Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Causes
Symptoms
Diagnosis
Treatment
Sulfite sensitivity affects roughly 4% of the U.S. population and is especially common among people with asthma who may experience a worsening of symptoms.True sulfite allergies can be treated with over-the-counter antihistamines orepinephrinefor severe cases. The avoidance of sulfite-containing foods and drugs is also essential.
Is a Sulfite and Sulfa Allergy the Same?
What Causes a Sulfite Allergy?
A sulfite allergy, like all allergies, is the result of an abnormal immune response to an otherwise harmless substance (known as anallergen).
Sulfites are chemical compounds found naturally in certain foods but are also manufactured for commercial use as food preservatives or flavor enhancers. They are even sulfites used in injectable medications as a preservative.
An allergy to sulfites can happen to anyone but is most common in people withasthmaof whom 3% to 10% may be affected.
An increase in sulfite allergies led the U.S. Food and Drug Administration (FDA) to ban their use in fresh vegetables and fruits back in 1986. Today, food manufacturers must declare on product labels if their food contains more than 10 parts per million (ppm) of sulfites.
Food that contains over 100 PPM of sulfite include:
Food that contains 50 to 99 PPM of sulfite include:
Foods that contain 10 to 49 PPM of sulfite include:
Injectable medications that contain sulfite include:
There are several different sulfites used as food additives, including:Sodium sulfiteSodium bisulfiteSodium metabisulfitePotassium bisulfitePotassium metabisulfiteSulfur dioxideIf you have a sulfite allergy, check product labels to see if any of these are included.
There are several different sulfites used as food additives, including:
If you have a sulfite allergy, check product labels to see if any of these are included.
Sulfite Allergy Symptoms
With a sulfite allergy, the symptoms mainly involve the respiratory tract, causing asthma-like symptoms such as:
Food sensitivitieslike these are largely indistinguishable from a “true” food allergy.
With sulfite sensitivity, elevations of IgG may make you ill, but it will not cause anaphylaxis.
When to Call 911Anaphylaxis requires immediate emergency care. Symptoms tend to develop within 30 minutes of consuming sulfites. If not treated appropriately, anaphylaxis can lead toshock, coma, heart or respiratory failure, and death.
When to Call 911
Anaphylaxis requires immediate emergency care. Symptoms tend to develop within 30 minutes of consuming sulfites. If not treated appropriately, anaphylaxis can lead toshock, coma, heart or respiratory failure, and death.
How Is Sulfite Allergy Diagnosed?
If a sulfite allergy is suspected, yourallergistwill most likely perform anoral challenge. This involves drinking fluids with increasing amounts of sulfites as yourlung function, heart rate, and blood pressure are monitored. A significant drop in lung function confirms the diagnosis.
Oral challenges should only be performed under medical supervision so that emergency treatment can be prescribed if anaphylaxis occurs.
Treatment Options
If you are diagnosed with a sulfite allergy or sensitivity, the best treatment is to avoid foods and medications that contain sulfites. Reading product labels can help you steer clear of them.
If accidental exposure occurs, the treatment can vary based on how sensitive you are to sulfites. Some of the more common include:
Summary
Some people are allergic or sensitive to sulfites found in certain foods and medications. This can cause asthma-like symptoms and, on rare occasions, a potentially life-threatening allergy known as anaphylaxis.
If you are sensitive to sulfites, the most important thing to do is avoid foods and medications containing them. U.S. law requires food manufacturers to declare if sulfites are in their products.
If accidentally exposed to sulfites, treatment may include antihistamines, steroids, rescue inhalers, or epinephrine to relieve symptoms and avoid serious complications.
Adverse Reactions to Food Additives and Preservatives
10 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.Giles A, Foushee J, Lantz E, Gumina G.Sulfonamide allergies.Pharmacy (Basel). 2019;7(3):132. doi:10.3390/pharmacy7030132American Academy of Allergy, Asthma, and Immunology.Allergic reactions.U.S. Food and Drug Administration.Appendix: FDA guide to foods and drugs with sulfites.Lien KW, Hsieh DPH, Huang HY, Wu CH, Ni SP, Ling MP.Food safety risk assessment for estimating dietary intake of sulfites in the Taiwanese population.Toxicol Rep.2016;3:544–51. doi:10.1016/j.toxrep.2016.06.003U.S. Food and Drug Administration.CFR - Code of Federal Regulations Title 21.Silva D, Carolino F, Pereira AM, Santos N, Coimbra A, Placido JL.Sulfite hypersensitivity – retrospective study in a food allergy unit.Clin Transl Allergy.2015 Mar 30;5(Suppl 3):P65. doi:10.1186/2045-7022-5-S3-P65Witkowski M, Grajeta H, Gomulka K.Hypersensitivity reactions to food additives—preservatives, antioxidants, flavor anhancers.Int J Environ Res Public Health. 2022 Sep 13;19(18):11493. doi:10.3390/ijerph191811493Fischer D, Van der Leek TK, Ellis AK, Kim H.Anaphylaxis.Allergy Asthma Clin Immunol.2018;14(Suppl 2):54. doi:10.1186/s13223-018-0283-4Kow ASF, Chik A, See KM, Khoo LW, Abas F, Tham CL.Identification of soluble mediators in IgG-mediated anaphylaxis via Fcγ receptor: a meta-analysis.Front Immunol. 2019 Feb 12;10:190. doi:10.3389/fimmu.2019.00190Australasian Society of Immunologist and Allergists.Sulfite sensitivity.Additional ReadingSampson HA, Aceves S, Bock SA, et al.Food allergy: a practice parameter update-2014.J Allergy Clin Immunol. 2014;134(5):1016-25.e43. doi:10.1016/j.jaci.2014.05.013U.S. Food & Drug Administration.Guidance for industry: Food labeling guide. PDF available for download.
10 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.Giles A, Foushee J, Lantz E, Gumina G.Sulfonamide allergies.Pharmacy (Basel). 2019;7(3):132. doi:10.3390/pharmacy7030132American Academy of Allergy, Asthma, and Immunology.Allergic reactions.U.S. Food and Drug Administration.Appendix: FDA guide to foods and drugs with sulfites.Lien KW, Hsieh DPH, Huang HY, Wu CH, Ni SP, Ling MP.Food safety risk assessment for estimating dietary intake of sulfites in the Taiwanese population.Toxicol Rep.2016;3:544–51. doi:10.1016/j.toxrep.2016.06.003U.S. Food and Drug Administration.CFR - Code of Federal Regulations Title 21.Silva D, Carolino F, Pereira AM, Santos N, Coimbra A, Placido JL.Sulfite hypersensitivity – retrospective study in a food allergy unit.Clin Transl Allergy.2015 Mar 30;5(Suppl 3):P65. doi:10.1186/2045-7022-5-S3-P65Witkowski M, Grajeta H, Gomulka K.Hypersensitivity reactions to food additives—preservatives, antioxidants, flavor anhancers.Int J Environ Res Public Health. 2022 Sep 13;19(18):11493. doi:10.3390/ijerph191811493Fischer D, Van der Leek TK, Ellis AK, Kim H.Anaphylaxis.Allergy Asthma Clin Immunol.2018;14(Suppl 2):54. doi:10.1186/s13223-018-0283-4Kow ASF, Chik A, See KM, Khoo LW, Abas F, Tham CL.Identification of soluble mediators in IgG-mediated anaphylaxis via Fcγ receptor: a meta-analysis.Front Immunol. 2019 Feb 12;10:190. doi:10.3389/fimmu.2019.00190Australasian Society of Immunologist and Allergists.Sulfite sensitivity.Additional ReadingSampson HA, Aceves S, Bock SA, et al.Food allergy: a practice parameter update-2014.J Allergy Clin Immunol. 2014;134(5):1016-25.e43. doi:10.1016/j.jaci.2014.05.013U.S. Food & Drug Administration.Guidance for industry: Food labeling guide. PDF available for download.
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.
Giles A, Foushee J, Lantz E, Gumina G.Sulfonamide allergies.Pharmacy (Basel). 2019;7(3):132. doi:10.3390/pharmacy7030132American Academy of Allergy, Asthma, and Immunology.Allergic reactions.U.S. Food and Drug Administration.Appendix: FDA guide to foods and drugs with sulfites.Lien KW, Hsieh DPH, Huang HY, Wu CH, Ni SP, Ling MP.Food safety risk assessment for estimating dietary intake of sulfites in the Taiwanese population.Toxicol Rep.2016;3:544–51. doi:10.1016/j.toxrep.2016.06.003U.S. Food and Drug Administration.CFR - Code of Federal Regulations Title 21.Silva D, Carolino F, Pereira AM, Santos N, Coimbra A, Placido JL.Sulfite hypersensitivity – retrospective study in a food allergy unit.Clin Transl Allergy.2015 Mar 30;5(Suppl 3):P65. doi:10.1186/2045-7022-5-S3-P65Witkowski M, Grajeta H, Gomulka K.Hypersensitivity reactions to food additives—preservatives, antioxidants, flavor anhancers.Int J Environ Res Public Health. 2022 Sep 13;19(18):11493. doi:10.3390/ijerph191811493Fischer D, Van der Leek TK, Ellis AK, Kim H.Anaphylaxis.Allergy Asthma Clin Immunol.2018;14(Suppl 2):54. doi:10.1186/s13223-018-0283-4Kow ASF, Chik A, See KM, Khoo LW, Abas F, Tham CL.Identification of soluble mediators in IgG-mediated anaphylaxis via Fcγ receptor: a meta-analysis.Front Immunol. 2019 Feb 12;10:190. doi:10.3389/fimmu.2019.00190Australasian Society of Immunologist and Allergists.Sulfite sensitivity.
Giles A, Foushee J, Lantz E, Gumina G.Sulfonamide allergies.Pharmacy (Basel). 2019;7(3):132. doi:10.3390/pharmacy7030132
American Academy of Allergy, Asthma, and Immunology.Allergic reactions.
U.S. Food and Drug Administration.Appendix: FDA guide to foods and drugs with sulfites.
Lien KW, Hsieh DPH, Huang HY, Wu CH, Ni SP, Ling MP.Food safety risk assessment for estimating dietary intake of sulfites in the Taiwanese population.Toxicol Rep.2016;3:544–51. doi:10.1016/j.toxrep.2016.06.003
U.S. Food and Drug Administration.CFR - Code of Federal Regulations Title 21.
Silva D, Carolino F, Pereira AM, Santos N, Coimbra A, Placido JL.Sulfite hypersensitivity – retrospective study in a food allergy unit.Clin Transl Allergy.2015 Mar 30;5(Suppl 3):P65. doi:10.1186/2045-7022-5-S3-P65
Witkowski M, Grajeta H, Gomulka K.Hypersensitivity reactions to food additives—preservatives, antioxidants, flavor anhancers.Int J Environ Res Public Health. 2022 Sep 13;19(18):11493. doi:10.3390/ijerph191811493
Fischer D, Van der Leek TK, Ellis AK, Kim H.Anaphylaxis.Allergy Asthma Clin Immunol.2018;14(Suppl 2):54. doi:10.1186/s13223-018-0283-4
Kow ASF, Chik A, See KM, Khoo LW, Abas F, Tham CL.Identification of soluble mediators in IgG-mediated anaphylaxis via Fcγ receptor: a meta-analysis.Front Immunol. 2019 Feb 12;10:190. doi:10.3389/fimmu.2019.00190
Australasian Society of Immunologist and Allergists.Sulfite sensitivity.
Sampson HA, Aceves S, Bock SA, et al.Food allergy: a practice parameter update-2014.J Allergy Clin Immunol. 2014;134(5):1016-25.e43. doi:10.1016/j.jaci.2014.05.013U.S. Food & Drug Administration.Guidance for industry: Food labeling guide. PDF available for download.
Sampson HA, Aceves S, Bock SA, et al.Food allergy: a practice parameter update-2014.J Allergy Clin Immunol. 2014;134(5):1016-25.e43. doi:10.1016/j.jaci.2014.05.013
U.S. Food & Drug Administration.Guidance for industry: Food labeling guide. PDF available for download.
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