What Is The Main Use Of Sulfites
Sulfites are used as preservatives in some drinks, foods and medications. Low levels of natural sulfites are also found in many foods. Sulfites release sulfur dioxide gas, which is the active component that helps preserve drinks, foods and medications.
Sulfites have been used since Roman times to preserve food flavour and colour, inhibit bacterial growth, reduce food spoilage, and help preserve medications.
What Foods And Drinks Contain Sulphites
Sulphites are important, as they help preserve many foods and drinks and prevent them from going off. Sulphites are also used in the production of most wines, as they stop the fermentation process, which would otherwise make the wine turn sour.
Foods which may contain added sulphites include :
- pickled foods and vinegar
- dehydrated, pre-cut or peeled potatoes
- fresh or frozen prawns
- some processed meat products
EU food labelling rules require all food sold in the UK to show clearly on the label if it contains sulphur dioxide or sulphites at levels above 10mg per kg or 10mg per litre . Bear in mind that nonpre-packaged foods are also covered by this labelling requirement, but if in doubt, it is always wise to ask.
The following food additives contain sulphites the same chemicals may be found in medications or cosmetics:
- E220 Sulphur dioxide
- E150d Sulphite ammonia caramel
Living With A Sulphite Sensitivity Online Workshop
So. This is my low-down in sulphites. Ive done lit-reviews, Ive studied the evidence, and Ive learnt a lot of things. Trial and error through personal experience. Ive come to the conclusion that there is not enough awareness and resources out there to support people with a sulphite sensitivity.
Which is why I created a LOW PRICE online workshop on how to live sulphite free!
If you answered yes to any of these this course is for you.
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What Is A Sulfite Sensitivity
Sulfites are chemicals used as preservatives to slow browning and discoloration in foods and beverages during preparation, storage and distribution. Sulfites have been used in wine making for centuries.
You can find sulfites in certain foods and beverages, as well as a variety of medications. The use of sulfites as preservatives in foods and beverages increased dramatically in the 1970s and 1980s. Due to cases of severe reactions to sulfites, a ban by the Food and Drug Administration went into effect in August, 1986. This ban prohibited use of sulfites in fresh fruits and vegetables.
Although reactions to sulfites were recognized initially with salad bars in restaurants, this has not been a source for sulfite exposure for more than three decades. Sulfites continue to be used in potatoes, shrimp, and beer/wine, and are also used in the pharmaceutical industry. Sulfites are added to many medications, including some of the medications given to treat asthma and allergic reactions.
Sulfites have been implicated as a cause of asthma symptoms that may range from mild wheezing to potentially life-threatening asthmatic reaction. It is also a very rare cause of anaphylaxis in people who have become allergic to sulfites.
Can Sulphites Cause Allergy
It is rare for someone to be allergic to sulphites. However, sulphites can cause allergy-like symptoms in people with underlying asthma and allergic rhinitis. The most common reaction is wheezing, tight chest and cough. The incidence of sulphite sensitivity in the general population is thought to be less than 2%, but this rises to between 5 and 13% in asthmatics.
Severe reactions to sulphites have been reported but are very rare. Some people with urticaria, a type of skin rash, can also experience worsening of symptoms after eating sulphites.
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Benefits Of Drinking Wine
Its not all gloom and doom, even if the emphasis of this article is wine intolerance. Here are some benefits of drinking wine I came across during my research:
Unless you are one of the few unfortunate people with an intolerance or allergy to wine, a little bit of what you fancy wont do you any harm. In fact, it may actually do you some good. For most people, the old advice is the best: drink in moderation, enjoy responsibly and choose well-made wine instead of factory-conditioned, mass-produced slosh.
Do Medicines Contain Sulphites
Sulphites are sometimes used in medicines, as a preservative. These include topical creams and eye drops. However, since most people only react to sulphites when the substance comes into contact with acid in the stomach, it is very rare for these medicines to cause any adverse effects.
Some injection drugs contain sulphites as a preservative. If you are sulphite sensitive, ask your pharmacist to check that your medicine is sulphite-free. Check the ingredients on the patient information leaflet for any medicines you are given, including those that you buy yourself over-the-counter.
Some adrenaline injections and auto-injectors contain sulphites but there is no evidence that this causes problems, and adrenaline should be given as prescribed in an emergency.
Note that sensitivity to sulphites is different from allergy to sulphonamide-containing antibiotics. Sulphonamide is a different substance from sulphite, and used to be commonly found in antibiotics. However, due to allergies to this particular compound, the use of antibiotics containing sulphonamides has decreased, as alternatives are often available.
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Potential Mechanisms Of Sensitivities To The Sulphite Additives
Given the wide variations in symptoms, in the severity of reactions, and in the sensitivities of individuals to different forms of sulphite, it is unlikely that any single mechanism can explain all reactions to the sulphite additives.
A number of potential mechanisms that might explain asthmatic reactions to the sulphites have been postulated, although the mode of exposure is a confounding factor . Nebulized bisulphite solutions, acidified metabisulphite solutions, encapsulated metabisulphite and sulphite containing food or drinks may or may not provoke reactions in the same individual, and the types of reactions and concentrations of sulphite that provoke reactions may vary widely with different forms of exposure. Inhalation of SO2, generated from ingested sulphites in the warm acidic environments of the mouth and stomach, may cause respiratory symptoms. Although nebulized metabisulphite was also thought to cause bronchoconstriction through generation of SO2 in the airways , airway responsiveness to acidic metabisulphite solutions and SO2 were not significantly related .
Suspect #: Intolerance To Some Types Of Alcohol
We explained in our article Why wine gives you a hangover that alcoholic fermentation creates different forms of alcohol: methanol , ethanol and tail types of alcohols like propranol, butanol , which are not as toxic.
All these alcohols are important in the process of wine maturation because they interact with acids and form the aromas in wine. The process of fermentation creates many of these flavours, which are not present in grape juice. Grape juice can only ever taste of grapes, whereas people write encyclopaedias about the taste of wine.
Tail types of alcohol can cause headaches and nausea. If you are sensitive to them and experience these symptoms after even a small glass of wine, stick to clear, high-quality spirits such as gin and vodka. Both these drinks can contain traces of gluten though so you should avoid them if you are gluten intolerant.
You also need to remember that alcohol increases your existing sensitivities by decreasing your immunity to them. This is why Matthews hay fever is worse after he has had a few drinks.
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What Are The Treatment Options
If you have an allergic reaction to sulfa drugs, treatment will be centered on relieving your symptoms. Your doctor may prescribe antihistamines or corticosteroids to relieve hives, rash, and itching. A bronchodilator may be prescribed if you have respiratory symptoms.
Your doctor may recommend a desensitization procedure if you need medication and there isnt a sulfa-free alternative. Desensitization involves slowly introducing the medication at low doses until an effective dose is reached and tolerated. Youll be monitored for allergic reactions as the medication doses are increased.
Both anaphylaxis and Stevens-Johnson syndrome require immediate medical attention. If youre having an anaphylactic reaction, epinephrine will usually be given.
If you develop Stevens-Johnson syndrome, youll likely be admitted to an intensive care unit. Treatment for Stevens-Johnson syndrome includes:
- corticosteroids to control inflammation
- antibiotics to prevent or control skin infections
- intravenous immunoglobulins to halt the progress of the disease
How To Remove Them
You wont find sulfites in fresh, raw fruits and vegetables or any whole, unprocessed foods. For wine, there are sulfite-free options on the market, which means that theres less than 10 mg/L of sulfites present.
When it comes to sulfites in wine, theres actually a method to remove the preservatives, at least in theory. Apparently adding a few drops of hydrogen peroxide to your bottle of wine can eliminate the sulfites.
There are products, containing hydrogen peroxide and water, that are meant to remove sulfites when added to your wine. Although these product labels suggest only adding a few drops of the H2O2 solution, its important to keep in mind that consuming high concentrations of hydrogen peroxide can be poisonous, as shown my scientific research.
Its not recommended to consume it unless under the care of a doctor. So adding it to wine? Not an ideal solution to sulfite sensitivity.
For people who experience allergy symptoms to sulfites, avoiding foods containing the additive is the safest and most effective way to avoid adverse reactions.
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Natural Wines: A Viable Wine Sulfite Sensitivity Cure
One increasingly popular soloution, that we have spoken about previously on the Sobur blog, is natural, sulfur-free wines.
These natural wines, which are still only a small market, have little or no Sulfur dioxide added. This is easier to do with red wines, because the tannin within the wine acts as a as a natural anti-oxidant. Tannin within the wine means less sulfur dioxide is needed to protect the wine during the winemaking and maturation process.
Why Sulfites Are Added To Foods
Sulfites are added to foods for various reasons. They include:
- Reducing spoilage due to bacteria
- Slowing the browning of fruit, vegetables, and seafood
- Inhibiting growth of bacteria during fermentation of wines
- Conditioning of dough in frozen pie and pizza crust
- Bleaching effect for maraschino cherries and hominy
Sulfites used to be added to fresh foods in restaurants and grocery stores to prevent browning. An increase in reactions led the U.S. Food and Drug Administration in 1986 to ban them in fresh foods, particularly on fresh lettuce in salad bars.
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How Is It Diagnosed
Its tricky to diagnose sulphite sensitivity or allergy. Allergy testing for sulphite intolerance isnt something that the NHS routinely offers, because such tests arent thought to be particularly reliable, or helpful, says Dr Morrison.
Generally, the diagnosis is made by looking at what foods seem to trigger a reaction, she explains.
If you suspect you might be reacting to sulphites, both Dr Morrison and Amena Warner, Allergy UKs head of clinical services, recommend keeping a food diary to show to your GP, which can help with the diagnosis.
There are no validated tests for sensitivity apart from a trial elimination to see if the symptoms resolve.
A food exclusion and reintroduction diet may be suggested, says Dr Thiyagarajan, which involves removing foods high in sulphites for a set period of time and then slowly re-introducing them into your diet to see if they cause symptoms.
There are no validated tests for sensitivity apart from a trial elimination to see if the symptoms resolve, adds Warner.
Is A Sulphite Sensitivity The Same As A Sulphite Allergy
Additionally, sulphite sensitivity it not a true sulphite allergy, as allergies cause an allergic reaction to happen within minutes of being exposed to the food and can often include anaphylaxis. While anaphylaxis is possible in some cases of sulphite intolerance, it is less common overall.
I talk about the difference of these in my online sulphite free workshop, and why it matters.
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Safe Medications For People With Sulfa Allergies
Not all drugs that contain sulfonamides cause reactions in all people. Many people with sulfa allergies and sensitivities may be able to safely take the following medications but should do so with caution:
- some diabetes medications, including glyburide and glimepiride
- migraine medication sumatriptan
- some diuretics, including hydrochlorothiazide and furosemide
The ability to take these medications can vary from person to person. If you have a sulfa allergy and are unsure if you should take any of these medications, talk with your doctor.
Symptoms of an allergic reaction to sulfites include:
- swelling of the mouth and lips
- wheezing or trouble breathing
- asthma attack
If you experience more serious symptoms of a sulfite allergy, contact your doctor. Anaphylaxis requires emergency medical attention.
According to the Cleveland Clinic, people with asthma have between a 1 in 20 and 1 in 100 chance of having a reaction to sulfites.
Sulfites are common in processed foods, condiments, and alcoholic beverages, such as red and white wine. Sulfites occur naturally in wine during fermentation, and many winemakers add them to help the process along.
For the past two decades, the Food and Drug Administration has required winemakers to display the warning contains sulfites if levels exceed a certain threshold. Many companies voluntarily add the label to their products as well.
- sulfur dioxide
Allergic Reactions To Sulphites
Sulphites do not cause true allergic reactions, and are generally grouped with the priority food allergens because sulphite-sensitive individuals may react to sulphites with allergy-like symptoms.
An allergic reaction usually happens within minutes after being exposed to an allergen, but sometimes it can take place several hours after exposure. Anaphylaxis is the most serious type of allergic reaction.
Symptoms of anaphylaxis generally include two or more of the following body systems:
- Skin: hives, swelling , itching, warmth, redness
- Respiratory : coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms , trouble swallowing
- Gastrointestinal : nausea, pain/cramps, vomiting, diarrhea
- Cardiovascular : paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
- Other: anxiety, sense of doom , headache, uterine cramps, metallic taste
However, a drop in blood pressure without other symptoms may also indicate anaphylaxis. It is important to know that anaphylaxis can occur without hives.
If you have a sulphite sensitivity, keep an epinephrine auto-injector with you at all times. Epinephrine is the first-line treatment for severe allergic reactions .
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My Story Of A Sulphite Sensitivity
It started when I was a newly graduated dietitian. I LOVED wine. I was part of a wine club and I had a wine subscription. Wine came to my door, and Id normally enjoy a glass during the week, and a glass or two on weekends. I loved making beef bourguignon for guests. Whipping up a fantastic white wine risotto with lemon and green peas. I loved eating fancy cheeses with different wines. BUT, I began to notice, more and more, that each glass of wine I drank had me feeling worse and worse as time went on. Maybe I was always intolerant to sulphites. Or maybe I grew into it. But over time, I found wine made me feel like crap!
When my work schedule changed to starting at 6:45 am every Wednesday, I would pre-pack dried fruit my favourites being apricots and dates, as well as nuts for a quick and easy breakfast. I thought I was brilliant. Pre-packing 4-5 baggies at once for a grab-and-go breakfast or snack. I felt like garbage on these days. I thought early mornings just werent my thing.
Avoiding Problems With Asthma And Sulfite Allergy
Your doctor can tell if you have a sulfite allergy with a test called a controlled sulfite challenge. During this test, you are exposed to a small amount of sulfites under close supervision to see if you have a reaction.
If you have asthma — and sulfites cause an allergic reaction — you need to be very careful to avoid them. This can be tough, especially since sulfites are in many foods and drugs. And even a very small amount can cause a reaction. But here are a few things you can do.
- Read labels, checking for sulfite substances listed above.
- Be careful with foods that commonly contain sulfites. Many are listed above.
- When you eat out, ask the waiter or waitress whether the food you’re ordering contains sulfites.
- Check with your doctor to make sure that the asthma drugs you use do not contain sulfites.
- Be prepared in case you do ever accidentally eat sulfites. Ask your doctor what to do in an emergency. Always carry your rescue inhaler and an epi-pen with you.
SOURCES:American Academy of Allergy, Asthma, and Immunology web site: “Sulfite Sensitivity.” American Medical Association, Essential Guide to Asthma, 1998. Grayson MH and Holtzman MJ, “Asthma,” ACP Medicine, 2005. Monro, T.Sensors , published online Aug. 6, 2012.
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Are There Any Solutions Or Cures Available For People Who Suffer From Sulfite Sensitivity
Most people who suffer from sulphite sensitivity are usually self-diagnosed, as it doesnt return a positive result on allergy tests.
In most cases, health professionals recommend an elimination diet of foods, drinks and products containing sulphites. This may be followed by a food challenge, usually under medical supervision.
That, of course, was the official recommendation for sulfite sensitivity available online. What about a solution for those who just want to enjoy an occasional glass of wine without suffering from a tight chest, rashes, aches and digestive problems?