Sulfites are natural or added chemicals in some foods and drinks to enhance flavor. They are mostly found in processed foods, but they can also occur naturally in the process of making beer and wine. They’re also used in some medications to increase shelf life. The FDA has deemed sulfites safe to consume, however, for some people, these chemicals can cause a mild or severe allergic reaction, most commonly asthma symptoms. Some individuals create allergic antibodies against sulfites, while others may just suffer from a sulfite sensitivity. In this case, the sensitivity affects the digestive system instead of the immune system. Symptoms include bloating, diarrhea, indigestion, and vomiting. Whether you have a true sulfite allergy or just a sensitivity, it’s important to know which foods to avoid. The allergists at NY Allergy & Sinus Centers have created a sulfite allergy food list that you may need to stay away from. Sulfite Allergy Foods Dried fruitsMolassesPotato chipsBottle lemon juiceSauerkrautFresh mushroomsBottles lime juiceGravies/ saucesImported fruit juice/ soft drinksWine/ beerFruit toppingsProcessed foods This is just a short list of the many items that may contain sulfites. It’s important to read the labels of all the products you consume. However, the FDA doesn’t require companies to label products containing less than 10 ppm of sulfites. This is because foods containing only a small amount of sulfites haven’t been known to cause allergy symptoms. There are also some ingredients to look for that contain sulfites. These ingredients include: • Sulfur dioxide • Potassium bisulfite or potassium metabisulfite • Sodium bisulfite, sodium metabisulfite, or sodium sulfite Some foods contain higher levels of sulfites and may produce more severe symptoms. These include dried fruits, grape juices, and wine. Other foods contain low levels of sulfites and may be safe to consume. Low levels of sulfites are also found in some medications. Although these medications haven’t been known to cause severe allergic reactions, you should consult with your doctor to determine if they’re safe for you. Sulfite Allergy Medications EpinephrineBronkosolIsuprelDopamineGaramycinNovocaineThorazineAramineBleph-10 Sulfites are added to these medications to prevent discoloration which can decrease the effectiveness of the drug. While epinephrine does contain sulfites, it is the only treatment for anaphylaxis and should not be avoided by individuals allergic to sulfites. Epinephrine hasn’t been reported to cause any allergic reactions. Sulfite Allergy Symptoms Breathing problems/asthmaAllergic rhinitisUrticaria (Hives)Flushin The most common symptoms of a sulfite allergy are related to asthma. Up to 10% of asthma patients suffer from this allergy. Symptoms range from wheezing to more severe cases of asthma attacks. If your asthma worsens after eating or drinking certain products, seek medical attention to determine if you have a sulfite allergy. Very rarely does a sulfite allergy lead to more severe symptoms. There haven’t been any cases of repeated anaphylaxis due to sulfites. Most symptoms are mild and subside on their own. However, you can seek still treatment for these symptoms. Sulfite Allergy Diagnosis Since there isn’t an accurate allergy test to diagnose a sulfite allergy, a food challenge is necessary. In this case, a board-certified allergist will feed you sulfites in small amounts to see if it evokes a reaction. If an allergic reaction is seen, your allergist will provide a treatment plan. Food challenges should only be done in a safe, clinical setting. You should never try to diagnose your own allergy. An allergist will have emergency equipment on hand in the event you experience a life-threatening allergic reaction. Your allergist can also provide allergy medications to soothe any symptoms related to your sulfite allergy. Sulfite Allergy Treatment Symptoms related to a sulfite allergy usually subside on their own. However, more severe reactions need treatment provided by an allergist. For asthma symptoms, an oral steroid needs to be prescribed. Keep your inhaler with you to soothe your asthma symptoms throughout the day. For reactions on the skin, antihistamines and cortisone creams can help soothe your symptoms. Sulfite Allergies rarely cause anaphylaxis, but if you’re really sensitive to sulfites, consult with your allergist about carrying an epinephrine auto-injector. They will determine if an EpiPen is necessary for your condition. You should train your friends and family how to administer the medication in the event that you are unable to. Sulfite Allergy Frequently Asked Questions Can I be Allergic to Sulfites? If you experience asthma symptoms or allergic rhinitis after consuming foods or drinks containing sulfites, you might be allergic. Also, those who already suffer from asthma or other allergies are at risk of developing a sulfite allergy. What is the Difference Between a Sulfite Allergy and a Sulfite Sensitivity? A sulfite allergy is an adverse immune response. It is when the immune system reacts negatively to sulfites. A sulfite sensitivity deals with the digestive system. It is when the body cannot properly digest sulfites. Are There Sulfite-free Wines? Sulfite occurs naturally in wine, so it’s impossible for it to be completely sulfite free. However, there are brands that don’t use added sulfites. Talk to your doctor about the amount of sulfites you can safely consume. Is Sulfite Allergy the Same as Sulfa Allergy? No, sulfites are different from sulfa. Sulfa is a drug used in some antibiotics. Sulfites are natural or added chemicals to enhance flavor or preserve medications. Are Sulfites the Same as Sulfates? Sulfates and sulfites are both sulfur-based compounds, but they are used for different things. Sulfates are usually harsh chemicals added to soaps, detergent, and other cleaners. Sulfites are more natural and act as preservatives. Is Sulfite Allergy Genetic? No, sulfite allergy is not genetic. Physicians aren’t sure what causes a sulfite allergy. How is Sulfite Allergy Diagnosed? A sulfite allergy can only be diagnosed by a doctor. A food challenge will be ordered to confirm the diagnose. In this case, an allergist will feed you a small amount of sulfites and watch for a reaction. How is Sulfite Allergy Treated? Sulfite allergy symptoms can be treated with antihistamines or oral steroids. Consult with an allergist to determine which medications will best treat your symptoms. Is Sulfite Allergy Curable? No, sulfite allergy is not curable. However, some patients become less severe to the allergen over time. You should still avoid sulfites if you are allergic. Conclusion If you believe you suffer from a sulfite allergy, contact the NYC allergists at NY Allergy & Sinus Centers. We offer allergy testing and treatment for most allergies and can diagnose your allergy today. NYASC offers six convenient locations throughout Manhattan and Queens. Call (212) 686-4448 to book your appointment today.