What is Salicylate Sensitivity/Intolerance?

October 11, 2012 in Categories: , by

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One of the many challenges that people face when adopting a paleo diet is dealing with the confounding factor of additional food sensitivities.  Sometimes these sensitivities are known (perhaps you had allergy or food sensitivity testing done at some point or react so violently to certain foods that it was a no-brainer).  Sometimes these sensitivities are unknown and make it frustrating when we don’t experience the instant improvements to our health touted by so many paleo enthusiasts.  One such sensitivity is salicylate sensitivity/intolerance.

What are salicylates?  Salicylates are the salts and esters of salicylic acid, an organic acid that is a key ingredient in aspirin and other pain medications, is frequently found in cosmetics and beauty products, and is also naturally occurring in varying concentrations in plants.  In plants, salicylates act as a natural immune hormone and preservative, protecting the plants against diseases, insects, fungi, and bacterial infection.  Why does it always come down to plants’ natural protective mechanisms!?

Salicylic acid is toxic to everyone in high doses.  In the case of salicylate sensitivity/intolerance, much smaller doses produce symptoms of toxicity.  Salicylate sensitivity/intolerance was initially described in terms of adverse drug reactions; and to date, most of the studies regarding salicylate sensitivity are performed in the context of drugs and medications that contain salicylates and/or salicylic acid.  Although the research into this intolerance is still limited, the definition has expanded to a more inclusive definition including sensitivity to foods and to cleaning and beauty products that contain high levels of salicylates1,2.  The typical reactions are gastrointestinal and/or asthma-related and/or what is called pseudoanaphylaxis (the symptoms of anaphylaxis through a non-IgE antibody mediated pathway).  Symptoms of salicylate sensitivity include:

  • Itchy skin, hives or rashes
  • Stomach pain, nausea and/or diarrhea
  • Asthma and other breathing difficulties, such as persistent cough
  • Headaches
  • Swelling of hands, feet, eyelids, face and/or lips (angioedema)
  • Changes in skin color
  • Fatigue
  • Sore, itchy, puffy or burning eyes
  • Nasal Congestion or sinusitis
  • Memory loss and poor concentration (linked to ADHD)
  • Ringing in the ears
  • Depression and anxiety

Salicylate Intolerance may be a key player in many gastrointestinal disorders, such as Inflammatory Bowel Disease, Colitis and Crohn’s Disease 3,4,5,6.  It is also deeply implicated in asthma (the reason why aspirin and other NSAIDs are not recommended for asthmatics) 4,6,7 and may be linked to Attention Deficit and Hyperactivity Disorder 4.  There also seems to be an important link to inflammation since supplementation with high doses of omega-3 fatty acids (in the form of fish oil) reduces symptoms dramatically 8.

There is no diagnostic test for salicylate sensitivity.  The only method to determine whether or not you are intolerant to salicylates is to dramatically reduce your exposure from both your diet and your environment and see if you improve.  If you do, then the typical recommendation is to consume salicylates and see if your symptoms return.

So, where are salicylates in your environment?  I recommend the website www. salicylatesensitivity.com for complete lists of products, medications, and foods which contain salicylates.  The following products often contain salicylates (yeah, this list is not fun):

  • Acne products
  • Air fresheners
  • Alka Seltzer
  • Breath savers
  • Bubble baths
  • Cleaning products
  • Cosmetics
  • Detergents
  • Fragrances and perfumes
  • Gum
  • Hair sprays, gels and mousse
  • Lipsticks and Lip glosses
  • Lotions

  • Lozenges
  • Medications (including aspirin and other NSAIDs)
  • Mouthwash
  • Muscle pain creams
  • Pain relievers
  • Shampoos and Conditioners
  • Shaving cream
  • Skin cleansers or exfoliants
  • Soaps
  • Sunscreens and tanning lotions
  • Toothpaste
  • Topical creams
  • Wart or callus removers

Given how readily salicylic acid can be absorbed through the skin and lungs and enter the bloodstream, these environmental sources can potentially add up to a significant dose.  There seems to be good evidence that those with salicylate sensitivity should avoid exposure to skin care and cleaning products that contain even moderate concentrations of salicylic acid.

Where are salicylates in your food?  These lists are only those paleo foods that are highest in salicylates.  There are many others with moderate to high amounts that may also need to be eliminated; however this is probably the best place to start.  Many seasonings (especially nightshades) also contain salicylates; although it is debatable the contribution to total exposure given how little is typically used when cooking.  It’s also important to note that it’s very controversial whether or not restriction of salicylates from food is important, especially when compared to the much larger doses typically found in medications and possible with environmental exposure. 

Paleo Foods High in Salycilates:

  • All dried Fruits
  • Most berries
  • Apricot
  • Avocado
  • Blackberry
  • Cherries
  • Date
  • Grape
  • Guava
  • Orange
  • Pineapple
  • Plum/Prune
  • Tangelo
  • Tangerine

  • Green Olives
  • All Nightshades (peppers, eggplant, tomato, chili)
  • Endive
  • Gherkin
  • Radish

  • Almond
  • Water chestnut

  • Coconut Oil
  • Olive Oil
  • Honey

It’s important to mention that salicylic acid is actually believed to be an essential micronutrient in the human diet, potentially even qualifying it as a vitamin. It also has potential cancer-fighting properties.  Does it just come down to dose?  Or source (food versus drugs versus environment)?  There just aren’t answers to these questions, yet.

There is no doubt that salicylate sensitivity exists but the extent to which diet modifications are necessary is still a contentious issue.  Given the role that omega-3 fatty acids (and potentially zinc 9) plays in the severity of symptoms, there is likely a strong correlation between severity of symptoms other health factors (such as insulin sensitivity, leaky gut, inflammation, micronutrient deficiencies, stress and potentially autoimmunity).

Do I recommend eliminating salicylates from your diet and environment?  It is worth strong consideration if you suffer the symptoms above after following a standard paleo diet and particularly if you are not seeing improvement with a more restricted version like the autoimmune protocol.  In fact, limiting chemical exposure in general is one of the recommendations for all people with autoimmune disease in Practical Paleo.  Addressing intake of salicylates from medications is definitely the first step (as these are concentrated and hit the stomach and duodenum with quite a punch, and I mean that literally as these drugs increase intestinal permeability!).  Concentrated topical applications such as acne creams, wart removal treatments, and muscle pain creams is definitely the next step.  How sensitive you are will determine to what extent you will want to remove salicylates from your environment and potentially even diet.

1. Fitzsimon M et al “Salicylate sensitivity in children reported to respond to salicylate exclusion.” Med J Aust. 1978 Dec 2;2(12):570-2.

2. Fernando SL and Clarke LR. “Salicylate intolerance: a masquerader of multiple adverse drug reactions” BMJ Case Rep. 2009;2009. pii: bcr02.2009.1602..

3. Raithel M et al “Significance of salicylate intolerance in diseases of the lower gastrointestinal tract” J Physiol Pharmacol. 2005 Sep;56 Suppl 5:89-102.

4. Perry CA et al “Health effects of salicylates in foods and drugs.” Nutr Rev. 1996 Aug;54(8):225-40.

5. Pearson DJ et al. “Proctocolitis induced by salicylate and associated with asthma and recurrent nasal polyps.” Br Med J (Clin Res Ed). 1983 Dec 3;287(6406):1675.

6. Sivagnanam P et al “Respiratory symptoms in patients with inflammatory bowel disease and the impact of dietary salicylates.” Dig Liver Dis. 2007 Mar;39(3):232-9. Epub 2006 Sep 18.

7. Kawane H. “Aspirin-induced asthma and artificial flavors.” Chest. 1994 Aug;106(2):654-5.

8. Healy E et al “Control of salicylate intolerance with fish oils.” Br J Dermatol. 2008 Dec;159(6):1368-9. Epub 2008 Sep 15.

9. Wecker, H.; Laubert, A. (2004). “Reversible hearing loss in acute salicylate intoxication” (in German). HNO 52 (4): 347–51

10. Food lists are from:  http://salicylatesensitivity.com


I recently began to read about this. I don’t tolerate broccoli or avocado, and I could never figure out any correlation between the two; it was suggested that this could be it, but I tolerate many other foods on this list. Any comment on that?

I have a daughter who is incredibly salicylate sensitive… and I too am a scientist turned mom turned food researcher!!

thank you for your article and for your research!

Here is some of the reserch I have done on the topic… my daughter is suspected of a metabolic disorder called mitochondrial disease… and a low salicylate diet has improved her gut issues and behavior issues greatly!

Great! Some people also talk refer substances like free glutamates (MSG) and amines (histamine, serotonin, dopamine, phenylethylamine, tyramine and others) in aged proteins and fermented foods like cheese, game and hung meat as possible culprits…

This may explain why my allergies are exactly the same, if not worse, now that I am on the Whole30. I have been eating more things on the high list. I am going to remove the medium/high foods from my menu this weekend and see what happens. Tonight was planned leftover night, I was very sad leaving my broccoli and stir-fried peppers in the fridge. I think I moped through dinner. Very timely article. Thank you.

I suffer from this. It was my own research and diagnosis. I have ulcerative colitis and that’s how I came across salicylate intolerance. It was trial and error and a medication reaction ( a salicylate is a uc drug, go figure) that confirmed my suspision. All my symptoms that i remember since childhood were explained and have gone away since going low sal. I have found the foods and spices that affect me the worst. I do believe this is genetic because my father, brother and my daughter all have this. Once I put my daughter on a low sal diet she stopped throwing up every morning. The sal free soaps, shampoos,and loions have made her eczema she’s had since her first bath as a newborn, dissapear.
Another funny thing is different salicylates will give me different reactions, whether its a skin reaction, gi pain, or nausea. And sokme will give me no noticible problems at all. Sometimes its the accumulation of salicylates that cause issues.
I remember my ears ringing so loud that I was asking ppl around me if someone is ringing bells, I then realized a medication I was taking for a sore muscle was a salicylate. I’ve written a little about my experience on my blog http://www.musicandmarathons.blogspot.com. but it is so nice to see this article and know others are talking about this condition.

I started juicing spinach to up my folate levels and started having massive agitation, anxiety and my ears were ringing and I had that “wearing a helmet” feeling that can occur with a head cold or sometimes on flights. I knew it was correlated to the juicing as it was the only new thing I was doing and it occurred so rapidly.
I also have an autistic child who has auditory processing delay. My tinnitus experience on the high salicylates made me lose conversational dialogue, but background noise was massively amplified. I now get the sense that this has been something likely affecting her for many years.
The tinnitus effect slowing receded along with my other symptoms after I stopped juicing, but I have more work to do. I’ve read on (Wikipedia) that Singular is something used for salicylates. I haven’t researched any validity to that. Also, in acute salicylate poisoning, sodium bicarbonate is used.
Another interesting note about tinnitus is newly theorized it is a harbinger of heart disease. Just sharing that for whatever it’s worth. Since salicylates can cause hypo or hyperkalemia, the research rabbit hole could chase down to a salicylate–>heart disease correlation.
Anyway, thank you for posting about your tinnitus experience since I knew that sudden onset from my overly eager juicing was not a coincidence.

Dear PaleoMom, Please help me. I feel so lost and confused in my diet endeavors. I went through aspirin desensitization 3 years ago which doctors told me is key in decreasing the growth of my sinus polyps and improving my asthma symptoms. In order to stay desensitized, I’m on a daily aspirin regimen. Would it still be beneficial for me to stay away from salicylates even though I purposely take large doses of aspirin every day? I’ve tried so many diets, and I feel so sick every day. I have no idea where to find help. I’ve heard that the aspirin regimen can help me to not be as sensitive to the salicylates?

I feel very strongly that aspirin is a problem for almost everyone. I suggest reading my page on the Autoimmune Protocol, which is very useful for immune diseases like asthma in addition to autoimmune diseases.

Thanks for the reply. The page you suggested is very informative. If you were me, would you discontinue the use of aspirin even if it might bring back the salicylate sensitivity? I’m scared to try because the aspirin desensitization would have to be redone if I found my health declining after stopping the aspirin. I feel like it’s a lose-lose situation. Your thoughts would be MUCH appreciated.

I would suggest getting the diet and lifestyle stuff down first’ heal much as you can with it, and then tackle getting of NSAIDs. It’s definitely worth a chat with a healthcare professional first though.

I’m not sure if I should love you or hate you. and I say that with love. With every link I am taken to a new reason to OOHHH and AHHHHH and shake my head because something else suddenly makes sense….
I’m getting answers and losing even more food options but I’m amazed because I really thought I was the only one who had to modify my paleo ways so much that I was left with practically nothing. But I’m getting answers.
I am going to pre-order your book and will be combing through your site for every bit if information i can find. thank you.

Thanks for the explanation on this! I always knew that my skin did not react well to salicylic acid and have avoided it in beauty products for years. I recently noticed skin products, especially the natural ones, are using some nightshades including goji berry and tomato seed. Does the same principle apply? Can they also be absorbed through the skin and enter the bloodstream? I try to remain as nightshade-free as possible. Thanks!

For me they absorb through my skin and make me unable to function the next day. The burts bees products were my first clue something was wrong because my “acne” was so much worse with them. It wasn’t acne. It was salicylates. Acne free now.

As an IBS sufferer, I’ve been searching for years for ways to improve my symptoms. Over the years I’ve seen temporary improvement from eliminating certain foods. Most recently I’ve eliminated nuts and seeds and have to diligently read ingredient labels to avoid seed oils. I have seen some improvement but still have bad days. After stumbling upon your article, I feel l may have an intolerance to Salicylates. My question is about avoiding salicylates in my environment. Is it safe to use nut oils as moisturizers? I have been using coconut oil or almond oil on my skin in an effort to limit my exposure to endocrine disrupting chemicals. The quest for good health can be so confusing and frustrating. I appreciate any advice you can give me.

So my huge psoriasis flare is not improving at all, and new lesions are even showing up. I feel like I react to every food I put in my mouth. Im now suspecting a sal intolerance. I thought I was doing so well sticking to AIP and completely switching to natural cleaners/products. But now I realize everything I use has sals. Coconut oil as a moisturizer, the clay toothpaste that contains mint, my vintage tradition tallow which has olive oil. And if eating fruit/veggies is so important for healing, Id be limited to green beans, celery, leeks, cabbage, Brussels and bananas. I don’t know if this is really my issue, I only suspect because my eyes will burn and nose will slightly run sometimes after I eat, and they kind of burn/water if I get coconut oil too close to my eyes. But because Im not healing despite doing everything else Im supposed to, Im left to question this. Whats a girl to use? Should I be cutting out all the vegetables that are moderate-high? What can I put on my skin!? FWIW, Ive never noticed a reaction when using asprin or the other high sal products in the past.

It’s suspicious if you’ve never had a reaction to aspirin. It does sound like a trial without coconut oil is in order though. Also, are you eating seafood? organ meat? lots of veggies? Have you tried digestive support supplements? How is your sleep and how well managed is your stress?

Truthfully, its been a long time since Ive taken aspirin, but I don’t remember ever reacting. What would a reaction look like?

Yes, eating seafood and tons of veggies. But now Im worried about the veggies because of the sal content of most of the ones I eat. Still not great about the organ meat, and Im reading that it is very high in sals too! Talking HCL and ox bile, along with DGL, vitamin C and LDN. Sleep is between 7-8 hours per night. I really cant manage much more because of how early I have to get up. Really the only thing Im stressed about is my skin, but I don’t know how not to be when seeing how bad it is every day is a constant reminder.

DO you think it would be wise to start taking glutamine for further gut healing?

The only(and BEST) salicylate-free diet I have heard of was from Dr. St. Amand on behalf of the guaifenesin protocol for fibromyalgia. Read the book “What you doctor may not tell you about fibromyalgia” to get all the specifics but to break it down for you here’s the main ‘meat’ of it: salicylates are a plant’s immune system. Those plants or plant products with the highest amounts of SA(salicylic acid) tend to make those of us with an intolerance have horrible reactions. He’s done studies on tons of plants, oils, nuts, and the like and even used(willing) fibromyalgia patients of his for over 30 years to create a list of no-no’s. Over the years of being on the protocol(go to his website to learn more– they have a nice discussion board, too.) a person can gradually begin to eat or be exposed to some lesser amounts of SA. But it takes a few years.

Here’s how I remember his diet, and the easiest way he broke it down for me:

CROWS. Corn, rice, rye, oat, wheat, and soy. Those are the main oils which can be used on the skin or oral mucosa with no problem. Any plant extract outside of that is a salicylate. For example, coconut oil, 100% of the time it is a salicylate. However cocoa oil or cocoa butter is not. They’re different plants entirely. Cocoa is a bean. MOST bean oils are safe but things like sunflower oil are not. It’s a nut.

Mint is a major salicylate we all come into contact with. Essential oils of ALL varieties are salicylates.

The worst ones which were hard for me to kick were the ones in salad dressings. Sunflower oil, olive oil, and all those others… made me sicker than hell. It wasn’t worth it to be that miserable just to enjoy a salad or veggies dipped in the dressing or oil.

I’ve had to switch to plain animal fats like bacon grease for all my cooking needs. I will not use corn oil or any other oil for cooking simply because of the GMO issue. If it can’t be cooked using bacon grease then I use the fats which drip from the meat I’m currently cooking with that meal and baste my veggies with it to keep them from scorching. You do what you have to do.

For skin and hair I rely on either the chemical shampoos from the store or a alternate with homemade lard soap. I have found that lard soap has cured my eczema issues, too.

Cocoa butter and shea butter are PERFECT to use on skin and hair. SA-free. A little dab’ll do ya. Warm it up between your palms and smooth on and rub in. Lovely.

And of course it’s wonderful for your dry lips. I make my own lip balm and lipsticks using cocoa and shea butter. It got to where I couldn’t buy chapstick or lipstick out of stores anymore because of the menthol or mint or SA oils used in them and I hate the feel of petroleum or mineral oil on my lips. All natural is best.

Thank you for bringing up the salicylates issue, Paleo Mom.

IBS, chronic fatigue, and fibromyalgia plus migraines and all those other sensitivities aren’t fun to deal with but if we can understand what’s causing it then we can live happier lives.

A lot of people on the gauier(the guai protocol) diet swear that you can eat any salicylate you want with no problem that it’s just skin contact which makes us miserable but I know this isn’t true. If that was true then why does injested medicines like Aspirin make us so sick?! And the oral mucosa is on the way down to the tummy so yeah, you’re going to absorb quite a bit there as you’re chewing. No way around it. You have to be strict or just suffer.

Touching plants can make SA-intolerant people flare, too, btw. I had to start doing all my gardening with rubber gloves. SA’s are even in the soil. Remember, it’s literally the immune system of all living things on our planet. Unless it has mold, it has at least a little bit of SA in it. That’s what keeps stuff un-moldy and thriving.


Peeling high salicylic acid containing fruit is something which is a trigger for some people. Like peeling and orange or lemon. Or even crushing basil leaves for your meal between your fingers. For a while the simple action of chopping up an onion would set me off! It’d absorb it through my fingers.

Hi Paleo Mom,

I just found this post after looking up the effect of salicylates in coconut oil, as find I have a mild stomach reaction to it when I eat it in raw form, and I suspect it may contribute to anxiety. I expect as a Northern European I haven’t really evolved to eat coconuts, have you heard of may people who have issues with coconut oil?

I was also surprised to see the extensive list of other foods containing salicylates–berries are pretty much the only fruit I eat (to keep my fructose intake low) so I can’t really imagine cutting them out. Do you think I really need to give them up? Would cooking foods high in salicylates reduce their effect?

Thanks a lot,


Hi Sarah. You are an amazing resource and a huge help for all of us with learning to heal ourselves. Thank you for all that you do!

I suspect I have a mild sensitivity to salicylates due to leaky gut. My eyelids get itchy and swell slightly. My darn patch of psoriasis flares. Brain fog, too.

For the past year have been trying following Paleo, several months of Paleo AI, then GAPS. I am back to following Paleo AI, much more strictly this time and recently added Low Oxalate which has really helped the healing.

So the foods I am eating that are high salicylate would be apples, coconut oil and honey. They are my only “treats”.

What I’m wondering is whether I should give up my treats and go low sal also. If I stay the course, will high salicylate foods inhibit my gut from healing? What do you suggest?

Thanks for you help!


It’s probably something you will have to experiment with and see how you feel. Salicylate Sensitivity/Intolerance is discussed in The Paleo Approach. You can read more about what is included in the book here: http://www.thepaleomom.com/the-paleo-approach-reverse-autoimmune-disease-and-heal-your-body You may also want to join our new The Paleo Approach Community group on Facebook and ask for support there. You can request to join here: https://www.facebook.com/groups/TPACommunity/ — Tamar, Sarah’s assistant

Thank you, Tamar. I appreciate the reply. I think I found the answer that sals to damage the gut and therefore I should stay low till healed.

Sarah’s book looks amazing. It is most definitely on my wish list.

Jo-Ann, I know this post was from a long time ago so hopefully you see this.

I’m that boat right now and wondered how you got through it.


My daughter is very sensitive to salicylates and it took so long to figure out what was going on. It was especially confusing because she also has oral allergy syndrome so she reacts to two different categories of food and this makes fruits and vegetables very tricky for her. We followed the Paleo diet for 2 years and once we figured out how to eliminate the high salicylate foods and the oral allergy syndrome foods we were just not left with enough food options, so we added grains back in. (We are still gluten-free.) I’d be curious to hear if there are people who really manage to do Paleo that is low-salicylate.

Also, I wanted to mention that my daughter’s main symptom after eating high-salicylate foods is not on your list. For her it primarily shows up as a strong urge to pee, which she often has trouble controlling. It essentially causes symptoms of interstitial cystitis for her. I wonder if there are any others out that who have made that connection? She also gets symptoms like fatigue, tummy aches, headaches, bright red cheeks and a bad mood.

Thanks for this wonderful article – there is not enough information about salicylate sensitivity out there.

Yes, I have spoken with people that have modified Paleo for a low-salicylate diet. Additional restrictions are never easy – they often require more planning and cooking – but they are possible. – Christina, Sarah’s assistant

That is one of my daughter’s symptoms as well. She will have lots of tiny accidents. She gets many other symptoms too.

My daughter and I were extremely sensitive to salicylates and multiple food chemicals as per diagnosis through the Royal Prince Alfred Elimination Diet. After the novelty of an extremely limited diet wore off, even though it greatly improved many of our symptoms, I then started looking for answers to expand our diet into something that involved more than a handful of tolerated vegetables and fruit…. When you are highly salicylate sensitive (like we were) even a very small break in your diet causes a rapid flare up of multiple symptoms that often last for several days.

Anyways – after 6 years of searching we have pretty much “cured” our food intolerances doing a modified version of the Specific Carbohydrate Diet. This is pretty close to a Paleo diet, just more restricted and prescriptive in the beginning.

We are still very sensitive to environmental salicylates – but this is a minor issue compared to living with a highly restricted diet for several years.

So for us it looks like our answers were all in the gut 🙂

Wow. How encouraging. We are highly sensitive as well. I would really be interested in learning more about what you did to increase your tolerance. Please email me.

Hello! We just started the SCD diet for my son to help heal his gut and to help with various development disorders (sensory processing, dyspraxia, ADHD, etc) and he has already had reactions to the first 2 things we have introduced. I have always thought sal-intol because he would get a red ear after eating certain things. I was just thinking we would need to adjust SCD to better avoid natural food chemicals. Would you mind sharing what you did? Thanks so much for your time!

I feel I am mostly sensitive to berries, and just discovering that there is indeed a correlation between the skin rash that appears like hives, itches and then can fade away completely again within 24 hours. The rash only appears on my shins, knees & elbows. Could it be a reaction to salicylates? If so, can a person only react to them in the form of berries?

If you’re sensitive to salicylates, it’s more likely they’d all trouble you. But if you try eliminating berries and the problem goes away — well, go figure. Perhaps there’s something else about the berries. 🙂 – Christina, Sarah’s assistant

Is it possible to be sensitive to some salicylates but not all of them? A blood test put broccoli, strawberries, pears, grapes, and black pepper in a severe intolerance category for me. almonds, bananas, cauliflower, olive were in the mild intolerance category. But it came back that coconut, avacados, blackberries, cherries, etc were OK and I did not have any intolerance to them. This article has me thinking about all the products I use as salic acid acne products never seemed to work for me…

You should definitely avoid the ones that came back positive for allergy/sensitivity, but the ones that came back okay may not actually be okay — false negatives are fairly common. You may have to play around with your diet a bit to find what actually works for you. But, I suppose certain foods are higher in salycylates than others so you may be more sensitive to those. – Christina, Sarah’s assistant

Sounds like your lists of foods are correlated more to the amount of pesticides and chemicals applied to each group of food. Your highest sensitivities are the most sprayed. Your lowest are the least sprayed.

I have been dealing with Salicylate Intolerance for 6 yrs now. I take Zyrtec everyday or I am full of itchy hives. Does anyone have any recommendations for chemical free body wash, lotion & shampoo/conditioner? Most natural ones are full of aloe or other plants that I can’t tolerate.

Use only edible oils on your body as moisturizers, then wipe excess off with a washcloth. For cleaning hair: if it’s oily, use baking soda dissolved in water. If not, just rinse it with plain water. If you need a bit of relaxing or softening, buy some organic distilled vinegar at a health food store, mix with water, and saturate your hair with that, then rinse thoroughly.

oh, for the love of Pete. I’ve been listening to every podcast you have done that I can find. I just (finally) dealt a death blow to the lyme (it’s gone) that put my immune system into craziness for over a decade….after celiac and samter’s triad cropping up. One sinus surgery down and I have been trying to get to the root of this continued inflammation before another sinus surgery is necessary. Ok. So, I’ve been GF for about 7 years and paleo for about 1.5 years. Just found out about your Paleo Approach book and am not very far into it yet. I am tons better than before but still have some autoimmune issues so wanted to try your approach. I just now found out about coconut milk/oil being high in salicylates. I have been using that a lot. What am I supposed to cook with if i can’t use coconut oil? And how on earth can i get enough calories (and fat) if I can’t eat avocados or nuts? The chronic sinusitis and fatigue are my big issues. And i suspect there is some adrenal fatigue & candida just to make things interesting 🙂 Any suggestions? Thanks for all you do. It is appreciated.

You can use any other cooking fat in place of coconut oil, like lard or palm shortening. You can get fats from other oils, olives, and fatty cuts of meat. – Christina, Sarah’s assistant

Any association with salycylates found naturally occuring in foods and added to cosmetics as a trigger for Rye Syndrome in children?

According to the Reye’s Syndrome Foundation, only aspirin has been shown to be a trigger, but they do recommend avoiding all salicylates until more research has been done. – Christina, Sarah’s assistant

i’m both histamine and salicylate intolerant.pls suggest me an omega 3 source and can I have cassava roots (they are low in salicylates) . thanx for the post

Hi -very informative thank you .You mentioned no diagnostic tests available -actually there is .I am doing Bioresonance therapy with the Bicom 2000 -and the machine definitely can test for salicylates as well as any other allergies or intolerances -as well as reverse the allergic or intolerance reaction…worthwhile to have a look into it – it cured me from long standing health issues -so much so that I gave up my registered nursing career -and went into really helping people get better.

Hi Liezel,
I’m so interested in your career path and have never heard of the Bicom 2000. I found their website but I would love to know what you do specifically to help people get better – and how you test for salicylate sensitivity with that equipment. Do you have a website? or a way to get in touch with you? Thanks!

good stuff, I have SEVere histamine intolerance, includes saponins and salicylates. It’s off the charts – I’m so careful and never take any kind of over the counter or prescription meds, none… but one time I find out the hard way, I suck at flying and I was miserable on a 28hour plane trip, started to dose with Dramamine, reluctantly, then about 2 days later I started to vomit uncontrollably and was bed ridded for a couple days. Yep aspirin derivative in Dramamine. Willow bark etc, always in products. Great article. I also made the connection from dabbling with an acne cream and kept getting hives, luckily a strict histamine intolerance diet promotes nice skin and a healthy body composition…however, I wish it upon nobody.

I believe salicylate intolerance is triggered/aggravated by toxic liver, probably coupled to mitochondrial and/or methylation issues. I reversed my intolerance (high uric acid also involved) by supplementing magnesium only (to bowel tolerance) for 4-6 weeks, based on this letter by a British nephrologist published on The Lancet in 1982 about the PST enzyme:

“Their [free phenols’] ability to chelate magnesium ions and to interfere with Mg-ATP and phosphate transfer may be especially important for neurones.”

Sodium bicarbonate baths also helped me.

I think there are means to reverse salicylate intolerance and it is NOT a condition that you have to just “live with”. Sure it can be complicated by issues such as amines/histamine intolerance/mast cells issues, you name it.

This nephrologist is also author of the book “Guide to Signal Pathways in Immune Cells” (2009) which is an extremely heavy reading.

I’m already strict AIP and low FODMAP, in addition to not being able to tolerate oranges or sweet potatoes, winter squash and taro in only small amounts, and I re-introduced carob and coconut in the last two weeks, much to my rejoicing. I haven’t even been able to eat coconut oil without aching (truthfully, I haven’t tested the oil for more than one day yet, so for all I know, I still can’t). I’ve noticed that eating too much fruit, even supposedly low-FODMAP stuff like melon, pineapple, and banana, makes me ache and feel tired, sometimes nauseous. It’s like a mini version of what I feel after gluten exposure. I only noticed about 6 months ago when things were hitting their worst, as I was having a hard time eating fruit at all, or even my only source of starch, green plantains. I convinced my Dr. to give me a round of Rifaxamin and started on a good probiotic and started an agressive stress-reduction regime, and have seen lots of improvement, including in the amount of fruit I can tolerate without getting all achy. But the thing is, I can’t find anything on fructose making people achy! I just had someone suggest it could be salicylate intolerance. I don’t get asthma or a lot of symptoms on the list, (ringing in ears, anxiety, ADHD-like symptoms, sometimes burning eyes, fatigue, and stomach pain, yes, but those can also be caused by the fibro and IBS I’ve been diagnosed with, as well as a billion other things) but I saw other sites listing arthritic pain as a symptom. The idea that I could be intolerant to yet another group of things pretty much makes me want to cry, but I have found no other explanation for aching after eating fruit. I am also extremely sensitive to additives or preservatives of any kind, as well as trace amounts of corn, so much so that I can’t eat meat purchased from the grocery store (corn on the plastic wrap) or legally slaughtered for sale (must be washed in lactic acid). Do you have an opinion on arthritic-type pain as a response to salicylate intolerance? Is this something that can be healed with proper treatment of leaky gut? I thought I was starting to turn a corner with being able to add in limited amounts of coconut.

I am currently experiencing a psoriatic arthritis flare and I am suspecting it is due to the fruit I have consumed recently – specifically cherries and mangoes. I thought it was the fructose but now I am thinking it could be the salicylates? I experienced the same pain last Christmas after eating some cherries as my only Christmas treat. Looks like fruit is off the menu for me next year. I am also wondering whether my sons bed wetting is due to salicylate intolerance? I experience severe pain after consuming coconut oil too. It took me a while to work that one out especially when the paleo community recommends it as a safe oil.

Scorchd, like you, I also get extremely ache-y after fruit, tired, and nauseous sometimes. Also, causes migraines, sometimes. It’s not arthritic pain but just very achey. I am low FODMAP and also have a hard time with even the low-Fodmap fruits, coco oil, as well as starchy vegies. (Trace amount of corn seems to cause stomach aches (supplements, etc)). I’ve been doing SCD for a couple years and it’s helped me with energy and other things with my IBS. But like you, I am also frustrated by the fruit and carb issue, as well. So… my next trick is I have started AIP just 3 days ago. I need to toss out eggs, legumes, all dairy, and nuts, allowed on SCD. I realize now they are preventing full healing. I will modify my SCD for my gut issues, and eliminate those things which Sarah recommends with AIP since IBS is autoimmune, too. It’s tough, though, because of the starches and fruits that I can’t have due to the achiness and fatigue, PLUS the other starches/fruits allowed on AIP, but not SCD. I’m kind of nervous (yes, it makes me want to cry as well!) because not much is left, and my weight is low, but I don’t have much choice. Just wanted to let you know that you are not alone with the achiness and fructose, and possibly salicylates (which am just learning about). I do read/believe that it’s gut issues at the source, though.

Thanks for responding. It’s simultaneously comforting and horrifying to know there’s someone out there experiencing the same thing. Going AIP helped me a lot. It’s been a year since I dropped the eggs, nuts, and legumes, and 9 months since I also dropped black pepper and other seed spices and started taking down my FODMAP consumption, as well as going very strictly corn, chemical, and preservative free, which means no bagged salads or veggies unless labeled “preservative free”, since most of those are sprayed and I frequently react, and dropping most meat from the grocery store for the same reasons. Since making these changes, and working hard at stress reduction, I’ve had my symptoms mostly disappear, as long as I stick to the diet. I hope you can find similar relief. I also tracked my symptoms, and it looks like they spike during the two times a month my estrogen takes a dip, at ovulation and menstruation. I wonder if you might have a similar situation? It’s worth checking into, and reading the Paleo Mom’s post on adrenal fatigue. Good luck!

I didn’t look to see if anyone else had mentioned this but the LEAP MRT test actually tests for salicylic acid sensitivity. I’ve had a lot of success working with patients with chronic inflammatory issues using the MRT test and finding out they were sal. acid sensitive. Just thought I’d mention that since it might be an easier way than just an elimination diet for a lot of people 🙂

It’s been suggested by my nutritionist that I could have a salicylate sensitivity due to a nasty itchy rash I’ve had a couple of times now. This is the only symptom I’ve had, so I’m not sure yet. I’ve been eating sals-free for a week so far, and wondering how long do I need to do it until I can “test” some sals foods? What is the best way to go about this?

On 4th july, I got anaphylactic shock because of a oral gel named “ Bon Gel- containing 9% Colin Salicylate”. After applying the medicine I discover Itchy hives all over my body, and my dentist asked me to admit in emergency. I’s totally collapsed my heart ‘s almost dead, I’s in ICU for 3 days. By the mercy of al mighty I recovered from that situation.
but after that I find the salicylic allergy very active in my life, which I never felt before in my life. I always feel- Depressed/ Anxiety/ Fatigue/ Poor concentration/ memory loss/ Nasal Congestion.

is there any treatment to cure this uncomfortable life.

Just avoid anything with salicylates, gluten and do some liver cleanses. You will improve with time. Lastly think positive always. Good luck.

I have hashiomoto and IBS symptoms. Have been eating Paleo and still have GI symptoms. I started using salicylic acid on my foot per doctor instructions and it resulted in having a metallic taste in my mouth, foot pain and redness. I am wondering if I have a sensitivity and perhaps need to look into eliminating the salicyclic acid exposure.

Also, think about gluten sensitivity. When I cut out gluten all of my bowel problems go away. When I add it back, stomach problems. I also have Hashimotos and have read that you can’t have an autoimmune disease without leaky gut.

I have a daughter who may be sensitive to salicylates so we try to minimse intake via diet, we have also been using essential oils in our home for a while now, we have had trouble finding info on which oils have high levels of salicylates and which are lower. Have you ever done any research in this area?

I’ve had chronic tinnitus since my teen years (I’m 47 now) and doctors have never found any reason for it. My ear drums are apparently “the picture of good health”. eliminating NSAIDs hasn’t helped, and I don’t use any products that contain salicylates, so I guess I’m off to further reduce my diet and eliminate the list of foods above!

Coincidently, I was just wondering last night about berries and if they could be the cause of my tinnitus…*sigh* Looks like I’m down to avocado oil on my salad, and no more dates or berries for dessert for a while.

Struggling with Paleo and amines sensitivity. All fermented foods, avocado, slow cooked broths etc are high amines. Any guidance?

I have struggled with asthma with food sensitivities for years. I went gluten-free, then dairy free, several years ago, but recent flare-ups and struggles with asthma lead me to the AIP protocol, which I’ve been on for 3 weeks. Continued asthma attacks everytime I ate convinced me to adopt the FODMAP protocol, as well. Now, even FODMAP safe foods are causing asthma, and my food selections are now so limited that I’m at my wit’s end. I looked over the salicylate sensitivity list, and realized that foods I am still eating (about the only ones left… blueberries, coconut oil and olive oil, fish, are all on the list. Coconut oil and olive oil are in everything I cook.) Many FODMAP foods overlap with salicylate, so I’m still unsure, but salicylates are the only sensitivity that lists asthma as a symptom. The asthma flares up almost instantly, within 1-5 minutes after eating a problematic food (which nowadays, is everything.) This never made sense to me, since I couldn’t understand how I could react to food before it had even been digested. Do you think it’s likely that I have a salicylate sensitivity, even after all of these eliminations? We use all natural/homemade personal care products, and have removed chemicals from our household.)

Thank you so much for this post.
I recently found out I have Hashimoto’s and after the diagnose I kept going back in past and then noticed that sometimes something would trigger a hypothyroidism crisis.
I stated to get suspicious of almonds and today, after long time without having any almonds I decided to have almond butter and all these symptoms listed above came back. So I decided to do some research ultimate I came across your website. I’m also treating 2 warts with salicylic acid. Which I’ll continue to do so for now, but I’ll definitely make some changes on my diet.

Thank you again!

The best research and information I have come across regarding Salicylates comes from the Royal Prince Alfred Hospital in Australia-


I used this in conjunction with Sue Dengate’s website-


Salicylate research and percentages in food

We found out with-in a week(she was 6-takes longer for adults) of doing the elimination diet that all of her symptoms were food related.
ADHD syptoms
facial tics
MAJOR meldowns/tantrums
would not read
would not write

I have had respiratory infections, earaches, allergies and rashes since I was a kid. Those are all gone and have been for three years now.

My husband was on four different medications for IBS, Heart palpitations, cholesterol and neuropathy. He also had really terrible acne almost like boils. Those were all eliminated with-in six months.

When you first read it seems so upside down compared to how our country tells you how to eat for health but it completely works.

This makes me feel less crazy. My son started having problems in 3rd grade. Behavior, mood swings, crying, depression (I can’t count how many times I’ve heard I just want to die I want to kill myself). We joined Feingold after we realized dyes were a huge part of the problem. He has always had allergies and asthma but they were getting worse and his sensitive skin was covered in rashes to a lot of old things. Everything that covered his skin (soap, sunscreen, bug spray, bath bombs) by the 3rd use caused a full body, red and itchy rash. His depression was so bad, by 4th grade the teachers were saying it’s time to try medication. The process was sooooo slow. Medication started the summer before 5th grade. Guess who was allergic to all the anti-anxiety medicine? We rejoined Feingold and decided on a full elimination diet after an 8 week process of figuring out horrible stomach pain. The special diet the specialist put us on let us know, by accident, that he developed an intolerance to eggs. We stared home making all his food. Got a saliva test for gene mutations (MTHFR plus a lot to do with depression and vitamin deficency). I realized 10 months into Feingold that he couldn’t have apples or cinnamon (we just had a horrible night due to the apple natural ingredient in Lay’s bbq chips. Now we can add that to our list of things to stay away from). He has hypersensitivity to medication but I think it’s all related- pain medicine (Vicodin), anything with sulfur (and all the Dr.’s say sulfa but no, it’s sulfur) scabies medicated cream, his flu shot. It all leads to crying, screaming, rubbing his arms up and down in a weird repetitive way and the depression comes raging back. We do vitamin therapy, he gets weekly zinc, evening primrose oil (extra Omega 6), Vits E and A, 5 mg of the vitamin lithium, l-lysine, and magnesium. It has made such a huge difference in anxiety and depression but we still have to be careful of apples (processed food sneaks it in, in so many tricky ways), cinnamon (he can taste it and spits it out if it is remotely cinnamony) and dye. Salicylate wise, he eats berries, melon and veggies no problem. He gardens too.

Wow Grace, your (son’s) story breaks my heart! I have a 2 1/2 yr old who’s going through some mystery stuff (medical/developmental/thyroid/constipation/allergies/extremely poor growth) but the challenges are no where near where things are for you (hopefully I’ll be able to make a difference to prevent worsening health for my son) and I am so compassionate! That’s all I’ve got! Compassion and hope and prayers and love for you and your son towards better health and happier days in the nea r future. I think Sarah is brilliant. My top two resources to help my son are this website and Sarah’s book The Paleo Approach as well as the Solving Leaky Gut program by scdlifestyle.com. I think the hardest part of this is not trying to do everything perfectly. Dr. Sarah and SLG both seem to deliver congruent grounded advice which helps me get my head back on when I lose it. This being, try to find a balance of diet lifestyle and gut support supplements and not get caught up trying to ‘treat’ symptoms by being too focused on any one area (or all three) – instead focus on finding a maintainable/manageable balance of the three areas with the primary focus being to heal the gut. Poco a poco. I’d like to do everything for my son all at once to help him not be in pain/discomfort and to get healthier – and I see every issue raised as a potential issue for my son (like the post here on salicylates) BUT I’m just one person with very limited and finite resources and I have to work within my means so that I don’t drop in exhaustion before I’ve been able to help my son have any real improvement. Every time I learn something new I remind myself of my focus to help my son heal his gut and the bigger picture of the balance of diet, lifestyle, and GI targeted supplements (enzymes, etc that both Dr. Sarah and SLG recommend investigating). I’ve made my decisions in each of these ares based on what makes most sense to me as being helpful to my son, and what the Dr agrees is the highest priority as far as providing the greatest potential health benefit, and what I can afford sustainably – time/energy/financial. These are very difficult and emotional decisions because nobody knows exactly how to make my son better, and nothing is a given – it’s scary. But I do know that the timing in his development and growth is critical and all decisions that are made now will have a tremendous impact on his health and wellbeing lifelong – for better or worse…and that’s a lot of pressure! I wish you and your family all the best Grace!

What about pyrrole and Salicylate sensitivity being on the same page and having similar symptoms? Also the article that’s supposed to be about zinc deficiency and salicylate sensitivity – can you please post it here? “Wecker, H.; Laubert, A. (2004). “Reversible hearing loss in acute salicylate intoxication” (in German). HNO 52 (4): 347–51” I’m wondering what was said if there is a translation available?

Thanks for all your help.

Trying to follow AIP while also paying attention to salicylates honestly feels like I’m trapped. Everything I eat affects me negatively in some way. I can’t fucking win. Life is so unfair.

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