Salicylate Sensitivity and Adrenal Fatigue – Part 2

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


Read Part 1

Metabolism and Salicylate Sensitivity

Salicylate sensitivity and leaky gutIn a normal body, metabolism of phenols and salicylates poses no problem. Normal bodies have sufficient levels of sulfates and liver enzymes to detox the body of these substances. The normal body will use what it needs of these phenols, then expel the rest. But in cases where adrenal fatigue has become a problem, leaky gut due to metabolic issues can lead to salicylate sensitivity quickly.

Leaky gut occurs when the small intestine is too damaged to properly protect the gut, allowing food particles, bacteria, and toxins to enter the bloodstream. This occurrence will trigger an immune response and inflammation. Due to the presence of phenols/salicylates in large numbers of plants, people with leaky gut will have higher than normal levels of these substances in their bodies, leading to sensitivities.

In addition to being present naturally in plants, phenols/salicylates are present in many additives and preservatives. They may actually be present in many foods without any requirement for listing them on product content labels. For example, the lining of many cereal products is sprayed with phenol-containing substances. They do not have to list this because it is not directly a part of the food.
These substances are also found in non-food products like toothpaste, hair dyes, and medications.

In order for the body to metabolize phenols/salicylates, an enzyme called phenol sulfotransferase (PST) is needed. This PST pathway is necessary to detox the body of phenols. It converts Sulphur to sulfates that then will attach to toxins to enable them to be expelled from the body. If sulfates are not produced, a buildup of toxins will occur. This leads to more salicylate sensitivity.

In this case, the hormone adrenaline, or epinephrine, won’t be metabolized. This puts more strain on the body and can lead to adrenal fatigue. The same difficulty will be seen with neurotransmitters that can build up in the brain and lead to depression, as well as other mental problems.

The best way to remedy any problems that may arise with sensitivities to phenols/salicylates is through the NeuroEndoMetabolic approach to stress responses. The inflammation and detoxification circuits will be most affected by these sensitivities. With the emphasis of this viewpoint on organ systems interacting, what affects one will affect others, as well. This gives healthcare professionals an approach that targets the root causes of illness conditions.

Remediation Options for Salicylate Sensitivity

Making significant changes in your diet is the best way to deal with this kind of sensitivity. With the pervasive nature of salicylates, you will have to try several dietary changes until you find a diet that doesn’t bring on symptoms.

A first step could be to eliminate sugars, dairy products, and gluten to see how you feel. Cutting out these common triggers for food sensitivities for 30 days will give you a good idea if you’re on the right track.

Some people even respond with symptoms to healthy foods like nuts, seafood, and eggs. You may want to try food allergy testing if you have sensitivities to these foods. Especially if you have gut-related symptoms, “brain fog”, skin problems, or headaches. All of these symptoms can be caused by food allergies.

Histamines are often the cause of inflammation that results from sensitivities to salicylates. Some people are intolerant to histamines. Diets like Paleo diets contain foods high in histamines. These may not be tolerated well by people who are sensitive to salicylates because of the propensity of the release of histamines that cause inflammation. If you have high histamine, you may experience fatigue, anxiety, and mental fatigue.

Salicylate sensitivity and your healthcare practitionerYou should consult with your healthcare practitioner before putting yourself on a diet low in histamines or salicylates. An anti-histamine diet may be helpful, but it often has to be adjusted to fit the individual. You should always consult this professional before deciding you have this kind of sensitivity. Never make this decision by yourself.

As mentioned before, if you attempt this elimination diet, you should keep it up for at least 30 days. Then see how you feel. Once the salicylates are out of your body, you should feel a difference. However, just as everyone has a different constellation of symptoms with this sensitivity, everyone responds in a different amount of time to getting these foods out of their system.

When the salicylates are out of your system and you’re feeling better, begin re-introducing foods with salicylates to your diet one at a time. Start with those low in salicylates, move to those that have moderate amounts, and then on to ones with higher amounts. Monitor yourself closely.

If symptoms return, go back to a diet with no salicylates and give your body time to heal. Keep a record of the foods you re-introduce. This way, you begin to build a diet you can tolerate well and an amount of those foods you can handle.

You must be careful when re-introducing foods with salicylates. Do this slowly and in smaller amounts. If you don’t, you can trigger a cascade of symptoms that may become severe. There is a possibility of an anaphylactic response, as is seen in other severe allergic reactions. This can lead to anaphylactic shock and even death.

Some research with capsaicin strongly suggests this substance can be effective in dealing with salicylate sensitivity. Capsaicin is the ingredient in chili peppers that give them their characteristic hot flavor. It and salicylates compete with each other for access to the nervous system receptor called TRPV1.

The ingestion of capsaicin shortly before eating salicylates reduces the bioavailability of salicylates in the blood stream. Continuing to ingest capsaicin leads to a further reduction of the levels of salicylates. The effects of capsaicin appear to last only two to three hours and must be eaten just prior to eating foods with salicylates.

In addition to avoiding foods containing salicylates, it’s also important to avoid products such as cosmetics and other products with fragrances if you’re sensitive to salicylates. This can prove very difficult because many of the products used daily contain salicylates.

Associated Sensitivities

An associated problem is the development of Multiple Chemical Sensitivities (MCS). Many people with salicylate sensitivity also develop MCS due to the prevalence of salicylates in the environment. MCS is sensitivity to non-food chemicals. These reactions can be very severe. The person doesn’t have to come in physical contact with these chemicals for a response to be triggered. Paints, perfumes, carpets, plastics, and cleaning products are some of the things that can trigger responses in people with MCS.

For people with salicylate sensitivity who develop MCS, the potential problems multiply. It is best for you to avoid products and foods with salicylates, fragrances, or chemicals so you can avoid reactions.

People with sensitivities to salicylates often also are intolerant of amines. The symptoms of amine intolerance are very similar to those in salicylate intolerance. This can make the two sensitivities difficult to differentiate. These amines occur during protein breakdown and the fermentation of some foods and drinks. Amines are present in fermented products like alcohol and some cheeses.

Salicylate sensitivity and overcooked foodsOvercooked meats or meats that aren’t fresh also are high in amines. Remediating this sensitivity requires you to eliminate these kinds of foods from your diet. About 70 percent of the foods containing salicylates also contain amines.

Around 40 percent of children’s behavior problems may be due to amine sensitivity. A higher percentage of these problems have been associated with salicylate sensitivity. With salicylates, these behavior problems appear to be more silliness and hyperactivity; with amines, the behavior turns aggressive. Some clinicians have seen many children asked to leave daycare centers due to aggressiveness to be sensitive to amines.

The kind and severity of symptoms experienced with amine sensitivity depend on how much is consumed. These symptoms typically appear when the enzymes responsible for breaking down histamines are either saturated or used up completely.

As with salicylate sensitivity, removing foods containing amines is the best way to avoid this sensitivity and the symptoms that accompany it. Also just as with salicylates, any dietary attempt at remediation of amine sensitivity should be carried out under the guidance of a healthcare professional. The reason for this is the wide range of foods containing amines and the variability of tolerance levels among individuals.

Foods that can contain amines include citrus foods, papaya, strawberries, pineapples, some nuts, tomatoes, spinach, and chocolate. Animal sources include fish, crustaceans, pork, and egg whites. Other sources include additives, licorice, herbs, and spices.

Some possible ways to reduce or even eliminate some of the symptoms of a reaction to amine sensitivity include mast cell stabilizers, such as cromoglycate or ketotifen, may bring longer-term symptom relief and could allow a less restrictive diet. Antihistamines may bring immediate relief of symptoms.

Vitamin C and salicylate sensitivityThe use of vitamin B6 and vitamin C in large doses may help with symptoms of amine sensitivity, also. Some spices, such as curcumin and garlic, reduce the formation of biogenic amines in food.

Always consult with your healthcare provider before taking supplements. Large doses of vitamin B6 has been shown to cause some neurological disorders. If you’re pregnant or breastfeeding, be sure to talk with your doctor before taking B6. You may experience sleepiness, upset stomach, and sensitivity to sunlight with this supplement.

Vitamin C should not be taken without care. Consult with your physician before taking this supplement if you’re pregnant or breastfeeding. You may experience headaches, flushing or redness of the skin, nausea, vomiting, and upset stomach.

Read Part 1

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


Salicylate sensitivity