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.
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. 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.
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. I thought 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.
It was then that a dietitian friend introduced me to the concept of a low histamine diet. Dr. Janice Joneja, who is ALSO a 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. 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.
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 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!)
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. 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.
The 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)
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.