Alex Fisher Health www.alexfisherhealth.com.au Page 1 Salicylate Sensitivity

All plants have defence mechanisms to protect them from the outside world. Some have thorns, some have poisons and some have a group of chemicals called salicylates. This group of chemicals act as a natural pesticide to help protect the plant from insects, fungi and harmful bacteria.

Salicylates are found in some fruits & vegetables, nuts, teas, wine, herbs, aspirin, spices and fruit extracts. Unfortunately the symptoms of salicylate sensitivity are so varied and wide it’s hard to detect if you have a sensitivity. Some people are very prone to have a reaction to silicates and often live for years, even a lifetime without knowing it.

The most common symptoms of salicylate sensitivity

• Angioedema • Hyperactivity • Anxiety, panic attacks • Irritability, restlessness Irritable Bowel Syndrome (constipation, Asthma & breathing difficulties • • diarrhoea, flatulence) • Bed wetting • Itchy skin, hives or rashes Behavioural problems, poor attention, ADD, • Joint pain, arthritis ADHD • • Changes in skin colour • Memory loss and poor concentration • Cystitis • Nausea • Depression • Persistent cough Pseudo-anaphylaxis (non IgE mediated Depression • • pathway) • Diarrhoea • Rhinitis (allergic) • Eczema • Sinusitis, nasal polyps • Fatigue • Sore itchy, puffy, burning eyes • Headaches • Stomach Pains / Upset Stomach

FACTS ABOUT SALICYLATE SENSITIVITY • Salicylates trigger hives in 62% to 75%* of people who are prone to skin rashes (1) • Salicylates worsen/trigger eczema in 52% of people with eczema (1) • Salicylates worsen/trigger irritable bowel in 69% of people with IBS (1) • Salicylates trigger migraines in 62% of people prone to migraines (1) • Salicylates trigger behaviour abnormalities (such as ADHD, aggression and anxiety) in 74% of people with behaviour issues (1) • Salicylates trigger lethargy and a range of systemic symptoms in 74% of people with systemic symptoms (symptoms affecting the whole body) (1)

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TOPICAL STEROID CREAM WITHDRAWAL AND SALICYLATES

Topical steroid creams block the immune system and act as a vasoconstrictor (constrict your blood vessels). When people discontinue topical steroid use their blood vessels excessively dilate causing a rebound reaction due to excessive immune cells reaching the effected area.

Salicylates, when consumed act as a vasodilator (blood vessel dilator). So when discontinuing steroid cream use it’s important to reduce salicylates in your diet to prevent further vasodilation.

WHAT CAUSES SALICYLATE SENSITIVITY?

Sensitivities are caused by a number of different factors. The main underlying issue is intestinal permeability (gut damage). Research on Aspirin, which is high in salicylic acid has been shown to trigger gastointesinal damage in high doses (2), causing intestinal permeability (leaky gut) (3). Antibiotics also disturb the beneficial gut bacteria, increasing the risk of intestinal permeability.

For sensitive people, foods high in salicylates can the intestinal lining, allowing undigested food particles to enter the blood stream. Our immune systems identify these undigested food particles as foreign invaders and mount an attack to destroy them. This causes an overactive immune system and can lead to many autoimmune related issues.

Liver insufficiency can also cause salicylate sensitivity. The liver detoxifies chemicals in a process called phase 1 and phase 2 detoxification via the cytochrome P450 enzymes. If this detoxification pathway is reduced the ability to remove toxins is impaired leading to increased sensitivity to otherwise harmless substances such as salicylates.

Liver insufficiency is caused by nutritional deficiencies, low antioxidants and high sugar diets. In adults its most commonly caused by frequent alcohol consumption, high intakes of sugar and take away foods.

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HOW TO DIAGNOSE SALICYLATE SENSITIVITY

The best and easiest way to identify salicylate sensitivity is to avoid consuming salicylate rich foods for a period of 4 weeks to 3 months (in severe cases). Often people see instant improvement in symptoms from reducing salicylates in their diet. With the help of a professional salicylates can be slowly reintroduced in your diet.

If Salicylates are the cause of your health condition, it’s important to follow a low salicylate protocol. This protocol removes salicylates and other gut irritants in order for the intestinal lining to heal. The protocol must be followed strictly at all times for the given time periods. Failure to do this will result in continued salicylate sensitively and reduced health improvements. If you experience a reaction in any steps, repeat the previous step for a further 2 weeks. Avoid Aspirin at all times during the protocol.

Supplementation

Supplementation is imperative in repairing Salicylate sensitivities during the protocol. The correct use of nutrients significantly improves symptoms and recovery time. AF Health will prescribe you high strength practitioner only products to aid in immune system modulation, liver detoxification and liver restoration.

STEP 1 - Weeks 1 & 2

Consume only foods on this list for 2 weeks

• Meats - Beef, Chicken, Turkey, Lamb, Pork, Fish, Scallops, Prawns

• Eggs - Free Range organic if possible

• Nuts - Hazelnuts, Pecans

• Grains - Amaranth, Barley, Buckwheat, Millet, Rice,

• Legumes - Beans (other than Broad and Fava), Bean Sprouts, Lentils, Chickpeas

• Fruits - Banana, Pomegranate, Lime, Rhubarb, Peeled Pear, Apple – Golden Delicious, Papaya

• Vegetables - Bamboo shoot, Brussel Sprouts, Cabbage, Carrot, Cauliflower, Peas, Leek, Onions, White peeled potato, Shallots, Celery, Iceberg Lettuce, Swedes, Beetroot

• Herbs & Spices - Salt, Chives, Fennel, Garlic, Parsley, Saffron, Gluten Free soy sauce or Tamari

• Oils - Butter, Ghee

• Sweeteners - Maple Syrup (in small amounts)

• Drinks - Water, Non-Instant Decaffeinated Coffee, Rice Milk

• Alcohol - Advised to avoid alcohol, however best choices are Whiskey, Brandy, Gin & Vodka

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STEP 2 - Week 3

Combine the foods below with allowed foods from step 1

• Nuts - Coconut, peanut butter (but not peanuts - salicylates in peanut skin), walnuts

• Fruits - Custard apple, kiwi fruit, loquat, lychee, pear with peel.

• Vegetables - Peeled eggplant, carrot, lettuces other than iceberg, tomato juice, mushrooms, Tinned asparagus, beetroot, black olives, sweetcorn

• Herbs & Spices - Salt, Chives, Fennel, Garlic, Parsley, Saffron

• Sweeteners - Molasses

STEP 3 - Week 4

Combine the foods below with allowed foods from step 1 & 2 Be very careful in this step. These foods contain higher levels of Salicylates and have the potential to set you back if your intestinal lining is not fully healed. Introduce these foods slowly. It’s recommended to write down what you eat during this step. If a reaction occurs, you can narrow down the potential food that triggered the reaction. If you have a reaction go back to previous step for 2 weeks before trying this step again.

• Nuts - Brazil nuts, macadamia nuts, pine nuts, pistachio, sesame seeds

• Grains - Corn

• Fruits - Avocado, most other varieties of apples, rock melon, cherries, grapefruit, mandarin, mulberry, nectarine, peach, tangelo, watermelon

• Vegetables - Alfalfa sprouts, eggplant with peel, broad bean, broccoli, cucumber, tinned okra, parsnips, fresh spinach, sweet potato, tinned tomatoes and tomato puree, watercress

• Drinks - Coffee

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STEP 4 - Week 5

Combine the foods below with allowed foods from steps 1, 2 & 3

Be very careful in this step. These foods contain higher levels of Salicylates and have the potential to set you back if your intestinal lining is not fully healed. Introduce these foods slowly. It’s recommended to write down what you eat during this step. If a reaction occurs, you can narrow down the potential food that triggered the reaction. If you have a reaction go back to previous step for 2 weeks before trying this step again. • Nuts - Almonds, Peanuts

• Grains - Wheat products in small amounts (1 meal per day)

• Dairy - Butter, cheese, milk, yoghurt

• Fruits - Fresh apricots, blackberry, blackcurrant, blueberry, boysenberry, cranberry, fresh dates, grapes, guava, orange, pineapple, plum, strawberry, sultana.

• Vegetables - Chicory, chilli peppers, zucchini, endive, tinned green olives, peppers, radish, water chestnut

• Herbs & Spices - Basil, bay leaf, caraway, chilli powder, nutmeg, vanilla essence, white pepper

• Oils - Coconut oil, olive oil

• Drinks - Peppermint tea

• Sweeteners - Honey

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STEP 5 - Week 6 Combine the foods below with allowed foods from steps 1, 2, 3 & 4

Be very careful in this step. These foods contain higher levels of Salicylates and have the potential to set you back if your intestinal lining is not fully healed. Introduce these foods slowly. It’s recommended to write down what you eat during this step. If a reaction occurs, you can narrow down the potential food that triggered the reaction. If you have a reaction go back to previous step for 2 weeks before trying this step again.

• Fruits - Dried apricots and dates. Currant, loganberry, prunes, raisin, raspberry, red currant

• Vegetables - Gherkins

• Herbs & Spices - Allspice, aniseed, black pepper, cardamom, cayenne, celery powder, cinnamon, cloves, cumin, curry powder, dill, fenugreek, garam masala, ginger, liquorice, mace, mint, mustard, oregano, paprika, rosemary, sage, tarragon, turmeric, thyme, wine and cider vinegars

• Drinks - fruit and vegetable juices, tea

STEP 6 - Week 7 & Beyond

If you have made it this far, then well done! Your symptoms should have disappeared or dramatically improved by now. For people with Salicylate sensitivity symptoms can reappear at a later date unless managed correctly.

Many herbs that Naturopaths use contain Salicylates. Now that you are able to tolerate salicylates a more aggressive detoxification protocol can be administered. This is where we restore you to optimal health and significantly reduce the risk of repeated sensitivity.

REFERENCES

1) Warin, R, Smith, R, Challenge test battery in chronic urticaria, British Journal of Dermatology, 94, pp. 401-406

2) Huang, E. S., Strate, L. L., Ho, W. W., Lee, S. S., & Chan, A. T. (2011). Long Term Use of Aspirin and the Risk of Gastrointestinal Bleeding. The American Journal of Medicine, 124(5), 426–433

3) Bjarnason, I, Williams, P, Smethurst, P, Peters, T, Levi, A 1986, Effect of non-steroidal anti- inflammatory drugs and prostaglandins on the permeability of the human small intestine, Gut, 27, pp. 1292 - 1297

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