Salicylate Sensitivity and Adrenal Fatigue – Part 1

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM


Diagnosing salicylate sensitivityThe connection between salicylate sensitivity and Adrenal Fatigue Syndrome gains clarity daily. Both consist of a lot of nonspecific symptoms that can become debilitating. Neither is well understood by conventionally trained physicians and thus are not always handled well by the medical establishment. Both are at the foundations of significant illnesses but most physicians do not consider them when assessing or addressing the illnesses they can cause.

As we discuss salicylate sensitivity, what it is, what causes it, and its symptoms, the similarities with adrenal fatigue will make themselves clear.

Salicylate Sensitivity: What Are Salicylates?

Salicylates are a type of phenol found naturally in plants. The purpose of salicylates there is to act as a natural hormone and preservative. Salicylates are in all kinds of plants, so it’s very difficult to avoid consuming them. They protect the plants from bacteria, fungi, and insects. Salicylates are stored in the roots, bark, leaves, and seeds of plants. They are found in many foods and can be eaten by humans. This is unfortunate because allergic reactions to phenols are not uncommon, especially in this stress-filled society in which we live.

In large amounts, salicylates are poisonous. Much lesser amounts consumed in foods you eat can lead to salicylate sensitivities. Salicylate sensitivity will begin showing symptoms anywhere from twenty minutes to two hours after ingesting food with these phenols in it. Phenols and salicylates can easily penetrate the blood-brain barrier due to the ratio of fat to water in the cell membranes. This ability to penetrate the barrier is the reason sensitivities to phenols or salicylates can occur so quickly.

Higher amounts are found in raw or dried foods and in fruit juices. When these same foods are cooked, the level of salicylates is lower.
Salicylates are also found in products other than food. They are one of the main ingredients in aspirin and other pain medications, as well as cosmetics and beauty products. Flavored products like sweets, toothpaste, and chewing gum also contain salicylates, possibly leading to sensitivity. Artificial coloring and flavoring can also contain salicylates.

Salicylic acid is readily absorbed through contact with your skin as well. This is one reason people with salicylate sensitivities should avoid cosmetics and other products containing them. Exposure to enough of these products could quickly lead to a toxic amount getting into your body.

Of equal importance is the fact that salicylic acid is a micronutrient useful to your body. Research isn’t clear how much is needed by your body, or whether the source of the salicylic acid getting into your body is important. Its essential quality may even classify it as a vitamin.

Aside from its role as a micronutrient, salicylic acid also appears to play a role in the development of some chronic conditions such as Adrenal Fatigue Syndrome (AFS). Omega 3 fatty acids and possibly zinc appear to have some effect on the severity of symptoms of salicylate sensitivity as well.

This involvement shows a strong correlation between the severity of symptoms and other health disorders, such as inflammation, leaky gut, stress, insulin sensitivity, and deficiencies in micronutrients.

What Is Salicylate Sensitivity?

Sensitivity to salicylates is the body’s inability to deal with more than a certain amount of the substance at any given time. People with this sensitivity may not be able to eat some fruits or vegetables or handle some products.

The apparent mechanism behind salicylate activity is called cyclooxygenase, which is the inhibition of the action of two enzymes. The enzymes involved normally convert an essential fatty acid, arachidonic acid, into prostaglandins and leukotrienes.

When the production of prostaglandins is hampered, more leukotrienes are produced. This can lead to problems in people who are sensitive to leukotrienes. Leukotrienes have been linked to a wide range of inflammatory conditions.

Chronic sensitivity to salicylates is reported to be an unrecognized but common source of health problems, especially for the elderly and those who are weak. This is due to the wide variety of symptoms and the fact that they tend to be nonspecific.

Research shows many people with chronic health conditions may be sensitive to salicylates to some degree. Possibly as many as 20 percent of adults with asthma, 60 percent of people with food allergies, 70 percent of people with irritable bowel syndrome, and 75 percent of children with behavioral problems may actually be showing signs of this kind of sensitivity.

Sensitivity varies greatly among people; the severity and who or when they will be affected can’t be predicted accurately. Salicylate sensitivity may play a major role in many gastrointestinal disorders. There is also a very strong relationship between this sensitivity and asthma, which is one reason why care must be used when prescribing aspirin and other NSAIDs for asthmatics. It is also strongly linked to inflammation since Omega 3 fatty acids in high doses decrease symptoms dramatically.

Symptoms of Salicylate Sensitivity

Symptoms associated with this condition vary and are relatively nonspecific. Many of them are similar or the same as those found with AFS. The severity of symptoms varies from person to person. Some people may experience only one of the possible symptoms, while other may have several of them.

Physical symptoms include:
Salicylate sensitivity and asthma symptoms

  • Stomach pain/upset
  • Asthma
  • Headaches
  • Fatigue
  • Nausea
  • Joint/muscle aches
  • Blood sugar imbalances/variability
  • Chronic fatigue syndrome
  • Insomnia
  • Dizziness
  • Weight problems

Mental symptoms include:

  • Memory loss
  • Confusion
  • Difficulty concentrating
  • Depression
  • Anxiety
  • Brain fog
  • Disorientation
  • Mood swings
  • Panic attacks

This is not a comprehensive list of possible symptoms, but it does give you an idea of what can occur with sensitivity to salicylates. You can also easily see the similarities between this sensitivity and AFS.

Adrenal Fatigue Syndrome

The symptoms of AFS develop slowly and without you realizing they are there. They are the result of your body’s normal response to stress. This response begins with activation of the hypothalamic-pituitary-adrenal (HPA) hormonal axis.

The adrenal glands are the organs on top of your kidneys that fight the effects of stress by secreting cortisol, the hormone that deals with stress. If stress continues unabated, the adrenals continue secreting cortisol until adrenal exhaustion takes place.

It is then that the nonspecific symptoms begin. Some of those symptoms include:

  • Weight problems, especially gaining weight around the middle of your body
  • Memory problems
  • Depression
  • Feeling lightheaded/dizzy
  • Lack of energy
  • Nervousness
  • Feeling tired even after sleeping all night
  • Inability to think clearly
  • Anxiety attacks

Not everyone will have all of these symptoms. Some may have only one, while others may have several of the symptoms. The more advanced the AFS, the more likely it is that you will develop these symptoms.

The NeuroEndoMetabolic (NEM) Model

Symptoms of both AFS and salicylate sensitivity are often overlooked or missed by physicians who are conventionally trained. These physicians typically deal with symptoms only or with individual organs rather than addressing the root causes of AFS.

In the NEM model, practitioners assess and address how the interrelationship among organ systems may be the cause of your symptoms on a holistic basis. This is a more comprehensive approach to diseases and their remediation.

The NEM viewpoint says six organ systems called circuits typically interact with each other. Whatever affects one of these systems affects others. In the case of salicylate sensitivity, the metabolic system is affected. Specifically, the inflammation and the detoxification circuit is dysregulated. Additional associated symptoms can include chemical sensitivity, liver congestion, paradoxical reactions, leaky gut, food sensitivities, irritable bowel, and pain of unknown origin leading to fatigue, sexual irregularities, and low thyroid function.

Salicylate Sensitivity and AFS

AFS and salicylate sensitivityWhen you have a sensitivity, allergy, or intolerance to foods or food ingredients, it may take hours or even days to manifest symptoms. By the time these symptoms show up, you may not remember even eating the food that brought on the symptoms. But your adrenal glands feel the stress from your sensitivity, allergy, or intolerance quickly.

Thus, sensitivity to salicylates or other food products can be viewed as a hidden source of stress. Since your body responds to stress from any source the same way, that is, through activation of the HPA axis, your adrenals begin the process of dealing with this stress by secreting cortisol.

When you’re continually introducing salicylates into your body, you keep your adrenals burdened and continually working to respond. You may not even know what food you ate that started this flood of problems.

With all of the possible symptoms caused by this sensitivity and their nonspecific nature, you may not realize what you’re feeling was caused by something you ate several days ago. If you should happen to figure out your symptoms were brought on by eating something, you will probably think you ate something different than your usual foods.

You may never suspect something you eat all the time made you so sick. It is also possible that you may have a negative response to a combination of foods that you wouldn’t have any reaction to if you ate them individually.

If you have sensitivities to several foods, the lining of your gut becomes inflamed and irritated. If you continue eating foods to which you’re sensitive (or those that are irritating by themselves), your stomach lining never has a chance to heal or recover. This will lead to continuing stomach problems, possibly even to leaky gut.

If you develop this syndrome, the lining of your gut will develop weak spots, allowing partially digested food, bacteria, yeasts, and fats to travel through, or leak, into your bloodstream. This sets up perfect conditions for your immune system to react to these “foreign” products and inflammation begins. This is an autoimmune response that triggers the release of cortisol to fight the inflammation. Your sensitivities also trigger histamines that cause inflammation, thus adding to the overall level of inflammation in your body.

Food sensitivities and salicylate sensitivityBy constantly consuming foods that lead to this inflammatory response, you are putting pressure on your adrenals to supply cortisol to fight it because cortisol is the body’s main anti-inflammatory hormone. If your sensitivity is to some food, such as wheat, that is a part of almost every meal in some form, you are exposing your body to this process all the time. Doing so will almost certainly lead to adrenal fatigue.

Since salicylates are everywhere, if you are sensitive to them, you have a major problem. You may be able to control your diet and limit exposure to salicylates through food, but you also can absorb them through your skin or nasal passages by breathing in a multitude of scents.

Research and clinical practice have shown foods can affect people with chronic fatigue syndrome and lead to many of the symptoms they experience. It’s not always easy to recognize their contribution, but they can lead to any of the symptoms that show up with chronic fatigue.

Food sensitivities will typically interfere with your daily activities in addition to causing a tremendous burden on your adrenals. This makes it imperative that you find out the foods that bring on your sensitivities, avoid them as completely as you can, and lessen the load on your adrenals and improve your overall health.

Read Part 2

© Copyright 2018 Michael Lam, M.D. All Rights Reserved.


Dr. Lam’s Key Question

Salicylate sensitivity is a type of allergic reaction to foods containing salicylates. Raw fruits and vegetables are high in salicylates. You will have many nonspecific responses that can lead to serious chronic health conditions. A diet restricting foods with salicylates is the best option for remediating this sensitivity.


salicylate sensitivity