Adverse Reactions to Food Additives and Preservatives

Table of ContentsView AllTable of ContentsFood AdditivesPossible ReactionsDiagnosisProblem AdditivesTreatmentFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Food Additives

Possible Reactions

Diagnosis

Problem Additives

Treatment

Frequently Asked Questions

Thousands of substances are added to various foods for the purposes of coloring, flavoring, and preserving them. Additives are usually only a very small component of foods, but a small number of them have been suspected of causing various adverse reactions.

The U.S. Food and Drug Administration (FDA) keeps a list of all of the food additives currently used in the United States. Food additives can be categorized into a handful of groups:

Many types of adverse reactions can occur as a result of food additives. Some of them appear to stem fromallergieswhile many others appear to be anintoleranceorsensitivity. Reports of reactions to food additives are mainly to do with skin, digestion, and breathing.

You may suspect a food-additive reaction if you experience symptoms withprocessed foodsand/or restaurant-prepared meals but do not experience them with similar foods prepared from scratch. Various seemingly unrelated foods might, in fact, have common ingredients, such as colorings or preservatives.

Once a food or food additive is suspected, allergy testing (using skin testing orRAST) may be possible for certain natural substances such as annatto, carmine, and saffron.

Many food additives are synthetic, and testing for such substances is not possible or reliable. You may want to try a preservative-free diet to see if it resolves your symptoms.

In many instances, the only way to truly diagnose an adverse reaction to food additives is to undergo an oral challenge, which involves eating increasing amounts of the suspected problem food while under the close supervision of an allergist.

Problematic Food Additives

Nine particular food additives are the most common causes of allergic or adverse reactions.

Tartrazine

Also known as FD&C Yellow No. 5, tartrazine has been suspected as the cause of many reactions, including hives, asthma, and other illness.

Recent studies have disproven the thought that aspirin-allergic asthmatics were especially sensitive to tartrazine. Other studies suggest a role of tartrazine as worsening atopic dermatitis.

The FDA says tartrazine can cause hives in approximately one in 10,000 people or fewer.

Potential Risks of Yellow 5 (Tartrazine)

Carmine

Carmine is a red food coloring made from a dried insect calledDactylopius coccus Costawhich can be found on a particular type of cactus plant. This coloring is also found in various cosmetics, drinks, red yogurt, and popsicles.

Reactions to carmine include anaphylaxis and occupational asthma and are probably due to allergic antibodies.

Can Red Dye Cause Allergies or Behavior Problems?

Annatto

Annatto is a yellow food coloring made from the seeds of a South American tree,Bixa orellana.

This additive has been found to cause allergic reactions, including anaphylaxis, hives, andangioedema.

The Connection Between Annatto and Nut Allergies

Antioxidants

Antioxidantssuch as BHA (butylated hydroxyanisole) and BHT (butylated hydroxytoluene) are added to prevent the spoilage of fats and oils.

Both BHA and BHT are suspected of causing hives and angioedema.

Emulsifiers and Stabilizers

Emulsifiers:Lecithin is an emulsifier made from soybeans or eggs and may contain soybean proteins. Reactions to soy lecithin are rare, even in soy-allergic people, since the level of this additive is usually very low in most foods.

Gums:Various gums are used as food additives and function as emulsifiers and stabilizers. Major gums include guar, tragacanth, xanthan,carrageenan, acacia (Arabic), and locust bean.

Many gums are known to worsen asthma, particularly in the occupational setting, when airborne. Others are known to cause allergic reactions when present in foods. Guar gum can cause severe anaphylaxis.

Monosodium Glutamate

Monosodium glutamate (MSG)is a flavor enhancer added to various foods, and it also occurs naturally. Reactions to MSG have been called the “Chinese Restaurant Syndrome,” and symptoms include:

MSG is also suspected of worsening asthma symptoms.

What Is MSG Symptom Complex?

Spices

Spices are the aromatic part of various weeds, flowers, roots, barks, and trees. Because they are derived from plants, spices have the ability to cause allergic reactions, just like pollens, fruits, and vegetables.

The most common spices used include:

According to a study published in theAnnals of Allergy, Asthma, and Immunology,spice allergiesare underdiagnosed.

How to Know if You Have a Spice Allergy

Aspartame

Aspartame is a sweetener used in many sugar-free foods and drinks. This food additive has been suspected of causing such symptoms as:

Sulfites

Sulfites or sulfate agents (in the forms of sodium sulfite, sodium bisulfite, sodium metabisulfite, potassium bisulfite, and potassium metabisulfite) are common preservatives used in various foods and medications.

Sulfites may increase asthma symptoms in between 3% and 10% of adult asthmatics, particularly those with severe disease. Sulfites can also cause anaphylaxis in a small number of people.

Sulfites cause little to no problems in most people without allergies andasthma, even when large amounts are consumed.

Sulfite Allergy and Foods You Need to Avoid

Many reactions to food additives are mild and resolve without treatment. More severe reactions—including urticaria,angioedema, worsening asthma, and anaphylaxis—may require immediate medical attention.

The main treatment for people with adverse reactions to food additives is prevention, which means avoiding the culprit additive.

Frequently Asked QuestionsBHA and BHT are antioxidants that help preserve the fat content in food. They are often found in processed foods. When food is exposed to oxygen, a reaction between the two slowly causes the food to go bad, but antioxidants delay this effect. Limited amounts of BHA and BHT are considered safe, but some studies show that ingesting excessive amounts of BHT can lead to irritation of the skin, eyes, and breathing.The symptoms of an aspartame allergy includecontact dermatitis(skin irritation), mood disorder, stress, and depression. However, studies suggest that these symptoms usually only occur when ingesting large amounts of aspartame for an extended period of time. Research is still being done on the effects of aspartame.Food additives like MSG can cause diarrhea in some people. Those with a food intolerance to MSG can experience this effect a few hours after eating. Other symptoms of the intolerance can include stomach pain, bloating, gassiness, skin rash, and itchiness.Yes, it is possible to have a guar gum allergy. This additive has been associated with worsened asthma in some people. There is one report of guar gum causinganaphylaxis, an extremely serious allergic reaction.Food allergies make up a majority of potential triggers for anaphylaxis.

BHA and BHT are antioxidants that help preserve the fat content in food. They are often found in processed foods. When food is exposed to oxygen, a reaction between the two slowly causes the food to go bad, but antioxidants delay this effect. Limited amounts of BHA and BHT are considered safe, but some studies show that ingesting excessive amounts of BHT can lead to irritation of the skin, eyes, and breathing.

The symptoms of an aspartame allergy includecontact dermatitis(skin irritation), mood disorder, stress, and depression. However, studies suggest that these symptoms usually only occur when ingesting large amounts of aspartame for an extended period of time. Research is still being done on the effects of aspartame.

Food additives like MSG can cause diarrhea in some people. Those with a food intolerance to MSG can experience this effect a few hours after eating. Other symptoms of the intolerance can include stomach pain, bloating, gassiness, skin rash, and itchiness.

Yes, it is possible to have a guar gum allergy. This additive has been associated with worsened asthma in some people. There is one report of guar gum causinganaphylaxis, an extremely serious allergic reaction.Food allergies make up a majority of potential triggers for anaphylaxis.

18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Food & Drug Administration.Food additives & petitions.Singh RL, Mondal S, eds.Food Safety and Human Health. Academic Press, an imprint of Elsevier; 2019.Food Allergy Research & Education.Blood tests.Asthma and Allergy Foundation of America, New England Chapter.Adverse reactions to food additives.Smolinske, SC.CRC Handbook of Food, Drug, and Cosmetic Excipients. CRC Press. doi:10.1201/9781315140513Michigan News. University of Michigan.Food dye can cause severe allergic reactions.Myles IA, Beakes D. AnAllergy to goldfish? Highlighting the labeling laws for food additives.World Allergy Organ J. 2009;2(12):314-316. doi:10.1097/WOX.0b013e3181c5be33Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Soybeans and soy lecithin.Saha D, Bhattacharya S.Hydrocolloids as thickening and gelling agents in food: A critical review.J Food Sci Technol. 2010;47(6):587-97. doi:10.1007/s13197-010-0162-6Adkinson NF, Middleton E, eds.Middleton’s Allergy: Principles and Practice. 8th edition. Elsevier/Saunders; 2014.Metcalfe DD, Sampson HA, Simon RA, Lack G, eds.Food Allergy: Adverse Reactions to Foods and Food Additives. 1st ed. Wiley; 2013.Institute of Agriculture and Natural Resources.Spices and herbs.Chen JL, Bahna SL.Spice allergy.Ann Allergy Asthma Immunol. 2011;107(3):191-265. doi:10.1016/j.anai.2011.06.020Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Sulfites - USA.National Center for Biotechnology Information. PubChem.Annotation Record for , 2,6-DI-T-BUTYL-P-CRESOL, Source: Hazardous Substances Data Bank (HSDB).Czarnecka K, Pilarz A, Rogut A, et al.Aspartame—true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021;13(6):1957. doi:10.3390/nu13061957National Health Service.Food intolerance.Skypala IJ.Food-induced anaphylaxis: Role of hidden allergens and cofactors.Front Immunol. 2019;10:673. doi:10.3389/fimmu.2019.00673Additional ReadingSimon RA.Allergic and asthmatic reactions to food additives. UpToDate.Vally H, Misso NL.Adverse reactions to the sulphite additives.Gastroenterology and Hepatology From Bed to Bench. 2012;5(1):16-23.

18 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Food & Drug Administration.Food additives & petitions.Singh RL, Mondal S, eds.Food Safety and Human Health. Academic Press, an imprint of Elsevier; 2019.Food Allergy Research & Education.Blood tests.Asthma and Allergy Foundation of America, New England Chapter.Adverse reactions to food additives.Smolinske, SC.CRC Handbook of Food, Drug, and Cosmetic Excipients. CRC Press. doi:10.1201/9781315140513Michigan News. University of Michigan.Food dye can cause severe allergic reactions.Myles IA, Beakes D. AnAllergy to goldfish? Highlighting the labeling laws for food additives.World Allergy Organ J. 2009;2(12):314-316. doi:10.1097/WOX.0b013e3181c5be33Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Soybeans and soy lecithin.Saha D, Bhattacharya S.Hydrocolloids as thickening and gelling agents in food: A critical review.J Food Sci Technol. 2010;47(6):587-97. doi:10.1007/s13197-010-0162-6Adkinson NF, Middleton E, eds.Middleton’s Allergy: Principles and Practice. 8th edition. Elsevier/Saunders; 2014.Metcalfe DD, Sampson HA, Simon RA, Lack G, eds.Food Allergy: Adverse Reactions to Foods and Food Additives. 1st ed. Wiley; 2013.Institute of Agriculture and Natural Resources.Spices and herbs.Chen JL, Bahna SL.Spice allergy.Ann Allergy Asthma Immunol. 2011;107(3):191-265. doi:10.1016/j.anai.2011.06.020Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Sulfites - USA.National Center for Biotechnology Information. PubChem.Annotation Record for , 2,6-DI-T-BUTYL-P-CRESOL, Source: Hazardous Substances Data Bank (HSDB).Czarnecka K, Pilarz A, Rogut A, et al.Aspartame—true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021;13(6):1957. doi:10.3390/nu13061957National Health Service.Food intolerance.Skypala IJ.Food-induced anaphylaxis: Role of hidden allergens and cofactors.Front Immunol. 2019;10:673. doi:10.3389/fimmu.2019.00673Additional ReadingSimon RA.Allergic and asthmatic reactions to food additives. UpToDate.Vally H, Misso NL.Adverse reactions to the sulphite additives.Gastroenterology and Hepatology From Bed to Bench. 2012;5(1):16-23.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

U.S. Food & Drug Administration.Food additives & petitions.Singh RL, Mondal S, eds.Food Safety and Human Health. Academic Press, an imprint of Elsevier; 2019.Food Allergy Research & Education.Blood tests.Asthma and Allergy Foundation of America, New England Chapter.Adverse reactions to food additives.Smolinske, SC.CRC Handbook of Food, Drug, and Cosmetic Excipients. CRC Press. doi:10.1201/9781315140513Michigan News. University of Michigan.Food dye can cause severe allergic reactions.Myles IA, Beakes D. AnAllergy to goldfish? Highlighting the labeling laws for food additives.World Allergy Organ J. 2009;2(12):314-316. doi:10.1097/WOX.0b013e3181c5be33Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Soybeans and soy lecithin.Saha D, Bhattacharya S.Hydrocolloids as thickening and gelling agents in food: A critical review.J Food Sci Technol. 2010;47(6):587-97. doi:10.1007/s13197-010-0162-6Adkinson NF, Middleton E, eds.Middleton’s Allergy: Principles and Practice. 8th edition. Elsevier/Saunders; 2014.Metcalfe DD, Sampson HA, Simon RA, Lack G, eds.Food Allergy: Adverse Reactions to Foods and Food Additives. 1st ed. Wiley; 2013.Institute of Agriculture and Natural Resources.Spices and herbs.Chen JL, Bahna SL.Spice allergy.Ann Allergy Asthma Immunol. 2011;107(3):191-265. doi:10.1016/j.anai.2011.06.020Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Sulfites - USA.National Center for Biotechnology Information. PubChem.Annotation Record for , 2,6-DI-T-BUTYL-P-CRESOL, Source: Hazardous Substances Data Bank (HSDB).Czarnecka K, Pilarz A, Rogut A, et al.Aspartame—true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021;13(6):1957. doi:10.3390/nu13061957National Health Service.Food intolerance.Skypala IJ.Food-induced anaphylaxis: Role of hidden allergens and cofactors.Front Immunol. 2019;10:673. doi:10.3389/fimmu.2019.00673

U.S. Food & Drug Administration.Food additives & petitions.

Singh RL, Mondal S, eds.Food Safety and Human Health. Academic Press, an imprint of Elsevier; 2019.

Food Allergy Research & Education.Blood tests.

Asthma and Allergy Foundation of America, New England Chapter.Adverse reactions to food additives.

Smolinske, SC.CRC Handbook of Food, Drug, and Cosmetic Excipients. CRC Press. doi:10.1201/9781315140513

Michigan News. University of Michigan.Food dye can cause severe allergic reactions.

Myles IA, Beakes D. AnAllergy to goldfish? Highlighting the labeling laws for food additives.World Allergy Organ J. 2009;2(12):314-316. doi:10.1097/WOX.0b013e3181c5be33

Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Soybeans and soy lecithin.

Saha D, Bhattacharya S.Hydrocolloids as thickening and gelling agents in food: A critical review.J Food Sci Technol. 2010;47(6):587-97. doi:10.1007/s13197-010-0162-6

Adkinson NF, Middleton E, eds.Middleton’s Allergy: Principles and Practice. 8th edition. Elsevier/Saunders; 2014.

Metcalfe DD, Sampson HA, Simon RA, Lack G, eds.Food Allergy: Adverse Reactions to Foods and Food Additives. 1st ed. Wiley; 2013.

Institute of Agriculture and Natural Resources.Spices and herbs.

Chen JL, Bahna SL.Spice allergy.Ann Allergy Asthma Immunol. 2011;107(3):191-265. doi:10.1016/j.anai.2011.06.020

Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program.Sulfites - USA.

National Center for Biotechnology Information. PubChem.Annotation Record for , 2,6-DI-T-BUTYL-P-CRESOL, Source: Hazardous Substances Data Bank (HSDB).

Czarnecka K, Pilarz A, Rogut A, et al.Aspartame—true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021;13(6):1957. doi:10.3390/nu13061957

National Health Service.Food intolerance.

Skypala IJ.Food-induced anaphylaxis: Role of hidden allergens and cofactors.Front Immunol. 2019;10:673. doi:10.3389/fimmu.2019.00673

Simon RA.Allergic and asthmatic reactions to food additives. UpToDate.Vally H, Misso NL.Adverse reactions to the sulphite additives.Gastroenterology and Hepatology From Bed to Bench. 2012;5(1):16-23.

Simon RA.Allergic and asthmatic reactions to food additives. UpToDate.

Vally H, Misso NL.Adverse reactions to the sulphite additives.Gastroenterology and Hepatology From Bed to Bench. 2012;5(1):16-23.

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