Wondering what exactly sulphite (or sulfite) intolerance is? Hear from a registered dietitian about common symptoms, sulfites in wine, foods to avoid, and much more.
As I’m sure you’ve noticed – in quite a few of my posts I have hinted to my avoidance on sulphites. Well, cats outta the bag – I’m sulphite intolerant. (well if you want to get technical – sulphite sensitive – but let’s use the language everyone uses, for simplicity sake). What the WHAT?! Some people also refer to this as a sulphite allergy, but technically sulphites don’t cause a true allergic reaction, but rather allergy-like symptoms.
Is sulfite different than sulfa?
As a registered dietitian – even being specialized in food sensitivities, if someone told me they didn’t eat sulphites 5 years ago, I would have been like “oh you’re allergic to sulpha drugs? Common allergy. No biggie. Don’t take the antibiotics that contain them and you’re GOLDEN!”.
Well. I did NOT know what I was talking about. sulphites ≠ sulpha.
Understanding food sensitivities is complicated and nuanced. That’s why I love sharing my story and how it helped me to learn SO MUCH about how to manage sulphite sensitivity as a registered dietitian – both for myself and for patients who also deal with this condition!
Table of Contents
- My Story of Sulphite Sensitivity
- What are Sulphites?
- Symptoms of a Sulphite Sensitivity (Intolerance)
- Risk factors of Sulphite Sensitivity
- Sulphite-Containing Foods
- Label Reading Tips to Identify Sulphites
- Ignite’s Online Sulphite Workshop for Patients
- Sulphite Sensitivity Training for Dietitians and Health Professionals
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 I’d 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 weren’t my thing.
Symptoms of Sulphite Sensitivity
One day after a bag of dried fruit and nuts, I was rounding with my team. I was dizzy. My lungs were constricted. I felt a fogginess in my brain. It felt like my blood vessels were going to burst out of my eyes. I was SO vasodilated – the veins in my arms and hands were like Arnold Schwarzenegger in his prime. I told the team I felt like crap. Concerned as they were- they took my blood pressure. 142/90-something. Hypertensive. What was going on?!
Days and weeks went on – I felt like crap. I was constantly dizzy, foggy after eating, burdened with uncontrollable heart burn. It felt like my childhood athsma had taken a resurgence – I was using my rescue inhalers more and more, and still having troubles breathing.
I went to the doctors. Wanting to replicate the effects of what was going on, I went about my usual day. My dried fruit & nuts? check. I mentioned my symptoms – Dizziness. Fogginess. Difficulties breathing. Upper right quadrant pain in my gut. I worked in oncology though, and that’s how neuroendocrine tumors often presented. Did I have a neuroendocrine tumor? Is THAT why I was so sensitive, all of a sudden? My mind asked these questions, in this frenzy. The doc took my blood pressure. 160/low 100’s. Compared to my usual 120 over 80 – this was extremely high. He sent me on my way with two large jugs to collect my urine. Of course, it was negative for a neuroendocrine tumor -but they didn’t really have an answer for why I felt so unwell.
The Low Histamine Diet
It was then that a registered dietitian friend introduced me to the concept of a low histamine diet. Dr. Janice Joneja, who is ALSO a registered dietitian has done a LOT of fantastic research in this area. I consumed it all. Why had I not learned about this before? Yes, I had learned about allergies. Unusual intolerances & sensitivities? Not so much. I did my research. Then I went on a low histamine diet. I felt good. But it was hard – oh so hard (and later, I found out, unnecessarily restrictive!). I started gradually re-introducing foods. And each time I would expose myself to sulphites, or sulphite-containing foods, I would feel unwell. All symptoms described above.
Can an allergist help with sulphite intolerances?
I requested a referral to an allergist – maybe they had fantastic insight on how to manage a sulphite intolerance.
The allergist, verbatim, told me that I would “know more about avoiding sulphites than (he) did” and sent me on my way.
I don’t think I had ever been so frustrated. If I struggled as a registered dietitian and health professional to understand what was going on, how was the rest of the public coping?
What are Sulphites?
Sulphites are an inorganic salt, and are used in the preservation of food, cosmetics, and pharmaceuticals. They prevent oxidation and browning. All fine and dandy, everyone likes well-kept food, food that isn’t infested with bugs and germs, unless of course, you have a horrible reaction to that preserving agent.
As a general rule, sulphites are safe for the majority of the population. Unfortunately, there are some individuals whose body can’t hack sulphite exposure. Mechanism – unknown – although, it DOES appear to involve the immune system, which is why it’s technically classified as a SENSITIVITY, and not an intolerance (though for some, it might be an intolerance too!)
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.
Symptoms of a Sulphite Sensitivity (Intolerance)
- chest congestion
- asthmatic reaction/bronchospasm
- nausea, vomiting, abdominal pain, diarrhea
- flushing, urticaria, hives, dermatitis or eczema
- A drop in blood pressure (oddly – mine goes up)
- anaphylaxis (people have died of sulphite exposure – usually secondary to asthma)
Risk Factors of a Sulphite Sensitivity
We are still trying to understand the cause of a sulphite sensitivity. It appears about 0.5-1% of the population is sulphite sensitive. If you have asthma, you appear to be more likely to suffer from a sulphite sensitivity – with about 5-10% of asthmatics being sulphite sensitive.
Unfortunately, the labelling of sulphites can be confusing – and the risk of accidental sulphite exposure leaves us on edge! LUCKILY Canada has made sulphites one of its priority allergens. Legally, added sulphites above 10 ppm must be labelled, even if it’s a secondary (or further down the list!) ingredient. So trust that in Canada, the US, Europe, and Australia – sulphites are properly labelled. (your dietitian may provide you specific advice around this due to labelling issues that currently exist – but for the most part – our labelling laws are great.)
Some common sulphite-containing foods include:
- beer, wine, champagne
- Condiments like squeezable lime and lemon juice, vinegar, pickles/pickled foods, soya sauce, curry pastes
- dried fruit & coconut (if its brightly coloured its likely sulphite containing)
- Potato flakes, pre-made pastries, buns, bread, biscuits, pizza dough
- some canned tomato products, especially sun-dried tomato products
- Pre-sliced fruit, potatoes, etc. (Think: those little packs of sliced apples that don’t brown)
Read Ingredient Labels – common forms of sulphites listed on ingredient labels include:
- Sodium Sulphite
- Potassium Sulphite
- Sulphurous Acid
- Sulphur Dioxide
- Sodium Metabisulphite
- Potassium Metabisulphite
- Sodium Bisulphite
- Potassium Bisulphite
- Sodium Dithionate
Pro tip: Don’t forget to check the contains and may contain statements, too!
If you Google ‘foods with sulphites’, you are guaranteed to see tons of lists that might scare you out of wanting to eat ANYTHING. These lists are often quite outdated and inaccurate and ultimately overcomplicate things for sulphite sensitive people. The trick is to focus on label reading and ignore all the other claims about sulphite-containing foods. If the ingredient list has sulphites (or any of the other ingredients listed above) on the label, eliminate it. Sulphites MUST be disclosed on the label if they are present in over 10 ppm.
‘Living with a Sulphite Sensitivity’ Online Workshop
So. This is my low-down in sulphites. I’ve done lit-reviews, I’ve studied the evidence, and I’ve learnt a lot of things. Trial and error through personal experience. I’ve 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!
- Do you have a sulphite sensitivity or intolerance?
- Struggling with figuring out what you need to avoid, and what you can safely eat?
- Or maybe you’re stuck in a really restrictive diet because of your sulphite intolerance?
If you answered yes to any of these – this course is for you.
This sulphite sensitivity course contains:
- a 1-hour online workshop teaching you about sulphites
- how to identify sulphites in foods
- CFIA, FDA and EU labelling laws – reviewed in detail
- understanding undeclared sulphites
- drugs with sulphites added & what to ask your doctor or pharmacist to keep you safe
- a 7 day sulphite free menu plan
- a 7 page resource with everything YOU need to know to avoid sulphites successfully
- a list of safe, caution and avoid foods
- a swap this for that list of the most commonly sulphited foods – so you don’t feel like you’re missing out on anything
- a list of most commonly asked questions about sulphites
- email access to Andrea Hardy, RD if needed, about sulphites (*not individual care – answering course content questions)
In the course we review everything YOU need to know to live sulphite free and manage your symptoms!
Sulphite Sensitivity Training for Dietitians and Health Professionals
This blog post is most frequently visited by my RD colleagues and doctors – I get a TON of emails from my colleagues asking for help in this area. You can access the course content on sulphite sensitivity here – keep in mind this is for medical professionals and is HIGHLY technical.
Looking for one-on-one counselling?
If you’re a patient looking for one-on-one counselling I recommend working with one of our Ignite dietitians trained in immune-mediated food sensitivities!
FAQ About Sulphite Allergy / Intolerance
Sulphites are an inorganic salt, and are used in the preservation of food, cosmetics, and pharmaceuticals. As a general rule, sulphites are safe for the majority of the population. However, there are some people who react poorly when exposed to sulphites. Find out why.
Sulphite content will vary depending on product and brand, but some common sulphite-containing foods include: beer, wine, champagne, condiments, dried fruit, and shellfish. See the full list of commonly sulphited foods here.
Symptoms of sulphite sensitivity include asthmatic reactions, chest congestion, dizziness, headaches, nausea, and diarrhea. Click here for the full list of possible symptoms.
Most wine does contain sulphites. USDA organic wine cannot contain added sulphites, however, may contain naturally occurring sulphites up to 100 ppm. While this is less than many other wines, it could still lead to symptoms in someone who has a sulphite sensitivity.
Some soy sauce does contain sulphites. It is best to read the label to compare products to find soy sauce without sulphites. Sulphites must be listed in the ingredients if there is greater than 10 ppm of sulphites per serving.
A sulphite-free diet is a diet where all foods with sulphites (or sulfites) added to the ingredient list are avoided. This diet is usually implemented when a person has allergy-like symptoms when consuming foods that have sulphites in them. Learn more with this sulphite-free diet course.
I shared this with a friend who suffers from sulphite intolerance. It’s hard to imagine life without wine!
I got hives from a sulpha antibiotic and I had a white coating on my tongue that became very rancid and was hard to get rid of. I have been experimenting with food elimination for 8-10 years. With a lot of research and trial and error, I have come to realize I do have an intolerance or reaction to sulfites. I ruled out candida with strict diets, medicines and every probiotic I could find.The most obvious offenders from my reactions are frozen fish/ seafood, nuts, dried or frozen potatoe products, blue cheese, processed meats, beer (worse than wine), canned or bottled juices, jams and jellies, and dried fruit, and nut milks. I can have fresh seafood with no problem, or potatoe from fresh and of course fresher squeezed juice with no problems. I need to avoid processed and from frozen because unfortunately they don’t even have to label the use of sulfites in frozen French fries for instance.
I get headaches and vomiting from MSG as well. I’ve avoided that for 25 years. Not sure if that is related. And I do find that taking betaine helps keep the tongue symptoms under control. Good news is most of the sulphites in wines are naturally occurring from the grapes and I really don’t react often to wines. It seems to be added sulphites. I love eating in Europe where the food is real and I don’t have to worry about hidden ingredients. Food labelling laws need to be more strict in North America.
If I accidentally eat sulphites, I’ll usually wake up the next morning with those “boiled egg) sulfur burps & extremely nauseous. I don’t feel better until I vomit (my worst phobia). It’s like it’s poison & my body has to get rid of it. This just happened to me suddenly. Foods I used to enjoy are now making me sick. My general practitioner didn’t even know what to tell me. This is new to me so I hope I can find a dietitian that can help me!
I’m sorry you’re going through that – I would definitely chat with a GI dietitian to see how nutrition changes might help and to get some guidance as to what is going on!
Quite helpful, I’m definitely not crazy!!
Definitely not! Sulphite intolerance is real, and unfortunately since its a diagnosis of exclusion, its under-diagnosed!
Hello. I know this post is from 2015 but it rings close to home for me. If you are still working with people who may be sulpha/sulphite sensitive, please let me know. I have a history of both and of late, have incredible gastro issues when I eat certain foods and I suspect now they may have the preservative sulphite in them. I would love to hear from you as I am kind of at wits end trying to get a resolution to my issue. Thanks! Gretchen Winter
Hi Gretchen! Our team can absolutely help, we see patients across most of Canada! You can either book online through the website here or call our office for more details at 403-808-2348. -Andrea
Hi Andrea, I am a Registered Dietitian in Ontario. Thank you for this information! Quick question:
Do you avoid food with naturally occurring sulphites?
Hello! No we do not, it isn’t believed to be an issue. When patients start to pinpoint foods I often find other food chemicals are playing a role in their symptoms (usually I see the biggest overlap with histamine!) I hope that helps!
Are German beers safer for sulfite sensitivity? I heard their beer purity laws do not allow added sulfites.
I am not familiar with German beer labelling laws actually!
I have allergy-induced asthma (and likely have asthma but I throw up when they try to test me). When I was 16, I learned that I had a mold (mould) allergy and, since then, have assumed that I was allergic to all fermented foods as I could not eat aged cheeses, cottage cheese, cider, horseradish, sauerkraut, wine vinegar, tomato paste, and so on… I also could not eat deli meats, sausages, soups, sauces, dressings, and some gravies without getting sick. As a youth, the smell of wine or beer would give me an instant headache, so I avoided it like the plague. As a teenager, I accidentally ate a single bite of meat that had previously been marinated in wine. (The person who cooked it had forgotten there was wine in the marinade because I always asked specifically about the ingredients used.) I was told that I turned green at the dinner table and I experienced intense stomach pain for hours afterwards. I visited a dietician today who suggested that I might actually have a sulphite sensitivity which I had never heard of before. I am in my 50s and have lived on a very restrictive diet without knowing the true cause of my symptoms and generally guessing what I could and could not eat. Sometimes I have had a respiratory reaction to seeds (sesame seeds), other times, I have not. I have also believed that I have a strong allergy to pepper and spices, but I have never been tested. I have had severe headaches after eating a bite of something with pepper on it, or with rosemary used as a seasoning. It looks like I can be tested for an allergy to black pepper, but I’m not sure about the rosemary. I have generally avoided sauces and seasonings my whole life. I feel validated that this may actually be a true sensitivity or allergy, and that I am not the only person who experiences such reactions!
I’m so glad you feel validated with this post! Some food reactions are non-IgE mediated (non anaphylactic) like sulphites and histamines – I hope you’re able to rule out IgE mediated allergies to those foods and then go from there! <3