Sulfites allergy
Sensitivity to sulfite preservatives.
About sulfites allergy
Sulfites are preservatives, listed with E-numbers such as E220 to E228, that are added to wine, dried fruit, some soft drinks, processed potato products and various packaged foods to prevent spoilage and browning. Reactions to them are not usually a true IgE allergy but a sensitivity or intolerance, and they are recognised well enough that sulfites above a set level must be declared on food labels in the UK. They can be a particular problem for people with asthma.
Symptoms typically appear within minutes to a couple of hours and may include wheeze, chest tightness and breathlessness, especially in those with asthma, along with flushing, a runny or blocked nose, hives, stomach upset and, uncommonly, more severe reactions resembling anaphylaxis. The airways are often the main target, which is why sulfite sensitivity is most associated with asthmatic reactions to wine or dried fruit rather than the mouth and skin symptoms seen in food allergy.
Because standard allergy tests are generally unhelpful, diagnosis relies mainly on the history and sometimes a supervised challenge under medical supervision. Management means reading labels for declared sulfites and limiting high-sulfite foods and drinks, while keeping asthma well controlled. Most reactions are mild, but severe breathing difficulty is a medical emergency: use reliever and any prescribed emergency medicine and call 999.
Common triggers
- Wine, beer and cider\nDried fruit\nSome processed and packaged foods
Symptoms
- Itching or tingling in the mouth
- Hives, itching or eczema
- Swelling of the lips, face, tongue or throat
- Stomach cramps, nausea, vomiting or diarrhoea
- Wheezing or trouble breathing
- In severe cases, anaphylaxis
Avoidance & management
- Read ingredient labels every time
- Ask about ingredients and cross-contamination when eating out
- Keep the food out of shared cooking areas
- Carry prescribed antihistamines or an adrenaline auto-injector
- Seek emergency help for any severe reaction
Sources & references
Allergy safety: what everyone should know
Mild-to-moderate reaction signs
- Itching, hives or a raised rash
- Swelling of lips, face or eyes
- Tingling mouth, sneezing, runny nose
- Stomach pain, nausea or vomiting
Anaphylaxis — call 999 (UK) or 112 (EU) immediately
- Difficult or noisy breathing, wheeze, persistent cough
- Swelling of the tongue or tightness in the throat
- Dizziness, collapse, pale and floppy (young children)
- Use an adrenaline auto-injector (e.g. EpiPen) at once if prescribed, then call an ambulance even if symptoms improve
Allergy or intolerance? A true allergy involves the immune system and can escalate quickly; an intolerance (e.g. lactose intolerance) is unpleasant but not life-threatening. The symptoms overlap, so self-diagnosis is unreliable.
Getting tested: home-testing kits based on IgG are not diagnostically valid. If you suspect an allergy, ask a GP for referral to an allergy clinic for skin-prick or specific-IgE testing and a supervised food challenge where appropriate.