Sulfites are compounds that are used to make foods and beverages last longer. Sulfite sensitivity is an abnormal reaction to these compounds.
Foods that may contain sulfites include:
Many prescription and over-the-counter medications also contain sulfites. Sulfites are also contained in products applied to the skin, such as cosmetics.
It is not clear what causes a sulfite sensitivity to develop. It may be due to genetic and environmental factors.
There are no known risk factors for sulfite sensitivity. Most people with sulfite sensitivity have asthma.
Most symptoms are mild and can vary based on your body’s reaction to sulfite ingestion. It may be one or a combination of the following:
When the stomach breaks down sulfites, it releases a sulfur dioxide gas. This gas can pass up into and irritate airways in some people, such as those with asthma. This can cause symptoms such as:
Some people may lack the enzyme needed to breakdown sulfites. This can cause:
Some may also have an allergic reaction to sulfites. This means sulfites cause an autoimmune reaction, which may cause:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor may ask specific questions about what you were doing when the symptoms occurred. The exact cause may not be clear in the first visit. Your doctor may ask you to keep a diary of your symptoms to help determine the cause.
Your bodily fluids and tissues may be tested to eliminate other causes. This can be done with:
You may also 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 and can help find out what is causing your symptoms.
Symptoms can be reduced or eliminated by avoiding foods or drinks that contain sulfites.
To reduce sulfite intake:
Consider wearing a medical alert bracelet to inform others of your allergy. If you have difficulty breathing, call for medical help right away.
Medications may be given or advised to help ease breathing or treat other allergic symptoms such as:
If you have a confirmed sulfite allergy, consider seeing an allergy specialist.
American Academy of Allergy, Asthma, and Immunology
Food Allergy and Anaphylaxis Network
Allergy Asthma Information Association
Allergy testing. American College of Allergy, Asthma & Immunology website. Available at: http://www.acaai.org/allergist/allergies/treatment/diagnosing-allergies/pages/allergy-testing.aspx. Accessed October 28, 2013.
Boyce JA, Assa'ad A, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. Nutr Res. 2011 Jan;31(1):61-75.
Food allergy: an overview. National Institute of Allergy and Infectious Diseases website. Available at:http://www.niaid.nih.gov/topics/foodallergy/Pages/default.aspx. Accessed October 28, 2013.
Garcia-Gavin J, Parente J, et al. Allergic contact dermatitis caused by sodium metabisulfite: a challenging allergen: a case series and literature review. Contact Dermatitis. 2012;67(5):260-269.
Grotheer P, Marshall M, et al. Sulfites: separating fact from fiction. University of Florida website. Available at: http://edis.ifas.ufl.edu/fy731. Accessed October 28, 2013.
Papaioannou R, Pfeiffer C. Sulfite sensitivity—unrecognized threat: is molybdenum deficiency the cause? Orthomolecular website. Available at: http://orthomolecular.org/library/jom/1984/pdf/1984-v13n02-p105.pdf. Accessed October 28, 2013.
Sulfite allergy. Australasian Society of Clinical Immunology and Allergy website. Available at: http://www.allergy.org.au/patients/product-allergy/sulfite-allergy. Updated June 2010. Accessed November 4, 2013.
Sulfite sensitivity. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases_conditions/hic_Allergy_Overview/hic_Sulfite_Sensitivity. Accessed October 28, 2013.
Sulfites: FDA guide to foods and drugs with sulfites. The Extension Toxicology Network website. Available at: http://extoxnet.orst.edu/faqs/additive/sulf_tbl.htm. Accessed October 28, 2013.
Tarlo SM, Sussman GL. Asthma and anaphylactoid reactions to food additives. Can Fam Physician. 1993;39:1119-1123.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.