental ingestion of sulfides is significantly reduced, while foods containing untagged sulfide remain in restaurants, sulfide is an important concern in potatoes. . Therefore, people with sulfite allergy should not use all potato products when going out.
Finally, if a sulfide-containing product is consumed and an allergic reaction develops, then this specific reaction needs to be treated. For example, a severe allergic reaction and anaphylaxis may require treatment with injectable epinephrine, while symptoms of asthma may require the use of inhaled bronchodilator solutions (sulphide-free).
In this note, it is important to carry injectable epinephrine (EpiPen or Twinject) in people with severe sulfide allergy and obtain a Medic-Alert bracelet.
One word
The big picture here is that sulfite allergy is rare and is mostly seen in people with severe asthma. However, if you have asthma, you should avoid sulfide-containing foods unless you and your doctor suspect that you have sulfide allergy or have been diagnosed.
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